IRDAI, yani ki Insurance Regulatory and Development Authority of India, ne pakad li hai health insurance ki bagdor. Unhone bola hai ki ab sector mein ekdum se system change hoga, kyuki abhi kaafi problems chal rahi hain, jise regulator khud 'unstable equilibrium' keh raha hai.
Sabse pehle, June 2026 se sabko milengi simple aur affordable health insurance policies. Ye specially is liye banayi ja rahi hain taaki log easily samajh sakein aur insurance penetration, jo India mein abhi bas 3.7% of GDP hai (global average 7.3% se kaafi kam), woh badhe.
Iske saath hi, IRDAI ne insurers aur hospitals ke liye naye performance scorecards bhi launch karne ka plan kiya hai. Ismein claim settlement kitni jaldi ho raha hai, billing kitni accurate hai, aur documents kaise hain, yeh sab dekha jayega. Hospital payments ko bhi performance se link kiya jayega, matlab jo jaldi claims clear karenge unhe fayda hoga aur delays pe penalty lagegi.
Industry currently kaafi financial pressure mein hai. Last fiscal mein insurers ne ₹85,000 Cr ke claims pay kiye hain. Medical inflation bhi over 14% annually chal rahi hai, aur lifestyle diseases bhi badh rahi hain. Public sector insurers ka toh Incurred Claims Ratio (ICR) 103% tak pahunch gaya tha FY24 mein, matlab jitna premium kamaya, usse zyada claims pay kar diye. Haalanki, overall claim settlement ratio ab 87.50% ho gaya hai FY24-25 mein.
Patient complaints bhi 41% badh gayi hain, mainly claim disputes aur delays ke karan. Insurance premiums collect toh ₹1.2 Lakh Cr ho gaye hain FY24-25 mein, but settlement mein dikkatein abhi bhi hain. Recent 100% FDI approval se aur paisa aa sakta hai, but regulation strong rehna zaroori hai.
Toh policy holders ke liye kya matlab hai iska? Simple products aur transparent scorecards se logo ko better decisions lene mein help milegi. Hospital payments ko performance se jodna matlab claims jaldi clear honge aur disputes kam honge. Overall, IRDAI chahta hai ki sector mein trust build ho aur customer experience better ho.