PUBLIC DISCLOSURES ON QUANTITATIVE AND QUALITATIVE PARAMETERS OF HEALTH SERVICES RENDERED (INFORMATION AS AT — 31.03.2021) NATIONAL INSURANCE COMPANY LTD. a. Name of TPA — Vipul MedCorp Insurance TPA Pvt. Ltd. Validity of agreement with the TPA: 5/09/2020 to 4/09/2022 b, Number of policies and lives serviced in respect of which public disclosures are made: Description __| Individual | ___ Group __| _ Government No of policies serviced 161722 277 No of lives serviced. 386916 378127 ¢. Geographical Area of services Rendered in respect of which public disclosure is made. Sr.No. |_ Name of State Name of District 1__| West Bengal Kolkata 2 [Assam | Guwahati 3___| Maharashtra Pune 4 | Gujarat Vadodara 3___| Madhya Pradesh Indore 6 | Delhi New Delhi [_7__| Rajasthan a | ape 8 | Rajasthan Jodhpur 9 | Punjab Ludhiana 10 | Chandigarh Chandigarh 11__| Tamil Nadu_ Z [Chennai 12 | Tamil Nadu Madurai 13 | Karnataka _ | Bangalore Karnataka | Hubli a Kerala [Kochi Telangana | Hyderabad Uttarakhand | Dehradun Sharkhand —_____| Ranchi [ “Totald. Data of number of claims processed 1 7 Nevof No.of | No.of, No. of No. of claims . * . > ; claims | claims claims | Chims | claims outstanding | Settlement . a Brak received id vatio (”a)_ | eudiated | repudiation | outstanding oe during the | during the | during the % at the end beginning of year year year of the year year 11758 127459 | 124545 96% 4448 3% 5894 ¢. Tum Around Time (TAT) for cashless claims (in respect of number of claims) : ~|__ Individual Policies (in %) Group Policies (in %) _ | Sr. No. Description TAT for pre- | TAT for TAT for | TAT for auth** discharge*** | pre-auth** | discharge*** | Within<1 Hour | 82% 85% 81% 84%. 2_| Within 1-2 Hours 11% M% 10% O%. 3 | Within 2-6 Hours | 3% 4% 5% % [a Within 6-12 Hours 1% 2% 2% 1% —5 | Within 12-24 Hours 2% 1% 1% 2% {6 >24 Hours 1% 1% 1% 1% Total 100% 100% 100% 100% *percentage to be calculated on total of respective column **Reckoned from the time last necessary document is received by insurer/TPA (whichever is earlier) and till final pre auth is issued in the hospital ***Reckoned as final discharge summary sent to hospital from the time discharge bill is received by Insurer. £ Turn Around Time (TAT) in case of payment / repudiation of claims = *Percentage shall be calculated on total of respective column, 2[ Page Description (to ] reckoned from Individual | Group Government | Total the date of | | | receipt of last | —— necessary | No.of | Percenta | No.of | Percenta No.of | Percenta document) | claims | ge(%) | elaims | ge (%) claims | ge (%) [Within 1 Month | 40279[ 91% | 73703 | _87% | [ir3982 | 88% | | asa} | 9530] 11% 12793 | _ 10% Between 5-6 Months 451 1% 1074 1% __1525| 1% | More than 6 Months 264 1%| 229 1% Los 1% “Total suas | 100% | 84745 | 100% 128993 | 100% |g. Data of grievances received against the TPA: Sr.No. | Description No. of Grievances 1 | Grievances outstanding at the beginning of year pie: 2__| Grievances received during the year 288 “3 _| Grievances resolved during the year 288 4 _| Grievances outstanding at the end of the year 2 —eles Chairman dum Managing Director National Insurance Company Ltd. A ! B1Page