GIPSA – What Is General Insurance Public Sector Association (GIPSA) and How Does It Work?

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GIPSA or General Insurance Public Sector Association is composed of four general insurance companies. Let us learn about this association and the functioning of GIPSA insurance in this blog.

What do you mean by GIPSA or the General Insurance Public Sector Association?

Insurance is the best safeguard that has become a necessity to protect people against uncertainties and risks in the present times. These include risks against health, life, motor, travel and more. The General Insurance Public Sector Association, popularly known as GIPSA in short, is an association that represents the public sector insurance companies in the country. 

GIPSA comprises four general insurance providers in the country namely;

  • New India Assurance Company Ltd, 
  • United India Insurance Company Ltd
  • National Insurance Company Ltd, and 
  • Oriental Insurance Company 

Customers can avail of cashless treatment facilities in the network hospitals of the above public sector insurers spread across 12 Indian cities. The features, premiums, and other facilities offered under these public sector insurers are decided by GIPSA. The network hospitals under GIPSA provide special rates for specific treatments approved by the organization.  

The ailments covered by public sector insurers under GIPSA include;

  • Kidney stones
  • Appendicitis
  • Cataract
  • Angioplasty
  • Hysterectomy, etc.

The policies offered by these insurers have so far benefited as many as 6 crore policyholders.

What is GIPSA Full Form and Meaning?

GIPSA stands for General Insurance Public Sector Association. It is a group of four General insurance companies.

  1. New India Assurance Company Ltd,
  2. National Insurance Company Ltd,
  3. United India Insurance Company Ltd, and
  4. Oriental Insurance Company.

GIPSA comprises four public sector general insurance companies, such as New India Assurance Company Ltd., United India Insurance Company Ltd., Oriental Insurance Company and National Insurance Company Ltd. In this post, we will understand what GIPSA is and how it works to benefit the public.

What is General Insurance Public Sector Association (GIPSA) mean in Insurance?

As already mentioned, general insurance public sector association is an association of four public sector general insurance companies offering cashless healthcare services to policyholders in some specific hospitals across 12 cities in India. The rates at which medical treatment packages are offered under these hospitals is decided by GIPSA.

The band of hospitals offering treatment at GIPSA approved rates comes under the list of PPN hospitals or the Preferred Provider Network hospitals.

Also Read: Top 10 General Insurance Companies in India 2022

How is GIPSA Unique From the Rest of the Insurance Companies?

The thing about GIPSA is that this is a set of group insurance companies that allow a specific price band for their customers with a limited cashless offer.  Further, the services are available at a specific and limited number of health care centers and hospitals. These hospitals come under the Preferred Provider Network (PPN) of GIPSA and serve their customers at the price band decided by GIPSA. So far, as many as 5.48 Crore policyholders have benefitted by GIPSA insurance policies.

Also Read: Claim Settlement Ratio 2022

How does General Insurance Public Sector Association (GIPSA) Work?

Under GIPSA, the policyholder can get coverage for several diseases like kidney stones, appendicitis, cataract, angioplasty, hysterectomy and so on. Here, the hospitals that come under the GIPSA network or PPN will cover the medical treatment under the price band that is decided by GIPSA.

The policyholder getting protection under GIPSA policy must note some relevant points as mentioned below:

  • The insured in this case can avail cashless health services under the network hospitals or PPN network that is GIPSA approved
  • The PPN network hospitals that come under GIPSA must charge the insured as per the rate approved by the association
  • If there is overcharging of money beyond the approved package allowed by GIPSA, the insured can raise his/her grievance with the particular insurer
  • In this case, the insurer must reimburse the money as per the rate decided by GIPSA whenever a policyholder raises a reimbursement claim for a certain treatment under GIPSA in a PPN hospital
  • However, in case the insured raises a claim of reimbursement for a treatment done in a non-PPN hospital, the insurer reimburses the claim as per the customary rate in the clause.
  • Further, the insurer will calculate the amount depending on the medical service availed and the cost that is prevailing in that particular location/city.

Read More: 4 Amazing Term Insurance Policies to Consider to Buy 2022 India

General Insurance Public Sector Association (GIPSA) Benefits

  • Under GIPSA, the four health insurance companies that come under the gamut have pre-fixed special package rates with a number of hospitals across 12 Indian cities for numerous healthcare procedures
  • The cities included under GIPSA are namely, Ahmedabad, Bangalore, Chandigarh, Chennai, Coimbatore, Delhi, Hyderabad, Indore, Jaipur, Kolkata, Mumbai, and Pune
  • GIPSA aims at offering standard packages with nominal charges to its customers for certain medical treatments. This way, the organization aims to save customers from paying over charged rates and to ensure better use of sum insured of customers’ policies
  • GIPSA has over 550 network hospitals enrolled under them offering coverage for treatment like kidney transplant, knee replacement, dialysis, liver transplant, CABG, and so on

Also Read: Insurance Brokers in India

Points to Consider by Policyholders of a GIPSA policy

Here are some points to be considered by GIPSA policyholders:

  • The policyholder of a GIPSA policy can receive cashless treatment through the network hospitals approved by the association
  • The reimbursement claims for treatments filed by an insured under GIPSA in a network hospital are reimbursed at a rate pre-determined by GIPSA
  • The insured has the right to file a complaint with the insurer if the firm charges more money than what is permitted by GIPSA  
  • In case of reimbursement claims submitted by the insured for undergoing treatment in a non-PPN (non-network) hospital, the amount reimbursed is based on the policy’s customary clause. This amount is calculated as per the services availed by the insured and the expenses of the treatment/services in the particular hospital/city, etc.

How Hospitals Can Join the GIPSA Network Through the Empanelment Procedure? 

Interested hospitals willing to join the PPN or the Preferred Provider Network of GIPSA to provide cashless treatment to the insured can do so by submitting a form of GIPSA empanelment. They are also required to submit other important documents as required for the process along with the form to the insurer they want to join.  

Once GIPSA approves the proposal, hospitals can start offering cashless treatment to patients insured under the Group Health Insurance Policy. The GIPSA PPN network has as many as 550 hospitals in India.

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Conclusion

The consumers availing a health policy under GIPSA can benefit from a reasonably priced group health plan. So, if you are living in any of the above mentioned 12 cities, you can benefit from a GIPSA policy by buying an insurance policy from any of the four insurers that form GIPSA.

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FAQs on What is GIPSA Insurance

What is the difference between GIPSA and PPN?

GIPSA provides cashless services in hospitals that accept their policies and prices and are Preferred Provider Network (PPN) members. It requires hospitals to follow GIPSA guidelines and work with standardised rates. Those who accept this fall under the jurisdiction of GIPSA and are known as PPN.

What is GIPSA in mediclaim?

GIPSA full form is General Insurance Public Sector Association. It is an association of four public sector general insurance companies, as the name implies: The New India Assurance Company Ltd, National Insurance Company Ltd, Oriental Insurance Company Ltd and United India Insurance Company Ltd.

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Oct 07, 2022
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