Latest news with #HealthInsuranceMasterCircular
Mint
12-07-2025
- Business
- Mint
IRDAI pulls up 8 top insurers over health portfolio lapses, may take coercive action — Report
The Insurance Regulatory and Development Authority of India has started the process to issue show cause notices to as many as eight insurance companies after allegedly finding lapses in their health insurance portfolios, a report said. As per the report by CNBC TV18 on Friday citing sources, the eight companies that were are being sent show cause notices by the IRDAI include — Niva Bupa Health Insurance, Star Health & Allied Insurance, Care Health Insurance, ManipalCigna Health Insurance, along with New India Assurance, Tata AIG General Insurance, ICICI Lombard General Insurance, and HDFC ERGO General Insurance. Livemint could not independently verify the authenticity of the report. This article will be updated if IRDAI releases a statement. According to the report, IRDAI flagged multiple violations committed by the insurers with regard to the implementation of its Health Insurance Master Circular, issued in May 2024. The circular outlines strict norms for claim settlement time, cashless approvals, and customer information disclosures. Other violations include — unnecessary deductions from payouts of claims, improper rejection of claims and delayed claim settlement exceeding prescribed timeline. The IRDAI had last month found major lapses in health insurance claim processes of these insurers after it conducted inspections, the CNBC TV18 report says. In its board meeting next week, the IRDAI is reportedly going to formally discuss issuing the show cause notices to the companies. If the insurers remain non-compliant following the evaluation of their responses, the regulatory body may take coercive actions, including financial penalties or directions to refund amounts (with interest) to affected policyholders, according to the report. The IRDAI's plan comes simultaneously with the Centre's plans to bring its existing health insurance claims portal under the finance ministry and insurance regulator to curb overcharging by healthcare providers, which was reported by Reuters earlier. New India Assurance and ICICI Lombard have acknowledged the action by IRDAI, saying that these were part of routine regulatory supervision to strengthen compliance of operations. They also emphasised that they had taken up all necessary corrective measures, including simplifying overly detailed Customer Information Sheets and reinforcing Claims Review Committee membership rules. Other insurers have not yet issued a response.
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Business Standard
26-06-2025
- Business
- Business Standard
Irdai flags issues at 8 insurers over health master circular norms
Regulator begins phased inspections of health insurers; issues linked to claims settlement and compliance with the new Health Insurance Master Circular BS Reporter As part of routine inspections to review the implementation of regulatory norms, the Insurance Regulatory and Development Authority of India (Irdai) initiated inspections at several health insurance companies and flagged concerns with select firms regarding the implementation of certain norms under the new Health Insurance Master Circular, people aware of the development said. According to a CNBC-TV18 report, eight general insurance companies—New India Assurance, ICICI Lombard General Insurance, HDFC ERGO General Insurance, Tata AIG General Insurance, Star Health and Allied Insurance, Niva Bupa Health Insurance, Care Health Insurance, and ManipalCigna Health Insurance—are under the scanner for violations related to claims settlement and the implementation of the circular. The report stated that the violations noted by the regulator involve improper implementation of the Health Insurance Master Circular, which could lead to enforcement actions. 'In order to review the implementation of health prescriptions, Irdai had initiated inspection of all insurers in a phase-wise manner as part of its regulatory supervision and oversight. Accordingly, regulatory inspections were initiated for eight general and health insurance companies as part of the initial phase. The inspection report was shared with the insurance companies. The observations mainly related to industry-wide challenges in implementing the new prescriptions,' an ICICI Lombard spokesperson said in response to a Business Standard query. 'The company has submitted its response to the inspection report, in keeping with our endeavour and spirit of upholding the regulatory prescriptions. At ICICI Lombard, and as an industry leader, we follow high standards of regulatory compliance and corporate governance in all our operations,' the spokesperson added. Queries sent to the remaining insurance companies remained unanswered at the time of going to press.
