The General Insurance Council, the industry body of non-life insurers, has put forward a plan under which policyholders would pay 10% of every health insurance claim themselves, with the insurer paying the rest. The proposal covers retail indemnity and group policies, caps the policyholder's share at Rs 5 lakh per claim and carries a start date of January 1, 2027. It comes with a plan for a common network of about 5,000 empanelled hospitals and uniform pricing benchmarks. It needs the insurance regulator's approval.
Why it matters for listed companies
Two listed groups sit on either side of this. Health and general insurers would pay out less per claim, which is the industry's stated aim: it blames hospital billing inflation for rising claim costs and premiums. Hospital chains would face patients who bear part of every bill, plus common price benchmarks across a shared network. The report also notes the obstacles: consumer groups object to losing full-cover policies, and a co-pay adopted by all insurers together could be examined as anti-competitive. Until the regulator rules, this is an industry proposal, not a rule.
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