Health Insurance Policyholders May Have to Pay 10% of Hospital Bills From 2027 Under Insurers’ Proposal
Health Insurance Policyholders May Have to Pay 10% of Hospital Bills From 2027 Under Insurers’ Proposal
New Delhi, October 4 : Health insurance policyholders in India could be required to pay 10% of admissible hospitalisation expenses from their own pockets under a proposal being considered by non-life insurers for implementation from January 1, 2027. The proposed co-payment would be capped at Rs 5 lakh per claim.
Under the proposal being considered by the General Insurance Council, the 10% contribution would apply to inpatient hospitalisation claims, including accidents, whether settled through cashless treatment or reimbursement. In exchange, policyholders could receive lower annual insurance premiums.
For example, on an admissible hospitalisation claim of Rs 5 lakh, a 10% co-payment would mean the policyholder pays Rs 50,000 while the insurer pays the remaining admissible amount, subject to the policy terms.
The proposal is also linked to efforts to establish common hospital empanelment and standardise treatment costs while creating a mechanism for resolving disputes between hospitals and insurers.
Importantly, this is currently a proposal under consideration and should not be presented as a rule already in force. Final terms could change before any implementation.
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