According to data from Policybazaar, the trends reflect the impact of chronic health conditions, changing demographics, and seasonal factors.
Health insurance: A 30% increase in claims over 3 years
Health insurance claims have seen a steady rise in recent years, with the average payout increasing by 30% over the past three years. This increase is primarily driven by both seasonal and chronic health conditions.
Key health insurance trends
| Financial Year | Average Claim Payout (₹) |
| FY23 | 62,014 |
| FY24 | 70,152 |
| FY25 | 81,025 |
(Policybazaar)
The average claim payout has steadily increased from ₹62,014 in FY23 to ₹81,025 in FY25, indicating rising healthcare costs and higher medical expenses being claimed by policyholders.
This surge reflects the rising prevalence of chronic diseases such as heart disease, diabetes, and cancer, alongside seasonal illnesses like fever, Policybazaar said.
State-wise breakdown of claims
| State | % of total claims | Average claim size (₹) |
| Maharashtra | 14.50% | 86,402 |
| Delhi | 10.20% | 1,00,600 |
| Haryana | 5.90% | 97,573 |
| Tamil Nadu | 1.50% | 1,13,074 |
(Policybazaar)
Maharashtra and Delhi account for the highest share of claims, with Delhi reporting the highest average claim amount of ₹1,00,600.
Claims frequency on the rise
The frequency of claims has increased gradually over the last three years, reflecting greater utilisation of health insurance:
| Financial Year | Claims Frequency |
| FY23 | 4.90% |
| FY24 | 5.26% |
| FY25 | 6.39% |
(Policybazaar)
This growing trend indicates that more policyholders are using their health insurance benefits, likely driven by better awareness of coverage and increased access to healthcare services.
Claims by age group
| Age Group | % Share on Claim Amount Paid |
| 18 to 35 | 38.20% |
| 36 to 45 | 29.50% |
| 46 to 60 | 25.30% |
| 61 to 75 | 6.40% |
| 75+ | 0.50% |
(Policybazaar)
Younger adults (18-35 years) now represent the largest share of health insurance claims, at 38.2%.
This highlights a worrying rise in chronic conditions like diabetes, which are increasingly diagnosed in younger populations.
Motor insurance: Claims spike during monsoons
Motor insurance claims are heavily influenced by factors such as accidents, theft, and damage from natural events.
A significant rise in claims is observed during the monsoon months, with damage from flooding and accidents driving the surge.
Key motor insurance trends:
| Vehicle Type | Claim Volume Share | Claim Amount Range (₹) |
| Hatchback | 54% | 20,000 – 25,000 |
| Sedan | 21% | 25,000 – 30,000 |
| SUV | 26% | 30,000 – 35,000 |
(Policybazaar)
Monsoon claims surge
The monsoon season causes a notable spike in claims, especially in cities prone to heavy rainfall and flooding. Claims increase by 40% during the rainy months, driven by natural events such as floods and storm damage.
Additionally, there has been a growing trend toward adding extra coverage options to motor insurance policies. Add-ons like zero depreciation, engine protectors, and consumable cost coverage are becoming more popular as policyholders seek comprehensive protection.
Term insurance: Heart disease and natural deaths drive claims
In the term insurance segment, heart diseases and natural deaths remain the leading causes of claims. These trends reflect both the increasing burden of chronic health issues and the aging population.
Key term insurance trends:
| Cause of Claim | Percentage of Claims |
| Heart Disease | 25-30% |
| Natural Deaths | 30-35% |
| Accidents | 15-20% |
(Policybazaar)
Heart diseases and natural causes continue to dominate term insurance claims, which aligns with the growing awareness of health risks, particularly in urban populations.
Claims by gender
Male policyholders make up the majority of term insurance claims, with 90-92% of claims filed by men. This trend is largely due to the higher penetration of term insurance among men, as well as higher mortality rates.
Term Insurance riders gaining popularity
Approximately 35-40% of term insurance policyholders are opting for additional riders, such as critical illness and accidental death benefits.
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