The Basic Insurance coverage Council (GIC) and the Insurance coverage Regulatory and Improvement Authority of India (IRDAI) are in discussions with the central authorities to determine an impartial regulatory physique for the healthcare sector.
Ramaswamy Narayanan, CMD of the GIC of India informed Moneycontrol.
The proposed regulator would mirror current sectoral authorities similar to IRDAI for insurance coverage, SEBI for capital markets, and RBI for banking.
He cited two major issues 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: “In the present day, 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, typically adjustments dramatically.”
He famous that the healthcare business lacks “pricing standardisation” and oversight, with hospitals often charging insured sufferers as much as 3 times greater than cash-paying sufferers, typically “inflating prices” considerably.
He added: “Ultimately, policyholders are penalised by increased annual premiums. Whereas the IRDAI has set limits on annual premium hikes, the underlying drawback stays unaddressed.”
This observe, described as systematic fraud, contributes to “increased premiums” for shoppers.
A Nationwide Well being Authority report underneath Ayushman Bharat helps these findings, stating that personal hospitals typically invoice insured sufferers two to a few instances 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 Price range session 2025-26, proposed growing the overseas direct funding restrict within the insurance coverage sector from 74% to 100%.
