Health Claims Surge Over 3.5x in 2021: Digit Insurance Study

Digit Insurance Study

A study on trends in health insurance claims by Digit Insurance has revealed over 3.5x surge in number of claims in 2021.

The study is based on Digit’s claims settled data for retail as well as group health products evaluated between January and December of 2020 and 2021. The insurer compared 2021 data with that of 2020 to understand how the trends moved in the two years that were hit by the Covid-19 pandemic.

The “Delta” variant, popularly called as the second wave, caused higher hospitalizations across the country compared to the first wave of the pandemic in 2020. This led to a surge in overall health claims by 257% in 2021 compared to the previous year. In 2020, while both metros and non-metros reported nearly the same number of Covid-19 claims, the trend changed in 2021 as non-metros reported 17% more claims than metros.

Commenting on the findings of the study, Mr. Vivek Chaturvedi, Head of Direct Sales, Digit Insurance said, “The rise in number of claims in 2021 indicates increased awareness for health insurance products after the onset of the Covid-19 pandemic. The huge jump in claims, especially from non-metros, is a testament of how the pandemic impacted smaller cities. Similar ticket sizes from metros and non-metros shows that difference in healthcare costs is narrowing which highlights the need for faster adoption of health insurance in locations beyond metros.”

Key Highlights from the study:

  • Total number of health claims saw a jump of 257% (3.5x) in 2021 versus the same period in 2020. Covid-19 claims, too, surged by 178% due to the onslaught of the Delta variant.
  • Metros and non-metros both reported similar number of Covid claims in 2020; however, the same surged by 17% in non-metros compared to metros in 2021.
  • In terms of overall claims as well, non-metros reported 51% higher claims than metros in 2021. In the same year, overall claims from non-metros jumped nearly 300% compared to 2020.
  • Across all types of hospitalizations, average claim size in 2021 dropped by over 21% compared to the previous year. For Covid-19 claims in 2021, the average claim size in metro and non-metros was nearly the same at ₹69,259 and ₹68,919 respectively.
  • The average overall claim size for women in 2021 was ₹51,692, while the same for men stood at ₹66,636, a gap of 29% between the two sexes. For Covid-19 claims, the same gap was at 32%.
  • Telangana, Maharashtra, Karnataka, Gujarat, and Tamil Nadu reported the highest*overall claim size in 2021.
  • Policyholders between the age group 25-35 and 36-45 reported the highest number of claims in 2021. A similar trend was seen in 2020 as well.

In 2020, Covid-19 accounted for about 69% of Digit’s overall health claims and in 2021, the same stood at 54%. During this period, Digit’s health portfolio grew by 218%.

Digit’s study shows that men reported 127% more claims than women in 2021. In 2020, the same stood at 283%. “While we are seeing a gradual rise in women opting for health insurance, the huge gap in the number of claims reported by men and women shows there is still a long way to go. It’s important for women to proactively buy insurance and insurers, too, must work collectively to ensure increased awareness among them,” added Chaturvedi.

*Only cities that reported more than 1,000 claims have been considered.

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