Health Insurance News

Byadmin

August 14, 2025

Star Health Q1 FY26 Profit Slips 18 % as Underwriting Income Halves

Star Health and Allied Insurance reported a sharp year-on-year slide in earnings for the April–June quarter of FY-26. Profit after tax fell 17.7 % to Rs. 262.5 crore from Rs. 318.9 crore a year earlier, even as gross written premium edged up 3.7 % to Rs. 3,605 crore.

Underwriting profit almost halved to Rs. 71.7 crore (Rs. 140.3 crore a year ago) as claims costs and pricing adjustments weighed on margins. The insurer said its combined ratio stayed high but stable at 95.1 %. Managing Director & CEO Anand Roy noted that the company “remained prudent in risk selection and implemented critical pricing and underwriting changes” to protect profitability.

On a sequential basis, Star Health swung from a token profit of Rs. 0.5 crore in the March quarter to a healthier bottom line, helped by steady retail-premium growth. Management reaffirmed double-digit premium-growth guidance and tighter cost control for the rest of FY-26.

Out-of-Pocket Health Spending Falls but Treatment Costs Still Heavy: Swiss Re

A new Swiss Re Institute study finds that India’s out-of-pocket (OOP) share of total health expenditure fell from 64 % in 2010 to 48 % in 2023—reflecting wider health-insurance uptake and government schemes such as Ayushman Bharat. Yet absolute household medical bills remain steep: average inpatient treatment now exceeds Rs. 35,000 per episode in urban areas and Rs. 26,000 in rural regions. The reinsurer warns that rising non-communicable diseases, costly private care and limited OPD cover keep millions at risk of “financial toxicity,” with 17 % of households still pushed below the poverty line after a major illness. Swiss Re recommends expanding retail health-insurance penetration, introducing outpatient reimbursement products and strengthening public-hospital infrastructure to ease the burden.

NRIs Power Surge in India’s Medical Tourism, Boost Health-Insurance Uptake

India’s medical-tourism sector is witnessing robust growth, chiefly driven by Non-Resident Indians (NRIs) who are flying home for elective and critical treatments. According to industry data, the number of NRI medical travellers has risen sharply in the past year, lured by treatment costs that are 50-70 % lower than in many Western countries, cultural familiarity, and an expanding network of internationally accredited hospitals.

A parallel trend is the marked rise in health-insurance adoption among NRIs. Insurers report a double-digit jump in policies bought by overseas Indians, with many opting for high-sum-insured plans that cover surgery, rehabilitation, and post-operative care in India. Claims data show a growing share originating from tier-II and tier-III cities as private hospitals in these regions upgrade facilities to match metro standards.

Analysts expect the combined effect of affordable care and wider insurance coverage to keep India among the world’s top medical-tourism hubs over the next decade.

Dengue Claims Jump 66 % in 5 Years as Monsoon Illnesses Surge, Finds ManipalCigna

Health-insurance claims for monsoon-related diseases have soared across India, rising at a 34 % compound annual growth rate (CAGR) between 2020 and 2024, according to new data released by ManipalCigna Health Insurance. Dengue tops the chart: claims linked to the mosquito-borne infection have climbed an alarming 66 % CAGR in the same period, dwarfing increases for malaria and viral fevers.

Regional disparities are stark. South India—where heavier rainfall and flooding are common—has become a hotspot, with monsoon-illness claims growing 36 % annually. By contrast, North India recorded an 8 % decline. Children up to 17 years of age account for 31 % of all claims, underscoring their heightened vulnerability, while men make up 57 % of cases.

ManipalCigna says the findings highlight the need for better vector-control measures and wider health-insurance coverage, especially in smaller towns where private hospitals are rapidly expanding

NRIs Drive 150 % Surge in Health-Insurance Purchases as They Return to India for Treatment: Policybazaar Report

A new study from Policybazaar for Business reveals a dramatic 150 % jump in health-insurance policies bought by Non-Resident Indians (NRIs) over the past three years. The spike coincides with a sharp rise in medical-tourism traffic, as overseas Indians increasingly choose Indian hospitals for elective and critical procedures that cost up to 70 % less than in the US or UK.

The report shows that cardiac, orthopedic, oncology and fertility treatments account for the bulk of claims, with average sums insured exceeding Rs. 50 lakh. Most policy buyers are aged 45-60 and reside in the US, UAE, UK and Singapore. Preferred treatment hubs include Delhi-NCR, Mumbai, Bengaluru and Hyderabad, where internationally accredited hospitals offer concierge services and cashless claim processing.

Policybazaar attributes the trend to better tele-consultation options, simplified KYC for NRIs and the rupee’s favourable exchange rate, predicting continued double-digit growth in NRI health-insurance penetration.

Only 2 in 5 Indians Have Health Insurance, Rural Gap Widest: IBAI Report

Just 40 % of Indians are covered by health insurance and only half hold any life cover, according to the Insurance Brokers Association of India’s report “Leading the Path to Insurance for All.” The study warns that millions remain financially exposed despite more than 90 % of citizens owning bank accounts. Rural and low-income households are most vulnerable: with barely 2 % of life-insurance branches located outside cities, access, affordability and awareness remain major hurdles.
Key findings show average families want life protection worth 8–10 × annual income, yet fewer than 10 % achieve that level. The association urges insurers and policymakers to expand branch networks, simplify products and intensify financial-literacy drives to close the protection gap and shield households from medical or income shocks.

Critical Gaps Persist in Health Insurance for India’s Elderly, New Study Warns

A new nationwide study, highlighted by Tripura Star News, reveals that India’s senior citizens remain gravely under-insured despite rising life expectancies and soaring medical costs. Fewer than 30 % of people aged 60 + hold any active health-insurance policy, and only 12 % enjoy coverage adequate to meet the average Rs. 35,000–Rs. 40,000 cost of a single hospital stay.
Key barriers include high entry-age premiums, lengthy waiting periods for pre-existing ailments, mandatory co-pays of up to 30 %, and limited outpatient benefits. Rural seniors are hit hardest: nearly three-quarters rely on savings or family loans to fund treatment, often delaying care until conditions worsen.
Researchers urge insurers to launch low-premium, no-co-pay plans tailored to chronic-disease management, and call on policymakers to expand subsidies under flagship schemes such as Ayushman Bharat. Without urgent reform, the study warns, millions of elderly Indians risk “medical impoverishment” and declining quality of life as healthcare inflation outpaces pension growth.

Insurance Firm’s Google-Timeline Evidence Backfires as Consumer Forum Orders Claim Payment

A Silvassa resident’s Rs. 48,251 mediclaim for viral pneumonia was rejected by Go Digit General Insurance after investigators cited his Google Maps Timeline—which failed to record his hospital stay—as proof of “discrepancy.” Vallabh Motka challenged the repudiation before the Valsad Consumer Disputes Redressal Commission. The forum found the insurer ignored the treating doctor’s certificate and hospital records, ruled the location data unreliable, and ordered full reimbursement plus compensation for mental harassment. The case spotlights rising use of digital footprints in claims investigations and the privacy and evidentiary questions such practices raise. Advocates warn that insurers often gain phone access under false pretences and that Google location logs can be incomplete due to network issues or disabled settings. The decision may deter insurers from leaning on unverified app data to deny legitimate health-insurance claims.

August 2025-Insurance Times

IRDAI News Life Insurance News

Author

This entry is part 20 of 23 in the series August 2025-Insurance Times

Byadmin