Health claims increased by 2.5 Times in 2021

It should come as no shock that health claims have increased during the COVID-19 pandemic. And this is confirmed by a recent study by Digit Insurance. Digit Insurance is a general insurance company. It found its study that the country’s gross total number of health claims increased by enormous amounts in 2021 – by about 257 percent (3.5 times) compared to the same period in 2020. Covid-19 claims surged by 178 percent due to the onslaught of the second pandemic wave led by the “Delta” variant. It caused far higher hospitalizations across India than the first pandemic wave in 2020. While in 2020, both metros and non-metros reported a similar number of COVID-19 claims, it took a turn for the worse in 2021 when non-metros had 17 percent more cases reported.

The study was based on the claims settled data from Digit Insurance for both retail and group health products as evaluated between January and December of 2020 and in the same period of 2021. One must note that the researchers only considered the cities that had more than 1,000 claims reported.

The head of direct sales at Digit Insurance, Vivek Chaturvedi, commented, “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, the study noted, for all types of hospitalizations fell significantly by more than 21% in 2021 as compared to the previous year. For Covid-19 claims in 2021, the average claim amount in metro cities and non-metro cities was almost the same at Rs 69,259 and Rs 68,919, respectively.

However, the most shocking discovery was the difference in health claims made by men and women. The average overall amount claimed by women in 2021 was Rs 51,692, while the same figure for men was Rs 66,636, showing a tremendous gap of 29 percent between the two sexes. For Covid-19 related claims, this gap was at 32 percent. These differences persist even as women’s health is gaining attention worldwide in general and in India in particular.

Also, men made 127 percent more claims than women in 2021, and in 2020, this stood at 283 percent. This means that there is a gradual rise in women opting for health insurance, yet there continues to be a huge gap in the overall number of claims reported by men and women. That proves that the nation has a long way to go when it comes to gender equality in this regard. Women must proactively buy the insurance and must work hard collectively to increase awareness among them.

Telangana and Maharashtra reported the largest overall claim size in 2021, followed by Karnataka, Gujarat, and Tamil Nadu. Policyholders making the highest number of claims both in 2021 and 2020 were from the age groups of 25–35 and 36–45.

In 2020, Covid accounted for about two-thirds (69 percent) of a total number of Digit Insurance’s overall health claims, while in 2021, the same figure stood at 54 percent. During the period, its health portfolio grew by 218 percent.

According to experts, the health claim data can actually help understand the relative strength of various health insurance companies.