Dr. Krishna P. Jaiswal, Promotor & Managing Director of Ericson Insurance TPA, carries medical expertise of 13 years as Physician. Born in business family & having other group companies dealing in healthcare, overseas recruitment. He has introduced many innovative ways in TPA industry & carries Never say die attitude. Ericson group has grown many folds under his dynamic leadership in highly turmoil phase & made presence across country in very short span.  

Q. What are the challenges you have faced in the last 4 months?

It’s never seen nor experienced situation. Nobody has expected on day 1 of lockdown that we will get confined to work from home culture for so long. Initial couple of months went in expectation that we will get freed by this condition but it doesn't happen. 

We, as TPA have to be always on toes & keep delivering services 24x7, as we are remembered only in case of medical need. Services of TPA can’t be kept on hold for couple of hours also. But, this is not ending challenge. Our various departments, which works hand in gloves & have dependency upon various interlinked department, got totally scattered. Our maximum staff was forced to work from home. Staff struggled for many things during initial two months like short of electricity supply in various cities, mobile network, slow data speed, etc.

Number of mails got increased tremendously & it forced our staff to stick to computer / mobile for attaining mails & replying at any time. Working hour lost meaning. 

New business has started getting scrapped & renewals also started getting delayed. This started giving financial instability. 

As courier services was halted in initial three months, claim document was not reaching on time..             

Q.     What are the challenges you assume for the next 8 months?

Challenges for next 8 months will varies like Business loss, very minimal growth or no-growth, Financial instability, Absence of human-touch for further development. Delay in taking decisions will hamper in bringing changes & adopting new steps.          

Q.     The IRDAI circular which is being widely published by the media you think will hamper the business and image of a TPA?

This is surely portraying image of TPA in very poor state. IRDAI has never issued any such kind of circular. Instead, guideline of IRDAI has been wrongly interpreted by media person. As per IRDAI Health Regulation (2016), it was ammended that TPA will do only claim processing & decide payability of claims. After complete claim processing, TPA will inform Insurance Company to release payment directly from company account to account of claimant or insured. Before this regulation, TPA used to get funds allocated from insurance company & used to settle claim, but it has been scrapped after said regulation came in force. Work of TPA has neither stopped nor going to be stopped. 

Q. What future do you see for TPA?

Future of TPA lies ahead. TPA is going to grow simultaneously & parallel to health insurance industry. TPA industry is giving strong support in case of hospital network, cashless facility, claim processing at very nominal cost, which is even lesser, very economical & ready to use to all currently operating insurance company. TPA will be useful & handy to all upcoming insurance companies in country in future. 

Q. What will be the bad side effects of the circular?

This has pressed panic button amongst policy holders & new policy purchasers only. This will give rise to unnecessary confusion between policy holder & sales force of health insurance industry. Sales force may have to spend some more time to explain & give confidence to those policy holders, which is totally unwanted & not required. Other stake holders like insurance companies, Insurance brokers, investors, equity holders, sales force of insurance industry are well aware of this development & it’s in practice since last 4 years. 

http://www.insurancealertss.com//Insurance/Service/Asia's%20Best%20and%20Emerging%20Insurance%20Company%20Awards%202020