ICMAI seeks cost audits for health insurance, essential commodities to curb inflation
The Institute of Cost Accountants of India (ICMAI) has urged the Central Government to bring the medical insurance sector under the ambit of cost audits through Section 148 of the Companies Act, 2013. ICMAI President Bibhuti Bhusan Nayak argued that there is a visible gap between premium paid and benefits received in medical insurance, and mandated cost audits could offer greater transparency. The institute also recommended the inclusion of essential commodities and the banking sector to help contain price inflation. ICMAI council member Chittaranjan Chattopadhyay cited the sharp rise in retail prices of goods like biscuits post-pandemic as justification for greater cost scrutiny. He stressed that mandatory cost audits could unearth high profit margins masked by heavy discounts. The appeal aligns with the broader objective of protecting consumer interests and ensuring fair pricing in crucial sectors like healthcare and daily-use goods.
SBI General eyes Tier-III/IV health insurance reach; mis-selling under focus
State Bank of India Chairman C.S. Setty has called for stronger tie-ups between health insurers and rural hospitals to expand access amid rising medical inflation. Speaking at the launch of 30 SBI General Insurance health branches across Telangana and Andhra Pradesh, Setty highlighted that outreach in Tier-III and Tier-IV towns will help realise IRDAI’s vision of “Insurance for All by 2047.” He stressed the importance of right-selling over mis-selling, especially in the bancassurance channel, calling it a “powerful” but often misused distribution method. Setty said SBI has strengthened its internal ombudsman system and investigates even look-up period complaints. Meanwhile, SBI General MD & CEO Naveen Chandra Jha said the dedicated health branches aim to build a more inclusive and customer-focused ecosystem. Setty also warned that without health insurance penetration, India’s demographic dividend risks turning into a liability.
Cancer treatment costs driving Indian families to ruin: Experts
Rising cancer treatment costs are pushing Indian families into financial distress, with annual out-of-pocket expenses averaging Rs. 3.3 lakh, experts said at a Kolkata summit on cancer care affordability. Aside from high medical bills for chemotherapy, surgery, and radiation, patients also bear heavy non-medical expenses—18.6% on accommodation, 17.9% on food, and 7.2% on travel. India records 18.5 lakh new cancer cases annually with 9.1 lakh deaths. West Bengal alone sees 1 lakh new cases yearly. “Catastrophic health expenditure is a reality,” said oncologist Dr. Soumen Das, who attributed the crisis to poor financing systems and skyrocketing drug prices. Experts called for urgent policy interventions to improve affordability and reduce dropout rates. The high cost of treatment is causing many families to discontinue care midway, worsening outcomes and increasing mortality.
Star Health Q1 profit declines 17% to Rs. 262 crore amid regulatory penalty
Star Health and Allied Insurance reported a 17% decline in its Q1FY26 net profit at Rs. 262.5 crore, compared to the previous year. The company’s gross written premium (GWP) rose 13% year-on-year to Rs. 3,936 crore, with retail GWP showing a robust 18% growth, and new retail premiums up 25%. MD & CEO Anand Roy said the company has seen steady growth due to strategic underwriting and pricing improvements, along with enhanced claims service. However, the firm disclosed a cybersecurity incident in August 2024 involving unauthorised access to certain data. While no legal proceedings have been initiated, the insurer has since upgraded its information security systems. Additionally, Star Health has made provisions for a Rs. 3.39 crore penalty imposed by IRDAI in July 2025 for violations related to cyber and information security norms, as acknowledged in its quarterly financial notes.
SBI General eyes Tier-III/IV health insurance reach; mis-selling under focus
State Bank of India Chairman C.S. Setty has called for stronger tie-ups between health insurers and rural hospitals to expand access amid rising medical inflation. Speaking at the launch of 30 SBI General Insurance health branches across Telangana and Andhra Pradesh, Setty highlighted that outreach in Tier-III and Tier-IV towns will help realise IRDAI’s vision of “Insurance for All by 2047.” He stressed the importance of right-selling over mis-selling, especially in the bancassurance channel, calling it a “powerful” but often misused distribution method. Setty said SBI has strengthened its internal ombudsman system and investigates even look-up period complaints. Meanwhile, SBI General MD & CEO Naveen Chandra Jha said the dedicated health branches aim to build a more inclusive and customer-focused ecosystem. Setty also warned that without health insurance penetration, India’s demographic dividend risks turning into a liability.
Cancer treatment costs driving Indian families to ruin: Experts
Rising cancer treatment costs are pushing Indian families into financial distress, with annual out-of-pocket expenses averaging Rs. 3.3 lakh, experts said at a Kolkata summit on cancer care affordability. Aside from high medical bills for chemotherapy, surgery, and radiation, patients also bear heavy non-medical expenses—18.6% on accommodation, 17.9% on food, and 7.2% on travel. India records 18.5 lakh new cancer cases annually with 9.1 lakh deaths. West Bengal alone sees 1 lakh new cases yearly. “Catastrophic health expenditure is a reality,” said oncologist Dr. Soumen Das, who attributed the crisis to poor financing systems and skyrocketing drug prices. Experts called for urgent policy interventions to improve affordability and reduce dropout rates. The high cost of treatment is causing many families to discontinue care midway, worsening outcomes and increasing mortality.
Star Health Q1 profit declines 17% to Rs. 262 crore amid regulatory penalty
Star Health and Allied Insurance reported a 17% decline in its Q1FY26 net profit at Rs. 262.5 crore, compared to the previous year. The company’s gross written premium (GWP) rose 13% year-on-year to Rs. 3,936 crore, with retail GWP showing a robust 18% growth, and new retail premiums up 25%. MD & CEO Anand Roy said the company has seen steady growth due to strategic underwriting and pricing improvements, along with enhanced claims service. However, the firm disclosed a cybersecurity incident in August 2024 involving unauthorised access to certain data. While no legal proceedings have been initiated, the insurer has since upgraded its information security systems. Additionally, Star Health has made provisions for a Rs. 3.39 crore penalty imposed by IRDAI in July 2025 for violations related to cyber and information security norms, as acknowledged in its quarterly financial notes.
Insurers accused of diverting medical claim funds: DMA
The Delhi Medical Association (DMA) has alleged that insurance companies are diverting a significant portion of funds allocated for medical claims towards administrative costs and commissions, rather than patient care. At a press conference, DMA officials claimed that only 35–40% of the claim amount actually reaches hospitals, while the rest is consumed by intermediaries. They urged the Insurance Regulatory and Development Authority of India (IRDAI) to intervene and regulate the practices of Third-Party Administrators (TPAs), ensuring that patients receive the full benefit of their health policies. DMA also criticized delays in claim settlement and non-transparent deductions, warning that such practices erode trust in the health insurance system. The Association plans to escalate the matter to the Union Health Ministry if corrective action is not taken.
OPD expenses surge in India, but insurance uptake remains low
Despite rising Outpatient Department (OPD) expenses in India, health insurance adoption for OPD services remains limited, according to industry experts. While more insurers are introducing OPD-inclusive plans, most policies still cater to hospitalization, leaving a large gap in everyday healthcare spending coverage. High out-of-pocket payments for consultations, diagnostics, and medicines continue to burden middle-class households. Experts believe the challenge lies in pricing, claim processing, and customer awareness. Many consumers also find OPD policies less attractive due to perceived complexity and low claim ratios. Analysts recommend regulatory incentives and simplified product structures to improve uptake. Insurers are being urged to innovate further to cover evolving healthcare needs beyond hospitalisation.
