India's insurance watchdog, IRDAI, has fined Care Health Insurance Rs 1 crore. The penalty stems from serious lapses in how the company handled insurance claims. These issues violated policyholder rights and corporate governance. IRDAI also issued warnings for other failures, including cybersecurity and accounting practices.
In a detailed order passed on December 15, 2025, IRDAI also issued multiple warnings and advisories to the Care Health Insurance company after a remote inspection that revealed widespread lapses across grievance redressal, cybersecurity, reinsurance accounting as well as handling of unclaimed amounts.
Read on to know what the charges were, how Care Health defended itself, and what IRDAI finally ordered.
IRDAI observed that when grievances were not resolved in favour of policyholders, Care Health failed to inform complainants about their right to approach the Insurance Ombudsman, along with the name and address of the ombudsman of competent jurisdiction.
Instead, grievance closure and claim repudiation letters only included customer care contact details, email ID, and vague hyperlink. The regulator pointed out that this approach placed an undue burden on policyholders and denied them clear access to grievance redressal mechanisms.