Healthcare Collaboration: In a significant development, Narayana Hrudayalaya, a Bangalore-based hospital chain, partnered with the Caymanian Government in April 2010 to establish a hospital in Grand Cayman. This initiative also included the creation of a medical university aimed at training doctors, nurses, and paramedical students. Health City Cayman Islands, spanning 107,000 square feet, became operational on February 25, 2014, marking the first foreign hospital owned by an Indian hospital chain. 

Tax Information Exchange Agreement: The Cayman Islands and India signed a Tax Information Exchange Agreement (TIEA) on March 21, 2011. This agreement, the 22nd of its kind for the Cayman Islands and the 5th for India, exemplified the commitment to transparency and cooperation in tax-related matters. 

Remittances: In 2011, India was the ninth largest destination for remittances from the Cayman Islands, receiving a substantial sum of US$2.5 million, highlighting the economic linkages between the two regions. 

Banking Presence: The Bank of India operates in the Cayman Islands and maintains a branch in Grand Cayman, facilitating financial services and transactions. 

Defense Industry Investment: Cayman Islands-based NCBG Holdings, Inc. proposed a 26% stake investment in a joint venture with Indian companies for the production of wiring sets used in military vehicles, aircraft, ships, and other defense machinery. This proposal, aimed at enhancing the defense industry, requires approval from the Indian Government. 

Participatory Notes: In a significant finding, a Special Investigation Team (SIT) appointed by the Indian Supreme Court uncovered that the Cayman Islands were the largest beneficiary of participatory notes from India. These notes accounted for 31.31% of the total outstanding Offshore Derivative Instruments. The Cayman Islands held a substantial investment of ₹85,000 crore (US$11 billion) in Indian stock markets as of February 28, 2015, underlining the economic significance of this partnership.