A new study has highlighted that individuals aged 25-35 are filing the most insurance claims, with a significant focus on maternity coverage. Women are leading the claims landscape, representing 60% of total claims compared to men's 40%.
The new report by Policybazaar.com also reveals that healthcare costs have been rising due to the high cost of healthcare services in private hospitals and expensive medical procedures. The new highlights emerging corporate strategies to provide more personalised and comprehensive health benefits tailored to specific workforce demographics.
PolicyBazaar.com director Sajja Praveen Chowdary said, "The evolving trends in group health insurance claims highlight the rising cost of medical care and the need for efficient claim processing.
The evolving trends in group health insurance claims highlight the rising cost of medical care."
The rising claims in the age group 35-45 reflect a rising trend in lifestyle-related illnesses such as diabetes, cardiovascular diseases and stress-related disorders. The company said that the corporates are increasingly customising age-specific health benefits, such as higher maternity coverage for female employees and wellness benefits for their workforce.
Also, the study found that companies with operations in Tier 1 cities are opting for higher sum insured policies to protect employees from out-of-pocket expenses. Tier 2 and Tier 3 cities employers are exploring co-payment and deductible models to keep insurance premiums manageable while maintaining adequate coverage.
Employees of industries involved in physically difficult roles like manufacturing, construction, transport and logistics register the highest claims for group insurance claims. Industries with rising group health insurance adoption highlight a shift in employee benefits strategy, especially in sectors with young, health-conscious workforces.
Customised, flexible health insurance plans are gaining traction, offering telehealth, mental wellness support and stress management programmes. Companies in technology sectors are bundling wellness incentives such as gym memberships and health-tracking apps into their policies to encourage proactive health management.
The study found that in terms of employee claim frequency 5% to 7% of employees file multiple claims annually, highlighting the impact of chronic illnesses and recurrent medical conditions.
Cardiovascular diseases, respiratory disorders, and joint problems are among the leading causes of repeat claims under the employee's claim categories. Companies in non-metro areas are encouraging employees to use insurer-partnered hospitals to maximise cashless benefits. Insurers are also expanding their cashless hospital networks in Tier 2 and Tier 3 cities to increase adoption rates.