The common cost of health insurance claims in India is ₹42,000, with 15% of these claims exceeding ₹1 lakh, a report stated.
This highlights the necessity for policyholders and insurance suppliers to think about potential high-cost situations, equivalent to hospitalisations exceeding 5 days and costing over ₹5 lakh, when designing protection choices.
The report by SecureNow on Reimbursement Health Insurance Claims supplies important findings on hospitalisation period, declare prices, settlement charges, and the effectivity of the declare settlement course of in India.
It analysed 3,846 health claims filed via the reimbursement course of versus cashless.
These claims have been geographically numerous and coated completely different sorts of insurers, members of the family, and each exterior and inside Third Party Administrators (TPAs).
Furthermore, it stated, lower than 3% of claims are as a consequence of accidents, with a decrease median cost of ₹33,000.
The report emphasises that the period of hospitalisation is a essential side of health insurance claims, in line with SecureNow Insurance Broker, co-founder, Kapil Mehta.
The complete examine reveals that the standard hospitalisation interval is 2 days, however greater than 21% of hospitalisations prolong past three days, he stated.
“This underscores the necessity for comprehensive coverage that accounts for longer hospital stays,” he added.
The report additionally signifies comparatively excessive declare settlement charges, with over 50% of claims having a settlement charge of 80% or greater of claims made. Maternity claims contribute considerably, comprising 20% of complete claims as a section.
Fever (5%), eye surgical procedures (5%), and accidents (3%) additionally make substantial contributions to the general declare quantity.
Although most cancers accounts for about 1% of claims, the per case cost is comparatively excessive. Conversely, accidents, regardless of being frequent, have a mean cost of ₹33,000, which is decrease than the general common cost of claims.
Commenting on National Insurance Awareness Day ICICI Lombard General Insurance Company managing director Bhargav Dasgupta, “We recognise the crucial mission of increasing insurance penetration in India. In a nation brimming with potential and opportunities, awareness and understanding of insurance play a paramount role.”
The visionary reforms set in movement by IRDAI have introduced forth transparency, consumer-centric practices and accessibility- finally fostering belief, he stated.
On the event of Insurance Awareness Day Sanjiv Bajaj, Managing Director of Bajaj Capital, stated elements influencing insurance buy selections are of paramount significance and affordability of premiums performs a big function.
