Medi Assist Healthcare Services Ltd Management Discussions

Indian Economy

A Year of Broad-Based Strength and Global Recognition

The Indian economy delivered a standout performance in FY26, reaffirming growing major economy in the world. Real GDP growth for FY2025-26 was estimated at 7.4% [1] in the National Statistics Offices First Advance Estimates, a marked acceleration from 6.5% in FY25, and was subsequently revised upward to 7.7% [2] under the Ministry of Statistics and Programme Implementation. Momentum was strong through the year driven by buoyant manufacturing, construction, and services activity. Growth was anchored by resilient domestic demand, meaningful income tax and GST rationalisation, sustained government capital expenditure, and softer crude prices that improved Indias terms of trade.

International validation of Indias macroeconomic trajectory was unambiguous. In August 2025, S&P Global Ratings upgraded Indias sovereign credit rating from BBB- to BBB [3] with a stable outlook, the countrys first sovereign upgrade in 18 years, citing buoyant growth, credible inflation management, and disciplined fiscal consolidation. For a Company whose revenues are structurally linked to the depth and formalisation of Indias insurance and healthcare markets, this strengthening of the macro foundation directly reinforces the durability of our long-term growth runway.

A Historic Low-Inflation Year, and a Well-Understood

Normalisation Ahead

Consumer price inflation moderated to historic lows over FY26. Headline CPI averaged 1.7%[4] over April December 2025, the lowest since the current CPI series began, with retail inflation touching a 99-month low of 1.54% [5] in September 2025, consolidating at 2.1% [6] in FY26. The Reserve Bank supported growth through a measured easing cycle, with the policy repo rate at 5.25% [7] through the close of the fiscal year. Part of FY26s disinflation reflected one-off effects, GST rate rationalisation coupled with a favourable base, and the RBI accordingly projects CPI inflation to normalise toward approximately 5.1% [8] in FY27. For the health insurance ecosystem, where premium pricing and claims costs are both linked to underlying inflation, this expected normalisation is a the countrys position as the fastest-planning input the Company is structurally well prepared for: our revenue model is linked to premiums under management, while our technology-led cost containment protects our insurer partners from the claims-side impact of rising prices.

External Strength and a De-Risked Trade Environment

Indias external position strengthened materially. Foreign exchange reserves stood at $697.1 [9] billion as of early April 2026, providing a substantial import-cover buffer.

A landmark development late in the fiscal year was the interim India-US trade agreement announced on

February 2, 2026, which reduced US tariffs on most Indian goods from a peak of 50% to 18%, removing a significant overhang on export-oriented sectors and improving business confidence. The International Monetary Fund cited the tariff reduction when raising its India growth forecast, revising calendar 2025 growth sharply upward to 7.6% [10] and calendar 2026 to 6.5% [11] .

Outlook: Moderation from Strength, Not Weakness

For FY27, growth projections cluster in the 6.5% 6.9% range across the RBI and the IMF which is a natural moderation from FY26s exceptional pace, and broadly consistent with Indias medium-term potential. Importantly for Medi Assist, the composition of this growth matters more than its headline pace: continued formalisation of employment, rising household disposable incomes following personal income tax relief, and policy-led affordability measures in insurance together expand the base of insured lives and administered premiums, the fundamental drivers of our business, even in years when aggregate GDP growth moderates.

Employment, Enterprise Formalisation and the GCC Engine

Beneath the strong aggregate numbers, the corporate employment landscape evolved in composition during FY26. Indias traditional IT services majors underwent a period of consolidation and AI-led restructuring, though the effect was concentrated rather than systemic: the combined headcount of the five largest listed Indian IT services companies declined by ~7,000 [12] in FY26, a sharply divergent trajectories. net Because IT services enterprises have historically been among the largest contributors to corporate group health portfolios, this recalibration is a development the industry must acknowledge and one that Medi Assist is explicitly structured to weather.

First, the technology sector as a whole remained a net creator of insured, formal employment. Direct tech sector employment grew to approximately 6 million in FY26, a net addition of roughly 135,000 employees [13] , as the industry crossed the $315 billion[14] revenue mark. The composition of that hiring shifted decisively toward Global Capability Centres (GCCs): India now hosts 2,117GCCs [15] operating across 3,728 [16] units and employing approximately 2.36 [17] million professionals as of FY26 , a 32% increase in centres since FY2021, with an estimated 506 of the Forbes Global 2000 running operations from India and an ecosystem revenue of $98.4 billion [18] . GCCs are precisely the category of employer that deepen, rather than merely widening the group health opportunity: they offer richer, benefits-intensive health programmes, higher sums insured, growing OPD and wellness cover, and a strong appetite for the digital, data-rich administration experience that Medi Assists platform delivers.

Second, and more fundamentally, your Company has deliberately decoupled its growth from any single hiring cycle. Medi Assist operates not as a volume-dependent transactional processor whose revenues mirror domestic corporate headcount, but as the digital orchestration layer of the health benefits ecosystem. Growth in FY26 came primarily from inorganic growth, along with expanding platform depth, more services per account, more benefits per member (particularly high-frequency OPD benefits), technology and SaaS monetisation, government scheme administration, and international benefits, which together increased the value generated per insured life and per claim handled. The result is visible in our numbers: 25.1% revenue growth and a 340-basis-point group market share gain in a year in which traditional IT services hiring was soft. Simultaneously, the retail demand environment received a coordinated fiscal stimulus through personal income tax slab revisions and the GST exemption on individual health insurance premiums, lowering the affordability barrier for individual policies and releasing demand that had been deferred earlier in the year.

