India's Health Insurance Sector Grows At 9 pc

New Delhi: India’s health insurance sector continues to witness robust growth, growing at a rate of around 9 per cent, with total health insurance premiums volume exceeding Rs 1.2 lakh crore in 2024-25. This growth reflects increasing awareness, improved access to healthcare financing, and a rising demand for financial protection against medical expenses, according to a finance ministry statement.

The ministry further said that in order to enhance efficiency and ensure timely support to policyholders, the Insurance Regulatory and Development Authority of India (Irdai) has prescribed specific timelines for the processing of cashless health insurance claims. “Time limit has been prescribed for cashless settlement including cashless pre-authorisation has to be approved within one hour and final authorisation within three hours. These timelines are aimed at minimising delays and ensuring that patients receive timely access to medical care,” it said.

As per the government, there has been an increase in health insurance premiums driven by factors such as ageing policyholders, higher coverage, enhanced features, among others. “Irdai's 2024 regulations specify that insurance products are priced fairly, based on all relevant risk factors, and remain viable and value-driven, with periodic review by the appointed actuary using credible data and customer feedback,” the government said in the statement.

Further, as per Bima Bharosa portal of Irdai, it said, during 2024-25, 1,37,361 general and health insurance grievances were reported, of which 1,27,755 (93 per cent) were disposed of during the year itself. “Instances of claims disallowance or repudiation are largely attributable to specific policy conditions and limitations,” it said, adding that some of the reasons for claims disallowance or repudiation include exceeding sum insured, co-payment clause, sub-limits in policies, deductible in top-up policies, room rent capping, proportionate charges, non-medical expenses, etc.