Health Insurance News

A new report by the National Centre for Promotion of Employment for Disabled People (NCPEDP) has revealed that over 80% of persons with disabilities (PwDs) in India are excluded from health insurance coverage.

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Report reveals 80% of Indians with disabilities lack health insurance

The findings, released during a national consultation, highlight widespread structural discrimination in both public and private health insurance schemes, which fail to adequately address the needs of the disabled community.

The report, titled "Health Insurance and Disability: A Study of Exclusion", shows that many policies either outright exclude preexisting disabilities or offer limited and unclear benefits. In some cases, insurance companies even ask for additional medical documents or impose discriminatory clauses that prevent PwDs from availing proper coverage.

Arman Ali, Executive Director of NCPEDP, stated, "The systemic denial of healthcare financing to PwDs is not just exclusionary - it's a violation of their rights."

The report calls for regulatory interventions by IRDAI, including mandatory disability-inclusive product guidelines, awareness campaigns, and better grievance redressal systems.

India's health insurance sector loses Rs. 10,000 crore annually to fraud and abuse

India's health insurance sector is grappling with an estimated Rs. 10,000 crore in annual losses due to fraudulent claims and abuse, according to recent industry assessments. This figure represents a significant drain on insurers and highlights systemic issues in claim processing, hospital billing, and data transparency.

A key concern is the rise in nonstandard or exaggerated claims, often facilitated by unscrupulous agents, third-party administrators (TPAs), and collusive healthcare providers. Fraudulent activities range from unnecessary diagnostic tests and inflated bills to admission under false pretenses and multiple claims for the same illness. Insurers are now intensifying the use of data analytics, artificial intelligence, and hospital audits to detect and prevent such practices.