IRDAI ne Health Insurance ka game badla! Hospitals aur Insurers ki ladai khatam? Naye groups banaye

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AuthorAnanya Iyer|Published at:
IRDAI ne Health Insurance ka game badla! Hospitals aur Insurers ki ladai khatam? Naye groups banaye
Overview

IRDAI ne health insurance mein chal rahi gadbadi ko theek karne ka mood bana liya hai! Unhone **paanch** naye groups banaye hain jisme insurers aur hospitals dono milke kaam karenge taaki patients ko better service mile aur claims ka system smooth ho jaaye.

IRDAI ne saaf kar diya hai ki ab se health insurance mein jo hospitals aur insurers ke beech roz ladai hoti rehti hai, usko khatam karne ka time aa gaya hai. Iske liye unhone paanch alag-alag working groups banaye hain.

Yaar, apna health insurance market badh toh raha hai, experts keh rahe hain $322.10 billion tak pahunchega 2034 tak. Lekin medical inflation bhi 12-15% saal mein badh rahi hai, jisse treatment aur premiums dono mehenga ho raha hai. Is friction ki wajah se patients ko bhi dikkat ho rahi hai.

Ye groups, jisme hospital aur insurance wale dono hain, ek plan banayenge ki kaise operations smooth hon aur trust badhe. Abhi toh sirf discussions hain, dekhte hain results kab aate hain.

Health insurance premiums toh 9.19% badhkar ₹1,17,505 crore ho gaye hain 2024-25 mein, par abhi bhi sirf 15% log covered hain. Policyholder complaints toh 41% badh gayi hain! Iska main reason claims mein delays aur pura paisa na milna hai. Ye groups ab hospital discharge aur empanelment jaise cheezein standardize karenge. National Health Claims Exchange (NHCX) ko bhi promote kar rahe hain taaki claims jaldi ho jayein. Abhi 34 insurers aur TPAs NHCX use kar rahe hain, aur 300 hospitals bhi jud gaye hain.

Lekin ye masle itne aasan nahi hain. Pehle bhi hospitals aur insurers mein rates aur claim denials par ladai hoti thi. Lagbhag half se zyada claims mein processing ya payment mein dikkat aati hai, kai baar toh reject ho jaate hain ya aadha paisa milta hai. Providers bhi apni fees 12-14% saal mein badha dete hain.

Ye working groups April 2026 se start honge aur 2 se 4 mahine mein apna kaam khatam karenge. IRDAI Chairman Ajay Seth ka kehna hai ki sab milkar kaam karenge toh system behtar hoga aur patients ko fayda hoga. Umeed hai ki yeh sirf baatein na reh jayein aur asli solutions niklen.

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