Indian Healthcare Sector

Sector Overview

Indias healthcare sector delivered robust growth in Q4FY26 and FY26, underpinned by strong revenue expansion across hospitals and diagnostics, sustained capacity additions, and continued investor interest, as per the EY-Parthenon Healthcare Sector Update. Growth was driven by rising patient volumes, improving realizations, and a gradual shift toward higher-acuity treatments.

The hospital segment remained the primary growth engine. Revenue and EBITDA growth across major hospital operators was >15% [19] year-on-year. Hospitals operational performance was supported by stable occupancy levels, typically ranging between about 60% and 75% [20] , alongside improvements in average revenue per occupied bed (ARPOBS). High-acuity specialties such as cardiology and oncology continued to grow strongly, with growth rates exceeding 15% [21] , in certain cases, thereby contributing a larger share to total revenues.

The sectors structural constraints are, from the standpoint of a health benefits administrator, its most powerful long-term growth drivers. India has approximately 1.3 hospital beds per 1,000[22] population, significantly below the global median of about 2.9 [23] , highlighting a substantial infrastructure build-out still ahead. Government health expenditure stood at 1.43% [24] of GDP in 2022-23, rising steadily but still well below the National Health Policy target of 2.5%. Most tellingly, out-of-pocket expenditure, the share of health spending Indian families bear directly, has declined from 64.2% [25] of total health expenditure in 2013-14 to 43.4%[26] in 2022-23. However, it ticked up from 39.4% [27] the prior year as pandemic-era government spending normalised, a reminder that the shift toward pooled financing will not move in a straight line. Over the same period, the share of private health insurance in health financing has nearly tripled to 9.2% [28]. Every percentage point of this ongoing shift from out-of-pocket payment to pooled, insured financing flows through an administration layer, and Medi Assist operates the largest one in India.

Key Milestones and Developments in FY26

? Hospital capacity expansion accelerated, funded by deep institutional capital. The healthcare, pharma, and hospital sectors recorded 72 [29] deals worth $3.5 billion [30] in Q3 2025 alone, a 166% [31] increase in deal value over the preceding quarter. Between 2022 and 2024, hospitals attracted M&A of $6.74 billion [32] and private equity of $4.96 billion [33] . Corporate hospital groups and PE-backed platforms continued brownfield and greenfield expansion, with capital increasingly deployed into Tier-2 and Tier-3 cities, directly expanding the provider universe that connects to your Companys network.

? Digital health infrastructure crossed generational milestones. Cumulative Ayushman Bharat Health Accounts (ABHAs) crossed 90 crore[34] in May 2026, up from 84.5 crore[35] in 2025 and 72.2 crore [36] at end-2024, and over 100 crore [37] health records are now linked to ABHA under the Ayushman Bharat Digital Mission. The interoperability rails being laid through the National Health Claims Exchange (NHCX) are materially reshaping the claims settlement landscape in favour of scaled, technology-native administrators.

? The insurance sector was opened to 100% foreign direct investment through the Sabka Bima Sabki Raksha (Amendment of Insurance Laws) Act, 2025, passed by Parliament in December 2025 and effective February 5, 2026, inviting global capital and operational expertise into the ecosystem Medi Assist serves.

? Government-funded coverage deepened. AB PM-JAY provides 5 lakh of cashless cover to 12 crore [38] families, representing the bottom 40% of Indias population. As at February 28, 2026, 43.52 crore [39] Ayushman cards had been issued and 36,229 hospitals [40] empanelled, alongside 1.14 crore [41] Ayushman Vay Vandana cards created for citizens aged 70 and above.

Medical Inflation and the Case for Managed Healthcare

India continues to experience among the highest medical inflation rates globally. Aons 2026 Global Medical Trend Rates Report projects employee medical plan costs in India to rise 11.5% in 2026, moderating from 13% in 2025 but remaining well above the global average of 9.8%. The drivers are consistent. Advanced medical technology is raising input costs, pharmaceutical prices continue to climb, the chronic disease burden is growing, and constrained public capacity is diverting patients toward higher-cost private facilities.

For policyholders and their employers, this translates into rising premiums and, over time, harder choices about the level of cover they can sustain. For insurers, it puts pressure on loss ratios and pricing. Neither outcome serves the objective of wider health insurance penetration in India.

This is the problem our business exists to address.

Effective claims adjudication, fraud and abuse detection, and negotiated network rates are the levers available to moderate what a given episode of care actually costs. In FY26, average claim size across the portfolios we administer grew 4.4%, roughly one-third of the prevailing industry medical trend. That gap represents cost that did not pass through to insurers. As inflation persists, the value of these capabilities to risk carriers increases. The more directly useful measure, however, is the one above: how far we hold claim cost growth below the market trend.

Health Insurance Sector

Sector Performance in FY26

The Indian health insurance sector staged a decisive recovery in FY26, following a muted FY25 that was affected by the transition in long-term policy accounting norms. Gross direct premium underwritten by the non-life industry grew approximately 9.3% [42] year-on-year in FY26, with general insurers up 8% [43] to 2.79 lakh core [44] and standalone health insurers (SAHIs) leading the market at 19.8% [45] growth to 44,699 crore (Group +Retail). Health insurance consolidated its position as the single largest line of business in Indias non-life market, contributing 40.8% [46] ( 1.37 trillion including government and overseas medical) of the non-life insurance portfolio, and the growth trajectory was supported by premium hardening linked to medical inflation, sum-insured top-ups, and new policy additions.

