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• Cashless claim settlement resumed for CARE and Star Health by AHNA, not for TATA AIG

  At present, around 35 AHNA-member hospitals have been allegedly indiscriminately blacklisted by insurers, as per a list shared by Dr. Gadhvi.

  

• Star Health appoints Rajeev Kher as board chairperson

  A former commerce secretary to the Government of India and a senior officer of the Indian Administrative Service, he has held roles in the ministries of Environment and Commerce, and served as a Member of the Competition Appellate Tribunal.

  

• Cigna raises full-year profit forecast, latest to beat medical cost estimates

  On an adjusted basis, the company's adjusted income from operations rose to $6.74 per share in the first quarter from $6.47 per share a year earlier, and came in above analysts' average estimate of $6.35.

  

• Humana's lower medical costs ease investor fears after UnitedHealth results

  Humana, like Elevance, has said it is not seeing anything unusual around medical use in both its insurance and caregiving operations, said Julie Utterback, an analyst at Morningstar. "So perhaps there is a UnitedHealth-specific issue going on."

  

• Star Health PAT crashes to 51 lakh in Q4 FY25

  The Chennai-headquartered health insurer reported an operating loss of Rs 86.9 crore during the Jan-Mar quarter of 2024-25. It had an operating profit of Rs 90 crore in the same quarter last year.

  

• ICICI Lombard to up health biz investments, look at buyouts

  In recent years, ICICI Lombard has sought to correct this imbalance by launching new products and expanding its sales force focused on health insurance.

  

• Transparency and awareness are crucial to avoid health insurance claim rejections: Experts

  Claims can also be rejected for treatments not covered under the policy. Another common reason is when customers provide false information or fail to disclose important medical history, including pre-existing conditions like diabetes or hypertension, or lifestyle habits like smoking or drinking alcohol.

  

• Elevance confirms quarterly profit beat, reaffirms 2025 forecast

  For the quarter, the company's medical loss ratio, a closely watched ratio to track costs, was 86.4%, below analysts' average estimate of 86.8%. Companies aim for a ratio close to around 80%.

  

• LIC’s Entry into Health Insurance: A Game Changer or a Risky Bet?

  A major concern is whether LIC’s agents, who are already associated with other health insurers, will fully commit to selling LIC-branded health policies. Another worry is the risk of brand dilution—if the health company with “LIC” brand struggles with claim settlement issues, its long-standing trust in life insurance could also take a hit.

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• Irdai’s common empanelment drive gains momentum, insurers begin onboarding hospitals for cashless treatment network

  The empanelment of hospitals means officially adding a hospital to a list or network of approved healthcare providers. Once empanelled the hospital can offer cashless treatment to people covered under health insurance plans. Irdai's plan, which is a directive to insurers, hopes to make insurers enrol more hospitals in the network. While such a move will help in standardising hospital charges, it hasn't been well received by all hospitals.

  

• Over 1.3 crore persons insured through GeM in FY 2024-25

  By ensuring that only Insurance Regulatory and Development Authority of India (IRDAI)-approved service providers are onboarded. GeM has established a reliable and trusted mechanism for availing insurance services.