New Delhi: The Delhi Medical Association Nursing Home Forum (DMA NHF) has lodged a complaint with the Insurance Regulatory and Development Authority of India (IRDAI), accusing private health insurers of cartelisation and abuse of dominance under the General Insurance Council’s (GIC) “common empanelment” system.
Calling the arrangement “illegal combined bargaining,” forum chairman Dr V.K. Monga said insurers controlling more than half the market were forcing hospitals to accept uniform tariffs, suppressing rates and threatening the sustainability of quality healthcare.
The forum alleged hospitals are being compelled to provide cashless services under expired contracts at outdated tariffs, warning that further suppression would stifle investment and compromise standards of care.
Citing incurred claims ratios of 54%–67% in FY 2024–25, the Forum said, “Large portions of premiums are being spent on commissions and administrative overheads rather than patient care.” “This suppression is not in the interest of policyholders. Insurers are prioritising their bottom lines over the patients whom health insurance is meant to protect,” Monga said.
The forum urged IRDAI to investigate the GIC’s role, examine alleged abuse of dominance, ensure fair inflation-linked tariffs, safeguard continuity of cashless services, and involve the Serious Fraud Investigation Office (SFIO) in probing insurers’ conduct.