The GST exemption granted on individual health insurance premiums in September 2025 was a watershed affordability intervention. As anticipated, some purchase decisions were deferred around the September renewal quarter as customers awaited clarity, followed by a meaningful uptick in new policy issuances and average ticket sizes in the second half of the year. Combined with personal income tax relief, this coordinated policy push structurally lowers the entry barrier for the price-sensitive retail segments where insurance penetration has historically stalled and where Medi Assists tech led retail business line is best positioned to capture the resulting volume.

Key Regulatory Developments in FY26

Development	Description and Implication for Medi Assist
FDI Cap Raised to 100%	The Sabka Bima Sabki Raksha (Amendment of Insurance Laws) Act, 2025, passed by Parliament in December 2025 and effective from February 5, 2026, raised the FDI limit in Indian insurance companies from 74% to 100%, subject to prescribed conditions. Global capital and expertise entering the market expands the universe of insurer partners requiring scaled, technology-led administration
GST Exemption Individual Health	The GST Council exempted individual health and life insurance premiums from GST effective September 2025, significantly improving affordability and expected to lift retail penetration, expanding the premium base Medi Assist serves by licensing its platforms to retail insurers who administer claims in- house
Bima Sugam	India\u2019s digital insurance marketplace was launched, designed as a one- stop portal for policy comparison, purchase, and servicing, democratising distribution and accelerating the digitisation of the policy lifecycle
NHCX & ABDM Integration	Continued onboarding of insurers and TPAs onto the National Health Claims Exchange is standardising electronic claims exchange. Over 90 crore ABHAs created (May 2026) with 100+ crore health records linking the digital rails on which high-volume, low-value claims will move
Cashless Everywhere	The General Insurance Council\u2019s initiative enabling cashless hospitalisation at any hospital (with prior notification) operated across network participants, advancing the industry\u2019s ambition of a fully cashless claims ecosystem, an environment that rewards administrators with real-time adjudication capability
IRDAI Expense of Management (EoM)	Rationalised EoMcaps continued to incentives efficiency, with the framework rewarding investments in technology, InsurTech, rural reach, and operational excellence, squarely aligned with Medi Assist\u2019s operating model

Health Insurance Industry Snapshot

Parameter	FY25	FY26
Non-life industry premium growth	6.2% YoY	9.3% YoY
Health Insurance as a % of Non-Life Premiums (Group+Retail+Government+Overseas Medical Insurance)	38.6%	40.8%
General insurers\u2019 premium growth [45] (Health Group+Retail)	70,789.9 crore (8.9%)	80,637.4 crore (13.9%)
SAHI premium growth (Group+Retail)	37,307.3 core (16.0%)	44,699.9 crore (19.8% )
ABHA accounts (cumulative)	72.2 crore (end-2024)	84.5 crore (end-2025); crossed 90 crore in May 2026
Claims settled through TPAs (by number)	69% of 3.26 crore claims (FY25)	Structural shift toward specialist administration
TPA share of industry premiums (Medi Assist DRHP; Frost and Sullivan)	54.6% (FY18 22 average)	Projected to reach 61.2% by FY28

Source : GIC council segment reporting; Ministry of Health and Family Welfare

TPA Industry Overview

Health insurance in India involves multiple independent parties: enterprises, hospital networks, risk-bearing insurers, and policyholders. Each holds different information and operates on different systems, and no single party is positioned to coordinate with the others. Specialized administration performs that coordination, connecting the parties and carrying a claim from intimation through to settlement.

The IRDAI Annual Report 2024-25 [47] , the regulators most recent published account of the industry, confirms this centrality. TPAs administered 69% of health insurance claims by number and 58% by value in FY25.

General and and standalone health insurers settled 3.26 crore claims in that year, paying 94,248 crore at an average of 28,910 per claim. Frost & Sullivan [48] projects TPA-serviced premiums to rise from a historical 54.6% of industry premiums to 61.2% by FY28, as insurers increasingly entrust complex adjudication and network management to specialist operators. Frost & Sullivans market diagnostics further indicate that insurer in-house cashless claim sizes can meaningfully exceed independent TPA-managed configurations, underscoring the structural cost advantage of independent network optimisation.

The TPA Ecosystem in the Regulators Numbers

The regulators data also quantifiesMedi Assists position within the system. The charts that follow set out the IRDAIs FY25 record across settlement channels, cashless adoption, premium growth by insurer class, business mix by lives and premium, each of which maps directly to a segment of the Companys business.

Health insurance claims settled through TPAs – FY25 (3.26 crore claims; 94,248 crore paid)

Settlement Method	By Number of Claims (%)	By Claims Amount Paid (%)
Settled through TPAs	68.7%	58.5%
In-house	31.3%	41.5%
Total	100.0%	100.0%

Source: IRDAI Annual Report 2024-25

Indias health insurance system is moving steadily towards the fully cashless ecosystem contemplated by NHCX and Cashless Everywhere, and the FY25 settlement mix shows how far that journey has already come. Cashless settlement accounted for 58% of claims by number and

66.4% by amount during the year. The IRDAIs data also shows who is driving the shift. Over 60% of cashless claims processed by the industry is facilitated by TPAs, placing specialised administrators at the forefront of the industrys cashless transition.

Cashless claims settlement, FY25 – share of claims by number (TPA vs Insurer in-house)

TPA 60.1%	Insurer in-house 39.9%

Source: IRDAI Annual Report 2024-25

The premium tables trace the same growth vectors that shaped Medi Assists year. Health premiums of general and health insurers, covering group and retail business, reached 1,25,337.27 crore in FY26, with the private and SAHI segment growing 19.2% — the segment in which the Companys Group premium under management rose 28.1% and in which a MAtrix SaaS partnership was signed with the largest standalone health insurer to service the in-house claims operation of its retail book.

