The Common Insurance coverage Council (GIC) and the Insurance coverage Regulatory and Growth Authority of India (IRDAI) are in discussions with the central authorities to ascertain an unbiased regulatory physique for the healthcare sector.
Ramaswamy Narayanan, CMD of the GIC of India informed Moneycontrol.
The proposed regulator would mirror present sectoral authorities equivalent to IRDAI for insurance coverage, SEBI for capital markets, and RBI for banking.
He cited two main considerations prompting this initiative together with “fraudulent practices” and “discriminatory pricing” by hospitals primarily based on sufferers’ insurance coverage standing.
Narayanan was quoted by Moneycontrol as saying: “As we speak, when a affected person walks right into a hospital, the primary query requested is whether or not they have an insurance coverage coverage. If the reply is sure, the hospital’s perspective, and pricing, usually adjustments dramatically.”
He famous that the healthcare trade lacks “pricing standardisation” and oversight, with hospitals continuously charging insured sufferers as much as thrice greater than cash-paying sufferers, typically “inflating prices” considerably.
He added: “Finally, policyholders are penalised via larger annual premiums. Whereas the IRDAI has set limits on annual premium hikes, the underlying downside stays unaddressed.”
This apply, described as systematic fraud, contributes to “larger premiums” for customers.
A Nationwide Well being Authority report beneath Ayushman Bharat helps these findings, stating that personal hospitals usually invoice insured sufferers two to a few occasions greater than uninsured sufferers for “equivalent remedies”.
This discrepancy inflates medical prices for insurers and drives up client premiums, the report added.
Individually, the Indian Authorities, within the Funds session 2025-26, proposed rising the overseas direct funding restrict within the insurance coverage sector from 74% to 100%.
