Managing Abuse Pertaining to Hospitalization in Emergency
Both the underwriter and claim assessors require deep insights into risk factors, pathophysiology, symptoms/ signs, investigations and treatment modalities commonly occurring infections (include sepsis). Death/ hospitalization in acute setting Death/ hospitalization occurring over hours/ days often requires expertise to identify GREEN flags, in order to settle claims without spending time and money on investigations (or minimal focused investigation).
Programme includes discussion of insurance perspective of - Acute febrile illness – Malaria, Dengue etc - Acute gastro enteritis/ dehydration - Common infections & Sepsis etc.
Programme includes discussion of insurance perspective of - Acute febrile illness – Malaria, Dengue etc - Acute gastro enteritis/ dehydration - Common infections & Sepsis etc.
Recommended for
- Underwriting professionals in health insurance
- better evaluate proposals w.r.t. physiological abnormalities that do not signify the disease identifying the pathology and it’s severity translating the observed pathology into future risk suited for both freshers, experienced Claims professionals’ in health insurance to better evaluate claims pertaining to
- Health reimbursement
- Critical illness
10 February 2023
9.00 a.m. - 4.00 p.m.
Method: Virtual Learning
CPD Hours: 11
Registration Closing Date:
27 January 2023
CPD Hours: 11
Registration Closing Date:
27 January 2023
About the trainer:
| Dr C H Asrani DNB (Family Medicine); PGD Medicolegal Systems Adv. Dip in Forensic Medicine & Toxicology CEO, Founder – INCHES’ group of companies |  |
A renowned expert in this area, Dr Asrani pioneered medical audit in insurance in India. With over 300 presentations in insurance risk management, Dr Asrani has been conducting training across Dubai, Bangkok, Kuala Lumpur and Singapore. He also has the distinction of being associated with the National Health Authority (Ayushman Bharat scheme), consulting with The World Bank and being a panelist on various talks on monitoring, audit, and fraud surveillance in the Insurance industry.
He is also one of the first medico entrepreneur to devise cloud-based fraud prevention solutions for insurance companies in India (www.inches-insuretech.com). He is now on an expansion drive to extend his company’s service innovative solutions internationally.
The solutions include medical insights for underwriting, rational claim adjudication, medical processes architecture, clinical audit of claims & underwriter or claim assessor trainings. Dr Asrani’s group of companies have also developed Intelli-Claims, a proprietary tool for medical adjudication of claims using standard treatment guidelines and rule-based analytics.
| Need for hospitalization |
| Rational investigations |
| Rational line of management |
| The above with regards to Malaria Dengue Leptospirosis Acute gastro enteritis Enteric fever H1N1 Chikungunya Pyrexia of unknown origin Viral fever Fever with rash Infective hepatitis |
| Impact of pre-existing co-morbidities on each of the above |