Gross Written Premiums Growth by Insurer Type

Insurer Category	FY 25 Premium	FY 26 Premium	Year-on-Year Growth (%)
General Insurers (PSU)	36,580	40,080	+9.6%
General Insurers (Private)	34,210	40,558	+18.6%
Standalone health insurers	37,307	44,700	+19.8%

The class-of-business mix underscores why Group leadership matters most. Of the 58 crore lives covered under health insurance in FY25, Group business accounted for 47.4% of lives and 51.2% of premium, which is the single largest pool on both measures. Medi Assists 33.7% share of Group premiums as of FY26, under TPA administration therefore represents leadership of the deepest segment of the market.

Health Insurance Mix by Class of Business (FY 25)

Total Lives Covered: 58 crore

Total Gross Premium: ?1,17,505 crore

Business Class	Lives Covered (%)	Gross Premium (%)
Group	47.4%	52.3%
Government	42.3%	8.0%
Individual	10.3%	39.7%
Total	100.0%	100.0%

Finally, the regulators own records document both the consolidation of the TPA industry and the Companys role as its consolidator. Active TPAs stood at 17 as on March 31, 2025, with the report noting the merger of Raksha Health Insurance TPA into Medi Assist Insurance TPA effective January 1, 2025, and the exit of a further licensee. Also Paramount Health Services was acquired by Medi Assist in Q2 FY26.

Group and Retail: Two Administration

Disciplines, One Platform

The regulators class-of-business data also illuminates a structural truth about TPA capability that consolidated market-share figures obscure: Group and Retail are different administration disciplines, and few operators run both at scale. Group administration is an enterprise discipline with deep integrations with employer HR systems and brokers, high-velocity enrollment and endorsement cycles, benefit design and utilisation analytics, OPD and wellness layers, and dedicated corporate service desks, where the economics are won on retention and depth per account. Medi Assists 33.7% Group market share and 93.2% retention rate reflect two decades of compounding in exactly this discipline.

Retail administration in a market with 2.52 crore individual policies in FY25 requires policy-level servicing at mass-market volumes across the length and breadth of the country, supported by interactions with a large distribution network and self-service member journeys. The retail claims experience delivered is a direct reflection of the insurers brand promise. Finally, the insurers leave no stone unturned in reducing the churn in their retail portfolio, a relatively expensive base to acquire and retain. The fastest-growing carriers are, the SAHIs, at 19.8% premium growth in FY26 compete precisely on this experience and historically chose to own all aspects of delivery. The MAtrix (SaaS) deployment at Indias largest SAHI is the clearest evidence of that shift.

Consolidation and Market Leadership

The industry is consolidating rapidly. Scale advantages in proprietary technology, real-time analytics, and network purchasing leverage have raised entry barriers beyond process millions of health insurance the reach of legacy operators. Medi Assist has been the primary aggregator of this consolidation cycle with five acquisitions completed, the most recent being Paramount TPA in July 2025, the largest TPA acquisition in India.

Taking their FY25 disclosures together, the two businesses served over 390 million lives (Group+Retail+Government) during the year, comprising 46.4 million in group business, 16.0 million in retail and 328.2 million under government schemes. They processed 14.4 million claims, as reported in their respective annual disclosures to IRDAI in FY25. ~50% of Paramounts claims volume migrated onto the MAtrix transaction layer by April 2026. Driven by this momentum, Total Premium Under Management (Group+Retail) reached 25,923 crore, up 22.8% year-on-year, with Group premiums of 23,104 crore (up 25.6%) taking the Companys Group segment market share to a dominant 33.7% which is a gain of 340 basis points in a single year.

The consolidation goes beyond premiums under management. The Companys technology platforms enabled rapid integration of acquired companies operations with almost no disruption to existing clients operations. All of the differentiators and core experience features have been seamlessly extended to the policyholders served by Paramount.

Technology: Led by Empathy

Health benefits in India, and increasingly across borders, require an interconnected system in which insurers, hospitals, employers, government schemes, payers, regulators, and members exchange structured data in real time. The Company has been at the forefront of building the most widely integrated orchestration layer that connects all of these stakeholders. The orchestration layer along with highly modular components enable the ecosystem to use what they need in conjunction with their existing technology investments to participate in industry workflows.

The Companys core capabilities such as Network (NaaS),

Fraud, Waste, and Abuse prevention (Maven Guard),

Technology-led end to end claims management (MAtrix),

Intelligent document processing (MAven IDP) are available as integrated solutions as well as a set of plug-n-play technology modules for insurance companies. In addition to these, the Company has enabled digital experiences through MAven and better cashless experience through MAgnum solutions.

MAtrix is the most widely used claims management system in the health insurance industry in India. MAtrix is used by Medi Assist TPA and multiple insurers as a SaaS platform to efficiently. Our technology revenues grew by 91.9% to 21.7 crores in FY26. In FY26, 44.5% of OPD claims were processed as real-time cashless and the inpatient cashless share reached 63% by volume. Pre-authorisation was completed within 10 minutes in over 90% of cases and discharge within 30 minutes in over half the cases. Reimbursement turnaround reduced from 11.2 days to 7.41 days, with 91.8% of reimbursements processed within a single day.

MAven Guard, an AI-powered FWA prevention engine prevented 540 crore of fraud in FY26. MAven Guard is trained on millions of claims and uses over 160 parameters to find fraud patterns and reduce wasteful investigations.

