IRDAI flags lapses in health insurance claims, issues show-cause notices, says Report – Here are 8 insurers under scrutiny
July 11, 2025
The IRDAI has initiated the process to issue show-cause notices to eight insurance companies due to irregularities detected in their health insurance portfolios.
The Insurance Regulatory and Development Authority of India (IRDAI) has initiated the process to issue show-cause notices to eight insurance companies due to irregularities detected in their health insurance portfolios, a CNBC TV18 report stated citing sources.
These insurers included Niva Bupa, Star Health, Care Health, ManipalCigna, New India Assurance, Tata AIG, ICICI Lombard, and HDFC Ergo.
Earlier on June 26, another report by CNBC TV18 had stated that IRDAI had initiated inspections at health insurance companies and flagged concerns with some insurers on implementation of certain regulatory norms in the new health insurance master circular. The regulator had found significant lapses in health claim practices at these insurance companies.
Reacting to this, ICICI Lombard told CNBC TV18 that over the past year, IRDAI had introduced several regulatory guidelines, including master circulars. The company further maintained that the regulator carried out inspections in stages to assess the insurers’ compliance with these directives.
“ICICI Lombard has gone through the inspection and as an industry leader, we follow high standards of regulatory compliance and corporate governance in all our operations,” it said.
Further, New India Assurance also said that IRDAI has the right to inspect all insurers. The company called the inspections “not adversarial” but aimed at promoting better operations and compliance. New India Assurance stated it has fully adopted the Master Circular.
During the inspection, per the report, IRDAI identified some procedural concerns. These included an excessively detailed Customer Information Sheet, which has since been simplified; the absence of Product Management Committee members on the Claims Review Committee, which has now been rectified; and delays in submitting portability data, which have been resolved through updated systems and protocols.
[The Financial Express]
