Page 14 - The Insurance Times February 2026

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News

Health insurance coverage expands in FY25 despite enabling better understanding for pa-
tients and their families.
dip in policy sales
The move is intended to address fre-
Health insurance coverage in India continued to broaden in FY25, even as quent disputes arising from unclear or
the number of policies sold edged lower, according to the annual report of inconsistent billing formats, particularly
the Insurance Regulatory and Development Authority of India. The number in cashless insurance and reimburse-
of lives covered by general and health insurers rose to 580 million in FY25 ment-based treatments. "Adoption of
from 573 million in FY24, while the total number of health insurance policies the standards is expected to reduce
declined marginally to 26.5 million from 26.8 million. billing-related disputes, enhance con-

Premium collection under the health insurance segment grew 9.12 per cent sumer confidence and support in-
year-on-year to Rs 1.17 trillion, reflecting higher average ticket sizes and formed decision-making," BIS said in a
the growing dominance of group and government-backed covers. Health in- release.
surance business is categorised into government-sponsored schemes, group The standards are voluntary in nature
policies and individual policies. In terms of lives covered, 42.3 per cent were and do not impose mandatory compli-
insured under government schemes, 47.4 per cent under group insurance ance obligations. However, they are
and 10.3 per cent under individual policies. expected to serve as a benchmark for
Claims experience remained stable. During FY25, insurers settled 32.6 mil- hospitals, insurers and regulators seek-
lion health insurance claims, paying out Rs 94,248 crore. Net incurred claims ing greater transparency and
stood at Rs 84,850 crore, up around 11 per cent from the previous year. The standardisation in healthcare billing,
incurred claims ratio improved to 86.98 per cent from 88.15 per cent in FY24, especially as health insurance coverage
indicating a modest strengthening in underwriting and claims management and claim volumes continue to rise
despite rising healthcare costs. across the country.

BIS issues voluntary stan- ments, including the use of legible Telangana government
fonts, clear itemisation and the avail-
dards to standardise hos- ability of bills in both physical and digi- announces Rs. 1 crore ac-
pital billing tal formats. cident cover for staff

The Bureau of Indian Standards (BIS) According to BIS, the standards provide The Telangana government has an-
has issued new standards for hospital sample formats for both summary bills nounced an accident insurance cover of
bills, aimed at improving transparency, and detailed itemised bills to guide Rs. 1 crore for 5.14 lakh regular gov-
readability and consistency in hospitals and healthcare establish- ernment employees across the State.
healthcare billing practices. The stan- ments. Bills may be issued in English as The announcement was made by
dards lay down formatting require- well as the relevant regional language, Deputy Chief Minister Bhatti

12 February 2026 The Insurance Times