MAgnum platform for hospitals now brings Raksha Prime to hospitals in a self-help mode. Raksha Prime enables hospitals to let patients checkout without waiting for a formal approval letter from an insurer by estimating insurance payouts with high accuracy. This service enabled 3.22 lakh bill-free, zero-wait discharges across roughly 6,000 hospitals in FY26.

International Business: Borderless Benefits at

Scale

Health benefits administration is becoming borderless. Capital, talent, and patients now move across markets faster than the systems built to insure them as global employers run workforces across dozens of countries.

Indian insurers underwrite members who live and travel worldwide, and international carriers need trusted service delivery inside India, one of the worlds fastest-growing healthcare markets. Every one of those flows requires the same thing: eligibility, network, adjudication, and claims orchestration that works across borders. Our subsidiary

Mayfair We Care (UK) is purpose-built for exactly this, serving members across the globe. The International Benefits Administration segment delivered revenue of 41.1 crore in FY26, up 11.9% year-on-year, contributing 4.5% of total revenue.

Indias medical value travel market is estimated at $8.7 billion [48] in 2025 and projected to grow at a 13.2% CAGR to $16.2 billion[49] by 2030, supported by the Governments Heal in India initiative. Every inbound patient journey requires cross-border eligibility, network, and claims orchestration. Outbound, Indias globally mobile population continues to expand, and the 2,117 global capability centres operating in India anchor multinational employers whose benefits programmes inherently span borders. Industry estimates point to large, fragmented,assessed, under-digitised health insurance markets across Asia with substantial claims leakage conditions that reward exactly the combination of administration, technology, and cost containment the Company has already built at scale in

India. Our international business is poised to make an impact in chosen markets and become a growth engine for the Company.

Opportunities :

Indias insurance penetration stood at 3.7% [50] of GDP in FY25, with non-life at approximately 1%, against a globalassessed, average of 4.3%[51]. Several structural forces are expanding the market for health benefits administration.

The missing middle. An estimated 40 crore [52] self-employed and informal-sector individuals fall outside scheme eligibility without affordable private cover. Expanded coverage enabled by Bima Sugam and GST-exempt retail products require benefits administration at scale.

Government schemes. PM-JAYs extension to citizens aged 70 and above, state scheme convergence and new state entries continue to expand the publicly insured population thereby requiring administration capabilities at national scale.

Claims profile. As OPD benefits proliferate, the mix is shifting to higher-volume, lower-value transactions, requiring mature systems and processes to handle large volumes of claims.

Fraud containment. Fraud, waste and abuse costs the Indian health insurance sector an estimated 8,000 to 10,000 crore annually, and containment is now an essential tool to improve loss ratios for insurers.

Provider networks. Institutional capital entering Tier-2 and Tier-3 hospital infrastructure increases network availability, and every additional empanelled provider carries an administration requirement across pricing, eligibility and settlement.

International administration. Global employers, travelling members and inbound carriers each generate an administration requirement that spans jurisdiction, eligibility, network access, adjudication and claims orchestration across borders.

Risk Mitigation:

Our risk management framework is designed to be both comprehensive and adaptive, ensuring that potential threats are systematically identified, and addressed across all levels of the organisation. The framework was extended this year to reflect our expanded scale following the Paramount integration, and to bring newly material risk themes, market structure change driven by digital public infrastructure, and business continuity under operational disruption, into formal tracking alongside our existing risk categories.

The Risk Management Committee that is constituted by the Board of Directors is responsible for overseeing the Companys enterprise-wide risk management framework, and ensuring that risks are identified, mitigated in a timely and structured manner. The Committee reviews the Companys risk appetite and tolerance, evaluates the adequacy of existing controls, and monitors emerging risks arising from changes in the business, regulatory, and operating environment.

It works closely with management to ensure that risk andmitigation plans are implemented effectively reports periodically to the Board on the Companys overall risk posture.

The Companys comprehensive risk management framework is designed to identify, assess, and mitigate risks across the enterprise, including business, regulatory, operational, technological, geopolitical, human capital, and other risks. Risks are evaluated for likelihood and impact, assigned clear ownership, and monitored on an ongoing basis as part of a periodic review process. Some of the material risks being assessed and mitigated through the Companys risk management framework include:

1. Client Concentration Risk

Risks: We derive a significant revenues from a limited number of clients, with the top five contributing 64.8% of revenue. The loss of one or more large clients, or a decline in business or fees from them, could have an adverse effect on our business and results of operations.

Mitigation Measures

The Company has implemented the following mitigation measures to address these risks:

? Diversification of the client base across industries and geographies

? Enhanced service offerings, including at scale could lead to service consumption-based and platform models, to increase value proposition for existing clients

? Introduction of new revenue channels and products to attract a wider range of clients

? Continuous monitoring of client satisfaction benchmarks and pro-active addressing of concerns

In FY26, we deepened our presence in the Private/ SAHI insurer segment, specifically in retail with our MAtrix Platform deployment in Star Health.

In FY26, we also expanded into self-funded corporate and PSU-entity administration, broadening portfolio resilience beyond our core account base.

These measures have reduced client concentration from 69.6% of revenue from the top five clients in FY25 to 64.8% in FY26.

2. Technology and Cybersecurity Risks

Risks: Our business is dependent on complex IT systems. Disruptions, failures, or security breaches could significantly impact our operations and reputation. Integration of acquired systems introduces additional complexity to our technology environment.

