The Insurance Regulatory and Development Authority of India (IRDAI) has constituted a sub-committee aimed at reviewing the current landscape of private health insurance in India. The move is part of its efforts to boost the penetration of health insurance.
The sub-committee of the Insurance Advisory Committee will recommend regulatory, policy and operational measures to promote innovation, wider coverage, better risk pooling and improved financial protection through health insurance. The emphasis will be on increasing trust and improving the overall consumer experience.
The sub-committee will also examine the role of healthcare provider networks, hospital tariffs, fraud control and digital systems in enhancing value for policyholders while reducing administrative inefficiencies. A review of the interaction between private health insurance and public health insurance schemes, including opportunities for complementarity, portability and convergence where appropriate, will also be undertaken.
The panel will also be responsible for reviewing and incorporating recommendations from working groups formed by the Confederation of Indian Industry (CII) on key issues relating to the health insurance ecosystem, including a joint code of conduct for insurers and providers, methodology for commercial engagements and provider classification, adoption and scale-up of the National Health Claims Exchange (NHCX), analytical studies on claim trends and medical inflation, and a framework for a basic product.