Prime Highlights :
- India’s health insurance premiums cross Rs 1.2 lakh crore for 2024-25, with the sector growing nearly 9 percent.
- IRDAI tightens cashless claim rules, setting a one-hour pre-authorisation window and three-hour final approval.
Key Facts :
- Claims paid ratio rises to 87.50 percent in 2024-25 from 82.46 per cent a year earlier.
- Bima Bharosa portal closes 93 percent of 1,37,361 grievances within the same financial year.
Background :
Health insurance collections in India have moved past the Rs 1.2 lakh crore mark for 2024-25, the Health Ministry noted, with the sector growing at a rate close to 9 per cent. More people are buying cover, financing options have improved, and demand for protection against medical costs keeps climbing.
Insurers now face tighter timelines on cashless claims. The Insurance Regulatory and Development Authority of India requires pre-authorisation within one hour and final sign-off within three hours, cutting the wait for patients seeking treatment.
Several factors pushed the growth. Growth also traces back to an ageing population, rising coverage uptake, and richer policy features from insurers. IRDAI’s 2024 rules bring another requirement, actuaries have to price risk carefully and come back to those numbers periodically, using real data and customer feedback.
Settlement numbers back the trend. The claims paid ratio hit 87.50 percent in 2024-25, rising from 82.46 percent the year before and 85.66 percent the year before that.
Grievances also saw quicker resolution. The Bima Bharosa portal logged 1,37,361 complaints through the year, and insurers closed 93 percent of them within the same period.
Sum insured limits, co-payment clauses, and room rent caps continue to guide how claims get settled. Regulators are pushing policyholders and insurers toward greater clarity and openness, a step meant to build trust in the system over time.
