PUBLIC DISCLOSURES ON QUANTITATIVE AND QUALITATIVE PARAMETERS OF HEALTH SERVICES RENDERED AS ON MARCH 31, 2023

Name of Insurance Company: Future Generali India Insurance Company Limited

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

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

Description	Individual	Group	Government
Number of policies serviced	127924	1607	0
Number of lives serviced	333796	2271375	0

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: --	7675
ii. Number of claims received during the year ----	135277
iii. Number of claims paid during the year: ---- (also to specify % in brackets)	119839 (89%)
iv. Number of Claims repudiated during the year: --- (also to specify % in brackets)	14945 (11%)
v. Number of claims outstanding at the end of the year: ---	8168

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

S. No	Description	Individual policies (in %)		Group policies (in %)
S. No	Description	TAT for pre-auth**	TAT for discharge***	TAT for pre-auth**	TAT for discharge***
1	Within <1 hour	38%	33%	39%	30%
2	Within 1-2 hours	46%	51%	47%	53%
3	Within 2-6 hours	10%	15%	10%	16%
4	Within 6-12 hours	2%	0%	2%	0%
5	Within 12-24 hours	5%	0%	2%	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

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	5395	17%	6884	7%	0	0%	12279	9%
Between 1 – 3 Months	27154	83%	95351	93%	0	0%	122505	91%
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	32549	100%	102235	100%	0	0%	134784	100%

*Percentage shall be calculated on total of the respective column

Data of grievances received against the TPA: Not applicable

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