IRDAI, CII Push Basic Health Cover & Data-Led Pricing to Reshape Insurer-Hospital Dynamics

• IRDAI and CII are moving from tariff dispute resolution to structural market design in health insurance.
• A high-level meeting chaired by Ajay Seth on March 16 led to the formation of 10 working groups.
• Proposal for a standardized "basic insurance product" with wellness components to reduce ambiguity and improve accessibility.
• Focus on data-led interventions, including studies on claim trends and medical inflation, to address pricing opacity.
• National Health Claims Exchange (NHCX) to become the digital backbone for real-time, standardized claims processing.