The report highlights the urgent need to curb Fraud, Waste, and Abuse (FWA) in India’s health insurance sector, where annual losses of ₹8,000–10,000 crore threaten financial sustainability and public trust. It proposes a three-pillar strategy—Prevention, Detection, and Deterrence—supported by standardized pricing, AI-driven analytics, legal enforcement, and interoperable digital platforms. By embedding transparency, accountability, and technology-enabled integrity, the roadmap aims to reduce FWA leakage to below 1% by 2047 and strengthen the foundations of a universal, trustworthy health financing system.
Rebuilding Trust: Combating Fraud, Waste, and Abuse in India’s Health Insurance Ecosystem
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Alpesh Shah, Swayamjit Mishra, Aditya Daga, Anushree Naik, and Adesh Kyal, Rebuilding Trust: Combating Fraud, Waste, and Abuse in India’s Health Insurance Ecosystem, Boston Consulting Group, 24 Nov 2025
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24 Nov 2025
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Alpesh Shah, Swayamjit Mishra, Aditya Daga, Anushree Naik, and Adesh Kyal, Rebuilding Trust: Combating Fraud, Waste, and Abuse in India’s Health Insurance Ecosystem, Boston Consulting Group, 24 Nov 2025
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