In a major push to fix delays and confusion in India’s health insurance system, the Finance Ministry has issued strict new directions to hospitals and insurance companies, calling for uniform policies, faster cashless approvals and tighter control on rising medical costs.
The orders were issued after a high-level review meeting chaired by Financial Services Secretary M. Nagaraju, attended by top insurers, major hospital chains, the General Insurance Council and AHPI. The government said the aim is to make cashless treatment smoother, transparent and more patient-friendly.
Uniform Rules for All Insurers Soon
The government highlighted a long-standing problem — every insurer follows a different empanelment policy. This forces hospitals to juggle multiple rules and creates confusion for patients seeking cashless treatment.
To solve this, insurers have been instructed to:
●Adopt one common empanelment policy
●Use standardised documents and norms
●Expand their pan-India cashless network
●Reduce administrative hurdles for hospitals and patients
This single set of rules is expected to help patients access cashless care at more hospitals without hassle.
No More Delays in Cashless Approval
One of the biggest patient complaints is slow pre-authorisation, which often forces families to deposit large sums during emergencies.
The ministry has now ordered insurers to:
◆Approve claims within defined timelines
◆Remove repeated documentation queries
◆Improve hospital desk coordination
◆Offer immediate help at the time of admission
Officials said improving approval speed is essential to restore public trust in health insurance.
Medical Inflation Under Scanner
With rising treatment costs and increasing insurance premiums, the government has asked hospitals and insurers to work together to control medical inflation.
Key focus areas include:
●Standardising treatment packages and billing
●Improving transparency in hospital pricing
●Offering better value to policyholders through collaboration
Industry representatives agreed that containing medical inflation is crucial to keep health insurance affordable for Indian families.
Push for National Health Claims Exchange (NHCX)
The ministry also directed both hospitals and insurers to speed up onboarding on the National Health Claims Exchange, a digital platform meant to centralise and simplify all health claims.
Once fully adopted, NHCX will:
●Make claims fully digital and paperless
●Reduce errors and manual delays
●Curb fraud through data transparency
●Standardise claim workflows
●Enable faster settlements
The government believes NHCX will modernise India’s health insurance ecosystem.
What This Means for Patients
If fully implemented, policyholders will benefit through:
●Wider cashless access across more hospitals
●Faster claim approvals
●Transparent treatment pricing
●Uniform procedures across all insurers
●Less paperwork, thanks to digital processing
The government hopes these reforms will finally fix long-standing flaws in India’s cashless health insurance system and offer patients a smoother, predictable and stress-free experience.
