CONSUMER INSIGHTS REPORT
The Moment of Truth: A Policybazaar Study
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The satisfaction gap between cashless (89%) and reimbursement (79%) processes
~70%
reimbursement claimant needed financial aid to fund upfront costs when cashless was unavailable or rejected
63%
of rejected reimbursement claimants were given no clear reason for rejection: the sharpest transparency
India’s health insurance industry approves 94% of claims overall, yet approval alone does not guarantee a good experience. Satisfaction differs sharply by claim type, with cashless delivering a meaningfully better outcome than reimbursement. When cashless is unavailable, the financial impact on families is severe: most are forced to borrow or liquidate investments to cover upfront costs. And even among successful claimants, frustrations run deep: claim denials, paperwork burden, out-of- pocket expenses, and lack of transparency consistently top the list of pain points, with every measure worse for reimbursement than cashless.
Finding 1
86% of claimants are satisfied overall, but the claim type drives the experience. Cashless satisfaction stands at 89%; reimbursement lags at 79%. Speed of initial approval and minimal paperwork are the top drivers of a positive cl 86 aim experience.
Finding 2
When cashless is unavailable or rejected, Indian families bear severe financial strain. Nearly 70% of reimbursement claimants needed outside help: borrowing or liquidating investments to cover upfront costs.
Finding 3
Irrespective of claim type, dissatisfaction traces back to four consistent pain points. Claim denial is one of the sharpest drivers, made worse when no clear reason is given.
About this research
This study assesses the health insurance claims experience across all zones and city tiers in India, interviewing policyholders who had made at least one claim.
To assess the claim process satisfaction levels and the reasons behind the same
Quantitative face-to-face interviews with structured questionnaire (2 modules: listing + main). Supplemented by qualitative discussions.
2,128 respondents (1,692 male, 436 female). Age ranged from under 18 to 55+, covering patients across all life stages.
39 cities across all zones: Metro, Tier 2 and Tier 3.
North 532 · East 503 · West 554 · South 539. Balanced coverage ensures regional findings are representative.
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