Govt targets 30 million PMJAY hospital admissions in FY27
The Union Health Ministry has set an ambitious target of 30 million hospital admissions under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana in FY27, with projected claims outgo of Rs. 36,000 crore. This marks a 63 per cent jump over the Rs. 22,000 crore earmarked in FY26.
The expansion plan includes empanelling 1,800 additional hospitals, taking the total beyond the existing 33,000 facilities. Of these, 17,505 are public and around 15,600 private institutions. Budget allocation for PMJAY in FY27 stands at Rs. 9,500 crore.
Launched in 2018, the scheme offers Rs. 5 lakh annual health cover per family to around 550 million individuals. Over 431 million Ayushman Cards have been issued. The government has also set a fraud detection cap of 1 per cent of total claims for FY27.
Star Health Q3 net profit falls 40% despite premium growth
Star Health and Allied Insurance Company reported a 40 per cent decline in net profit to Rs. 128 crore in Q3FY26, compared with Rs. 215 crore a year earlier.
Gross written premium rose to Rs. 4,624 crore from Rs. 3,796 crore, while total income increased to Rs. 4,445 crore. However, higher expenses at Rs. 4,375 crore and lower investment income weighed on profitability.
The solvency ratio moderated to 214 per cent as of December 31, 2025, from 222 per cent a year ago, remaining above the regulatory requirement of 150 per cent.
Health insurers post strongest claims ratio since pandemic
India’s health insurance industry recorded a post-Covid low incurred claims ratio (ICR) of 86.9 per cent in FY25, reflecting improved underwriting conditions.
At the peak of the pandemic in FY22, the ICR had surged to 109.12 per cent. It subsequently eased to 88.89 per cent in FY23, 88.15 per cent in FY24, and further to 86.98 per cent in FY25.
However, stress persists in group health business, which accounts for 55 per cent of the segment. Public sector insurers reported a group claims ratio of 103.61 per cent in FY25, compared to 87.79 per cent for private insurers and 67.74 per cent for standalone health insurers, resulting in underwriting losses in PSU portfolios.
Niva Bupa reports Q3 loss despite 55% premium surge
Niva Bupa Health Insurance posted a net loss of Rs. 87.64 crore in Q3FY26 against a profit of Rs. 13.24 crore a year earlier.
Net premium written rose 22.5 per cent year-on-year to Rs. 1,766.7 crore. On a reported basis, gross written premium grew 55 per cent to Rs. 2,231 crore. However, the combined ratio remained elevated at 108.19 per cent.
The insurer’s solvency ratio declined to 2.49 from 3.03 last year, while the expenses of management ratio improved to 33.10 per cent. The customer base expanded 23 per cent year-on-year to 24.5 million lives insured as of December 2025.
Religare to demerge financial services and insurance businesses
Religare Enterprises has approved a proposal to split its financial services and insurance businesses into two separately listed entities, in a bid to unlock shareholder value and sharpen strategic focus.
The decision was cleared at the company’s board meeting and marks the first major restructuring since the Burman family assumed control of the company in February 2025. The group plans to complete the demerger and list Religare Finvest by the first quarter of FY28.
Under the proposed scheme of arrangement, Religare Enterprises will retain its stake in Care Health Insurance, which will continue as the insurance-focused entity. The financial services business, including lending, broking, investment activities and related support services, will be transferred to Religare Finvest on a going-concern basis.
As consideration, Religare Finvest will issue fully paid-up equity shares to existing shareholders of Religare Enterprises on a 1:1 mirror basis. Post-demerger, Religare Finvest will be listed on both BSE and NSE with identical shareholding structure.
Hospital-led insurers could ease healthcare costs: Devi Shetty
Devi Shetty has suggested that the ongoing friction between hospitals and insurance companies over treatment pricing and claim settlements could ease if more hospital chains establish their own insurance arms.
Speaking at the 25th Global Conference of Actuaries in Mumbai, the chairman and founder of Narayana Health said the conflict between providers seeking higher reimbursements and insurers aiming to contain payouts is a universal issue, not unique to India.
Shetty argued that when hospitals operate as insurers, incentives shift fundamentally. As insurers, hospitals would focus on keeping care affordable for patients rather than maximising billing per procedure. He added that the entry of innovative and digital-driven insurance players could further transform pricing models and claims management.
According to Shetty, healthcare quality may become less dependent on personal wealth over the next five to seven years if structural changes in insurance design and hospital participation materialise.
