IRDAI issues new 2025 framework to tighten fraud monitoring rules

Insurers must implement a board-approved Anti-Fraud Policy.

The Insurance Regulatory and Development Authority of India (IRDAI) has released new Insurance Fraud Monitoring Framework Guidelines, 2025, setting stricter requirements for insurers to prevent and report fraud.

Effective 1 April 2026, the rules require all insurers and distribution channels to adopt a zero-tolerance policy toward fraud and establish dedicated Fraud Monitoring Committees and Fraud Monitoring Units.

These bodies will oversee detection, investigation, and reporting, with quarterly updates to boards.

Insurers must implement a board-approved Anti-Fraud Policy, conduct annual fraud risk assessments, and report all incidents to authorities. 

The framework covers five fraud types, including internal, claims, and distribution-related fraud, and extends to cyber and digital fraud.

IRDAI also directed insurers to share fraud-related data through the Insurance Information Bureau’s Fraud Monitoring Technology Framework, creating an industry-wide “caution repository” of blacklisted entities.

The new guidelines replace the 2013 framework and aim to build stronger fraud controls and greater accountability across India’s insurance industry.