India's health insurers paid 87.50% of health insurance claims by number in 2024-25, according to IRDAI data published by PIB (the claims paid ratio). That is up from 82.46% in 2023-24 and 85.66% in 2022-23. For 2024-25, news reports of the IRDAI annual report put repudiated claims at around 8% and pending claims at roughly 5%.
Source · IRDAI, figure for March 2025 · checked
| Period | Value (%) |
|---|---|
| 2024-25 | 87.5 |
| 2023-24 | 82.46 |
| 2022-23 | 85.66 |
The low end is 2023-24 and the high end is 2024-25, both as published by PIB from IRDAI data. The share of claims paid by rupee value is lower: 71.29% in 2023-24.
| Measure | Figure | Source |
|---|---|---|
| Paid, by number of claims, 2022-23 | 85.66% | PIB, from IRDAI |
| Paid, by number of claims, 2023-24 | 82.46% | PIB, from IRDAI |
| Paid, by number of claims, 2024-25 | 87.50% | PIB, from IRDAI |
| Repudiated, 2024-25 (rounded) | around 8% | India Med Today, from IRDAI annual report |
| Pending at year end, 2024-25 (rounded) | roughly 5% | India Med Today, from IRDAI annual report |
| Repudiated, 2023-24 (rounded) | about 11% | India Med Today, from IRDAI annual report |
| Disallowed, 2023-24, by value | Rs 15,100 crore (12.9% of claims filed) | Outlook Business, from IRDAI |
| Repudiated, 2023-24, by value | Rs 10,937.18 crore (9.34%) | Outlook Business, from IRDAI |
Health claims settlement The claims paid ratio (by number of claims) for Year 2022-23, 2023-24 and 2024-25 is shown below: Financial Year Claims Paid Ratio (by number of claims) 2022-23 85.66% 2023-24 82.46% 2024-25 87.50% Further, a s per Bima Bharosa portal of IRDAI, during FY 2024-25, 1,37,361 general and health insurance grievances were reported, out of which 1,27,755 (93%) were disposed of during FY 2024-25 itself. … IRDAI’s 2024 regulations specify that insurance products are priced fairly, based on all relevant risk factors, and remain viable and value-driven, with periodic review by the Appointed Actuary using credible data and customer feedback.
According to the Insurance Regulatory and Development Authority of India’s (IRDAI) annual report, about 87% of all registered claims were settled during the year, up from 83% in FY24. The share of repudiated claims dropped to around 8% from about 11% a year earlier, while pending claims edged down to roughly 5% from 6%, reflecting faster processing and tighter oversight of claim decisions. … Total payouts rose to ₹94,248 crore in FY25 compared with ₹83,493 crore in the previous year. However, the average amount paid per claim declined to ₹28,910 from ₹31,086, driven by a higher proportion of lower-ticket claims as retail and group health insurance penetration widened.
Health insurers disallowed claims worth Rs 15,100 crore or 12.9 per cent of the total claims filed during fiscal 2023-24, according to data released by regulator Irdai. … Of the total Rs 1.17 lakh crore claims under health insurance of general as well as standalone health insurers, only Rs 83,493.17 crore or 71.29 per cent were paid during the year ending March 2024. … Further, insurers repudiated claims amounting to Rs 10,937.18 crore (9.34 per cent) while outstanding claims totalled Rs 7,584.57 crore (6.48 per cent), said the annual report 2023-24 of Insurance Regulatory and Development Authority of India (Irdai).
A news report of the IRDAI annual report puts repudiated claims at around 8% in 2024-25, down from about 11% a year earlier, with roughly 5% still pending at year end. These are rounded figures; a disallowed share for 2024-25 is not printed in the sources we could read.
The 87.50% figure is by number of claims. By amount the share is lower: 71.29% of the claim amount was paid in 2023-24, the latest year where we found a value figure.
PIB says disallowance or repudiation is largely down to specific policy conditions and limitations. In IRDAI's 2023-24 data the two were reported as separate heads: Rs 15,100 crore disallowed and Rs 10,937.18 crore repudiated.
This figure is from IRDAI's own release or a report quoting it. We recheck it yearly. If you have a newer or better source, send it to us.
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