A regulatory push is underway to improve India’s private health insurance landscape, with a focus on enhancing coverage, trust, and customer experience.
Insurance Regulatory and Development Authority of India has constituted a sub-committee under its Insurance Advisory Committee to carry out a comprehensive review of the private health insurance ecosystem.
The panel will examine key areas including coverage, claims experience, product design, grievance redressal, and overall consumer experience. It has been tasked with recommending regulatory, policy, and operational measures to drive innovation, expand coverage, and strengthen financial protection for policyholders.
A major focus will be on improving transparency and trust within the system, along with enhancing risk pooling and accessibility of insurance products.
The review will also assess the role of healthcare provider networks, hospital tariffs, fraud control mechanisms, and digital infrastructure in delivering better value while reducing administrative inefficiencies.
In addition, the panel will study the interaction between private health insurance and public health schemes, exploring opportunities for complementarity, portability, and convergence.
The sub-committee will incorporate recommendations from working groups set up by the Confederation of Indian Industry. These include proposals for a joint code of conduct for insurers and healthcare providers, frameworks for commercial engagement and provider classification, and scaling up the National Health Claims Exchange.
The review will also include analysis of claims trends, medical inflation, and the development of a standardised basic health insurance product.
The initiative reflects a broader effort to strengthen India’s health insurance ecosystem and improve long-term access and affordability for policyholders.
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