A recent survey has revealed that more than half of Indian health insurance policyholders who filed claims in the past three years experienced either full rejection or partial approval of their claims, often for reasons deemed invalid. The findings, compiled by Local Circles, highlight widespread dissatisfaction with the current state of the health insurance sector.
The survey also uncovered significant delays in claims processing, with nearly two in five respondents reporting wait times ranging from 6 to 48 hours for claims approval and hospital discharge formalities. These delays run counter to the guidelines set by the insurance regulator, which mandates time-bound processing.
Moreover, 83% of participants expressed concerns about the lack of modern, transparent communication systems for claim processing. Many insurers still rely on traditional methods such as emails and phone calls from hospitals, leaving policyholders in the dark about the status of their claims.
The issue of delays has led to growing skepticism among policyholders, with over 40% suspecting that insurers intentionally prolong claim processing to pressure them into accepting lower settlements. Half of the respondents claimed to have experienced such delays personally.
The survey, which garnered over 100,000 responses from 327 districts, has been submitted to the Insurance Regulatory and Development Authority of India (IRDAI). The findings urge the regulator to enforce stricter reforms and to mandate the adoption of transparent, digital systems to streamline the claims process.
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