Cybersecurity, Claims Reporting Lapses: IRDAI Cracks Down on Care Health Insurance

IRDA found that complaint redressal and claim rejection letters only provided customer service contact details, an email ID, and a vague hyperlink. This lack of clear guidelines placed an additional burden on policyholders and prevented them from accessing an effective complaint mechanism.

During the inspection, deficiencies were also found in cybersecurity, reinsurance accounting, and unclaimed balance management. Care Health failed to address the cybersecurity issues within the stipulated time. IRDA clearly stated that transparency in claims and timely communication with policyholders are essential.

According to the regulator, such tactics impact policyholders' rights and undermine trust. Insurance companies have a responsibility to provide accurate information to customers and resolve complaints impartially. Violations of these rules will not be tolerated. IRDA has ordered Care Health Insurance to pay a fine of ₹1 crore from its shareholders' accounts within 45 days of receiving the order. The company must place the order before its board of directors and submit a copy to the regulator.