INDIA: Hansa Research, India’s leading consumer insights firm, has released the 1^st edition of the Health Insurance Customer Experience Score (CuES) 2025 report. This comprehensive study offers a deep dive into the evolving preferences, expectations, and satisfaction levels of health insurance customers across the country, drawing insights from over 3,800 respondents across 12 health insurance brands, and presents a robust framework for insurers to sharpen their strategies and drive stronger customer engagement.

India’s health insurance sector, which saw a surge in adoption during the pandemic, continues to expand since then (albeit at a moderated pace), as consumers prioritize financial protection amidst rising medical costs. According to the report, nearly half (48%) of health insurance buyers cited ‘protection from rising healthcare expenses’ as the primary driver for purchasing insurance, reflecting heightened concern over medical inflation. Moreover, customers increasingly view health insurance not just as a financial product, but as a gateway to access quality healthcare and better health outcomes. We are also seeing that nearly 30% of Policyholders supplement existing corporate health coverage with additional policies.

As the health insurance landscape in India becomes increasingly competitive, with a mix of public sector giants, private insurers, and standalone health firms, understanding and improving customer experience is no longer optional. 

The Health Insurance CuES 2025 report pegs the Industry Net Promoter Score at 55%, and among the top-ranked brands, Bajaj Allianz General Insurance, SBI General Insurance, and ICICI Lombard General Insurance emerge as standout performers. These brands are not only perceived as ‘trustworthy’ but also excel in product-related aspects, ease of claim filing, hospital network access, and customer support responsiveness, among other things.

Among these, Bajaj Allianz General Insurance is leading the rankings with an impressive Net Promoter Score (NPS) of 68%, winning customer loyalty through strong product delivery, digital support, excellent claims experience, and a well-rated hospital network. The brand has successfully positioned itself as a customer-centric insurer, fostering high levels of satisfaction and loyalty.

Sharing some insights on the Hansa Research, Health Insurance CuES report, Praveen Nijhara, CEO, Hansa Research, said, “The Health Insurance CuES 2025 report is a timely benchmark for the industry. It reflects a major shift in consumer mindset. Customers today are informed, vocal, and expect a seamless experience, and this highlights the importance of transparency, service quality, and innovation in building lasting trust.”

Key Findings from the Health Insurance CUES 2025 Report

1. Evolving Customer Expectations
   Customer expectations are rapidly changing, driven by a digital-first mindset for policy purchase and management. There is a clear preference for personalized, flexible, and wellness-oriented plans, which are associated with higher satisfaction and stronger brand affinity. Insurers that align offerings with these preferences are more likely to attract and retain today’s informed and health-conscious consumers.

2. Consumers’ brand preferences for health insurance 

Consumers’ preferences for health insurance brands are shaped by three core factors: the product offering, particularly the range and coverage of critical illnesses and plan flexibility; a strong and trustworthy brand reputation; and convenient access to 24/7 customer service. Notably, younger millennials place greater emphasis on round-the-clock support and seamless digital experiences, making these critical differentiators for insurers targeting this demographic.

3. Portability Empowers Consumers
   The growing ease of health insurance portability has shifted the balance of power toward the consumer, pushing insurers to focus on delivering value across the entire policyholder journey, not just at the point of acquisition. Increased competition is driving accountability. The study finds that premium increases, lack of transparency, and unsatisfactory claim experiences are the top reasons consumers switch providers. This highlights a growing demand for fair, transparent, and consistent service.

4. Claims Experience Remains a Key Challenge
   The claims process continues to be a critical friction point, with 55% of claimants reporting difficulties. Key concerns include limited hospital networks, pre-authorization delays, and slow payouts. These issues are even more pronounced among millennials, who have higher expectations for speed and simplicity. A smooth and efficient cashless claims process is strongly linked to overall satisfaction, underlining the need for insurers to invest in both digital capabilities and operational efficiency.

5. Barriers Among Non-Policyholders
   Despite rising awareness, several barriers continue to prevent non-policyholders from entering the health insurance ecosystem. The most cited concerns include a lack of perceived need/ benefits of health insurance, affordability, and complexity of terms and conditions. Addressing these barriers through clear communication, affordable micro-products, and simplified onboarding processes will be essential for expanding coverage and inclusion across demographics.

