Govt plots data fix to ease health insurance

New index will offer consumers visibility into how insurers handle claims

- Priyanka Sharma & Subhash Narayan

In an effort to make health insurance pricing more transparent and claims processing more predictable, the Centre plans to build a public ‘Health Claims Index’ using data flowing through the National Health Claims Exchange (NHCX), according to two officials aware of the development and documents reviewed by Mint.

Such an index would help consumers make more informed choices by offering visibility into how insurers handle claims. For insurers, it would create a common data framework to improve underwriting, reduce inefficiencies, and enable more consistent, risk-based pricing.

The index will use aggregated data flowing through the NHCX—a digital platform for processing health insurance claims—to publish industrywide benchmarks on claims processing timelines, approval rates and cost patterns across insurers. The data will be anonymized through a “data-blind” architecture to protect patient privacy.

“By making aggregated claims servicing data publicly accessible, the proposed health claims index aims to create accountability among insurers and healthcare providers,” one of the two officials cited above said, requesting anonymity.

A key part of the framework, the officials said, is the adoption of standardized clinical coding systems and treatment protocols, which could reduce billing discrepancies, enable automated claims processing, and help detect fraud.