Overview

• DMA Nursing Home Forum lodged a complaint with IRDAI alleging cartelisation and abuse of dominance by private insurers coordinating tariffs through the General Insurance Council’s common empanelment.
• The forum says hospitals are being forced to provide cashless services under expired contracts at unviable, outdated rates, and it wants inflation-linked tariffs and continuity of cashless access.
• DMA NHF says it represents 20,000 doctors and 1,100 Delhi establishments and claims private insurers control more than half of India’s health insurance market.
• Citing incurred claims ratios of 54%–67% in FY 2024–25, the forum alleges insurers divert large portions of premiums to commissions and administrative costs rather than patient care.
• Industry sources reject the cartelisation charge as an attempt to hinder common empanelment, while AHPI separately said some hospitals would suspend cashless services for certain insurers over unrevised rates.