SEO Title: IRDAI Health Insurance Panel Pushes Simpler Policies, Faster Claims and NHCX Adoption
Summary: The Insurance Regulatory and Development Authority of India (IRDAI) convened the third meeting of its Insurance Advisory Committee (IAC) Sub-Committee on Health Insurance on August 28, 2026. The meeting followed the sub-committee’s second meeting held on July 17, 2026, and focused on strengthening the health insurance ecosystem, improving customer trust and increasing health insurance penetration.
The deliberations placed particular emphasis on making health insurance simpler, more transparent and easier for policyholders to understand and use. The sub-committee discussed simplification of policy wording, stronger underwriting at the point of sale to reduce claim-related issues arising from inadequate disclosures, and measures intended to facilitate hassle-free claim settlements. It also considered the role of insurers, intermediaries, agents and Third Party Administrators (TPAs) in assisting policyholders at hospitals.
The discussions also addressed the economic value of health insurance and the need for greater efficiency and collaboration between stakeholders. The sub-committee considered measures to encourage insurers and hospitals to onboard onto the National Health Claims Exchange (NHCX), including possible incentives associated with onboarding, payments and faster settlement. The existing Master Circular on IRDAI (Insurance Products) Regulations 2024- Health Insurance also contains provisions concerning onboarding hospitals and healthcare providers onto NHCX for faster payment and settlement of claims. :contentReference[oaicite:0]{index=0}
Preventive healthcare was another area considered, including possible incentives for policyholders undertaking periodic health check-ups and following healthy practices. The sub-committee emphasised standardisation and enrichment of industry data to facilitate evidence-based policy interventions. It also noted that assessment of claims and grievance outcomes should not focus solely on settlement ratios and should take absolute values into account. Insurers may also consider publishing Standard Treatment Guidelines (STGs) and treatment package rates to enable policyholders to make more informed choices.
The meeting further considered coordinated action involving insurers, hospitals, intermediaries, policyholders and other stakeholders to improve claim settlement processes and the overall health insurance experience. Mr Rizwan Koita, Chairperson, National Accreditation Board for Hospitals & Healthcare Providers (NABH), presented on hospital certification and the introduction of Digital Health Standards aimed at improving healthcare outcomes. Strategies for accelerating onboarding of healthcare providers and insurers onto NHCX were also discussed.
Further areas identified for consideration included health savings accounts, value-added services, analysis of ported policies as a separate cohort and review of exclusions in the Customer Information Sheet (CIS) to improve clarity and customer trust. The CIS has previously been the subject of IRDAI regulatory measures, including the IRDAI circular on the Revised Customer Information Sheet and the IRDAI guidelines on the Health Insurance Customer Information Sheet.
The four-member sub-committee is chaired by Mr. Ajay Seth, Chairman, IRDAI. Its other members are Mr Deepak Sood, Member, IRDAI; Dr. Indu Bhushan, Former CEO, NHA; and Ms. Monika Halan, Financial Writer and Adjunct Professor at Banasthali Vidyapeeth, Rajasthan. The sub-committee is supported by invitees from the insurance sector, namely Mr. Sanjeeb Mantri, CEO, ICICI Lombard; Mr. Mayan Bathwal, CEO, Aditya Birla Health Insurance; and Mr. K. Ramachandran, CEO, Niva Bupa Health Insurance. It has also inducted Dr. Soumil Nagpal of the World Bank and Dr. Nishant Jain of the Asian Development Bank as experts with international experience.
The August 28, 2026 meeting records deliberations and areas for further consideration; the supplied press release does not state that the discussed measures have themselves become binding regulatory requirements or that specific implementation dates have been prescribed.
Insurance Regulatory and Development Authority of India
PRESS RELEASE
28th August, 2026
IRDAI IAC Sub-Committee Holds 3rd Meeting to Advance Health Insurance Penetration, Customer Trust, and Value
The Insurance Regulatory and Development Authority of India (IRDAI) convened the 3rd Meeting of the IAC Sub-Committee on Health Insurance on August 28, 2026, to deliberate on measures for strengthening the health insurance ecosystem and improving outcomes for policyholders. The meeting carried forward the discussions of the Sub-Committee’s second meeting held on July 17, 2026, with a focus on building customer trust, improving the economic value of health insurance and increasing health insurance penetration.
A key focus of the deliberations was the need to make health insurance simpler, more transparent and easier for policyholders to understand and use. The Sub-Committee discussed simplification of policy wording, strengthening underwriting at the point of sale to minimise claim issues arising from inadequate disclosures, and facilitating hassle-free claim settlements. The role of insurers, intermediaries, agents and TPAs in supporting policyholders at hospitals was also discussed.
The discussions highlighted the importance of improving the economic value of health insurance through greater efficiency and collaboration. The Sub-Committee considered measures to encourage insurers and hospitals to on-board onto the National Health Claims Exchange (NHCX), including possible incentives linked to on boarding, payments and faster settlement. The role of preventive healthcare was also discussed, including incentivising policyholders for periodic health check-ups and healthy practices.
The need for standardisation and enriching industry data was emphasised to support evidence-based policy interventions. The Sub-Committee also noted that assessment of claims and grievance outcomes should not focus solely on settlement ratios but should also consider absolute values. Insurers may also consider publishing Standard Treatment Guidelines (STGs) and treatment package rates, which could facilitate more informed choices by policyholders.
The members went on to discuss the need for coordinated action involving insurers, hospitals, intermediaries, policyholders and other stakeholders to facilitate smoother claim settlements and improve the overall health insurance experience. Mr Rizwan Koita, Chairperson, National Accreditation Board for Hospitals & Healthcare Providers (NABH) presented on the certification of hospitals and introduction of Digital Health Standards aimed at improving healthcare outcomes. Strategies to accelerate on boarding of healthcare providers and insurers onto NHCX were also discussed. The Sub-Committee discussed further work on health savings accounts, value-added services, analysis of ported policies as a separate cohort, and review of exclusions in the Customer Information Sheet to improve clarity and customer trust.
The four-member Sub Committee is Chaired by Mr. Ajay Seth, Chairman IRDAI. The other members of the sub-committee are Mr Deepak Sood, Member, IRDAI, Dr. Indu Bhushan Former CEO, NHA, Ms. Monika Halan, Financial Writer, and Adjunct Professon at Banasthali Vidyapeeth, Rajasthan. The sub-committee is supported by invitees from the insurance sector Mr. Sanjeeb Mantri, CEO ICICI Lombard, Mr. Mayan Bathwal, CEO Aditya Birla Health insurance, Mr. K. Ramachandran, CEO Niva Bupa Health Insurance. The sub-committee has also inducted Dr. Soumil Nagpal of World Bank and Dr. Nishant Jain of Asian Development Bank as experts with international experience.
