The Insurance Regulatory and Development Authority of India (IRDAI) is considering capping annual health insurance premium hikes at both the product and portfolio levels. The move aims to balance affordability for policyholders with the long-term sustainability of insurers. Caps at the portfolio level are likely to be benchmarked against medical inflation, ensuring pricing reflects actual cost trends.
Why This Move Matters
Currently, many policies are introduced at low premiums but see steep hikes over time, making them unaffordable for middle-class policyholders. Younger citizens have borne the brunt of these increases, since insurers cannot raise premiums for senior citizens beyond 10% in a year. With health insurance contributing nearly 40% of total general insurance premiums in FY25, the sector has become too important to leave unregulated.
Senior Citizens Already Protected
Earlier this year, IRDAI capped premium hikes for senior citizens at 10% annually, offering financial relief to older policyholders who were struggling with steep increases. While this decision was welcomed, insurers often shifted the burden onto younger age groups, sparking calls for broader regulatory oversight to ensure fairness across demographics.
Industry Impact and Insurer Reliance
Health insurance has become a major revenue driver for insurers, though exposure varies significantly:
- ICICI Lombard earns nearly 30% of its premiums from health insurance.
- New India Assurance relies on it for around 50% of its premium income.
- Go Digit has a smaller exposure at about 14%.
This increasing reliance means any regulatory change will directly impact insurers’ business models, forcing them to explore cost-cutting measures and efficiency improvements rather than relying on steep premium hikes.
What’s Next?
The IRDAI is expected to release a consultation paper soon, outlining detailed guidelines and inviting feedback from insurers, policyholders, and industry experts. The consultation process will be crucial in shaping fair, sustainable rules that can protect consumers while maintaining the health of the insurance sector.
Conclusion
The proposed cap on health insurance premium hikes marks a potential turning point for India’s insurance industry. By linking price increases to medical inflation and spreading the impact across portfolios, IRDAI seeks to make health insurance more predictable and affordable for millions of Indians.
