Sunday 15 July 2018

Applicability of claw back policy on 10 crore families, a free healthcare policy

Modicare: Government to let market decide NHPS rateTo be rolled out from August 15, the scheme would provide 10 crore families a free healthcare policy of Rs 5 lakh/annum.By: FE Bureau July 3, 2018 5:59 AM

With ref to above news the Centre’s model tender document for empanelment of insurance companies under the NHPS have invited criticisms for not putting in a mechanism to equitably share both the profits as well as the burdens.

The said scheme to be rolled out from August 15,to provide 10 crore families a free healthcare policy of Rs 5 lakh/annum.

The said ambitious Centre’s model tender document for empanelment of insurance companies under the NHPS have invited criticisms for not putting in a mechanism to equitably share both the profits as well as the burdens. The document says that as per clawback policy, insurers would have to refund premiums to the government if claims ratio is less than 100%. However, if the claims ratio exceeds 120%, the excess amount will be equally shared by the insurance company and the state government.
The said claw back policy is nowhere in the insurance Act 1938 of india whereas the said clause is having mentioned in the context of recovery of commission from the insurance agents,in case the insured company or the person is not depositing premium whose business is brought by the agent.But here the Govt is proposing claw back policy in different context which is perhaps not supported by an act or law in commensurate with the insurance Act on the land of india.
It is therefore suggested that  Govt may review the stand taken on claw back policy in the given context so that the possibility of heavy litigation. in the future are ruled out.

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