IRDAI’s latest measures are designed to enhance transparency and accountability in the health insurance sector, while tackling persistent issues like claim delays, billing disputes, and low insurance coverage.
The Insurance Regulatory and Development Authority of India (IRDAI) is planning to roll out simple, low-cost health insurance policies along with performance scorecards for insurers and hospitals, according to The Economic Times.
The initiative aims to boost transparency and accountability in the health insurance sector while addressing persistent challenges such as claim delays, billing disputes, and low penetration.
The sector is also facing profitability pressures after settling claims worth around Rs 85,000 crore in the last financial year, industry executives told ET.
Basic Health Plans to Boost Coverage
The Insurance Regulatory and Development Authority of India (IRDAI) plans to introduce basic, no-frills health insurance products to make policies more affordable and easier to understand.
These simplified plans are expected to expand access, particularly for those who find existing policies too complex or costly.
The initiative also aims to improve insurance penetration in India, which remains relatively low compared to global levels.
According to the report, industry body Confederation of Indian Industry (CII) is collaborating with IRDAI to design these products.
Scorecards to Evaluate Insurers and Hospitals
In addition to basic plans, the regulator is set to introduce performance scorecards for insurers and hospitals, expected to roll out from June 2026.
These scorecards will assess critical metrics such as claim settlement timelines, billing practices, and documentation quality.
The initiative aims to empower policyholders with clearer information, enabling better decision-making, while also encouraging improved behaviour across the sector through greater transparency.