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Indian Health Insurers Paid 71.3% of Claims in FY 2023-24
By Mehul Pathak
02 Mins read | Updated on December 31, 2024
Summary
Insurers in India settled 71.3% of health insurance claims totaling ₹1.2 lakh crore in FY 2023-24, facing ₹6,290 crore in outstanding claims from previous years.
Health insurance companies in India processed a significant amount of claims during the 2023-24 financial year. A total of ₹1.2 lakh crore in health insurance claims were filed, with insurers paying out 71.3% of these claims. Over 3 crore new claims were received, amounting to ₹1.1 lakh crore, while an additional ₹6,290 crore in outstanding claims from previous years were faced.
Of the total claims, nearly 2.7 crore claims worth ₹83,493 crore were successfully settled, accounting for 82% of the claims by volume and 71.3% by value. However, ₹15,100 crore in claims were disallowed based on policy contract terms, and another ₹10,937 crore worth of claims were rejected across 3.6 lakh policies. Approximately ₹7,584 crore in claims remained outstanding.
Premiums collected by health insurers totaled ₹1.1 lakh crore, with public sector insurers leading in premium collection at ₹40,993 crore, followed by private insurers at ₹34,503 crore, and standalone health insurers at ₹32,180 crore. Public sector insurers also had the highest incurred claims ratio at 103%.
The Insurance Regulatory and Development Authority of India (IRDAI) reported that three public sector insurers operated with negative solvency ratios. In the same period, the insurance ombudsman received over 34,000 health insurance complaints, with 6,235 decided in favor of policyholders.
Furthermore, the annual report highlighted that insurers in India denied 11% of health insurance claims and had 6% of claims pending as of March 2024. Insurance companies disallowed and repudiated health policy claims amounting to Rs 26,000 crore during the year, showing a notable increase compared to the previous year. Insurers also repudiated claims totaling Rs 10,937 crore in FY24.
In addition to health insurance claims, life insurance companies paid out Rs 48,512 crore in death claims for the year ending in March 2024, reflecting an increase from the previous year. The non-life insurance industry in India saw a direct premium growth of 12.76% in FY24 compared to the previous year.
Despite efforts to improve the insurance sector, the report noted a decline in insurance penetration in recent years. Measures such as amending insurance laws and enhancing customer experience have been suggested to address the challenges faced by the industry and boost consumer confidence in insurance products.