Mumbai: Nearly 43 per cent of health insurance policyholders have experienced difficulties in processing their claims in the last three years, a survey has revealed.
The survey, which included over 39,000 respondents from 302 districts in the country, said challenges included rejection of claims, partial approval and the long time taken to process them.
A majority of 93 per cent respondents to the LocalCircles survey advocate changes on the regulatory front, including making it mandatory for insurance companies to disclose detailed claims and policy cancellation data on their websites every month.
"Despite some interventions by the Insurance Regulatory and Development Authority of India (IRDAI), consumers continue to struggle with insurance companies to receive their health claims," LocalCircles said in a statement.
It pointed to rejection of health insurance claims, including "policy cancellation" by insurance companies, as the biggest problem facing consumers.
Challenges faced range from insurance companies rejecting claims by classifying a health condition as a pre-existing condition to only approving a partial amount.
"In many cases cited by policy holders, it took 10-12 hours after the patient was ready for discharge to actually be discharged as the health insurance claim was still being processed," it said.
The survey said that 39 per cent of those who buy or renew general insurance policies do so through agents, 40 per cent rely on online aggregators and 1 per cent through insurance companies' websites or apps.
The survey, which included over 39,000 respondents from 302 districts in the country, said challenges included rejection of claims, partial approval and the long time taken to process them.
A majority of 93 per cent respondents to the LocalCircles survey advocate changes on the regulatory front, including making it mandatory for insurance companies to disclose detailed claims and policy cancellation data on their websites every month.
"Despite some interventions by the Insurance Regulatory and Development Authority of India (IRDAI), consumers continue to struggle with insurance companies to receive their health claims," LocalCircles said in a statement.
It pointed to rejection of health insurance claims, including "policy cancellation" by insurance companies, as the biggest problem facing consumers.
Challenges faced range from insurance companies rejecting claims by classifying a health condition as a pre-existing condition to only approving a partial amount.
"In many cases cited by policy holders, it took 10-12 hours after the patient was ready for discharge to actually be discharged as the health insurance claim was still being processed," it said.
The survey said that 39 per cent of those who buy or renew general insurance policies do so through agents, 40 per cent rely on online aggregators and 1 per cent through insurance companies' websites or apps.
