Vidal Health Insurance TPA

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Banks and NBFCs have always played a pivotal role in the healthcare sector, although most of that is focused on services to healthcare providers. Working capital loans and financing for new projects and/or upgrades have been staples for many years. Secured or unsecured loans to doctors are relatively new but are gaining ground really fast, as many doctors upgrade their clinics and hospitals. In recent times, most banks have inked deals with insurance companies, both life and health, to distribute policies to their existing customer base.

However, much larger opportunity for banks and financial services companies like AMCs is to be a part of how consumers pay for healthcare. While there has been a lot of focus on health insurance, it is our belief that the most appropriate protection against healthcare costs is a health savings fund combined with a high deductible health insurance policy complemented with a critical illness cover from a life insurance company. Vidal Health is already partnering with banks, NBFCs and AMCs to design such specialised health savings funds that can help individuals deal better with healthcare expenses than a vanilla savings account, or sometimes even a base health insurance policy.

Customer acquisition

Most banks have inked distribution deals with health insurance and life insurance companies, and are banking on their branch networks as well as digital channels to sell policies to their existing customers. AMCs, on the other hand, are seeking to acquire more members into their funds and increase their AUM. Vidal Health can support this customer acquisition in more ways than one. It can equip the bank branch employees and independent financial advisors employed by AMCs with a more powerful narrative relating to health and the need for adequate protection. It can also help banks and AMCs engage with their existing members more effectively using health and wellness programs and create alternate channels for customer acquisition.

Tele-consultation with top specialists

Members of insurance companies often need help to identify the right doctor(s) to diagnose and treat their medical condition. Being able to access the right doctor at the right time can often result in significant savings by avoiding unnecessary visits to multiple doctors and any subsequent repeated spending on diagnostics. Vidal Health has invested in processes and technology platforms that enable convenient access to a credentialed network of empanelled doctors to members and their families.

Credit billing/cashless hospitalization

In addition to the convenience of not having to carry cash while in the hospital to settle the hospital bill, the bigger advantage of credit billing/cashless hospitalization is that it allows Vidal Health to review the final hospital bill for accuracy. Considering that hospitalization is a rare occurrence in the lives of most individuals, making sense of a hospital bill is not something they might be equipped to deal with. Vidal Health processes over 1 million hospital bills every year. This provides an assurance to members that they are paying the right amount for their treatments. Click here to visit

Preventive Health and wellness

Employers are taking a lot of interest in helping their employees stay healthy. While the underlying objectives could vary from employee engagement to productivity increase or even an attempt to reduce illness and therefore hospitalization (and therefore claims pay-outs), preventive health and well-being programmes are being seen as a compelling way to accomplish those objectives. These programmes could include health screenings, risk assessments, on-site activities, on-site health centres, counselling and many more. Over the last few years, Vidal Health has delivered such programmes to a large number of employers (most of who have spent top dollar on such programmes) which has resulted in over a hundred thousand participants and yielded some amazing insights into the health status of the workforce. This has in turn enabled these employers to strengthen their benefits programmes to deliver greater benefits.

Second opinion and navigation services

Most individuals are unequipped to deal with the complexity and costs involved in medical treatments. When selection of the hospital is added into the mix, it gets even more confusing. Whether one is paying out-of-pocket or is receiving benefits from an insurance policy (employer-provided or direct-purchased), it is always helpful if expert advice is on hand. It helps determine whether a particular treatment is required, will it deliver expected outcomes, which is the right hospital for the procedure and how to manage costs (of hospitalization etc.) Using its network of empanelled top medical specialists as well as extensive data available from its hospital relationships, Vidal Health can hand-hold individuals as they make their decisions in extremely critical situations for themselves or their families. A strong culture of empathy within the organisation ensures that the individual is given personalised attention.

Helplines for members

In addition to investing heavily in technology to deliver a superior stakeholder experience, Vidal Health believes that healthcare often requires high-touch. This is why it has a full service call centre, staffed with over 100 executives drawn from various backgrounds, including clinical. In addition to receiving in-bound calls from members on a variety of concerns like eligibility, claims status, customer satisfaction etc., the call centre also provides disease-specific support, toll-free support for specific clients and processes as well as out-bound calling if required. Click here to visit

Convenient access to out-patient services

Individuals are being recommended a wide range of medical/health services, many of which might be delivered outside a hospital. For example, in a clinical setting like a doctor’s office or a diagnostics lab, in the individuals’ homes, or over the internet. Services could include doctor consultations, lab investigations, expensive pharma therapies, counselling, preventive and well-being services etc. More often than not, individuals will pay for such services out-of-pocket (at this time most insurance policies do not include these services for coverage, though a few might be able to get this reimbursed from the insurance company since their policies might cover these services) and will therefore seek convenient access to these services. Vidal Health aggregates a wide variety of services available across the country from credentialed service providers on a web portal where individuals can discover, purchase and schedule appointments for the services.

Help desks in hospitals

When Vidal Health first offered the e-claims platform to its network hospitals, it set up help desks in hospitals with high volumes of insured members to support them take advantage of the technology platforms. Vidal Health continues to provide this support by setting up hospital help desks at the behest of an insurer or employer or government client from time to time. This makes it easier for members to avail themselves of the benefits under their policies. These help desks are staffed with resources who use technology extensively and are connected via telephone and internet to the Vidal Health back-end to offer a speedy response to the members.