Irdai asks insurers to create ABHA IDs for policy seekers

The unique ID enables citizens to authenticate, access, and manage their health records digitally and facilitates hospital and doctor appointments, helping patients avoid long queues for registration at healthcare facilities. The ID is part of the Ayushman Bharat Digital Mission (ABDM) being implemented by the National Health Authority (NHA). While NHA has created 402.6 million ABHA IDs so far, the target is to cover all Indians.

Since 2022, the Insurance Regulatory and Development Authority of India (Irdai) and NHA have been trying to expedite ABHA ID creation, and as part of the discussions, they have explored accelerating insurance claim processing by adopting the ABDM framework. “ABDM is working on developing the necessary information to support an integrated digital health system in the country. Digitization will help bridge the gap among different stakeholders of the healthcare ecosystem, of which the insurance industry is a significant part. It would be beneficial for insurers to capture the ABHA number of proposers if already existing or help create one for them after obtaining their consent,” Yegnapriya Bharath, chief general manager (health) at Irdai, said in a letter to all insurers. The letter was reviewed by Mint.

The insurance regulator has advised all insurers to provide a facility in a proposal form (including online forms) to capture the ABHA number of people seeking insurance cover and obtaining the member’s consent for sharing medical records with insurers or third-party administrators (TPAs) through ABHA.

The regulator has also asked the insurers to assist proposers in creating their ABHA numbers through agents/intermediaries as applicable. The existing policyholders can obtain and create their ABHA numbers during the renewal process.

The regulator has instructed insurers to display a message on their website to encourage ABHA registration and provide a link for policyholders to get their unique health IDs.

The ABHA ID would help identify the insured digitally and facilitate seamless healthcare and insurance delivery. It would also give insurers easy and timely access to a person’s medical records in a safe and paperless manner, even while helping the individual with a transparent and speedy process of claims servicing.

Queries sent to spokespeople for the health ministry and Irdai remained unanswered.

With regard to data privacy concerns, NHA claims it has developed a robust safety mechanism. ABDM has been built on the principle of ‘privacy by design’. It uses a federated architecture that ensures no central storage of any beneficiary’s data and personal health records. Medical records are made available to anyone only with the consent of the individual or their nominee.

The electronic medical records generated by healthcare providers are stored in their respective systems, as per legal mandates. ABDM only facilitates secure data exchange between the intended stakeholders on the ABDM network after the patient’s consent.

Updated: 12 Jun 2023, 06:22 AM IST