Why in News?
IRDAI has highlighted a widening gap between health insurance claims filed and claims settled in FY25. Despite rising premiums and increasing number of claims, settlement ratios have not kept pace—raising concerns about inefficiencies and disputes in the claims ecosystem.
Description:
Standalone Health Insurance Companies (SAHI):
Standalone Health Insurance Companies (SAHI) are specialized insurers that focus exclusively on health, accident, and travel insurance, distinguishing themselves from general insurance providers that offer a broader range of products.
- Examples: Star Health, Niva Bupa, Care Health etc.
- Their claims settlement ratio is lower than general insurers.
IRDAI:
Genesis:
- Formed on recommendations of the Malhotra Committee.
- Set up as an autonomous body in 1999.
- Became a statutory body in 2000 under the IRDA Act, 1999.
Objectives:
- Ensure orderly growth of the insurance sector.
- Speedy settlement of genuine claims.
- Provide effective grievance redressal.
Ministry: Functions under the Ministry of Finance.
Composition:
· 10-member body: 1 Chairperson, 5 full-time members & 4 part-time members.
Headquarters: Hyderabad, Telangana.
Key Roles:
- Issue, renew, modify, withdraw or cancel registration of insurers.
- Protect policyholders’ interests.
- Adjudicate disputes between insurers and intermediaries.
- Regulate and promote insurance and reinsurance organizations.
Facts about Insurance sector:
- Insurance penetration (percentage of insurance premium to GDP) at 4.2% in 2021-22 compared to 2.71% in 2001-02.
- Insurance Density (ratio of premium to population) at $91 in 2021-22 compared to $11.5 in 2001-02.
- ‘Insurance for All’ by 2047: IRDAI has committed to enable ‘Insurance for All’ by 2047, where every citizen has an appropriate life, health and property insurance cover etc.
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