Latest news with #Irdai
Time of India
21 hours ago
- Automotive
- Time of India
Govt plans 10% hike in third-party motor insurance premium
Talks to raise third-party motor insurance premiums have picked up pace again, with the ministry of road transport and highways considering an average increase of around 10%, people familiar with the matter told ET. The increase could be higher in certain loss-making segments, such as commercial vehicles . For categories such as school buses, the increases may be minimal or even held back entirely. "Talks have resumed between the ministry and the insurance regulator to increase the third-party motor rates, which could go up on an average 10%," said a source close to the development. "For certain segments like school buses, the hike may be minimal or held back entirely to avoid public backlash." Insurers had earlier written to the government and regulator seeking a 5-15% increase starting April 2025, citing mounting pressure from rising court awards, upfront claim payments, and a distorted claims cycle during the pandemic years. "On an accident-year basis, the motor third-party segment continues to bleed. A substantial hike is needed," a senior industry executive said. Premium rates for third-party motor cover-mandatory under the Motor Vehicles Act-are revised annually based on historical claims data. The ministry has been mandated to prescribe base premium and liability of an insurer in relation to third-party premium in consultation with the insurance regulator, the Irdai. But since 2018, increases have mostly remained capped at 2-3%, with no revision in 2021 and only marginal tweaks in 2022 and 2023. The net claims ratio stood at 82% in FY24 and FY23, with ultimate loss ratios of 88% and 91%, respectively. Currently, a third-party premium for small cars (up to 1000cc) is ?2,100, while the premium for mid-sized cars (1000cc-1500cc) is ?3,400. Insurers collected a total premium of ?54,455 crore under motor third party in FY23-24. The final increase, however, will take effect either in the middle of this financial year or beginning of FY26-27. "There is no provision to revise the rates, retrospectively. The earliest they can implement it is from April 1, 2026, or possibly mid-year from October 1, 2025," one of the people cited earlier said. Commercial vehicles have been a particular pain point. Claims have surged due to a mandatory ?1.5 lakh cashless hospitalisation rule for road accident victims during the "golden hour," regardless of whether the accident involved a hit-and-run or a covered vehicle. "This cashless rule applies to all road accidents. And while the final compensation may take years, the upfront payouts are immediate," said another executive.
Mint
2 days ago
- Health
- Mint
Why AYUSH claims keep getting rejected despite new insurance rules
Chhattisgarh-based Moin Vanak, who suffered from diabetes, hypertension, and poor digestion, turned to naturopathy for relief from persistent shoulder, knee and calf pain—as well as sleep issues. He got admitted for a 10-day in-patient treatment at a NABH-accredited facility, paying the expenses out-of-pocket despite having insurance, and later applied for reimbursement. Despite holding a valid policy, his claim was rejected. The insurance company said, "as per submitted documents, the patient was admitted primarily for diagnostic and evaluation purposes." Vanak has submitted his doctor's justification for why in-patient (IPD) care was essential, but the claim remains under dispute. "They are doing so even as the hospital is NABH-accredited," he said. As per the Insurance Regulatory and Development Authority of India (Irdai) directive issued in January 2024, all health insurance policies must cover AYUSH—Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy—treatments on par with modern medicine. While earlier policies included exclusions and sub-limits, insurers are now required to remove these. Yet, some exclusions remain. For instance, Star Health's comprehensive policy still excludes yoga and naturopathy. Niva Bupa's Reassure 2.0 plan also excludes yoga. Also read: Financial resilience: Why emergency funds are more crucial than ever Steep rejection rates Despite growing interest, many claims get rejected. 'We have spoken to a couple of AYUSH hospitals whose administration told us at least 70% insurance claims get rejected," said Shilpa Arora, co-founder & COO, Insurance Samadhan. Mumbai-based CA Mayank Gosar faced a similar situation. His parents, suffering from diabetes and digestive disorders, took a 7–8 day treatment at a NABH-accredited centre. 'There was substantial improvement in health post the treatment. They had taken panchakarma and detoxification therapies, full body acupressure, abdomen pack, neck pack, hydrotherapy and various other ayurvedic procedures," said Gosar. Gosar's mother's claim was rejected on grounds that the treatment didn't need hospitalisation. 'The doctor had clearly mentioned in the justification letter that staying in the AYUSH hospital for 7-8 days was medically necessary," he said. In his father's case, insurers kept asking for the same documents and have not processed the claim for over a year. Gosar has now approached the Insurance Ombudsman. Also read: Health insurance vs medical corpus: What should senior citizens prioritize? Faridabad-based Bhairav Vashishth's claim, initially rejected, was eventually accepted for cashless coverage. His daughter was undergoing treatment for morphea, a rare skin disease. 'After multiple rounds of back and forth and a justification by the doctor, the company accepted our request for cashless coverage," he said. What insurers say Insurance companies argue that AYUSH claims are treated like any other. 