Claim Denied

Dear Reader,

Kunal’s uncle did the right thing his whole life: he got a solid health insurance plan and paid his premiums on time.

Then, during COVID, his diabetes led to severe complications. He passed away at a private hospital in Delhi.

The final bill ran into Rs 50-60 lakh.

And according to Kunal, the insurance company refused to pay a single rupee.

“That whole experience was so disturbing,” Kunal told me. “The hospital didn’t allow us to remove his body. Very ugly, very disturbing.”

India’s health insurance industry is now larger than ever. In FY25, health insurance premiums crossed Rs 1.2 lakh crore as more Indians rushed to buy cover.

Premiums are rising each year, but so are complaints. Policyholder complaints against health insurance companies jumped 41% in FY25 reaching over 1.37 lakh grievances.

And stories like Kunal’s are familiar enough that many urban Indians now swap them like cautionary tales.

“Buying health insurance is a very complicated product in India,” personal finance expert Monika Halan told me. She says most consumers approach the system as powerless individuals while insurers, hospitals, and third-party administrators have entire teams handling claims and disputes.

So how do you protect yourself?

Monika suggests starting with a full medical check-up before buying a policy so all pre-existing conditions are properly documented. She also recommends working with a trusted advisor, ideally someone friends or family members have personally relied on during claims.

And then there’s the fine print.

Things like room rent capping, waiting periods, exclusions, and co-pay clauses can dramatically reduce payouts during emergencies, often when families are too overwhelmed to fully understand what’s happening.

To learn more, and to hear directly from consumers and experts, check out the latest episode of The Signal Brief.

You can find The Signal Brief on YouTube, Spotify, and Apple Podcasts.

Thank you once again for listening and supporting us. We’d love to hear from you; write to us at [email protected] or find us on Instagram or X at @thesignaldotco.

Best,
Kudrat
on behalf of The Core

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