Mitigation Measures

The Company has implemented the following mitigation measures to address these risks:

? Investment in state-of-the-art IT infrastructure and security systems

? Implementation and periodic testing of robust disaster recovery plans

? Regular security audits and penetration testing

? Mandatory Cybersecurity training for all employees

In FY26, we completed ISO 22301 Business Continuity portion of our Management certification and an independent SOC 2 Type II audit. We also operationalised SIEM and SOAR capabilities for continuous monitoring and automated threat response, and kick started the IRDAI-mandated cybersecurity audit for intermediaries. Encryption, access controls, and multi-factor authentication were strengthened across our systems.

3. Operational Risks

Risks: Challenges in managing a large network of healthcare providers and processing claims efficiently issues and customer dissatisfaction.

Mitigation Measures

The Company has implemented the following mitigation measures to address these risks:

? Continuous upgrade of advanced claims processing systems to improve efficiency

? Regular review and optimisation of operational processes

? Ongoing training to staffto enhance skills and knowledge

? Human oversight and structured audit layers alongside claims automation, to manage error and fraud risk as digital adjudication scales

? Strengthening provider network governance and empanelment controls as cashless volumes and network breadth expand

In FY26, all claims were processed through the Processor Assistant, a digital audit layer applied to every claim rather than to a random sample, providing a continuous feedback loop for real-time error detection

4. Talent Management Risk

Risks: Our success depends on our ability to attract and retain skilled professionals, particularly in key management positions. High attrition or inability to find suitable replacements could affect our operations.

Mitigation Measure

The Company has implemented the following mitigation measures to address these risks:

? Comprehensive employee retention strategies and competitive compensation packages to attract and retain top talent

? Strengthening technical skills at junior levels and managerial capability at mid-level to build future leaders

? Fostering a positive work culture and employee engagement

? Structured succession planning for key positions, including senior leadership

In FY26, we introduced a broader senior leadership structure across our lines of business, with second-line leaders identified across critical functions.

In FY26, Ms. Sunita Rebecca Cherian joined our

Board, bringing nearly three decades of human capital and organisational leadership experience. Her appointment strengthens the Companys access to Board-level advisory on talent strategy, organisational design, and people leadership.

Acquisition and Integration Risks

Risks: Our growth strategy includes acquisitions, which carry risks related to integration, cultural fit, and realising synergies.

Mitigation Measures

The Company has implemented the following mitigation measures to address these risks:

? Conducting thorough due diligence before acquisitions

? Development and implementation of comprehensive integration plans

? Clear governance structures, with quarterly performance reporting to the Board

In FY26, we completed the acquisition of Paramount Health Services and Insurance TPA and made significant progress on its structured integration, with full integration on track for completion within four quarters of the acquisition. In FY26, we developed a structured playbook for evaluation, diligence, and integration to support future acquisitions and strategic collaborations, including international transactions.

Performance Review and Outlook

Medi Assist delivered a strong performance with operating revenue of 9,047.7 million (25.1% growth), EBITDA of 1,746.1 million (19.3% margin), and profit after tax of 893.1 million, in a milestone year defined by the acquisition and integration of Paramount Health Services & Insurance TPA Private Limited (Paramount TPA or PHS). In FY26, your Company transitioned to a fully debt-free balance sheet and continued to scale its AI-powered claims platforms to a million claims processed per month, all while weathering sectoral headwinds leading to moderation in the industrys health premium growth.

The Year in Perspective

In FY26, growth was powered by a combination of healthy organic expansion and the consolidation of Paramount TPA. The organic growth was supported by ~93.2% retention of group premiums driven by superior value delivery to insurers and policyholders through value-added services including AI-led fraud, waste and abuse (FWA) detection, cashless services and instant discharges. Total Group and Retail premiums under management grew 22.8% to 259.2 billion, taking our overall share of group and retail health insurance premiums to 20.7% (up 115 bps year-on-year) and our group market share to 33.7% (up 340 bps year-on-year), consolidating our position as Indias largest health benefits administrator. During the year, we deepened corporate relationships with 1,339 corporate integrations (up from 1,066) across a portfolio of approximately 11,000 corporates spanning 25+ sectors.

The consolidated EBITDA margin was 19.3% for the year (FY25: 21.3%), reflectingthe consolidation of Paramount TPA from the second quarter along with integration costs and increased investment in technology. Paramount TPAs standalone margins improved through the year as claims volumes migrated to MAtrix and shared services were consolidated, expanding the groups margins from 17.1% in the quarter of acquisition to 18.6% and then 19.9% in the third and fourth quarter respectively.

The balance sheet strengthened materially. The Group became debt-free from January 2026, having fully repaid 1,550.7 million of acquisition-related borrowings (including interest) within seven months of completing the Paramount TPA acquisition, aided by operating cash flow of 1,177.2 million and a preferential allotment of equity shares aggregating 1,947.6 million to marquee long-term investors: Massachusetts Institute of Technology and 238 Plan Associates LLC. We closed the year with a free cash position of 2,605.0 million and net worth of 8,524.0 million. Medi Assist operates with negative working capital and an asset-light, low capital intensity model that generates strong cash flow. Reflectingthis confidence, a final dividend of 2 per equity share for FY26.

Total Income

Our total income increased by 23.6% to 9,232.4 million in FY26 from 7,470.8 million in FY25, primarily due to an increase in revenue from contracts with customers, which included nine months of consolidation of Paramount TPA with effect from 1st July 2025.

