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Four PSU insurers lacked appropriate checks and controls: CAG report

Report finds lapses such as multiple settlement of claims, excess payment over insured sum

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The CAG report on “Third Party Administrators (TPAs) in Health Insurance business of Public Sector Insurance Companies” said processing of claims was done digitally both by insurers and TPAs

Nikunj Ohri New Delhi
Inadequate checks leading to multiple claim settlements, excess payment over sum insured, and breaching of capping limit for specific diseases are some of the lapses by four public sector insurers that the Comptroller and Auditor General of India (CAG) has flagged in its report.

The four insurers are New India Assurance Company (NIACL), United India Insurance Company (UIICL), Oriental Insurance Company (OICL), and National Insurance Company (NICL). According to the report, the insurers have incurred an aggregate loss of Rs 26,364 crore in their health insurance portfolio between 2016-17 and 2020-21 on account of group health insurance policies where premium