(a) whether the Government has made any rule to punish the insurance companies which are paying less amount than the real amount the clients have insured for their medical treatment; and
(b) if so, the details thereof and the action taken by the Government against such erring insurance companies?
THE MINISTER OF STATE IN THE MINISTRY OF FINANCE
(a) In order to monitor the settlement of claims in health insurance policies, the Insurance Regulatory Development Authority of India (IRDAI) had notified IRDAI (Health Insurance) Regulations, 2016, which inter-alia, specifies various norms on settlement of claims and stipulate certain measures for protection of policyholder interests. Further, any insurer found to be violating the Regulations and Guidelines framed under the Insurance Act, 1938 shall be penalized as per the provisions of Section 102 of the Act.
(b) Since financial year 2015-16, there were 3 instances wherein the Authority has taken regulatory action on noticing excess deductions from health insurance policy claims. Details are given in Annexure.
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