Panel will assess coverage, claims, product design, and consumer experience, and suggest regulatory and operational steps to boost penetration, trust, and innovation

BS Reporter Mumbai

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The Insurance Regulatory and Development Authority of India (Irdai) on Tuesday constituted a sub-committee of the Insurance Advisory Committee to review the current landscape of private health insurance in India, including coverage, penetration, claims experience, product design, grievance redressal, and consumer experience. It will also recommend regulatory, policy, and operational measures to promote innovation, wider coverage, better risk pooling, and improved financial protection through health insurance.

This initiative is part of ongoing efforts to improve policyholder experience and the penetration of health insurance. The emphasis will be on increasing trust and overall consumer experience.

The sub-committee will also examine the role of healthcare provider networks, hospital tariffs, fraud control, and digital systems in improving value to policyholders and reducing administrative inefficiencies. A review of interaction between private health insurance and public health insurance/assurance schemes, including opportunities for complementarity, portability, and convergence where appropriate, will also be undertaken.

Irdai also said that the sub-committee will review and incorporate the recommendations emerging from the working groups set up 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.

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First Published: Apr 07 2026 | 7:29 PM IST