IRDAI Health Panel Discusses Stronger Underwriting at Point of Sale, NHCX Incentives

NEW DELHI – IRDAI Health Panel: The Insurance Regulatory and Development Authority of India (IRDAI) convened the third meeting of its IAC Sub-Committee on Health Insurance on August 28, 2026, to discuss measures aimed at strengthening the health insurance ecosystem and improving outcomes for policyholders, according to a press release issued by the regulator.

The meeting built on discussions from the Sub-Committee’s second meeting, held on July 17, 2026, with continued focus on customer trust, the economic value of health insurance, and increasing insurance penetration.

IRDAI Health Panel: Policy simplification and claims at the point of sale

According to the release, the Sub-Committee discussed simplifying policy wording and strengthening underwriting at the point of sale to reduce claim issues arising from inadequate disclosures. Members also discussed facilitating smoother claim settlements and the roles of insurers, intermediaries, agents, and third-party administrators (TPAs) in supporting policyholders at hospitals.

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IRDAI Health Panel: NHCX onboarding incentives on the table

A significant part of the deliberations centered on the National Health Claims Exchange (NHCX), IRDAI said. The Sub-Committee considered measures to encourage both insurers and hospitals to onboard onto the platform, including possible incentives tied to onboarding, payments, and faster settlement timelines.

The NHCX, developed under the National Health Authority, is designed to serve as a common digital platform linking insurers, TPAs, and healthcare providers for the exchange of health claims data. According to the release, the Sub-Committee’s discussions focused specifically on strategies to accelerate onboarding of both healthcare providers and insurers onto the exchange, alongside broader efforts to improve claims efficiency across the sector.

IRDAI said the panel weighed how financial incentives — linked variously to the act of onboarding itself, to payment processing, and to faster claim settlement — could be structured to encourage wider participation from stakeholders who have yet to join the platform. The release did not specify the nature or scale of the incentives under consideration, nor a timeline for their rollout.

The panel also discussed the role of preventive healthcare, including incentivizing policyholders for periodic health check-ups and healthy practices, according to the release, positioning NHCX adoption as one part of a wider push toward efficiency and collaboration within the health insurance ecosystem.

IRDAI Health Panel: Beyond settlement ratios: absolute values in focus

IRDAI noted that the Sub-Committee flagged the need for standardization and richer industry data to support evidence-based policy interventions. The release stated that assessment of claims and grievance outcomes should not rely solely on settlement ratios, but should also account for absolute values.

The Sub-Committee further suggested that insurers may consider publishing Standard Treatment Guidelines (STGs) and treatment package rates, which IRDAI said could help policyholders make more informed choices.

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IRDAI Health Panel: NABH presents on hospital certification and digital health standards

Rizwan Koita, Chairperson of the National Accreditation Board for Hospitals & Healthcare Providers (NABH), presented to the Sub-Committee on hospital certification and the introduction of Digital Health Standards intended to improve healthcare outcomes, according to the release. Strategies to accelerate the onboarding of healthcare providers and insurers onto NHCX were also discussed at the meeting.

Additional items on the agenda included health savings accounts, value-added services, a separate analysis of ported policies as a distinct cohort, and a review of exclusions in the Customer Information Sheet to improve clarity and customer trust, IRDAI said.

IRDAI Health Panel: Who’s on the Sub-Committee

The four-member Sub-Committee is chaired by Ajay Seth, Chairman of IRDAI. Its other members are Deepak Sood, Member, IRDAI; Dr. Indu Bhushan, former CEO of the National Health Authority (NHA); and Monika Halan, financial writer and adjunct professor at Banasthali Vidyapeeth, Rajasthan.

The Sub-Committee is supported by invitees from the insurance sector: Sanjeeb Mantri, CEO of ICICI Lombard; Mayank Bathwal, CEO of Aditya Birla Health Insurance; and K. Ramachandran, CEO of Niva Bupa Health Insurance. IRDAI said the Sub-Committee has also inducted Dr. Soumil Nagpal of the World Bank and Dr. Nishant Jain of the Asian Development Bank as experts with international experience.

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