76% health insurance reimbursement claimants face immediate financial burden: report
Around 76% health insurance reimbursement claimants borrowed or broke investments turning their medical bills into an immediate financial burden, found the latest national consumer insights
Around 76% health insurance reimbursement claimants borrowed or broke investments turning their medical bills into an immediate financial burden, found the latest national consumer insights report released by Policybazaar, an online insurance marketplace that allows consumers to manage various insurance products from multiple insurers through a single platform. Correspondingly, the ability to manage costs only with liquid savings dropped from 32% to 24% in 2024-25. Further financial stress at the time of raising claims has gone up across all city-tiers between 2023 and 2025, with the overall increase driven largely by metros, which saw the sharpest jump of 14% to 76%. Tier-2 cities recorded the highest incidence overall at 78% while Tier-3 cities saw a 6% point rise, with 71% of claimants borrowing money or liquidating investments in 2024-25. Customers seek transparency The report also notes that transparency is the number one concern posed by customers from the Indian health insurance sector with clear reasons for rejection being the most demanded answer. Around 73% of those dissatisfied with rejections cited the reason as unclear, highlighting a communication gap. Customers also demanded frequent updates to cashless hospital lists, simpler claims forms, and stronger verification at purchase to avoid surprises later.
Hospitalisation frequency creates one of the widest gaps in data. Customers with a single hospitalisation report a Health Claims Exchange (HCX) of 84.5, while those with multiple hospitalisations drop to 73.2, the lowest in all segments. Also middle-aged patients (36-40 years) record a relatively steadier experience, helped by stronger current experience scores and higher intent to continue with health insurance. The report also found that dense hospital networks alone do not guarantee a stronger claims experience and that repeated hospitalisation, metro complexity and higher reimbursement rates pull down the score because of what the claims pathway asks of them. The mode of claims, more than any other variable, is where that burden shows up most sharply, and cashless claims is where the clearest relief is found, said the report. Need stronger verification As much as 39% of customers asked for stronger verification at the point of purchase, with the South leading at 44% across all regions. Most importantly conditions missed at onboarding become the ground for rejection or pushing towards reimbursement. Customers want a transparent, streamlined, proactive insurance policy and procedure, the report found. The report also suggests that no claim should be closed with vague terms like “not admissible”.
The BriefWire