'We have observed a significant increase in the uptake of AYUSH treatments under health insurance. From FY24 to FY25, AYUSH claims rose over 30% and the amount paid grew around 48%," said Bhaskar Nerurkar, head - health administration team, Bajaj Allianz. A major challenge is the lack of standard treatment protocols. 'For the same condition, AYUSH medical management could differ greatly from allopathy. Sometimes insurers take an arbitrary stance on whether IPD was needed," said Sreejith Edamana, COO, Apollo AyurVAID. He added, 'More than 80% of our urban patients have insurance coverage, so it is critical to make the process seamless. Industry conversations to improve this are underway." Edamana also flagged CGHS pricing issues. 'Some insurers demand discounts on outdated CGHS rates last updated in 2016. This becomes a loss for everyone—patient, hospital, and insurer," he said. What patients should know Before opting for AYUSH treatment, confirm if your chosen hospital is in-network and NABH-accredited. Admission to an AYUSH hospital must be based on prior consultation and clear diagnosis by a recognised practitioner. Missing documents or unclear justification for hospitalisation often lead to claim rejection, said Bhabatosh Mishra, COO at Niva Bupa. 'You cannot simply go to an AYUSH center and get admitted. There must be a prior consultation with recognised AYUSH doctors and diagnostic reports justifying IPD treatment," he added. Hospitals must meet specific standards: at least five IPD beds, qualified practitioners available 24/7, and dedicated therapy sections. Mishra said that they have seen some AYUSH centers listed on travel aggregator websites offering a pleasant stay or organising an ayurveda retreat. "If you are a hospital treating ailments, how could you project yourself as a hotel?" he said. Also read: Life insurance is an interest area for us, says Star Health MD & CEO Anand Roy Also distinguish preventive vs curative care. 'Insurance covers treatment for disease, accident or infection. But preventive care—like managing blood sugar or BP without a formal diagnosis—may not be covered," said Bajaj's Nerurkar. Watch out for inconsistencies in hospital records. 'Sometimes the supervising doctor is qualified, but internal papers may mention someone else. That creates grounds for rejection," said Arora of Insurance Samadhan. As AYUSH gains ground, coordination between insurers and AYUSH hospitals is essential. Standardised packages and transparent billing could enable smoother, cashless claims. Curiously, even Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY), the government's flagship health scheme, is yet to include AYUSH treatments in its coverage. Also read: How corporate India is quietly becoming the health insurer for your parents
Economic Times
11-06-2025
- Business
- Economic Times
Financial sector regulators to work on universal KYC
Financial sector regulators, led by the RBI, are developing a universal KYC framework with the CKYCR to streamline verification processes. Nirmala Sitharaman urged regulators to ensure seamless KYC experiences for citizens and expedite refunds of unclaimed amounts through district-level camps. The FSDC also discussed strengthening cybersecurity and implementing budget announcements related to KYC simplification for NRIs, PIOs, and OCIs. Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads New Delhi: Financial sector regulators, including the Reserve Bank of India , will look at a universal know your customer (KYC) framework and develop systems with the Central Know Your Customer Registry (CKYCR) to promote the inter-usability of records and avoid multiple minister Nirmala Sitharaman in a meeting of the Financial Stability and Development Council (FSDC) in Mumbai on Tuesday urged the financial sector regulators to take proactive steps to ensure that citizens have a seamless experience with the KYC processes across the financial a statement, the finance ministry said the FSDC also considered strengthening the cyber resilience framework of the Indian financial sector through a financial sector-specific cybersecurity FSDC also discussed issues relating to formulating a strategy for implementing the past decisions and the budget announcements, which included prescribing common KYC norms, simplification and digitalisation of the KYC process, including digital onboarding for non-resident Indians (NRIs), PIOs and OCIs in the Indian securities FSDC has representation from the Reserve Bank of India (RBI), the Insurance Regulatory and Development Authority of India (Irdai), the Securities and Exchange Board of India (Sebi), the Pension Fund Regulatory and Development Authority (PFRDA) and officials from the finance and corporate affairs urged the regulators and departments to expedite the process of refund to rightful owners of unclaimed amounts by holding special district-level also emphasised that interest of common citizens be kept in mind and therefore expeditiously refund the claims of the rightful claimants, the statement unclaimed amounts comprise deposits in banks, unclaimed shares and dividends managed by IEPFA and unclaimed insurance and pension funds with Irdai and PFRDA, drive is to be conducted in coordination with RBI, Sebi, MCA, PFRDA and Irdai along with banks, pension agencies and insurance finance ministry statement noted that the FSDC also deliberated on the emerging trends from the domestic and global macro-financial situation and stressed the need to be vigilant."The council recognised the need for proactive efforts to mitigate potential risks to financial stability while adopting adequate safeguards for the financial system's resilience," it said.
