India’s health insurance sector continues to witness strong momentum, growing at an estimated 9 percent, with total premiums surpassing Rs 1.2 lakh crore in 2024–25. "This growth reflects increasing awareness, improved access to healthcare financing, and a rising demand for financial protection against medical expenses," the Ministry of Finance said in an official statement dated March 26, 2026.
Timely Cashless Claim Settlements
To improve efficiency and ensure timely support to policyholders, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated specific timelines for cashless health insurance claim settlements. Pre-authorization for cashless claims is to be completed within one hour, while final authorization must be issued within three hours.
"These timelines are aimed at minimizing delays and ensuring that patients receive timely access to medical care," the Finance Ministry added.
Drivers of Premium Growth
According to the Ministry, the increase in health insurance premiums is driven by factors such as ageing policyholders, higher coverage, enhanced features, among others.
Regulatory Oversight and Fair Pricing
IRDAI’s 2024 regulations emphasize the fair pricing of insurance products based on all risk factors, with periodic reviews conducted by the Appointed Actuary using credible data and customer feedback to ensure both viability and value.
Health Claims Settlement
The claims paid ratio, by number of claims, has shown improvement, standing at 85.66% in 2022–23, dipping slightly to 82.46% in 2023–24, and rising to 87.50% in 2024–25. According to IRDAI’s Bima Bharosa portal, 1,37,361 general and health insurance grievances were reported in FY 2024–25, of which 1,27,755 (93%) were resolved within the same period.
The Ministry further added that, "Instances of claims disallowance or repudiation are largely attributable to specific policy conditions and limitations. Some of the reasons for claims disallowance or repudiation include exceeding sum insured, co-payment clause, sub-limits in policies, deductible in top-up policies, room rent capping, proportionate charges, non-medical expenses etc."
Transparency and Policyholder Trust
IRDAI has also undertaken measures to enhance clarity, streamline claims processing, and bolster policyholder trust. "In essence, a balanced, informed approach from all stakeholders would be crucial in fostering a transparent and trustworthy health insurance ecosystem," the official release said.
