India insurers reject 20% of recent claims

Six in ten respondents waited 6 to 48 hours for approval and hospital release.

Amongst individuals in India who have made a claim in the past three years, more than half said their filings were either rejected or only partially approved for what they considered invalid reasons.

Specifically, 20% said claims were rejected, 16% reported similar rejections, and 33% said claims were partially approved with issues cited, the LocalCircles survey showed.

Only 25% said their claims were fully approved, whilst 6% said approval came after repeated follow-ups.

Delays in discharge after claim approval also remain common. 

Of over 30,000 respondents, 21% said the process took 24 to 48 hours, 12% reported 12 to 24 hours, and 14% said 9 to 12 hours. 

A further 12% reported delays of 6 to 9 hours and 21% said 3 to 6 hours. Only 8% said claims were processed instantly. 

Overall, six in ten respondents said it took between 6 and 48 hours to complete claim approval and hospital discharge.

Perceptions of deliberate delays are also widespread. 

Of more than 27,000 respondents, 47% said they or their family had experienced delays that led them to accept lower claim amounts, whilst 34% said similar cases had occurred within their network. 

Only 7% said such practices were not common. The survey also pointed to concerns over transparency. 

Amongst over 15,000 respondents, 83% said insurers lack fully transparent, web-based systems for claims processing and called for such systems to be mandated. 

Only 9% said such systems are already in place.

The nationwide survey conducted by LocalCircles, based on over 100,000 responses from policyholders across 327 districts, found that many continue to face difficulties.