Piyali Chatterjee, Executive Vice President, CX, Hansa Research, said, “Expansion of network coverage, simplifying pre-authorization protocols, and ensuring timely settlements will improve customer trust. Addressing these issues is critical for strengthening India’s healthcare financing ecosystem and delivering a seamless insurance experience.”

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PUNE: Bajaj Allianz Life Insurance, one of India’s leading private life insurers, has demonstrated its unwavering commitment to policyholders with a Claim Settlement Ratio of 99.23% for the fiscal year 2023-24. This figure underscores the Company’s dedication to providing prompt and reliable support during the toughest times a nominee faces and ensuring all policyholders that the Company will continue to stand by their family and keep their Life Goals on track. The Claim Settlement Ratio is a crucial metric that gives customers a sense of how an insurance company honors its policyholders’ claims.

“To stay true to our promise of Customer First, Bajaj Allianz Life has continuously invested towards enhancing processes and empowering its people. Our moment of truth on these investments is when our policyholder’s family member comes forth for a claim. Our latest Claim Settlement Ratio reflects that we are moving ahead in the right direction. Our focus will remain on further enhancing these experiences, leverage new-age tech and innovations to remain our policyholders’ most trusted Life Goals enabler”, said, Tarun Chugh, MD & CEO, Bajaj Allianz Life.

Bajaj Allianz Life has displayed sustained growth over the years, and while their investments in processes have helped business grow it has also helped the Company settle claims faster. The Company has consistently enhanced its claims settlements through various efforts assistance by experts to family members who can educate and assist them throughout the process, continuous communications with the claimants to keep them updated on the status of their claims, and so on.

Bajaj Allianz Life continues to keep its promise to customers, and it is reflected through a few milestones. For the period FY 2006 to FY2024, Bajaj Allianz Life settled over 2.8 lakh individual claims, amounting to a total payout exceeding INR. 6400 crores. Another key parameter reflecting the strength of a life insurance company is the rating provided by third-party experts. Bajaj Allianz Life has enjoyed a AAA Stable Rating awarded by CARE for four consecutive years now which underlines the Company’s strong performance across various business metrics and strengthens its position as the preferred life goals enabler.

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UNITED STATES: The Federal Trade Commission is launching a claims process for small businesses harmed by payment processing company First American Payment Systems’ undisclosed early termination fees.

The agency is mailing notices to 1,137 businesses that were customers of First American between June 2017 and April 2020 and later canceled their services. Businesses that paid an early termination fee are eligible to request a payment. The deadline to file a claim is May 28, 2024. Eligible businesses can file a claim online at www.ftc.gov/FirstAmerican. Those who have questions or need help filing a claim can call 877-595-0114 or email info@FirstAmericanPaymentSettlement.com. The Commission never requires people to pay money or provide account information to apply for a refund.

The FTC first took action against First American in 2022, alleging that the company failed to disclose early termination fees and made false claims about fees and cost savings to lure merchants, many of whom had limited English proficiency, into using its services. Once merchants were enrolled, the defendants withdrew funds from their accounts without their consent and made it difficult and expensive for them to cancel the service. 

Under the terms of the settlement, First American and two of its sales affiliates were required to return $4.9 million, stop their deception, stop charging existing customers early termination fees, and make it easier for merchants to cancel their services.

The Commission’s interactive dashboards for refund data provide a state-by-state breakdown of refunds in FTC cases. In 2023, FTC actions led to $324 million in refunds to consumers across the country.

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During this period, Star Health paid over 27,700 individual claims in Pune, of which over 23,200 claims were settled in cashless mode, and over 4,400 claims were reimbursement claims. The company settled all cashless claims within two hours, and in most cases, the initial authorization for cashless treatment was given within two hours. Star Health has also endeavored to make the payments of reimbursement claims within seven days of claim submission, ensuring that customers do not face hassles in settlement even though the reimbursement route.

