Health Insurance
INSURANCE LAW PROJECT | HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999 | Rudresh Pratap Singh Roll No. 49 Semester V RMLNLU |
Contents INTRODUCTION 4 The Insurance Regulatory and Development Authority 5 Regulatory issues in the health insurance business 5 It should be the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector: 5 II. Regulations Pertaining To Consumer Protection 8 Relationship Between Insurers And Providers 9 Is A Health Insurance Policyholder A Consumer? 10 III. Regulations Pertaining To The Functioning Of Third Party Administrators 10 Operational Requirements 11 Other Requirements 11 Recommendations Of The Health Insurance Working Group Constituted By The IRDA 12 Conclusion 16 Bibliography 17
Acknowledgement
I am highly indebted to Prof. Gaur for making us understand the complexities of the subject in such an easy and lucid manner. I would also like to thank him for guiding us to make this project of a decent standard.
I would also like to thank the staff at the Madhu Limaye library for helping in the search of the relevant material.
I would be failing in my duty if I do not thank my friends who have been a constant source of help throughout my stay at RMLNLU.
15th November 2008 Rudresh Pratap Singh
HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999
INTRODUCTION
Since neither the Insurance Act, 1938, nor the IRDA Act, 1999 contains any reference whatsoever to the health sector or to the health insurance, health is presumably included under “miscellaneous insurance business”. This non-inclusion and apparent lack of initiative as regards health insurance provisions in Indian government policy documents is reflective of the sanguine view of the functioning of the markets in health care provision and the necessity for health insurance in India.
It
Contents INTRODUCTION 4 The Insurance Regulatory and Development Authority 5 Regulatory issues in the health insurance business 5 It should be the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector: 5 II. Regulations Pertaining To Consumer Protection 8 Relationship Between Insurers And Providers 9 Is A Health Insurance Policyholder A Consumer? 10 III. Regulations Pertaining To The Functioning Of Third Party Administrators 10 Operational Requirements 11 Other Requirements 11 Recommendations Of The Health Insurance Working Group Constituted By The IRDA 12 Conclusion 16 Bibliography 17
Acknowledgement
I am highly indebted to Prof. Gaur for making us understand the complexities of the subject in such an easy and lucid manner. I would also like to thank him for guiding us to make this project of a decent standard.
I would also like to thank the staff at the Madhu Limaye library for helping in the search of the relevant material.
I would be failing in my duty if I do not thank my friends who have been a constant source of help throughout my stay at RMLNLU.
15th November 2008 Rudresh Pratap Singh
HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999
INTRODUCTION
Since neither the Insurance Act, 1938, nor the IRDA Act, 1999 contains any reference whatsoever to the health sector or to the health insurance, health is presumably included under “miscellaneous insurance business”. This non-inclusion and apparent lack of initiative as regards health insurance provisions in Indian government policy documents is reflective of the sanguine view of the functioning of the markets in health care provision and the necessity for health insurance in India.
It
Bibliography: Mahal, Ajay, Assessing Private Health Insurance in India – Potential Impacts and Regulatory Issues, Economic and Political Weekly, February 9, 2002 Singh, Avtar, A Textbook on Insurance Law, Eastern Book Co.,2207. [ 3 ]. Section 42 of the IRDA Act, 1999 deals with Licensing of Insurance Agents. [ 4 ]. Section 42 (4) of the IRDA Act, 1999 deals with the situations, which may lead to disqualification of the insurance agents. These include: (a) That the person in minor, [ 5 ]. Section 2(1)(d) Consumer Protection Act, 1986 [ 6 ]