Kathmandu. Insurance regulator IRDAI has come down heavily on complaints about non-payment of full health insurance claims.
IRDAI has clearly directed insurance companies to settle claims with honesty, transparency and speed. Because these reductions in claims are undermining customer confidence.
IRDAI is closely investigating the reasons for non-payment of health insurance claims. This is especially serious because more than half of all complaints are related to health insurance policies.
On the occasion of Insurance Ombudsman Day, IRDAI Chairman Ajay Seth said, “We continue to see some weaknesses in health insurance. Although the number of claims resolved is very high, the amount to be paid is often lower than expected. ’
Chairman Seth urged the insurance companies to maintain honesty and transparency in resolving the claims. Of the 53,230 complaints received in the fiscal year 2024, 54 percent were related to the health insurance sector.
Insurance companies, on the other hand, argue that claims fall because health care providers do not adhere to the rates agreed upon with the insurance companies.
