Niva Bupa faces IRDAI action for ₹248 crore expense breach: What policyholders need to know

Niva Bupa Health Insurance has been warned by the Insurance Regulatory and Development Authority of India (IRDAI) for exceeding the prescribed limit on management expenses for FY2024-25 and has been directed not to open a new place of business for six months.

According to an IRDAI order dated August 19, 2026, Niva Bupa's allowable expenses of management for FY2024-25 were ₹2,403.75 crore, while its actual expenses stood at ₹2,652.12 crore. This resulted in excess expenditure of ₹248.37 crore.

The regulator also noted that Niva Bupa had exceeded the EoM limits during FY2023-24, for which IRDAI had earlier granted forbearance. Referring to the latest financial year, the regulator said, “The insurer has again exceeded the EoM limits during FY 2024-25.”

Niva Bupa had requested forbearance from IRDAI, citing business expansion and investments in technology and brand transition. According to the order, the insurer also referred to its efforts to achieve scale, leverage technology, reduce costs and enhance customer centricity.

However, IRDAI rejected the request. The regulator said, “The insurer’s request for forbearance for financial year 2024-25 has not been acceded.”

As part of its decision, IRDAI warned Niva Bupa for its failure to comply with the applicable EoM limits and directed the insurer “not to open new place of business for a period of six months from the date of this order” under Regulation 22 of the EoM Regulations, 2024.

For policyholders, the order relates to the insurer's compliance with regulatory limits on expenses of management. It does not state that existing health insurance policies have been cancelled or that policyholders' claims have been suspended.

In a regulatory filing, Niva Bupa said, “IRDAI issued an order on August 19, 2026, whereby the company has been warned for not complying with the applicable EoM limits for the FY 2024-25 and has directed not to open a new place of business for a period of six months from the date of the order.”

The insurer further said, “The company is in compliance with Irdai (Expenses of Management, including Commission of Insurers) Regulations, 2024 for the full 2025-26 fiscal year, which ended on March 31, 2026 as well as for the April-June quarter of 2026 and is on track to ensure compliance with the said EoM Regulations, 2024 for the ongoing financial year.”

Niva Bupa added, “The company is evaluating the order and will take appropriate steps to safeguard the interest of stakeholders.”

The order will now be placed before Niva Bupa's Board at its upcoming meeting, with the insurer required to provide IRDAI a copy of the minutes of the discussion within 15 days of the meeting.