Grievances registered against life insurers due to misselling rose 14.3 per cent year-on-year to 26,667 in FY25 from 23,335 a year earlier, according to the Insurance Regulatory and Development Authority of India's (Irdai) annual report for FY25.
However, overall grievances against life insurers declined marginally to 120,429 in FY25 from 120,726 in the previous year.
The insurance regulator has flagged concerns over misselling in India's insurance sector and asked insurers to address the issue by conducting a root cause analysis to identify underlying causes.
It has advised insurers to implement measures such as assessing product suitability, introducing distribution channel to address complaints.
The number of lives covered under health insurance by general and health insurers rose to 580 million in FY25 from 573 million in FY24, even as the number of policies sold declined to 26.5 million from 26.8 million, according to the Irdai annual report.
Premiums collected under the health insurance segment grew 9.12 per cent year-on-year to Rs 1.17 trillion.
In FY25, general and health insurers covered 580 million lives under 26.5 million health insurance policies, excluding policies issued under personal accident and travel insurance.
Health insurance business is classified into three segments -- government-sponsored, group, and individual. In FY25, general and health insurers settled 32.6 million health insurance claims, paying out ~94,248 crore towards claim settlements.
In terms of lives covered, 42.3 per cent were insured under government-sponsored health insurance schemes, 47.4 per cent under group business, and the remaining 10.3 per cent under individual policies issued by general and health insurers.
In terms of premium collected, the group segment accounted for the largest share at 52.3 per cent, followed by individual business at 39.7 per cent and government-sponsored schemes at 8 per cent.
Net incurred claims under the health insurance business of general and health insurers stood at Rs 84,850 crore in FY25, marking an increase of about 11 per cent over the previous year. The incurred claims ratio (ICR) declined to 86.98 per cent in FY25 from 88.15 per cent in FY24. The average amount paid per claim stood at Rs 28,910.
In terms of claims settled, 58 per cent of claims were settled through the cashless route and 41 per cent through reimbursement, with 1 per cent settled through a combination of both modes.
In value terms, 66.35 per cent of the claims amount was settled through the cashless mode. -- Aathira Varier, Business Standard
