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The health insurance sector in India has undergone significant transformation over the years through a series of regulatory reforms aimed at improving accessibility, transparency, efficiency, and consumer protection. This paper examines the evolution of the regulatory framework governing health insurance in India and analyzes the recommendations made by various committees constituted by the Government of India and the Insurance Regulatory and Development Authority of India (IRDAI). The study traces the development of health insurance from early social security initiatives such as the Employees’ State Insurance Scheme (ESIS) and Central Government Health Scheme (CGHS) to the emergence of comprehensive regulatory mechanisms following insurance sector liberalization. Particular attention is given to the recommendations of the Malhotra Committee, the Committee on Health Insurance for Senior Citizens, the Committee to Evaluate the Performance of Third-Party Administrators (TPAs), and the Expert Committee on Health Insurance. These committees emphasized the need for standardized policy terms, enhanced consumer grievance redressal mechanisms, improved data sharing among stakeholders, stronger regulation of TPAs, protection of policyholders’ interests, fraud control measures, and increased transparency in health insurance operations. The paper highlights how these recommendations have contributed to strengthening the regulatory environment and promoting the orderly growth of the health insurance industry. It concludes that continuous regulatory reforms are essential to address emerging challenges, ensure affordable and quality healthcare coverage, and enhance public confidence in health insurance products. Effective implementation of committee recommendations can further support the development of a robust, inclusive, and sustainable health insurance ecosystem in India.
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