Mumbai: More than half of the health insurance claims received by non-life and standalone health insurers are settled through cashless mode.
According to the recently released IRDAI Annual Report 2022-23, around 56 per cent of the total number of health insurance claims settled were through cashless mode, 42 per cent through reimbursement mode while two per cent of the claims amount was through "both cashless and reimbursement mode."
In 2021-2022, around 59 per cent of the health claims settled were through cashless mode while 38 per cent through reimbursement.
Non-life and health insurers settled 2.36 crore number of health insurance claims and paid Rs 70,930 crore towards them.They covered 55 crore lives under 2.26 crore health insurance policies (excluding policies issued under personal accident and travel insurance).The FY23 numbers were slightly better as insurers had covered 52.04 crore lives under 2.26 crore health insurance policies in FY22.
During 2022-23,the average amount paid per claim was Rs 30,087 compared to a claim amount of Rs 31804 in 2021-22. In terms of number of claims settled, 75 per cent of the claims were settled through the third party intermediaries (TPA) while the balance 25 per cent of the claims were settled through in-house mechanism.
During the year 2022-23, non-life and health insurance companies collected Rs 89,492 crore as health insurance premium registering a growth of about 23 percent over the previous year.
While five States namely Maharashtra, Karnataka, Tamil Nadu, Gujarat and Delhi contributed about 64 per cent of total health insurance premium in 2022-23,the rest of the States have contributed remaining 36 per cent. The net incurred claims under health insurance business of general and health insurers stood at Rs 64,631 crore in 2022-23 an increase of about 2 percent from the previous year.” There is a decrease in Net Incurred Claims Ratio of health business from 109 per cent in 2021-22 to 89 percent in 2022-23 and this decrease is witnessed across all classes/sector of health insurance business said the IRDAI Annual Report.