Star Health currently covers over 2.64 lakh lives in Pune, including more than 2.53 lakh individuals through its retail health insurance and over 10,000 individuals via group health insurance. With 14 branch offices and a strong network of over 19,600 agents in the region, the company ensures accessibility and timely support for its customers. As of August 2023, Star Health boasts 777 network hospitals in Pune, facilitating cashless hospitalization for policyholders.

Star Health and Allied Insurance Company Limited covers over 77.54 lakh lives nationally, aided by a network of 6.58 lakh agents, 879 branch offices, and 18,993 network hospitals, guaranteeing accessible, quality healthcare. The company also harnesses AI and MI technologies to enhance customer service, reducing query turnaround times and offering a seamless, efficient experience.

Aditya Biyani, Chief Strategy & Investor Relations Officer, Star Health and Allied Insurance Co. Ltd., said, “We are happy to say that at Pune, Star Health has been quick to settle claims and approve cashless treatments. We are committed to our customers in the region and have constantly strived to provide the best experience possible for them, be it through our innovative products designed to address all the health cover needs of our customers or via our claims management. We continue to strengthen our hospital network in the city to make it easier for customers to gain access to cashless treatments at a hospital close to their residence.“

Better awareness brings a host of advantages to Star Health customers, including 24×7 telemedicine services, wellness programs promoting good health to reduce hospitalization, free annual health check-ups, and more. Accessible nationwide via the Star Health App, this platform also facilitates video conferencing for doctor consultations, ensuring an enhanced and efficient healthcare experience.

Star Health and Allied Insurance’s commitment to customer satisfaction and financial security is reflected in its quick settlement of claims and approval of cashless treatments. The company’s innovative products and claims management, coupled with its extensive network of hospitals and agents, ensure accessibility and timely support for its customers.

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To tackle hefty medical bills and minimize out-of-pocket spending Health Insurance becomes essential. Understanding its significance, nowadays, an increasing number of people opt for Health Insurance. Yet there are many people who still hesitate to invest in Health Insurance. The reason for this hesitation can be attributed to various misconceptions revolving around claim settlement by Health Insurance companies, among others. Hence it is essential to know about how the claim process works, what are the different types of claims, etc. as this will help minimize last-minute hassles.

There are two types of claims in Health Insurance – Cashless Claims and Reimbursement Claims. Knowing how each one of them works will come in handy at times of need.

Cashless Claim

It is a type of Health Insurance claim in which the Insurance company will directly settle with the hospital. Thus policyholders do not have to spend for medical bills out-of-pocket. The cashless claim can be availed for both planned hospitalization as well as emergency hospitalization. But it is crucial to remember that such a claim can be availed only if the treatment is taken in a Network Hospital. This is where many people face troubles during claim settlement.

Every Health Insurance company has tie-ups with a group of hospitals known as Network Hospitals. These hospitals will usually be listed on the official website of the respective Health Insurance companies. People can also get such information from intermediaries and Health Insurance agents.

For planned hospitalization, the policyholder can inform the insurer about the hospital admission typically from forty-eight to seventy-two hours in advance. However, no prior information needs to be given to the insurer in case of emergency hospitalization. But it must be communicated to the insurer within 24 hours of the hospital admission.

A cashless claim facility is indeed one of the biggest benefits in Health Insurance. While purchasing a Health Insurance policy, it is wise to choose an insurer that has a wide network of hospitals as people do not have to have a hard time finding the company’s network hospitals to avail of cashless treatment. In that regard, Star Health and Allied Insurance Co Ltd. have an extended network of over 14,000+ Network Hospitals spread across the country ensuring quality health care to people. It is important to know that cashless hospitalization is available for Group Health Insurance policies as well.

Reimbursement Claim

There may be times when people have to undergo treatments in non-network hospitals either due to some situations or lack of awareness. These are the hospitals with which the Health Insurance companies do not have tie-ups, and people cannot avail of cashless treatment facilities in those hospitals. However, still they are eligible to make claims in the form of reimbursements. The policyholder initially has to pay the hospital bills and request for reimbursement by submitting necessary documents including the proof of hospital bills as required by the insurer.

