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Health Insurance in India is an area of concern.
While the number of persons opting for Medical Insurance covers is increasing, insurers find the double whammy of Low Premiums and High
Medical costs difficult to cope with.
Over the years, we are seeing a dramatic decrease in the claim settlement ratios, coupled with an accompanying increase in claim related
grievances and disputes.
Often claims are settled at much lower values, or rejected outright, leaving the policy holder (who is
already under strain due to the medical costs) frustrated and worried.
Our experience shows the increasing reading of fine print by the Insurers/TPAs, and citing of technical clauses/conditions/exclusions by
the insurers, their doctors and lawyers, as the order of the day.
This is evident from the following graph issued by the Insurance Regulatory and Development Authority :
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