Average health insurance claims size rises 11.35% YoY in FY24: ACKO Report

2 min read Last Updated : Sep 26 2024 | 12:24 AM IST

The average health insurance claim size in India for FY24 has risen by 11.35 per cent, reaching Rs 70,558, up from Rs 62,548 in FY23, driven by a surge in healthcare expenses, said the ACKO India Health Report 2024.

According to the report, men on average claimed Rs 77,543, while women claimed Rs 69,553 (excluding maternity claims).

The report highlighted that medical inflation in India is currently at 14 per cent. The costs of common medical procedures have escalated, with angioplasty (PTCA) costs soaring from Rs 1-1.5 lakh in 2018 to Rs 2-3 lakh in 2024, and projections suggest that the cost could reach Rs 6-7 lakh by 2030.

Similarly, kidney transplant costs have doubled, from Rs 5-8 lakh in 2018 to Rs 10-15 lakh in 2024, with expectations of surpassing Rs 20 lakh by 2030.

The largest claim related to heart disease, specifically for a cardiac procedure filed in the past year, exceeded Rs 1.1 crore, while the biggest kidney disease-related claim topped Rs 24 lakh, underscoring the severe financial impact of serious health conditions, the report said.

The report also showed a sharp rise in hospitalisations due to neoplasms (tumours, both benign and malignant) and heart conditions as people age. Notably, hospitalisations for neoplasms saw a jump of 2.8 times from ages 31-40 (3.81 per cent) to 41-50 (10.61 per cent). Similarly, claims related to heart and circulatory system diseases saw a threefold increase between the ages of 31-40 (2.24 per cent) and 41-50 (6.88 per cent).

The data further revealed the critical need for a personal retail health insurance policy, as corporate policies frequently fall short in covering hospital expenses. Over the past year, ACKO’s platinum retail health plan covered 100 per cent of the total hospital bills claimed, while corporate policies only covered 74 per cent. This gap in coverage is largely due to the policy terms and conditions dictated by employers.

First Published: Sep 26 2024 | 12:24 AMIST