Claim rejections, affordability and delays in hospital discharge continue to be major pain points for India’s health insurance sector, according to industry leaders speaking at the second National Health Insurance Summit organised by the Bengal Chamber of Commerce and Industry in Kolkata. Parthanil Ghosh, Managing Director and Chief Executive Officer of HDFC ERGO General Insurance, said insurers reject an average of 10% of health insurance claims. The General Insurance Council has also recorded 2.1 lakh grievances up to 31 March 2026, with 75% related to health insurance. He stressed that policies bought at a young age, such as at 25, need to remain affordable over the long term.
The discussion also highlighted the challenge of rising healthcare costs and delays in cashless discharge. Ghosh suggested that a medical inflation index could improve transparency around premium increases and healthcare-cost trends, while a common protocol between healthcare providers and insurers could improve predictability. The report noted that IRDAI requires insurers to issue final cashless discharge authorisation within three hours of receiving the necessary documents from hospitals. Industry stakeholders are working on digital platforms and greater coordination between hospitals and insurers to reduce processing delays and improve the overall claims experience.
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