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Fixing health claims

Business Standard

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November 20, 2025

Settlement system needs improvement

Even as the Insurance Regulatory and Development Authority of India (Irdai) prepares to launch the Bima Sugam digital marketplace in December, the regulator has drawn attention to ongoing issues in health-insurance claim settlements.

Irdai Chairperson Ajay Seth recently observed that although the number of claims settled was high, the proportion of the amount settled to the amount claimed remains below expectations, especially in health insurance. In 2024-25, the general and health insurers settled $94,247 crore across 32.6 million health-insurance claims. Problems pertaining to transparency, claim adequacy, and clarity in insurance communication continue to be reported.

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