Revenue from Contracts with Customers

Our revenue from contracts with customers increased by 25.1% to 9,047.7 million in FY26 as compared to 7,233.2 million in FY25. This was primarily on account of an increase in our income from TPA services to 8,379.7 million in FY26 from 6,678.9 million in FY25, a growth of 25.5%. The increase in our income from TPA services was driven by an increase in our total Group and Retail premium under management to 259.2 billion in FY26 from 211.1 billion in FY25, a growth of 22.8%. Within this, group premiums under management grew 25.6% to 231.0 billion, driven by an increase in business from existing accounts, the addition of new group accounts, the consolidation of Paramount TPA and our retention of approximately 93.2% of group premiums managed during the year. Retail premiums administered under the TPA model grew 4.2% to 28.2 billion, while premiums serviced under our platform (SaaS) model scaled sharply to 181.6 billion following the enterprise deployment of our MAtrix claims platform with insurer partners.

Our revenue from operations attributable to servicing Government sponsored schemes increased by 42.6% to 1,135.7 million in FY26 from .796.6 million in FY25, reflecting our continuing involvement in major Government sponsored projects serving approximately 330 million beneficiaries across 13 states and 3 union territories.

Revenue from contracts with customers also includes income from health management services of 556.3 million in FY26, up 22.2% from 455.1 million in FY25.

This includes revenue from our International Benefits

Administration business, anchored by Mayfair, of 410.8 million in FY26, a growth of 11.9% over FY25. The foundation of our international benefits business is now in place, with a 400% expansion in retail lives served to over 950,000, a technology partnership with a leading insurance broker in Southeast Asia, and access to over half of the travel insurance premiums placed in India.

Our Technology Services vertical scaled rapidly, with revenue at 217.2 million, growing 91.9% year-on-year, following the commercial, full-scale deployment of our MAtrix claims platform with insurer partners. The MAtrix platform processed ~10.9 million claims during the year, including ~212,000 international claims. Our Fraud Detection Engine, MAven Guard, detected ~ 5,400 million of health insurance fraud (up 38.5% year-on-year). Raksha Prime, enabled over 322,000 patients to experience instant bill-free discharge across approximately 6,000 hospitals.

Paramount Health Services (PHS): Acquisition and Integration

On 1 July 2025, upon receipt of approval from the Insurance Regulatory and Development Authority of India, we completed the acquisition of 100% of the equity share capital of Paramount Health Services and Insurance TPA Private Limited through our wholly owned subsidiary, Medi Assist Insurance TPA PrivateLimited (MAITPA), for a purchase consideration of 4,124.4 million (against an enterprise value of 3,118.0 million, adjusted for closing balances including treasury assets). PHS has been consolidated in the Groups results for nine months in FY26 and was the principal driver of inorganic growth during the year.

The acquisition materially strengthened our competitive position, adding scaled group and retail relationships and contributing to the expansion of our group market share to 33.7%. Integration progressed well with more than 50% of PHS claims volume having been migrated to the MAtrix platform as of April 2026, with MAtrix on track to become the primary processing engine for the combined business by Q2 FY27. To accelerate structural integration, PHSs TPA business was transferred to MAITPA by way of a slump transfer, effective 1 February 2026, following the approval of the boards of MAITPA and PHS. During the year, PHS experienced a cyber-security incident that was fully contained at the PHS level with no impact on the Company or any other subsidiary; remediation and business-continuity costs of 37.7 million were recognised as an exceptional item.

Additionally, Paramount TPA has lodged an insurance claim under its cyber-insurance policy for recovery of the eligible costs incurred towards the above incident.

Other Income

Our other income decreased by 22.2% to 184.8 million in FY26 from 237.6 million in FY25, primarily due to deployment of cash from liquid, income-generating investments towards business acquisitions and strategic expansion. At the same time, internal accrual and proceeds from preferential allotments enabled us to free our debt position. This strengthened our balance sheet and provides a strong foundation to support future growth, improve operating leverage and maintain a healthy cash position.

Expenses

Employee benefits expense.

Employee benefits expenses increased by 28.8% to 3,940.72 million in FY26 from 3,058.62 million in FY25. The acquisition of PHS with effect from 1 July 2025, which added 2,500+ employees, accounted for approximately 82% of the increase. The balance reflects the continued strengthening of our capabilities across claims management, operations, provider partnerships, technology and public health schemes to support business growth.

Finance costs

Our finance costs increased by 107.9% to 214.1 million in FY26 from 103.0 million in FY25, primarily due to interest on borrowings availed to part-fund the Paramount TPA acquisition. These borrowings were fully repaid during the year and the Group has been debt-free since January 2026, which is expected to meaningfully reduce finance costs going forward.

Depreciation and amortisation expense.

Our depreciation and amortisation expense increased by 38.3% to 771.3 million in FY26 from 557.8 million in FY25, primarily on account of an increase in amortisation of intangible assets to 431.6 million in FY26 from 294.9 million in FY25. This is largely attributable to customer relationship intangibles of 1,375.0 million recognised on the purchase price allocation for the Paramount TPA acquisition, which are being amortised over ten years.

Other expenses

Our other expenses increased by 27.6% to 3,360.9 million in FY26 from 2,633.5 million in FY25, primarily due to consolidation of PHS. Some of the key expense items that had an increase is: sub-contracting expenses to 916.0 million in FY26 from 651.0 million in FY25, an increase in advertisement and business promotion expenses to 523.1 million from 312.0 million, and increases in software subscription charges and business support services associated with a larger, more digital operating footprint. These increases were partially offset by a decrease in legal and professional expenses to 474.1 million in FY26 from 510.7 million in FY25, which had included transaction-related costs in the prior year.

