New Delhi: India’s health insurance sector has witnessed robust growth, with total premiums exceeding ₹1.2 lakh crore in the financial year 2024-25, the government said on Thursday.

The sector continues to expand steadily at an annual growth rate of around 9 per cent, driven by rising awareness about health insurance, increased access to healthcare financing, and a growing demand for financial protection against medical expenses.

To enhance efficiency and provide faster support to policyholders, the Insurance Regulatory and Development Authority of India (IRDAI) has introduced strict timelines for processing cashless health insurance claims. Insurers are now required to approve cashless pre-authorisation requests within one hour, with final approvals completed within three hours.

“These measures are aimed at reducing delays and ensuring patients get timely treatment,” the government stated.

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The surge in health insurance premiums has been linked to several factors, including an ageing policyholder base, higher coverage amounts, and enhanced policy features. The IRDAI’s 2024 guidelines also emphasise fair pricing of insurance products based on risk factors, with regular reviews informed by data and customer feedback.

The health insurance sector has also shown improvement in claims settlement. The claims paid ratio rose to 87.5 per cent in FY25, compared with 82.46 per cent in 2023-24 and 85.66 per cent in 2022-23.

Data from IRDAI’s Bima Bharosa portal revealed that 1,37,361 grievances related to general and health insurance were reported during FY25. Approximately 93 per cent of these complaints were resolved within the same financial year.

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Despite improvements, some claims continue to be rejected due to policy conditions, including exceeding the sum insured, co-payment clauses, sub-limits, deductibles, room rent caps, and non-medical expenses.

The regulator has undertaken several initiatives to improve transparency and streamline the claims process, aiming to build greater trust among policyholders and ensure a more efficient, reliable health insurance ecosystem in India.

IANS