Paper Title
HEALTH INSURANCE GOVERNANCE IN INDIA: A CRITICAL STUDY OF LEGAL FRAMEWORKS AND INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA OVERSIGHT
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Registration ID: IJNRD_308927
Published ID: IJNRD2508143
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Keywords
Health Insurance, IRDAI, Legal Framework, Consumer Protection, Healthcare Access, Regulation, Governance
Abstract
Health insurance is a vital instrument for safeguarding individuals against catastrophic healthcare expenditures and promoting equitable access to medical services. In India, the growth of the health insurance sector has been shaped by a combination of legal frameworks, policy initiatives, and regulatory oversight, primarily under the Insurance Regulatory and Development Authority of India (IRDAI). This paper critically examines the existing legal and policy structures governing health insurance, focusing on the regulatory mechanisms, guidelines, and monitoring practices implemented by IRDAI to ensure consumer protection, financial stability, and market efficiency. It explores the historical evolution of health insurance legislation, the role of statutory provisions in standardizing policies, and the impact of regulatory interventions on coverage, premiums, and claim settlement processes. The study also identifies key challenges confronting the sector, including limited penetration in rural and marginalized populations, inadequate awareness about policy features, regulatory loopholes, and the increasing complexity of healthcare costs. Using a doctrinal research methodology supplemented by an analysis of secondary data from legislative texts, IRDAI reports, and scholarly literature, the paper highlights the gaps between policy intent and ground-level implementation. Recommendations are provided to enhance regulatory effectiveness, strengthen grievance redressal mechanisms, promote innovative insurance products, and expand access to comprehensive health coverage. By examining the interplay between law, policy, and regulation, this study underscores the importance of robust governance frameworks in ensuring that health insurance contributes effectively to financial protection, public health objectives, and equitable healthcare delivery in India.
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How To Cite (APA)
Bhupender Singh Tokas & Dr Veena Kumari (August-2025). HEALTH INSURANCE GOVERNANCE IN INDIA: A CRITICAL STUDY OF LEGAL FRAMEWORKS AND INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA OVERSIGHT. INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 10(8), b344-b352. https://ijnrd.org/papers/IJNRD2508143.pdf
Issue
Volume 10 Issue 8, August-2025
Pages : b344-b352
Other Publication Details
Paper Reg. ID: IJNRD_308927
Published Paper Id: IJNRD2508143
Research Area: Others area
Author Type: Indian Author
Country: Shimla, Himachal Pradesh , India
Published Paper PDF: https://ijnrd.org/papers/IJNRD2508143.pdf
Published Paper URL: https://ijnrd.org/viewpaperforall?paper=IJNRD2508143
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