What Is GIPSA & How Does It Work?

Insurance plays a significant role in protecting people or businesses against uncertainties or risks including those against life, health, travel, etc. And within the dynamic landscape that is the insurance sector, the General Insurance Public Sector Association, or GIPSA, holds a crucial position. An organisation that represents general insurance companies of the public sector, GIPSA plays an important role in setting standards, streamlining operations, and developing collaboration. In this article, we will understand the meaning of GIPSA, how it works, and how it is beneficial to policyholders. Also read: The Types and Features of General Insurance You Need to Know

General Insurance Public Sector Association (GIPSA) is a conglomeration that comprises four general insurance companies (of the public sector). GIPSA covers roughly 80% of the country’s cashless insurance market. The association consists of hospitals with fixed packages for surgeries in specific rooms. Founded with the aim to economise and standardise the cost of treating common ailments, GIPSA includes the below mentioned insurance companies:• United India Insurance Company Ltd.• Oriental Insurance Company• New India Assurance Company Ltd.• National Insurance Company Ltd.

GIPSA policies cover several ailments such as appendicitis, cataract, kidney stones, angioplasty, hysterectomy, etc. and these organisations offer policyholders cashless healthcare in select hospitals in 12 cities of the country. The 12 cities are Pune, Mumbai, Kolkata, Jaipur, Indore, Hyderabad, Delhi, Coimbatore, Chennai, Chandigarh, Bengaluru, and Ahmedabad.GIPSA decides the features, premiums, facilities, and the cost of treatment packages. The hospitals that provide care at these pre-approved rates join the GIPSA Preferred Provider Network (PPN) list.
These organisations have a specific price band and offer limited cashless healthcare services to patients and kin in specific hospitals across the above-mentioned cities. GIPSA regulates the prices of health treatment packages given by the hospitals. PPN (Preferred Provider Network) hospitals are a network of hospitals that offer healthcare at rates approved by GIPSA.In case of non-network hospitals (without a tie-up with GIPSA), cashless services will not be possible. However, it is possible to reimburse the amount according to rates that have been approved by GIPSA. Also read: Network and Non-Network Hospitals - Impact on Health Insurance Claims?

Given below are a few important points to keep in mind if you are a policyholder.• You can obtain cashless health services only within the GIPSA-approved PPN network.• If a policyholder applies for reimbursement for a treatment done in a hospital from the PPN network, the reimbursement must be in accordance with the GIPSA rate.• PPN hospitals have strict instructions to charge as per the agreed rates for treatment packages. Therefore, in case of overcharging or a patient being denied admission, policyholders can raise a grievance with the relevant insurance company.• If a policyholder applies for a reimbursement for a treatment in a hospital that is not a part of the PPN, the reimbursement must be according to the service and existing price in the specific geographical region.

• GIPSA encourages and fosters coordination and cooperation within insurance companies in the public sector. The member organisations can enhance their effectiveness and operational efficiency by sharing resources, best practices, and knowledge.• By working towards standardising insurance products and policies, GIPSA can bring about consistency in offerings. This makes it easier for customers to compare options and choose the product that suits them best.• By working as representation for its members, GIPSA can engage with authorities and stakeholders to advocate favourable regulations or policies. A consolidated point of view on the issues that affect the insurance sector can only bring about a positive change to improve the insurance landscape.• Through skill development, training, and teaching for member companies or employees, GIPSA can not only promote a culture of professional development, but it can also enhance the capabilities of the workforce.• Initiatives such as those related to sharing of infrastructure, adoption of technology, etc. can help the members in cost reduction and improve profits.• GIPSA was developed with the goal to establish uniform costs or packages for several medical procedures and protect customers from being overcharged. Therefore, all four insurance companies have negotiated a deal with several hospitals, which in turn provide cashless services to policyholders. Additionally, with a standardised practice, GIPSA ensures consistency in claim procedures, policy offerings, and customer service, thereby developing trust among the policyholders. Also read: What is GPA & GMC Insurance Policy? - Know The Difference!

Developed with the objective to streamline operations, GIPSA is helping policyholders by enhancing process standardisation and simplifying reimbursement. Additionally, GIPSA is also beneficial as all the hospitals under this network need to adhere to a standard cost for several treatment packages. GIPSA is, therefore, a crucial player in the insurance landscape as it enhances efficiency and enables transparency in healthcare.