Synopsis : The IRDAI has flagged significant irregularities in health claim practices, issuing show-cause notices to eight major insurers, including ICICI Lombard and HDFC Ergo. The move signals the regulator's sharpened focus on enforcing the new health insurance master circular amid rising complaints and system gaps.
The Insurance Regulatory and Development Authority of India (IRDAI) has taken a strict stance on irregularities within the health insurance sector, initiating show-cause notices against eight prominent insurers after identifying lapses in their claims handling practices. According to a CNBC TV18 report, the insurers under scrutiny include Niva Bupa, Star Health, Care Health, ManipalCigna, New India Assurance, Tata AIG, ICICI Lombard, and HDFC Ergo.
The regulator’s move follows inspections tied to the new health insurance master circular, where concerns were flagged regarding implementation of regulatory norms and operational practices. IRDAI identified several procedural concerns, including overly complex Customer Information Sheets, lack of Product Management Committee presence during claims reviews, and delays in portability data submissions. These issues have reportedly been addressed by insurers with updated systems and revised processes.
ICICI Lombard responded by affirming its commitment to maintaining high regulatory standards, while New India Assurance emphasized that inspections were not adversarial but part of improving operations and compliance across the industry. The IRDAI's proactive inspections underscore its intent to protect policyholders while pushing insurers to align with streamlined, transparent claim processes.
As the regulator sharpens its oversight, industry watchers will closely track how these insurers recalibrate their practices to ensure compliance and customer trust amid rising scrutiny in India’s expanding health insurance landscape.
Disclaimer : This article is for informational purposes only and does not constitute legal, financial, or investment advice. Please consult a qualified professional before making decisions based on this content.
