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IRDAI & Industry leaders collaborate to enhance health insurance ecosystem through strategic Working

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  • IRDAI & Industry leaders collaborate to enhance health insurance ecosystem through strategic Working

The Insurance Regulatory and Development Authority of India (“ IRDAI ”) has issued a press release dated March 17, 2026 on the collaboration with industry leaders to enhance health insurance ecosystem through strategic working groups (“ Press Release ”).

Key highlights of the Press Release are as follows:

  • The interaction with industry leaders was led by Chairman Shri Ajay Seth to address critical challenges and formalize a roadmap for systemic reforms in the healthcare and insurance sectors.
  • The event was hosted by Confederation of Indian Industry (CII) that brought together top executives from major hospitals, representatives of the Association of Health Providers India (AHPI), NatHealth, the Private Hospitals & Nursing Homes Association (PHANA), various state level health providers associations along with insurance companies.
  • The event aimed to formalize a roadmap for systemic reforms through five specialized Working Groups.
  • Each working group will be co-chaired by leaders from hospitals and insurance industry.
  • Further, the initiative aims to improve insurance penetration, transparency, and the overall patient experience by addressing long-standing operational gaps and coordination issues between insurers and healthcare providers.
  • The Chairman also mentioned in his remark that “The collaboration between payers and providers is essential for a sustainable healthcare ecosystem”.
  • The Working Groups are scheduled to begin their activities in April 2026, with durations ranging from two to four months.
  • The findings and recommendations from these groups will serve as a reference model for future industry standards and regulatory frameworks.

​The key Working Group initiatives are as below:

  • ​ Joint Code of Conduct : A primary focus is developing a practical framework to strengthen trust and transparency, specifically aiming to streamline the discharge process and standardize hospital empanelment.
  • ​ Categorization of Providers : The groups will establish a data-driven methodology for classifying healthcare providers based on accreditation and geography to ensure consistency across the industry.
  • ​Scale-up of NHCX : To improve the patient experience, a dedicated group will work to resolve bottlenecks and accelerate the adoption of the National Health Claims Exchange (NHCX).
  • ​ Focused Analytical Studies : Research will be conducted on claim trends, medical inflation drivers, and the dynamics of cashless versus reimbursement claims. These studies will provide an analytical base for future policy reforms.
  • Simplified Products and Wellness : Working Group will design a scalable, “no-frill” health insurance framework to increase penetration by integration of wellness components such as OPD-to-IPD conversion pathways and proactive health engagement models.

​This collaboration reaffirms IRDAI’s commitment to putting the patient at the centre of the care journey while ensuring operational efficiency and data-backed policy making.

A copy of the Press Release is attached herewith for your ready reference.

Source category: IRDAI

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