Cashless claims settled up 58% in FY24 from 56%in FY23

Mumbai: Non-life insurers and pure health insurance companies have settled 58.39 per cent of the total number of health claims through cashless mode in 2023-34 slightly up from 55.74 per cent claims settled in 2022-23 showed the IRDAI Annual Report 2023-24.

Insurance officials said that the “Cashless Everywhere” initiative launched by the non-life insurance industry in January 2024 would help improve the cashless settlement of claims and reflect in the coming quarters. They also said that for higher claim amount of Rs 1 lakh and above the cashless settlement is much higher at 75 per cent of the claims.

During 2023-24, non-life and health insurers have settled 2.69 crore health insurance claims and paid an amount of Rs 83,493 crore towards settlement of health insurance claims. In terms of mode of settlement of claims, 58.39 per cent of the total number of claims were settled through cashless mode and another 39 percent through reimbursement mode.

Insurers have settled one percent of their claims� through “both cashless and reimbursement mode”. In terms of cashless claims in amount, 66.17 percent or Rs 55235 crore were settled through cashless mode said the IRDAI Annual Report 2023-24 compared to 63.62 per cent or Rs 45128 crore in the year ago period.

In terms of number of claims settled, 72 percent of the claims were settled through TPAs and the balance 28 percent of the claims were settled through in-house mechanism.�

The average amount per claim has risen to Rs 31086 during FY24 from Rs 30087 in FY23.�

During 2023-24, insurers have settled about 83 percent of total number of claims registered in their books and have repudiated about eleven percent of them and the remaining about six percent were pending for settlement as on March 31st, 2024.