Time of India
11-06-2025
- Business
- Time of India
Financial sector regulators to work on universal KYC
Financial sector regulators, led by the RBI, are developing a universal KYC framework with the CKYCR to streamline verification processes. Nirmala Sitharaman urged regulators to ensure seamless KYC experiences for citizens and expedite refunds of unclaimed amounts through district-level camps. The FSDC also discussed strengthening cybersecurity and implementing budget announcements related to KYC simplification for NRIs, PIOs, and OCIs. Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads New Delhi: Financial sector regulators, including the Reserve Bank of India , will look at a universal know your customer (KYC) framework and develop systems with the Central Know Your Customer Registry (CKYCR) to promote the inter-usability of records and avoid multiple minister Nirmala Sitharaman in a meeting of the Financial Stability and Development Council (FSDC) in Mumbai on Tuesday urged the financial sector regulators to take proactive steps to ensure that citizens have a seamless experience with the KYC processes across the financial a statement, the finance ministry said the FSDC also considered strengthening the cyber resilience framework of the Indian financial sector through a financial sector-specific cybersecurity FSDC also discussed issues relating to formulating a strategy for implementing the past decisions and the budget announcements, which included prescribing common KYC norms, simplification and digitalisation of the KYC process, including digital onboarding for non-resident Indians (NRIs), PIOs and OCIs in the Indian securities FSDC has representation from the Reserve Bank of India (RBI), the Insurance Regulatory and Development Authority of India (Irdai), the Securities and Exchange Board of India (Sebi), the Pension Fund Regulatory and Development Authority (PFRDA) and officials from the finance and corporate affairs urged the regulators and departments to expedite the process of refund to rightful owners of unclaimed amounts by holding special district-level also emphasised that interest of common citizens be kept in mind and therefore expeditiously refund the claims of the rightful claimants, the statement unclaimed amounts comprise deposits in banks, unclaimed shares and dividends managed by IEPFA and unclaimed insurance and pension funds with Irdai and PFRDA, drive is to be conducted in coordination with RBI, Sebi, MCA, PFRDA and Irdai along with banks, pension agencies and insurance finance ministry statement noted that the FSDC also deliberated on the emerging trends from the domestic and global macro-financial situation and stressed the need to be vigilant."The council recognised the need for proactive efforts to mitigate potential risks to financial stability while adopting adequate safeguards for the financial system's resilience," it said.
Time of India
11-06-2025
- Business
- Time of India
ED issues summons to Care Health counsel over Rashmi Saluja Esops 'advice'
The Enforcement Directorate has summoned senior counsel Arvind Datar regarding his advice to Care Health Insurance on ESOPs issued to Rashmi Saluja. The investigation revolves around whether the ESOP issuance violated regulations, leading to scrutiny of legal opinions provided. Former Irdai chairman Hari Narayan may also be questioned in connection with the matter. Tired of too many ads? Remove Ads Tired of too many ads? Remove Ads Mumbai: India's federal anti-money laundering agency, the Enforcement Directorate, has issued summons to senior counsel Arvind Datar over his legal advice to Care Health Insurance on the controversial Esops (employee stock ownership) issued to former Religare Enterprises chairperson Rashmi Saluja. Religare holds a 62.98% stake in said the agency may also question former Irdai (Insurance Regulatory and Development Authority) chairman Hari Narayan, who also provided a legal opinion on the ESOP was forced to step down from Religare Enterprises-Care Health's parent-in February, after shareholders blocked her board re-appointment, ending an 18-month tumultuous legal battle against the Burman family-the biggest shareholders of Religare. Thereafter, the Burman family that runs Dabur officially took control of Religare as its new who has represented Sebi in high-profile cases like the Sahara fundraising case, is said to have told ED officials that lawyers cannot be summoned for investigations involving their clients. According to sources, he also told them that lawyers are also prohibited from disclosing legal advice given to their clients because of professional sent to Datar and Care in connection to this remained unanswered until press 2019, Care appointed Saluja as its non-executive chairperson. Two years later, it sought approval from Irdai to grant her Esops. In May 2022, Irdai rejected the plan on the grounds that Saluja's role as non-executive chairperson was similar to that of a non-executive director and that her remuneration should match such a then sought opinions from Datar and Narayan. Both of them advised the company that it could issue Esops because Saluja was an employee of Religare and held the position of executive chairperson. Giving her Esops as a non-executive chair of Care was not on this, Care allotted her 22,700,000 Esops. A securities lawyer explained that Esops can be given to both executive and non-executive directors if they are employees and not promoters. He added that Sebi rules consider non-executive directors as employees for the purpose of 2024, Irdai directed Care to buy back 7,569,000 shares given to Saluja at the same price paid for them (that is ₹45.32 per share) for violating its rules. The regulator also ordered the cancellation of all unused made headlines for opposing the Burmans attempting to gain control of the financial services company.
