Big move to check inflated hospital bills due to insurers: Report
The move follows detailed data analysis and inspections that revealed hospitals — rather than insurers — are inflating treatment costs to match policy coverage limits. The Finance Ministry believes that placing the National Health Exchange (NHE) under IRDAI's supervision will help improve oversight, ensure cohesive policymaking, and curb persistent inefficiencies in the health insurance sector. The National Health Exchange was originally conceptualised by the government under the Ayushman Bharat Digital Mission (ABDM), overseen by the Ministry of Health and Family Welfare. It is envisioned as a digital transaction layer that facilitates seamless claim settlement, data exchange, and service verification between insurers, TPAs (Third Party Administrators), and hospitals — similar to how stock exchanges enable standardised and transparent trading.
Healthcare costs in India are projected to rise by 13 percent in 2025, exceeding the global average of 10 percent, and up from 12 percent recorded a year earlier, according to professional services firm Aon's Global Medical Trend Rates Report. An analysis by the government and the Insurance Regulatory and Development Authority of India (IRDAI) found that hospitals are inflating treatment costs for patients and overcharging those with higher covers, the sources said earlier this week.
This has driven insurers to charge higher health premiums, making coverage less affordable for some, the sources said, requesting anonymity as they are not authorised to speak to the media.
"Strict supervision" of the National Health Claims Exchange - the platform that acts as a gateway between insurers, healthcare providers and patients - will improve the "collective bargaining power" of insurance companies to set treatment rates, the sources said.Currently, the exchange is overseen by the health ministry's National Health Authority and was developed in "consultation" with the insurance regulator, according to the authority's website. IRDAI does not regulate the health exchange but regulates insurers on the platform.
Annual growth in health insurance premium income has slowed to 9% in 2024-25 from over 20% a year ago, according to industry data, as premiums become unaffordable for many, leading to fewer policy renewals.
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