52% personal health insurance policy owners say premium increased by over 25% in last 12 months: Survey

About 52% personal health insurance policy owners surveyed say their premium has increased by over 25% in the last 12 months, according to a survey by LocalCircles.

With hundreds of health insurance policyholders raising concerns about rising health insurance premiums, LocalCircles through a new survey sought understand how much their premiums have increased by in the last 12 months. The survey received over 11,000 responses from personal health insurance pol holders located in 324 districts of India. 67% respondents were men while 33% respondents were women. 39% of respondents were from tier 1 locations, 30 were from tier 2 locations while 31% were from tier 3, 4 and rural locations.

The survey asked owners of personal health insurance policies, “How much has your annual health insurance premium increased in the last 12 months?” Out the 11,000 health insurance policy owners who responded, 52% indicated that their premium has increased by over 25% in the last 12 months. In fact, 21% health insurance policy owners indicated that the increase in premium was 50% or more in the last 12 months while 31% indicated that it has risen by 25-50%. the remaining respondents, 31% indicated an increase of 10-25%; while 2% indicated 0-10% increase in premium rates; 15% denied any increase in premium as “was same as last year”. In essence, 52% of health insurance policy owners surveyed say their premium has increased by over 25% in the last 12 months. A comparative study with the survey results of 2022 shows that the personal health insurance policy owners who had seen an increase in their premium by over 25% has dipped from 62% in 2022 to 52% this year. 2022 was marked with heavy increases in health insurance premiums as many insurance companies were projecting another wave of COVID in 2022-23 and had increased premiums in anticipation.

Difficulties in claim process

About 43% citizens who filed a health insurance claim in the last three years explicitly indicated that they had difficulty in getting it processed. Complaints ranged from outright rejection to exclusions to deduction and most common delays. The situation is so bad that in many cases, patients spend 8-12 hours on their last day after being ready for discharge to actually get discharged as they are waiting on the insurance claim to be processed. Doctors and hospitals owners are a frustrated lot as well as the patient is occupying a room which can used to admit and treat another waiting patient.

May get more expensive

The recent move of the Insurance Regulatory and Development Authority of India (IRDAI), the insurance regulator, to help senior citizens and those with pre-morbid conditions is expected to make health insurance premiums go up by 10-15%, according to reports quoting experts. From April 2024, IRDA has updated the definitions of the pre-existing condition and moratorium period (MP) in health insurance policies. While the waiting period for pre-existing disease (PED) coverage in health insurance policies has been reduced from four years to a compulsory three years, the moratorium period has be shortened from 96 to 60 months. Insurance companies enforce a "no look back" policy during this period.

The move comes at a time when consumers are struggling to get their health claims processed. Almost one-third or 1.6 lakh cases out of total 5.5 lakh pending consumer complaints received by the Department of Consumer Affairs are of the insurance sector, participants at a roundtable on Consumers and the Insurance Sector, organised last year, were told.