Explainer: Irdai sets up sub-committee to assess, solve health insurance sector concerns

Mumbai: In an effort to improve policyholder experience and penetration of health insurance in the country, the Insurance Regulatory and Development Authority of India (Irdai) has constituted a sub-committee of the Insurance Advisory Committee. The insurance regulator notified the establishment of the committee and its members on 2 April, and then its role and scope, as well as the issues it will address.

Mint looks at the major hurdles that the committee could address:The committee will evaluate private health insurance, from claims and pricing to fraud control, to recommend innovations that expand coverage and boost consumer trust. It will also explore aligning private insurers with public health schemes to improve efficiency and portability.The panel has been constituted for a year.

It will have to prepare and submit its first report with specific, actionable recommendations within 4 months.Health insurers, especially standalone health insurance companies, are grappling with the operational impact of losing input tax credits. Friction with healthcare providers has exposed issues such as delayed payments for cashless claims, the need to streamline processes between hospital administrations and insurers, and surging medical inflation.

These challenges underscore the need for better coordination and uniform pricing for medical treatments.Irdai chairman Ajay Seth will head the seven-member committee, which will also include Deepak Sood, member (Non-Life) from the regulatory body. Indu Bhushan, former chief executive officer of the National Health Authority (NHA), and Monika Halan, a financial writer, speaker, author, and adjunct professor at Banasthali Vidyapeeth, Rajasthan, will also be members.