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The IRDAI's Insurance Advisory Committee Sub-Committee on Health Insurance met for the third time on 28 August 2026, chaired by IRDAI Chairman Ajay Seth.
It considered measures, including incentives linked to onboarding and faster settlement, to bring more insurers and hospitals onto the National Health Claims Exchange (NHCX).
NHCX is built by the National Health Authority in consultation with IRDAI under the Ayushman Bharat Digital Mission, and went live in June 2024.
The platform uses the FHIR (Fast Healthcare Interoperability Resources) standard so that claim data can move between insurers, hospitals and third-party administrators without custom integrations.
The sub-committee also discussed simpler policy wording, stronger underwriting at the point of sale and hassle-free claim settlement; these remain areas for further consideration, not binding regulation.
NHCX does not decide claims. It is a gateway that carries claim information in one standard format between insurers, third-party administrators, hospitals, beneficiaries and other participants. Before it existed, each hospital had to build a separate digital link to each insurer, so most claims travelled as PDFs, emails and portal uploads, and every insurer received a differently structured file. NHCX standardises the message using the FHIR specification, so that eligibility checks, pre-authorisation requests, claim submissions and payment-status queries all move through one pipe.
Simple Analogy: Think of UPI. UPI does not hold your money or approve your payment; it is the common language that lets any bank's app talk to any other bank. NHCX aims to be that common language for health insurance claims.
Statutory regulator of the insurance sector in India; constituted under the IRDA Act, 1999
Implements Ayushman Bharat PM-JAY and the Ayushman Bharat Digital Mission; built NHCX
GS Paper 2 > Government policies and interventions in health; GS Paper 3 > Digital public infrastructure and the economy
General Awareness > Insurance regulation, IRDAI, digital financial infrastructure
General Awareness > Government schemes and regulatory bodies
Fast Healthcare Interoperability Resources - an international standard for exchanging health-care information electronically, which NHCX uses so that different systems can read one another's claim data.
An intermediary licensed by IRDAI that processes health insurance claims on behalf of an insurer.
The insurer's approval obtained before treatment begins, confirming that the proposed procedure is covered.
A statutory committee that advises IRDAI on regulations; its sub-committee on health insurance is the forum in which these measures were discussed.