We demand urgent reforms in India's health insurance system. From unclear claim decisions to denial of essential medical tools and rising technical hurdles, common people are suffering during medical emergencies. Sign this petition to support 14 actionable reforms that make insurance just, transparent, and truly helpful.

1. Medically Qualified Claims Reviewers
Claims should be reviewed only by professionals with certified paramedical degrees and 1–2 years of experience in a hospital’s insurance desk. They must understand medical terminology, diagnoses, treatments, and tests. Insurance is not a paperwork game it deals with people’s lives.

2. Mandatory Coverage for Emergency Diagnostics, OPD Consultations & Medical Equipment

Insurance must mandatorily cover:

1. Diagnostics like MRI, CT scans, X-rays, and ultrasounds in emergencies
2. Consultations with dieticians and counselors for conditions like diabetes, obesity, hypertension, and cardiac recovery

3. Essential medical equipment, especially when prescribed in OPD or during hospitalization, such as:

   CPAP machines
   2. BiPAP machines
   3. Oxygen concentrators
   4. Nebulizers
   5. Insulin pumps
   6. Mobility aids, orthopedic supports, or catheters
   These tools are life-sustaining medical necessities not optional purchases.

3. Acknowledging Medical Suffering Behind Tests
No one willingly undergoes invasive procedures like endoscopy, colonoscopy, laparoscopy, or exposure-heavy scans unless there’s significant medical concern. These tests should never be denied coverage when prescribed.
4. Fair and Verified Application Process

Insurance policies must follow a dual verification process to avoid future disputes:

One assessment from the applicant's personal physician
Another by an IRDAI-certified, independent doctor
Insurance forms should not carry the insurance company’s name or branding until these assessments are completed and verified.

5. Reliable Digital Infrastructure with Independent Auditing & Accountability Insurance websites and mobile apps must perform flawlessly during emergencies:

• Guarantee 99.9999% uptime
• Remove technical barriers such as low upload limits, broken submission flows, or login errors
• Ensure smooth updates for KYC, document uploads, and real-time claim tracking
  Additionally, all digital platforms must:
• Undergo quarterly independent third-party audits covering cybersecurity, performance, and usability. 
  Publish audit results publicly.
  
  Face criminal liability if the auditing agency is found to be complicit in covering up flaws or user-impacting bugs, and such agencies must be permanently banned from auditing any financial or health platform.

6. Detailed and Transparent Claim Rejection Responses
If a claim is denied, the insurer must provide a personalized, detailed explanation based on medical reasoning—not a generic template. For loyal customers who have paid premiums for years without a claim, a rejection should also trigger a 50% refund of premiums paid in cases of bad faith.

7. Swift, Paperwork-Free Reimbursements
Reimbursements must not be delayed by outdated procedures. Digital authorization and discharge summaries should enable processing within 15 days—not the 45+ days currently experienced.

8. Accountability of Agents and Brokers
Insurance brokers and agents must:

Publish monthly statistics on the number of claims raised, approved, and rejected.
Display customer satisfaction ratings.
Be held jointly accountable if misleading information is provided or if service quality is poor.

9. Government Oversight with Public Accountability
Establish a Health Insurance Council similar to the GST Council that includes government officials, medical experts, and public representatives. This council will:

Regulate treatment protocols and costs based on city/tier/hospital.
Host live, public sessions to discuss and resolve issues.
Provide a direct channel for patients to raise grievances.

10. Legal Consequences for Insurance Misconduct
Anyone involved in malicious claim rejections, fraudulent denials, or in suppressing critical medical facts must face:

Criminal charges.
A permanent ban from working in the insurance sector.

11. Neutral Health Checkups
Annual health checkups should be carried out by neutral, independent parties. These checkups are meant to support the insured, not later be used as a basis for claim denial or premium hikes.

12. Ethical Handling of Customer Data
If insurers choose to monitor health and fitness data through apps or devices:

It must be on an opt-in basis.
The benefits should be mutual offering discounts, reimbursements, or tie-ups with gyms/yoga centers.
Data must not be used to penalize or deny claims.

13. Immunization Must Be Covered
Given the rising incidences of viral infections (COVID-19, influenza, RSV), immunizations should be mandatory inclusions in all policies, safeguarding both children and adults.

14. Stop Excluding Life-Saving Medical Devices
Exclusions for critical equipment like CPAP, BiPAP machines, oxygen concentrators, nebulizers, and insulin pumps must be abolished. When prescribed, these devices are essential to patient care and survival, and insurance must honor their necessity.

Our Call to Action
We call on the IRDAI and the Ministry of Health and Family Welfare to implement these 14 reforms immediately to ensure that health insurance protects lives instead of penalizing them.

🖊️ SIGN this petition if you believe that insurance should serve people in their time of need, not obstruct their access to life-saving care.