New Delhi | November 16, 2025: In a major move aimed at improving India’s health insurance ecosystem, the Finance Ministry has issued fresh directives to hospitals and insurance companies, asking them to streamline and standardize the cashless treatment process. The government has emphasised that the current system needs greater uniformity, faster claim approvals and stronger cooperation between healthcare providers and insurers to ease the burden on patients.
The directions were issued after a high-level meeting chaired by Financial Services Secretary M. Nagaraju, which saw participation from representatives of leading general insurers, major hospital groups, the General Insurance Council and the Association of Healthcare Providers of India. The meeting focused on controlling medical inflation, addressing rising health insurance premiums and simplifying the claim-handling experience for policyholders.
Uniform Empanelment Policy Across Insurers
One of the key concerns highlighted in the meeting was the lack of uniformity in empanelment policies across various insurance companies. Presently, hospitals must deal with multiple standards, documentation requirements and operational rules depending on the insurer — often creating hurdles for patients seeking cashless treatment.
Secretary Nagaraju directed insurers to:
- Adopt a common empanelment framework for hospitals
- Standardise documentation and eligibility norms
- Ensure maximum hospitals across the country are part of their cashless network
- Reduce the administrative burden on both insurers and healthcare providers
According to the ministry, a uniform policy will allow policyholders to access cashless treatment at more hospitals without facing documentation conflicts or policy-related confusion.
No Delays in Cashless Claim Approvals
The ministry expressed particular concern over delays in pre-authorisation approvals for cashless claims — an issue that frequently leaves patients in distress during hospital admissions. Many hospitals insist on advance deposits when insurers take time to validate or approve claims.
To address this, the Finance Ministry instructed insurers to:
- Issue approvals within defined timelines
- Avoid unnecessary back-and-forth during documentation checks
- Ensure patients receive immediate assistance upon admission
- Strengthen hospital desks to improve coordination
The government believes faster approvals will enhance public trust in health insurance and significantly improve the patient experience.
Tackling Medical Inflation Through Collaboration
Rising medical inflation and surging health insurance premiums were among the major issues discussed during the meeting. The Finance Ministry noted that while several external factors contribute to higher healthcare costs — including diagnostic advancements, consumable prices and hospital operating expenses — better coordination between hospitals and insurers can help manage this upward trend.
The government stressed that:
- Standardisation of medical procedures and billing can help contain costs
- There is a need for greater transparency in pricing of treatments
- Insurers and hospitals must work together to offer better value to policyholders
Industry participants agreed that controlling medical inflation is crucial for the long-term sustainability of the Indian health insurance market.
Faster Onboarding on National Health Claims Exchange
Another major directive was the acceleration of onboarding onto the National Health Claims Exchange (NHCX) — a digital platform designed to bring all health claim processes under a single transparent, paperless system.
Once fully implemented, NHCX will:
- Digitalise claim submission and processing
- Reduce paperwork and manual errors
- Increase transparency and data accuracy
- Curb fraud and standardise workflows
- Speed up settlement timelines
The government believes that NHCX will modernise India’s health claims infrastructure and significantly reduce friction between hospitals, insurers and patients.
How Will Patients Benefit?
If implemented effectively, the new directives are expected to bring several benefits for policyholders:
- Wider access to cashless treatment at more hospitals
- Faster and more predictable claim approvals
- Transparent and controlled healthcare pricing
- Simplified and uniform processes across insurers
- Reduced paperwork through digital platforms
Overall, the government hopes these measures will eliminate long-standing inefficiencies in the cashless claim system and make health insurance more reliable and patient-friendly.
