Challenging Claims: A Deep Dive into Health Insurance Payouts

In fiscal 2023-24, health insurers disallowed claims worth Rs 15,100 crore, accounting for 12.9% of total claims filed. About 71.29% of the Rs 1.17 lakh crore claims were paid. Insurers repudiated Rs 10,937.18 crore due to outstanding claims, with Rs 7,584.57 crore remaining unresolved.

Health insurers denied claims worth Rs 15,100 crore, or 12.9% of total claims, during the 2023-24 fiscal year, according to the Insurance Regulatory and Development Authority of India (Irdai).

Out of Rs 1.17 lakh crore in health insurance claims, only Rs 83,493.17 crore—or 71.29%—were paid by the year-end, March 2024. Reportedly, Rs 10,937.18 crore of claims were repudiated, while Rs 7,584.57 crore remained unresolved.

Approximately 3.26 crore claims were filed in this period, with insurers settling 82.46% of these. Health insurance companies collected Rs 1,07,681 crore in premiums, showing a 20.32% growth. IRDAI highlights an average of Rs 31,086 paid per claim.

(With inputs from agencies.)