To sum up, knowledge about Health Insurance claims is crucial to avoid claim rejections and other claim-related troubles. Cashless claims can come in handy when getting admitted to network hospitals, whereas, in case of hospital admission in non-network hospitals, the policyholders can get coverage in the form of reimbursements. To avoid any last-minute hassle and rejection of cashless claims, it is better to check the network hospitals in and around your locality.

Photo by Lesly Juarez on Unsplash

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1. New Customers Calling for New Solutions

Over the years, the needs, knowledge, and expectation of customers have changed significantly. Hence customers are no more the people who accept everything that comes their way. Instead, they look deep into every matter and seek the best solutions. Similar to every other industry, customers are a disruptive force in the insurance sector as well. It is the time when we experience constant changes, immediate solutions, and extensive choices.

Therefore, insurance companies need to move ahead of their basic products and services in order to sustain them. Customers need insurance companies to be tech-savvy and be able to manage new demands in the new digital era so that they can get the most reliable deals without engaging themselves in many hassles.

2. A New Perspective on Growth

To achieve growth, insurance companies need to constantly evaluate their roadmap and align with the market needs and changes. The conventional approach of merely selling products and services is no longer sufficient, as customers know what is advantageous for them and what is not. So insurance companies will achieve growth by leveraging service-centric models, developing innovative products, and asserting more focus on preventive measures.

The rise in demanding customers means insurance companies have to continually innovate their products and services in order to stay relevant. Whether it is about a term insurance plan or any other life insurance coverage, customers are always looking for new ways to gain maximum financial security. And there is no way insurance companies can grow without moving along with these demands.

3. Collaboration and Expansion

In the current fiercely competitive scenarios, insurance companies have understood that merely organic growth and internal innovation are not sufficient. Along with offering the best insurance plan, these companies also need to focus on equity partnerships, M&A, and external alliances to facilitate their growth. Alliances with thriving tech start-ups can be highly advantageous for insurance companies. Presently, companies within this sector need exceptional deal-making skills to expand collaboration and remain relevant.

4. Embracing the Digital Disruption

No industry can overlook technological transformation, and the insurance sector is no different. However, being aware of this evolution and taking the necessary steps are two different notions. Insurance companies need to ameliorate the technological aspect and leverage cloud, blockchain, and analytics to their benefit. The emergence of new technologies is evidently going to create a certain degree of disruption.

In order to stay ahead of competitors, insurance companies need to understand and implement the technology to their benefit. Customers are inclined toward companies that are able to provide them with seamless products and services at a reasonable cost. Harnessing the potential of the right technology and methodology will enable the insurance company to provide products and services that cater to customers’ expectations. So beating the competition would not be tough for them.

A few Technologies that can be used by them are:

• Underwriting: Conventional underwriting resources are not enough to fulfill the modern-day requirements of the industry. With the help of AI and analytics, organizations can come up with more accurate underwriting by using a massive amount of customer data. Plus, blockchain technology will enable them to transfer information within the enterprise securely. So it can be used on multiple interfaces without any issues.
• Chatbots and Wearables: AI and IoT are two of the most innovative technologies in today’s market. When they are creating an impact everywhere, how can the insurance industry be left behind? These will bring a significant difference in the speed of quote-to-issue processing speed. Plus, it will offer an opportunity for insurers to motivate their customers for leading a healthy lifestyle.

5. Better Claim Settlement Process

When you look for the best insurance company in India, the claim settlement ratio plays a significant role. It helps you ensure that the insurer is good at settling the claims of its customers, which makes them more reliable for you. So with the increasing demands of customers and modern-day technologies, enhancing the claim settlement process is almost inevitable for organizations. It can be in the form of online claim portals or more efficient processing of claims, but the enhancement would be seen there.

6. Pandemic Coverage

How can we forget the major event of 2020, i.e., the coronavirus pandemic? As people are worried about such diseases that may turn into an epidemic in the future, insurers are looking forward to securing their customers for the same. On the other hand, insurance companies also need to ensure that they are not caught off-guard another time any such pandemic with high death rates hit the world.

Massive internet penetration, technological advancement, and rapidly changing demands of customers are bringing exponential transformations in insurance sectors. The companies in this industry need to stay updated with the existing trends and implement them in their operations to stay competitive and ensure growth.

Image by Freepik

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