Health insurance complaints are rising in India: What the data reveals

Complaints against health insurers in India are increasing, highlighting growing consumer awareness and the importance of grievance redressal mechanisms. According to Insurance Samadhan, a grievance platform, Q2 2025 saw a 45% rise in complaints compared to the previous quarter, with 974 cases involving claims worth over ₹119 crore.

Health insurance accounted for the majority of these grievances at 67.5%, followed by life insurance (25.5%) and general insurance (6.9%).

Endowment policies were the most commonly mis-sold products, often leaving policyholders exposed to reduced returns or penalties.

While the Insurance Samadhan data is recent, insights from the Council of Insurance Ombudsman (CIO) for FY2023-24 provide context on persistent challenges in the sector.

The ombudsman received the highest number of complaints against Star Health & Allied Insurance, with 13,308 cases, mostly regarding partial or complete claim rejection.

This was followed by CARE Health Insurance (3,718 complaints), Niva Bupa (2,511), and two public sector insurers: National Insurance (2,196) and The New India Assurance (1,602).

Adjusted for policyholder base, Star Health registered 63 complaints per lakh policyholders, significantly higher than its peers.

Officials from Star Health said the higher complaint volume is due to its predominantly retail business, which naturally involves more customer interactions, as per The Economic Times.

Experts note that mis-selling remains a key driver of disputes.

Aggressive agent commissions and sales targets often push unsuitable policies onto consumers.

Data from insurtech platforms such as Plum shows that most Indians first experience insurance through employer-provided group health policies, with retail purchases often triggered by claims or life events.

Many consumers face higher premiums or outright rejections due to pre-existing conditions, emphasising the need for early adoption and careful policy selection.

The combined trends from grievance platforms and ombudsman reports indicate that while awareness is improving, consumers must proactively evaluate their coverage and understand complaint mechanisms to ensure adequate protection.

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