Capacity grows as the regulator scrutinises claims and tariffs
The additional underwriting capacity arrives while IRDAI is reviewing the private health market through a subcommittee of its Insurance Advisory Committee. The panel’s remit covers coverage levels, penetration, claims experience, product design, and grievance redressal, and extends to provider networks, the setting of hospital tariffs, and controls for fraud, waste, and abuse. The commercial backdrop explains the attention. The aggregate incurred claims ratio for the health business of general and health insurers stood at 86.98% in 2024-25; because that measure excludes management expenses and commissions, the combined ratio runs higher still. For a new entrant, that leaves a narrow margin and frames both the pricing discipline and the fraud and tariff controls the segment demands.
