Archive · 17 Nov 2025
Irdai Highlights Health Claim Gaps, Low Insurance Penetration
Imagine India's insurance boss, Mr. Seth, is watching over all the insurance companies.
He noticed that while companies are paying out many health insurance claims, they aren't paying the full amount expected in some cases.
He also sees that not enough people in India have insurance, like car or health insurance.
This needs to change faster so everyone can be protected.
To help, the insurance boss is making it easier to buy insurance online and is encouraging simpler rules.
He also wants the people who handle complaints, called ombudsmen, to be quick and fair.
This way, more people will trust insurance and feel safe.
Irdai is closely monitoring health insurance claims where the amount settled is lower than expected, despite a high number of settlements.
Insurance penetration in India remains low, and faster growth is needed, particularly in rural areas and among specific demographics.
Irdai is enhancing digital access for policyholders and encouraging simpler product designs and communication.
The insurance industry collected ₹11.93 trillion in premiums in FY25 and settled claims worth ₹8.36 trillion.
Irdai emphasizes the crucial role of insurance ombudsmen and the potential appointment of internal ombudsmen for faster grievance resolution.
- Who
- Ajay Seth, Chairman of Irdai (Insurance Regulatory and Development Authority of India)
- What
- Irdai is monitoring health insurance claim settlement gaps and addressing low insurance penetration, emphasizing prompt, fair, and transparent practices and expanding digital access.
- When
- Fiscal Year 2025 (FY25) and future vision of 'Insurance for All' by 2047.
- Where
- India
- Why
- To build trust in the insurance system, deepen reach, especially in underserved areas, and ensure fair treatment and protection for policyholders.
Irdai (Regulator)
Insurers
Claim Settlement Amounts
Irdai (Regulator)
Irdai is monitoring health insurance claim settlements where the total amount settled is lower than expected, despite a high number of settled claims.
Insurers
Insurers have settled 3.26 crore health insurance claims and paid ₹94,247 crore during FY25.
Insurance Penetration
Irdai (Regulator)
Irdai notes that insurance penetration remains low and needs to grow faster, especially in rural areas and among informal workers and women, to meet the 'Insurance for All' by 2047 vision.
Insurers
The insurance industry collected premiums totaling ₹11.93 trillion in FY25, with life insurance contributing ₹8.86 trillion.
- Health Claims Settled (FY25)
- 3.26 crore
- Health Claims Amount Paid (FY25)
- ₹94,247 crore
- Total Claims Settled (FY25)
- ₹8.36 trillion
- Total Premiums Collected (FY25)
- ₹11.93 trillion
- Life Insurance Premiums (FY25)
- ₹8.86 trillion
- Policyholder Grievances Registered (Past Year)
- 257,000
- Industry Grievance Resolution Rate
- Nearly 99%
