Study Says Nearly Half of Indian Policyholders Faced Health Insurance Claim Rejections in the Last Three Years

According to a study conducted by social media portal and survey firm LocalCircles over half of Indian respondents who filed claims in the past three years said their claims were rejected or partially approved for invalid reasons. The survey also found that 83% of respondents believe health insurers lack transparent, web-based communication systems for claim processing.

Another painstaking point brought forward through the survey was that nearly two in five respondents reported waiting between 6 to 48 hours for claims to be approved and hospital discharges to be processed, contrary to the regulator's time-bound directives.

The survey also found that health insurance companies need to be smoother and more transparent in their communications given that many companies still rely on emails and hospital calls, leaving policyholders uninformed about claim status.

Another harrowing exposure of the report was that respondents expressed scepticism about claim delays, with over 2 in 5 believing insurers deliberately prolong processing to pressure policyholders into accepting lower settlements. Half of the respondents reported experiencing this firsthand.

The survey was conducted across 327 districts with over 100,000 responses. The findings have been submitted to IRDAI, urging stricter enforcement of reforms and mandating transparent digital systems to streamline claims.

Source: Insuranceasia