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      Call us on 1800 220 233 / 1860 500 3333

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PUBLIC DISCLOSURES ON QUANTITATIVE AND QUALITATIVE PARAMETERS OF HEALTH SERVICES RENDERED AS ON MARCH 31, 2022.

Name of Insurance Company: Future Generali India Insurance Company Limited

  1. Specify in-house claim settlement (if, data is in respect of in-house claim settlement)/ specify the name of TPA with whom insurer entered into service level agreement (if data relates to health services rendered by TPA) as may be the case: In-house claim settlement

  1. Number of policies and lives serviced in respect of which public disclosures are made

Description Individual Group Government
Number of policies serviced 117325 1765 0
Number of lives serviced 306483 1612776 0

 

  1. Guidelines on Public Disclosures by Insurers on the qualitative and quantitative parameters of the health services rendered to policyholders

Details Count
i. Outstanding number of claims at the beginning of the year: -- 5005
ii. Number of claims received during the year ---- 141835
iii. Number of claims paid during the year: ---- (also to specify % in brackets) 123968 (89%)
iv. Number of Claims repudiated during the year: --- (also to specify % in brackets) 15197 (11%)
v. Number of claims outstanding at the end of the year: --- 7675

     

  1.  Turn Around Time (TAT) for cashless claims (in respect of number of claims):

S. No Description Individual policies (in %) Group policies (in %)
TAT for pre-auth** TAT for discharge*** TAT for pre-auth** TAT for discharge***
1 Within <1 hour 46% 47% 49% 48%
2 Within 1-2 hours 42% 43% 40% 43%
3 Within 2-6 hours 9% 9% 8% 8%
4 Within 6-12 hours 1% 0% 2% 0%
5 Within 12-24 hours 1% 0% 1% 0%
6 >24 hours 0% 0% 0% 0%
Total 100% 100% 100% 100%

*Percentage to be calculated on total of the respective column.

**reckoned from the time last necessary document is received by insurer /TPA (whichever is earlier) and till final pre-auth is issued to the hospitals

***reckoned as final discharge summary sent to hospital from the time discharge bill is received by TPA

  1.  Turn Around Time in case of payment/repudiation of claims:

Description (to be reckoned from the date of receipt of last necessary document) Individual Group Government Total
Number of Claims Percentage Number of Claims Percentage Number of Claims Percentage No of claims Percentage
within 1 months 33319 98% 104330 99% 0 0% 137649 99%
Between 1 – 3 Months 784 2% 732 1% 0 0% 1516 1%
Between 3 to 6 Months 0 0% 0 0% 0 0% 0 0%
More than 6 months 0 0% 0 0% 0 0% 0 0%
Total 34103 100% 105062 100% 0 0% 139165 100%

*Percentage shall be calculated on total of the respective column

  1.  Data of grievances received against the TPA: Not applicable

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  • IRDAI Registration No: 132 (Validity 31 March 2023) License Category: General CIN: U66030MH2006PLC165287

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