Kerala sets up expert panel to draft blueprint for ₹25-lakh health cover scheme
Kerala has constituted a technical committee to prepare the DPR for the Oommen Chandy Health Insurance Scheme, which promises ₹25 lakh cover.
The State government has issued orders constituting a technical committee to prepare a detailed project report (DPR) for the Oommen Chandy Health Insurance Scheme, announced in the Revised Budget 2026–27. The scheme, which offers an enhanced insurance cover of ₹25 lakh, was a key poll promise of the United Democratic Front (UDF).
The committee has been directed to submit its report — covering the proposed programme, its design and a phased implementation roadmap — within four months.
Composition of the panel
The committee will be chaired by the Principal Secretary (Health and Family Welfare). The Additional Chief Secretary, Principal Secretary or Secretary of the Finance, Planning and Economic Affairs departments will serve as members, while the Executive Director of the State Health Agency will be the convener.
Three experts will join the panel: Girish Radhakrishnan, former chairperson and managing director of United India Insurance Company Ltd. and a former Insurance Ombudsman for the State; P.J. Joseph, former chairperson of an agricultural insurance company and former member (non-life) of the Insurance Regulatory and Development Authority of India (IRDAI); and K. Sanath Kumar, former chairperson and managing director of National Insurance Company Ltd.
Terms of reference
The committee's mandate includes recommending the overall design of the scheme — its objectives, population coverage, eligibility criteria, benefit package, financial protection limits and its relationship with existing health-financing schemes.
It will propose institutional and governance arrangements that clearly define the roles of the government, the State Health Agency, the Health department, public and private hospitals and other participating institutions.
On finances, the panel will examine funding sources, pooling of available resources, expenditure projections, risk-sharing arrangements, cost-control measures and the short- and medium-term implications for the State. It will also recommend the most suitable implementation mode — assurance, insurance or a hybrid model — along with mechanisms for hospital empanelment, strategic purchasing, claims management, quality assurance, grievance redressal and monitoring.
The committee is expected to review health insurance and universal health coverage initiatives in other States and identify practices relevant to Keralam.
IT platform and rollout
A suitable IT platform and digital architecture will also be identified, covering beneficiary identification, hospital transactions, claims processing, fraud control, monitoring, inter-operability with existing systems, data governance and protection of beneficiary information.
The panel will prepare a phased implementation plan spanning preparatory activities, transition from or convergence with existing schemes, geographical or population-wise rollout, institutional readiness, timelines, milestones and monitoring arrangements.
In preparing its report, the committee may consult relevant government departments, agencies, hospitals, private-sector technical experts including hospital associations, insurance sector experts and other stakeholders, according to the government order.