The Insurance Regulatory and Development Authority of India convened the third meeting of its Insurance Advisory Committee Sub-Committee on Health Insurance, advancing its review of reforms to increase health insurance penetration, customer trust and value. Discussions focused on simpler policy wording, stronger underwriting at the point of sale to reduce disclosure-related claim disputes, smoother claim settlement and better support for policyholders at hospitals by insurers, intermediaries, agents and third-party administrators. The sub-committee considered incentives to accelerate insurer and hospital participation in the National Health Claims Exchange, including measures linked to onboarding, payments and faster settlements. It also discussed rewards for preventive care, greater standardization and richer industry data, and assessing claims and grievances using absolute values as well as settlement ratios. Publication of Standard Treatment Guidelines and treatment package rates was raised as a way to help policyholders make informed choices. Further work will cover health savings accounts, value-added services, separate analysis of ported policies and a review of exclusions in the Customer Information Sheet. The sub-committee also examined hospital certification, digital health standards and coordinated action among insurers, health care providers and other stakeholders to improve the claims experience.

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