What is GIPSA?
GIPSA stands for the General Insurance Public Sector Association. Established in 2001, it is an association of India's four public-sector general insurance companies: New India Assurance, National Insurance, United India Insurance, and Oriental Insurance.
GIPSA helps its member insurers standardise hospital treatment rates through the GIPSA Preferred Provider Network (PPN). This makes cashless hospitalisation easier, reduces billing disputes, and improves consistency in treatment costs for covered procedures.
If your group health insurance policy or individual health insurance policy is issued by one of these insurers, GIPSA's hospital network and package rates may apply to your treatment.
What is GIPSA PPN?
GIPSA PPN (Preferred Provider Network) is a network of hospitals that have partnered with GIPSA's four member insurers to provide cashless treatment at pre-negotiated package rates. These hospitals agree to follow the package rates for specific medical procedures. If you receive treatment at a GIPSA PPN hospital, your insurer can settle the bill directly with the hospital through the cashless claim process, subject to your policy terms and conditions.
What is a Preferred Provider Network (PPN)?
A preferred provider network in group health insurance is a network of hospitals that agree to provide treatment to policyholders at pre-agreed package rates. These package rates are negotiated between the insurer and the hospital for specific medical procedures.
The package rate is determined based on the procedure, the city, and the policyholder's eligible room category. This means patients with the same room entitlement undergoing the same procedure at a PPN hospital are generally charged the same package rate.
What is the GIPSA PPN Form?
The GIPSA PPN form is the application that hospitals use to apply for empanelment under the GIPSA Preferred Provider Network (PPN). It includes details about the hospital's infrastructure, facilities, and services, which are reviewed by the member insurers.
The form is used only by hospitals seeking to join the GIPSA PPN. Policyholders do not need to fill it out to avail of cashless treatment.
Learn how cashless health insurance works and when you can use it.
What is GIPSA Empanelment?
GIPSA empanelment is the process through which a hospital is approved to join the GIPSA Preferred Provider Network (PPN). Only empanelled hospitals can offer cashless treatment at GIPSA package rates to eligible policyholders. If a hospital is not empanelled, GIPSA package rates and cashless treatment may not be available there.
Room category is the common cause of deductions
Package rates assume a specific room category. If an employee chooses a room above the category the policy or package allows, the hospital may bill higher associated charges, and the excess can become a proportionate deduction the employee has to pay. Always confirm the eligible room category before admission.
Things to Check Before Using a GIPSA PPN Hospital for Group Health Insurance
Before choosing a GIPSA PPN hospital for your group health insurance policy, keep these points in mind:
Confirm your insurer: GIPSA benefits apply only if your health insurance policy is issued by one of GIPSA's four member insurers.
Check the hospital network: Make sure the hospital is currently part of the GIPSA Preferred Provider Network (PPN), as network hospitals may change over time.
Verify your treatment: Check whether your planned procedure is covered under a GIPSA package rate.
Review your room eligibility: GIPSA package rates are linked to your eligible room category. Choosing a higher room category than your policy allows may result in additional charges.
Inform your insurer or TPA: Notify your insurer or third-party administrator (TPA) within the required timeline for planned or emergency hospitalisation to avoid delays in cashless approval.
How Does a Cashless Claim Work at a Network Hospital?
Confirm the hospital is in-network
Check that the hospital is empanelled with your insurer or TPA, and note whether it is a PPN hospital for the procedure you need.
Show your health card or policy details
Present your e-card or employee ID at the hospital insurance desk to start the cashless request.
Hospital sends a pre-authorisation request
The hospital submits the estimated cost, and for a PPN hospital, the applicable package rate, to the TPA or insurer.
Insurer approves the amount
The insurer confirms coverage up to the sum insured and the agreed package or tariff.
Settle only the non-payable balance
You pay only for excluded items such as certain consumables or a room upgrade; the insurer pays the hospital directly for the covered amount.
Key Takeaways
GIPSA is an association of four public-sector general insurers that standardises hospital package rates through the GIPSA Preferred Provider Network (PPN). New India Assurance, Oriental Insurance, United India Insurance, and National Insurance are its member insurers.
A PPN is a network of hospitals that offer treatment at pre-agreed package rates for listed procedures. The package rate is based on the procedure, city, and eligible room category.
Empanelment is the process through which a hospital is approved to join the GIPSA PPN. Once empanelled, it can offer cashless treatment at GIPSA package rates to eligible policyholders.
Private insurers are not part of GIPSA and maintain their own hospital networks. Always confirm that your hospital is on your insurer's current network list before a planned admission.
Frequently asked questions
GIPSA stands for General Insurance Public Sector Association.
About the authors
Neviya Laishram
Written by · Senior Editor – Health, Life and Group Health Insurance Content at ACKOWith a journalism background, she brings 9 years of experience in strategising and editing health, life, and group health insurance content. Having written for magazines and digital publications, she combines research and editorial expertise to create credible, useful content for readers.
Nitesh Kapur
Reviewed by · Senior Director – Underwriting & Claims, Group Health Insurance at ACKOWith over 15 years of experience in health insurance underwriting, he has led group health insurance strategy, risk assessment, and policy design. He has held leadership roles at leading insurers, building risk frameworks, evaluating complex health risks, and strengthening underwriting standards.
