National Insurance Academy, Pune|Special/Company Specific Programmes
P876 | Programme on Health Insurance for Doctors (The New India Assurance Co. Ltd.)
Academic Year 2026-2027
Duration
3Days
Scheduled Dates
31 Aug 2026 - 02 Sep 2026
Background
Health insurance has solidified its position as the leading business line in India's Non-life insurance sector, accounting for nearly 41% of total premiums, fueled by rapid product innovation, expanding healthcare infrastructure, widespread digitalization, and flagship public schemes like Ayushman Bharat-PMJAY. These factors have accelerated market penetration, particularly with inclusions like senior citizens under PMJAY and rising demand for retail and group covers, signaling sustained double-digit growth. However, persistent underwriting losses highlight the need for disciplined pricing, robust underwriting, effective provider management, and technology-driven claims control. Doctors in Health Insurance (HI) departments of public sector undertakings (PSUs) face unique clinical and operational challenges in navigating coding standards, regulatory compliance, product design, and care coordination within a resource-constrained PSU framework. This Programme delivers targeted, practical insights to empower these professionals for enhanced portfolio profitability and stakeholder value.
Learning Objectives
Drive profitable underwriting and claims decisions through clinical expertise and regulatory mastery.
Optimize provider networks and care management for cost efficiency and policyholder outcomes.
Partner in innovating health products aligned with emerging risks, public schemes, and digital health ecosystems
Key Contents
Healthcare financing models across the Globe and Insurance as a Sub-set therein
The Indian model: OOPE, Mass Health Insurance Schemes including AB-PMJAY; Private Health Insurance
ICD-10/CM-CPT basics/applications, FY2026 updates
Product features and Proliferating Innovations – Retail and Group
Regulator as driver of Health Insurance – Regulation Updates
Provider Management (credentialing, cashless)
Underwriting - Essentials and More - for doctors
Case/Care management (chronic focus)
TPA Models in PSUs – TPA-Insurer Synergy
Claims Management and Decisioning including Management of Fraud, Abuse and Leakage
Who Should Attend
Doctors and medical professionals in HI departments of multi-line non-life insurers, handling underwriting, claims adjudication, provider relations, and care coordination.
