Irdai Reports Rs 15,100 Crore in Rejected Health Insurance Claims for FY24
In a significant revelation, the Insurance Regulatory and Development Authority of India (Irdai) has reported that health insurers have rejected claims worth a whopping Rs 15,100 crore in the financial year 2023-2024. This staggering figure highlights the challenges faced by policyholders in getting their claims settled. According to the data, a substantial 72 per cent of claims were settled through third-party administrators (TPAs), while the remaining 28 per cent were settled directly by the insurance companies through their in-house mechanisms. The high rate of claim rejections underscores the need for greater transparency and efficiency in the health insurance claims process, as well as the importance of carefully reviewing policy terms and conditions to avoid disputes. With the rise of digital insurance platforms and increased awareness about health insurance, it is essential for insurers to streamline their claims settlement procedures and improve customer satisfaction. This can be achieved through the use of advanced technology, such as artificial intelligence and data analytics, to facilitate faster and more accurate claims processing. Furthermore, policyholders can also benefit from understanding their health insurance plans and the claims process to ensure a smooth experience. Key factors to consider include policy coverage, premium payments, and the role of TPAs in claims settlement. By prioritizing these aspects, individuals can make informed decisions when selecting a health insurance plan and minimize the risk of claim rejections.
