Health insurance complaints rise sharply to over 73,000
Health insurance complaints have surged significantly, with over 73,700 grievances recorded on the ‘Bima Bharosa’ portal in the first 11 months of FY26, exceeding FY25 levels by 14%.
According to government data, complaints stood at 47,658 in FY24 and 64,365 in FY25, highlighting a consistent upward trend. The rise comes amid higher premiums and growing concerns over claim rejections.
The Insurance Regulatory and Development Authority of India mandates insurers to provide clear reasons for claim rejection, referencing policy terms. Claims cannot be repudiated without approval from internal review committees.
Policyholders can escalate grievances to insurers’ redressal officers and further to the Insurance Ombudsman if unresolved, with penalties imposed for non-compliance.
Star Health targets 25% growth in Bengal market
Star Health and Allied Insurance Company Limited is aiming for 25% growth in West Bengal in FY27, with a premium target of Rs. 1,250 crore, building on its Rs. 1,000 crore milestone achieved in FY26.
The insurer currently holds a 32% share in India’s retail health insurance segment and around 36% in Bengal. The company reported a claims ratio of 65% in the state, lower than the national average of 70%, indicating relatively better risk experience.
With a network of 600 hospitals and over 50,000 agents in the state, Star Health has strengthened its distribution and claims servicing capabilities. The company also settled claims worth Rs. 600 crore in Bengal during FY26 and maintains a strong renewal ratio, reflecting customer retention and market confidence.
GST waiver drives shift to higher health insurance coverage
The removal of GST on health insurance premiums has led to a notable increase in entry-level policy sizes, with more customers opting for higher coverage limits.
Industry estimates suggest that 15-20% of entry-level policies have seen an increase in sum insured over the past six months. The traditional Rs. 3-5 lakh cover is gradually being replaced by Rs. 10 lakh as the new baseline for first-time buyers.
Insurers report that improved affordability, combined with tax benefits under Section 80D of the Income Tax Act, is encouraging both new purchases and policy upgrades. Younger customers, particularly those under 35, are showing a growing preference for comprehensive coverage and add-ons.
The trend reflects rising awareness of healthcare costs and a shift toward stronger financial protection among policyholders.
Patanjali’s Health Insurance Entry Faces Delay Amid IRDAI Approval Wait
Patanjali’s planned entry into the health insurance sector remains uncertain as regulatory approval from the Insurance Regulatory and Development Authority of India (IRDAI) is yet to be finalised. The delay has placed the company’s foray into the insurance market in limbo, despite earlier indications of expansion.
According to the report, Patanjali had proposed entering the health insurance space as part of its broader diversification strategy. However, the pending regulatory clearance has slowed progress, highlighting the rigorous approval process required for new entrants in the insurance sector.
The delay underscores the importance of compliance with regulatory norms related to capital adequacy, governance structures, and operational readiness. IRDAI’s scrutiny ensures that only entities with robust financial and management capabilities are allowed to operate, safeguarding policyholder interests.
From a market perspective, the entry of new players like Patanjali could increase competition, potentially leading to more product innovation and improved accessibility. However, regulatory approvals remain a critical gatekeeping mechanism to maintain stability and trust in the insurance ecosystem.
The development also reflects the complexities involved in entering regulated financial sectors, where business expansion must align with strict oversight and compliance requirements.
Prudential India Strengthens Health Leadership with New Appointment
ICICI Prudential Life Insurance has announced a new leadership appointment for its health business, signalling a strategic push to strengthen its presence in the rapidly growing health insurance segment.
According to the report, the move reflects the company’s focus on expanding its health portfolio, improving product innovation, and enhancing customer-centric offerings. With rising healthcare costs and increasing awareness, health-related insurance products have become a key growth area for life insurers.
The newly appointed leadership is expected to drive initiatives around product development, distribution expansion, and operational efficiency. Strengthening leadership in this segment aligns with broader industry trends where insurers are integrating health solutions into their offerings.
The development also highlights the growing importance of health insurance within the overall insurance ecosystem. Insurers are focusing on preventive care, wellness features, and digital health solutions to improve customer engagement and long-term value.
From a business perspective, leadership changes often indicate strategic realignment and renewed focus on specific segments. In this case, it underscores the importance of health insurance as a core growth driver.
From a risk management standpoint, expanding in the health segment requires careful underwriting, claims management, and cost control, given the rising claims ratios and medical inflation.
Health Insurance Complaints Rise to 73,729 in FY26 So Far
Health insurance complaints in India have reached 73,729 so far in FY26, according to government data, highlighting growing concerns around service quality, claims handling, and customer experience in the sector.
The report indicates that the rise in complaints reflects increased awareness among policyholders as well as expanding coverage across the population. As more individuals opt for health insurance, issues related to claims rejection, delays in settlement, and policy terms are becoming more visible.
A significant portion of grievances is linked to claim-related disputes, including documentation requirements, exclusions, and disagreements over admissible amounts. Customers often face challenges in understanding policy conditions, leading to dissatisfaction and escalation of complaints.
The trend underscores the need for insurers to strengthen customer communication, simplify policy terms, and improve claims processing efficiency. Transparent disclosures and faster resolution mechanisms are essential to build trust and reduce grievance levels.
From a regulatory perspective, the increase in complaints highlights the importance of robust grievance redressal frameworks and closer supervision to ensure fair practices. Regulators may continue to focus on improving standards in claims settlement and customer service.
The development reflects the growing maturity of India’s health insurance market, where rising participation is accompanied by higher expectations for service quality, accountability, and transparency.
