Page 26 - The Insurance Times September 2025

Conduct dry runs and scenario analyses. The challenge ahead is twofold: insurers clinging near the
minimum must strengthen or risk regulatory intervention,
Engage with boards to align business strategy with
while those with solvency well above 300% must stop
capital efficiency.
hoarding safety and put their capital to work - through
For Regulators: growth, dividends, or innovation.
Adequate steps to ensure that insurers are facilitated
with transitional challenges RBC is not just a compliance hurdle. Done right, it is Nepal's
Facilitate industry dialogue and capacity-building chance to align solvency with strategy, efficiency with
workshops. resilience, and finally separate insurers that are merely
surviving from those that are truly building for the future.
Adopt a phased approach with impact assessments.
Reassessment of capital charges for each assets class About Mr. Amit Kumar Keyal
based on availability of instruments A Chartered Accountant with an MBA over 16 years of
For Industry Associations: progressive leadership experience in strategic finance,
Standardize practices and templates. business transformation, and growth acceleration across
emerging and mature markets—including India, Europe,
Organize training for executives, boards, and middle
the Middle East, Africa, and Nepal.
managers.
Currently, I serve as Deputy CEO at Nepal Life Insurance
Serve as a bridge between regulatory intent and field-
Company Ltd., where I oversee Strategic and financial
level execution. stewardship, Operational excellence across the value
Conclusion: From Risk Measurement to chain and Institutional digital transformation
I bring a proven track record of partnering with
Market Maturity promoters, board members, and CXOs to drive
Nepal's adoption of a Risk-Based Capital regime is more than enterprise-wide initiatives spanning Mergers &
a regulatory upgrade - it is a litmus test for the maturity of acquisitions, Corporate finance and restructuring,
the insurance industry. The fall in average solvency ratios from Digital transformation and process automation, E-
295% to 228% shows that the old comfort was partly an commerce and startup ecosystems, Board advisory and
illusion. What looked like strength was often just idle capital; corporate governance, Strategic planning and
what now looks lean may actually be capital working at its execution, Business expansion (organic & inorganic)
most efficient, but margin of error is small for such companies.

Insurers accused of diverting medical claim funds: DMA
The Delhi Medical Association (DMA) has alleged that insurance companies are diverting a significant portion of funds
allocated for medical claims towards administrative costs and commissions, rather than patient care. At a press
conference, DMA officials claimed that only 35-40% of the claim amount actually reaches hospitals, while the rest is
consumed by intermediaries. They urged the Insurance Regulatory and Development Authority of India (IRDAI) to
intervene and regulate the practices of Third-Party Administrators (TPAs), ensuring that patients receive the full benefit
of their health policies. DMA also criticized delays in claim settlement and non-transparent deductions, warning that
such practices erode trust in the health insurance system. The Association plans to escalate the matter to the Union
Health Ministry if corrective action is not taken.

OPD expenses surge in India, but insurance uptake remains low

Despite rising Outpatient Department (OPD) expenses in India, health insurance adoption for OPD services remains limited,
according to industry experts. While more insurers are introducing OPD-inclusive plans, most policies still cater to
hospitalization, leaving a large gap in everyday healthcare spending coverage. High out-of-pocket payments for
consultations, diagnostics, and medicines continue to burden middle-class households. Experts believe the challenge lies
in pricing, claim processing, and customer awareness. Many consumers also find OPD policies less attractive due to
perceived complexity and low claim ratios. Analysts recommend regulatory incentives and simplified product structures
to improve uptake. Insurers are being urged to innovate further to cover evolving healthcare needs beyond hospitalisation.

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