The Financial Year 2026 includes exceptional items aggregating 142.0 million, comprising:

(a) 37.7 million of costs incurred by Paramount TPA towards security and business continuity measures, including the engagement of external experts to support system restoration and cyber-forensic activities, following a cyber-security incident during the year. The incident was fully contained at the Paramount TPA level and did not affect the Company or any of its other subsidiaries. The relevant authorities including the stock exchanges were intimated. Paramount TPA has lodged a claim under its cyber-insurance policy for recovery of eligible costs;

(b) 33.3 million towards the estimated incremental impact of past service costs on employee benefit provisions arising from the New Labour Codes, effective 21 November 2025. The Company will evaluate and record any further impact upon notification of the related Rules; and

(c) 71.0 million towards on-account payments made to an insurance company customer pending review and reconciliation of certain disallowed claims.

While management is of the view that the amount is fully recoverable, discussions with the customer are ongoing and a full provision has been made on a prudent basis.

For further details, refer to Note 48 of the Notes to the Consolidated Financial Statements.

Income Tax

Total income tax for FY26 was a net credit of 89.6 million, compared with an expense of 201.9 million in FY25. Current tax was 318.7 million in FY26, up from 272.6 million in FY25, and an adjustment for 12.8 million relating to earlier year taxes. While the Deferred tax was a credit of 421.1 million, of which 310.4 million represents a one-time reversal of deferred tax liabilities (recognised on intangible assets arising from the purchase price allocation for the Paramount TPA acquisition) consequent to the slump transfer of the PHS TPA business to MAITPA with effect from 1 February 2026. This reversal is non-cash and non-recurring in nature.

Profitability

Profit after Tax from continuing operations in FY26 was 893.1 million as compared to 916.0 million in FY25, with basic earnings per share of 12.14.

Cash Flows and Balance Sheet

Net cash flows from operating activities were 1,177.2 million in FY26 (FY25: 1,380.9 million), after absorbing acquisition-related integration costs and taxes. During the year, the Group deployed 4,018.5 million (net of cash acquired) towards the acquisition of PHS, funded through a combination of internal accruals, treasury investments, short-term borrowings and the preferential allotment of 1,980.0 million. All borrowings were repaid by January 2026, and the Group closed the year debt-free with a free cash position of 2,605.0 million (FY25: 3,122.4 million, prior to the acquisition outflow) and net worth of 8,524.0 million, providing substantial headroom to invest in technology, platform expansion and demonstrating capacity to fund capital expenditures and expansions internally without external borrowing.

Key Financial Ratios

Particulars	FY25	FY26	Change	Remarks
Current Ratio	1.49	1.34	-10.1%	The reduction in working capital is attributable to cash deployed in funding the the acquisition of PHS
Debt to Equity Ratio	0.37	0.06	83.8%	Due to achieving a debt free free balance sheet on repayment of borrowings associated with the PHS acquisition
Return on Equity	16.6%	8.1%	-850 bps	Dilution because of the acquisition and operational synergies that are yet to reach full potential
Debtor Turnover Ratio	3.62	3.56	1.7 %	Marginal improvement over the year
Interest Coverage Ratio	11.85	5.42	-54.3%	Increase in borrowing cost. However, subsequently became debt free in Q4FY26
Operating Profit Margin	21.3%	19.3%	-200 bps	Drag associated with the margins of the acquired entity
Adjusted Net Profit Margin	12.3%	7.5%	-480 bps	PAT margin subdued due to integration of PHS and exceptional items

Outlook

We enter FY27 with the strongest platform in our history: undisputed leadership in group health administration, a debt-free balance sheet, marquee long-term investors, and AI-powered platforms MAtrix, MAven Guard, Raksha Prime and the newly launched MAgnum hospital-facing platform — operating at national scale.

Our priorities are clear: complete the migration of PHS volumes to MAtrix by Q2 FY27 and realise the full synergy potential of the combined business; scale our platform (SaaS) model with insurers, building on the successful enterprise deployment achieved during FY26; grow our technology and international benefitsbusiness lines, including new strategic partnerships with global insurance leaders serving cross-border healthcare and medical travel; and continue expanding value delivery to insurers through fraud prevention, cashless expansion and instant discharge experiences. With employee costs as our largest expense and a fee-based model with no underwriting risk, we expect operating leverage to reassert itself as integration completes, supporting a return to our normalised margin trajectory while we continue to compound premiums under management ahead of industry growth.

Internal Control and Adequacy

The Company has established a comprehensive internal control framework designed to safeguard its assets from unauthorised use or disposal. This system ensures that all transactions receive proper authorisation, are accurately recorded, and are appropriately reported. The internal control structure also facilitates optimal resource utilisation and enhance so perational efficiency.

Regular monitoring of operations is conducted to ensure compliance with applicable laws and regulations.

Independent auditors have confirmed the adequacy and effectiveness of these internal control measures.

Human Resource Development and Industrial Relations

The Company recognises its workforce as a critical asset fundamental to its continued growth. A strong emphasis is placed on employee engagement and professional development, with initiatives aimed at enhancing skills demand and supply, and knowledge across all levels. The Company remains dedicated to strengthening its employer brand to attract and retain leading talent within the industry. During the reporting period, employee relations remained harmonious and constructive throughout the organisation. As at March 31, 2026, the Company headcount stood at 9,243 across its group entities.

Cautionary Statement

This Management Discussion and Analysis may contain statements relating to the objectives, projections, estimates, and expectations of the Company, its subsidiaries, and associates. Such statements are considered forward-looking in accordance with relevant laws and regulations. Actual outcomes may differ significantly from those anticipated. Key factors that may affect the Companys operations include economic conditions influencing price levels in domestic and international markets, changes in government regulations, tax legislation, and other statutory requirements, as well as other incidental factors.