As health claims continue to surge, this might be the right time to evaluate your health insurance plans.
According to a recent study by Digit Insurance, a general insurance company, the total number of health claims increased by 257 percent (3.5 times) in 2021 compared to the same period in 2020.Covid claims surged 178 percent due to the onslaught of the "Delta" variant. The second wave caused higher hospitalisations across the country compared to the first wave of the pandemic in 2020. In 2020, while both metros and non-metros reported nearly the same number of COVID claims, the trend changed in 2021 as non-metros reported 17 per cent more claims than metros.
The study is based on the claims settled data of Digit Insurance for retail as well as group health products evaluated between January and December of 2020 and 2021. Only cities that reported more than 1,000 claims were considered.
Vivek Chaturvedi, head of direct sales at Digit Insurance, said, "The rise in the number of claims in 2021 indicates increased awareness of health insurance products after the onset of the COVID pandemic." The huge jump in claims, especially from non-metros, is a testament to how the pandemic impacted smaller cities. Similar ticket sizes from metros and non-metros show that the difference in healthcare costs is narrowing, which highlights the need for faster adoption of health insurance in locations beyond metros. "
The average claim size for all types of hospitalizations fell by more than 21% in 2021 compared to the previous year.For Covid claims in 2021, the average claim size in metros and non-metros was nearly the same at Rs 69,259 and Rs 68,919, respectively.
The average overall claim size for women in 2021 was Rs 51,692, while the same for men stood at Rs 66,636, a gap of 29 per cent between the two sexes. For Covid claims, the same gap was at 32 per cent.
The study shows that men reported 127 per cent more claims than women in 2021. In 2020, the figure was 283 percent.While we are seeing a gradual rise in women opting for health insurance, the huge gap in the number of claims reported by men and women shows there is still a long way to go. It’s important for women to proactively buy insurance, and insurers, too, must work collectively to ensure increased awareness among them, "added Chaturvedi.
Telangana, Maharashtra, Karnataka, Gujarat, and Tamil Nadu reported the highest overall claim size in 2021. Policyholders in the age groups of 25–35 and 36–45 reported the highest number of claims in 2021. A similar trend was seen in 2020 as well.
According to industry experts, the health claim surge data actually helps in understanding the strength of health insurance companies. If a health insurance company is able to survive this period and is able to provide for claims adequately, then it is a bonus point for such a company. It will also help customers with selection or switching plans if needed. Going forward, claim settlement, claim settlement amount ratio, and rejection ratio of the last two years will be important criteria to watch out for, "says Anant Ladha, founder of Invest Aaj For Kal, a financial planning firm.
In 2020, Covid accounted for about 69 percent of Digit Insurance's overall health claims, and in 2021, the same stood at 54 percent. During this period, the company's health portfolio grew by 218 percent.
