Context:
The Ministry of Finance has urged the Insurance Regulatory and Development Authority of India (IRDAI) to intensify regulatory vigilance, improve claims settlement mechanisms, and address grievance redressal, amid growing concerns over surging health insurance premiums and lapses in corporate governance, especially within Stand-Alone Health Insurance (SAHI) companies.
Key Government Concerns Highlighted
- Sharp Rise in Premiums: Health insurance premiums rose by up to 15% in 2024, forcing many policyholders to drop out, especially senior citizens.
- Grievances and Delayed Claims: A growing number of complaints on delays and denial in claim settlements.
- Governance Lapses: Especially in SAHIs, allegedly influenced by private equity (PE) control.
Policy and Regulatory Context
| Issue | Government Action |
|---|---|
| Premium Hikes | Directed IRDAI to review product pricing; prevent excessive hikes, especially for senior citizens. |
| Governance | IRDAI asked to scrutinize board decisions and ensure compliance with all regulations. |
| PE Influence | Concerns raised over PE-backed firms driving aggressive pricing strategies to boost valuations. |
| Leadership Void | IRDAI has been without a Chairperson since March 2025; government may appoint a senior bureaucrat. |
Insurance Amendment Bill
The Insurance Laws (Amendment) Bill is likely to reshape the regulatory landscape:
- Allows 100% foreign direct investment (FDI) in insurance.
- Introduces a composite licence regime (life + non-life).
- Permits foreigners as Key Managerial Personnel (KMP) in Indian firms.
- Government expects regulatory protocols to be tightened ahead of the Bill’s passage.
IRDAI’s Past Action
In January 2025, IRDAI:
- Barred insurers from raising premiums for senior citizens (60+) by more than 10% per annum without prior approval.
- Cited disproportionate premium increases and their adverse impact on vulnerable groups.
