India’s health insurance industry recorded strong growth in FY 2024-25, with total premium collections exceeding ₹1.2 lakh crore, as per the Ministry of Finance. The sector expanded at an annual rate of around 9%, driven by growing awareness, better access to healthcare financing, and increasing demand for medical cost protection.
To ensure faster services for policyholders, the Insurance Regulatory and Development Authority of India has introduced strict timelines for cashless claim approvals. Pre-authorisation requests must now be processed within one hour, while final approvals are required within three hours, helping patients access timely treatment.
The rise in premium volumes is linked to factors such as an ageing insured population, higher coverage amounts, and enhanced policy features. IRDAI’s 2024 regulations also mandate fair pricing of insurance products based on risk assessment, with regular reviews using credible data and customer feedback.
Claims settlement ratios have shown improvement over recent years. The claims paid ratio rose to 87.50% in 2024-25, up from 82.46% in 2023-24 and 85.66% in 2022-23.
According to IRDAI’s Bima Bharosa portal, out of 1,37,361 grievances reported in FY 2024-25, nearly 93% were resolved within the same year. Claim rejections are generally due to policy conditions such as exceeding the sum insured, co-payment clauses, sub-limits, deductibles, room rent caps, and non-medical expenses.
Overall, regulatory efforts are aimed at improving transparency, streamlining claim processes, and building greater trust in the health insurance ecosystem.