As per the report by Policybazaar, health insurance claims in India are increasingly hitting the mark, with an impressive 94 per cent approval rate, indicating that the vast majority of policyholders are successfully getting their claims approved.
More importantly, the approval rate comes along with delivering a top-notch experience, with 86 per cent reporting satisfaction with their claims experience.
Talking about the minuscule pie of 6 per cent rejected claims, research indicates that the involvement of both online and offline intermediaries can help turn over the tide and boost approval rates.
The report titled, 'Is India Happy With Health Insurance Claims?’ recognises the crucial role of claims in the health insurance ecosystem, the study captures the nuanced nature of health insurance claims experience across regions, tiers and demographics. With a sample size of over 2,100 surveyees across 39 cities, the report provides a deeply-studied narrative of the health insurance claims index in India.
While an overwhelming 94 per cent of respondents reported having their health insurance claims approved, notably, this number surged to an impressive 97 per cent for claims initiated through online channels.
The study reveals that 86 per cent of customers expressed satisfaction with their health insurance claim experience, with 40 per cent indicating they were extremely satisfied. In this regard, cashless claims, online channels and minimal paperwork emerge as the biggest drivers of customer satisfaction.
Upfront payment for treatment remains a challenge for many, with approximately 70 per cent of reimbursement claimants seeking financial aid through formal or informal loans or breaking their savings funds meant for other life goals.
Sarbvir Singh, Joint Group, Chief executive officer (CEO), Policybazaar said, “Claim is the defining moment for any consumer in insurance and therefore, improving claims experience has been a key focus area for us through different initiatives like Claim Samadhan and Claims Assurance Program."
The IRDAI’s recent slew of initiatives like Cashless Everywhere and the three-hour timeline of claim settlement reflect the regulatory body’s timely and thoughtful move in the interest of the consumer.
"This study is an extension of our efforts to further enhance the claims experience for consumers. The report offers a nuanced perspective of the customer in every aspect of claims experience which provides us with valuable insights to further improve their experience. It also brings out the need for better transparency, awareness and digital adoption,” added Singh.
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