New Delhi

India’s health insurance sector is witnessing steady expansion, recording an annual growth of around 9 per cent, with total premium collections crossing ₹1.2 lakh crore in 2024–25, according to the Finance Ministry.

The rise reflects growing awareness about health coverage, better access to insurance products, and an increasing need for financial protection against medical costs.

To improve service efficiency, the Insurance Regulatory and Development Authority of India has introduced strict timelines for processing cashless claims. Insurers are now required to approve pre-authorisation requests within one hour and complete final approvals within three hours, ensuring quicker access to treatment for policyholders.

The ministry attributed the growth in premiums to multiple factors, including an ageing customer base, higher insurance coverage, and the addition of improved policy features.

Regulatory norms introduced in 2024 also emphasise fair pricing of insurance products, based on risk assessment, credible data, and customer feedback, with periodic reviews conducted by appointed actuaries.

Meanwhile, claim settlement performance has shown improvement over recent years. The claims paid ratio rose to 87.50 per cent in 2024–25, up from 82.46 per cent in the previous year, after standing at 85.66 per cent in 2022–23.

Data from IRDAI’s Bima Bharosa portal indicates that out of 1,37,361 grievances reported in the general and health insurance segment during 2024–25, nearly 93 per cent were resolved within the same financial year.

Officials noted that claim rejections or partial settlements are usually linked to policy-specific conditions such as sum insured limits, co-payment clauses, sub-limits, deductibles, room rent caps, and non-medical expenses.

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The regulator has also rolled out measures to simplify policy terms, streamline claims processing, and strengthen consumer confidence, aiming to build a more transparent and reliable health insurance ecosystem in the country.