IRDAI Flags Health Claim Issues at 8 Insurers, Issues Show-Cause Notices

India's insurance regulator, the Insurance Regulatory and Development Authority of India (IRDAI), has begun sending show-cause notices to eight insurance companies after finding issues in their health insurance portfolios.

Companies Under IRDAI’s Scanner

 The insurers involved include some of the biggest names in the sector:

These notices come after detailed inspections by the IRDAI revealed lapses in health claim practices, according to sources.

What Did the IRDAI Inspection Reveal?

The regulator has issued new guidelines and master circulars over the past year to improve claim handling and transparency. Inspections were done in phases to check how well these rules were followed.

Some of the key issues flagged during the inspections include:

• Complicated customer information sheets
• Improper representation of Product Management Committee members in the Claims Review Committee
• Delays in data submission for health insurance portability

Insurers Respond

ICICI Lombard acknowledged the inspection and said it follows high standards of compliance and governance. It also noted that it had already gone through the IRDAI review process.

New India Assurance said the inspection was not meant to be adversarial but was focused on promoting better compliance. The company confirmed it has implemented the Master Circular’s recommendations and fixed all flagged issues.

Read more: ITR Filing 2025: After 100-Day Delay, Excel Utilities for ITR-2 and ITR-3 Finally Released—Will Filing Speed Up Now?

Conclusion

IRDAI's move highlights the importance of transparent and customer-friendly health insurance practices. While the regulator pushes for stronger compliance, the companies involved have promised to correct procedures and improve their systems. This marks a crucial step toward building trust and ensuring better service in India's health insurance sector.

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