The Insurance Regulatory and Development Authority of India has constituted a sub-committee under its Insurance Advisory Committee to review and strengthen the private health insurance ecosystem in India. The initiative aims to improve policyholder experience, expand coverage, and enhance insurance penetration. The sub-committee will examine key aspects such as product design, claims experience, grievance redressal, and consumer satisfaction, while recommending regulatory and operational reforms to promote innovation and better risk pooling. It will also evaluate the role of healthcare provider networks, hospital pricing, fraud control mechanisms, and digital systems in improving efficiency and value for policyholders. Additionally, the sub-committee will study the interaction between private and public health insurance schemes to identify opportunities for complementarity and convergence. It will incorporate recommendations from industry working groups on issues such as provider engagement, claims exchange systems, medical inflation, and development of standardized health insurance products.
Insurance Regulatory and Development Authority of India
Press Release | 07 April, 2026
Constitution of Insurance Advisory Committee – Sub-committee on Health Insurance
As part of on-going initiatives to improve policyholder experience and penetration of Health Insurance, IRDAI has 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. The sub-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 and increasing trust and the overall consumer experience.
The sub-committee will also examine the role of health care provider networks, hospital tariffs, fraud control, and digital systems in improving value to policyholder, 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 done.
The sub-committee will also 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
yes it is needed , the private insurance companies are not settling the claims properly, the hospital tariffs are also not realistic