NEW DELHI: India’s maternity healthcare landscape is undergoing a significant shift, with more women accessing formal, institutional care than ever before. As per data from the Ministry of Health and Family Welfare, with over 88–90% of births now occurring in institutional settings, the share of institutional deliveries has reached 97.3% in 2023–24, signalling a sustained shift towards formal, hospital-based maternal care. Government data presented in 2025 further showed that C-section deliveries accounted for over 27% of all reported births in India during 2024–25, reinforcing the growing shift towards medically intensive maternity care.

Against this backdrop, Care Health Insurance highlights a clear expansion in women’s health claims, both in scale and intensity. Women’s health insurance claims rose 37% from FY25 to FY26, with the 20–40 age group continuing to drive this growth, increasing from 25% over the same period.

At the same time, maternity-related claims are becoming more cost-intensive, with Tier 2 and Tier 3 cities continuing to account for a larger share of overall claims, contributing to 60% of all maternity claims reported to the company.

A shift in the maternal age profile is also visible. In FY26, women aged above 35 years accounted for 12% of total maternity claim volumes, which was higher compared to previous years and increasing. The cost of this age group was 18% of the overall claim amount, indicating higher cost intensity associated with later-age pregnancies.

Overall maternity claim outgo has risen by 25% over the last two years, even as claim volumes have fluctuated, indicating a shift towards higher spend per case.

While deliveries are becoming increasingly institutionalized and more efficient, the proportion of women discharged within five days for maternal care has increased from 75% in FY24 to 82% in FY26. This duration of discharge is not resulting in cost reduction; instead, the company has seen an upward trend in cost intensity for maternal treatment.

Taken together, these trends reflect a structural shift in maternal healthcare, with rising cost intensity and evolving care patterns driving higher financial exposure. The findings are further reinforced by broader public health data, which indicates that a majority of women in India are accessing formal antenatal care services, while three out of four continue to have inadequate dietary iron intake, highlighting persistent nutritional gaps and long-term health vulnerabilities beyond maternity.

Commenting on the findings, Manish Dodeja, Executive Director & Chief Business Officer, Care Health Insurance, said, “Women’s health insurance claims are no longer following a linear growth pattern; they are expanding in both scale and intensity. We are seeing a clear shift in the maternity landscape, with costs rising steadily. While care pathways are becoming more efficient, the financial exposure associated with maternal healthcare is increasing. This is not just a utilisation trend; it reflects a broader shift in how women are accessing and experiencing healthcare today. It is therefore important for individuals to periodically reassess their coverage to ensure it remains aligned with evolving needs.”

As maternal healthcare continues to formalise and utilisation rises, ensuring adequate and timely health insurance coverage remains critical to managing financial exposure and ensuring continuity of care.

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AHMEDABAD: Bajaj Allianz Life Insurance, one of India’s leading private life insurance providers, expresses its deepest condolences to the families affected by the tragic aircraft crash in the Meghani Nagar area of Ahmedabad on June 12, 2025. In response to this unfortunate incident, the Company has activated special measures to assist families of its policyholders affected by the crash.

Understanding the immense challenges faced by the affected lives assured’s families during this difficult time, Bajaj Allianz Life Insurance has established a dedicated special claims settlement desk to prioritize the processing of death and disability claims for its customers impacted due to this tragedy. With utmost urgency, an expeditious process has been established to swiftly settle these policy claims.

To simplify the process, Bajaj Allianz Life Insurance has listed a minimal documentation process that nominees, legal heirs, or policyholders need to submit to process their claims. In case the Death Certificate is not immediately available, a certificate issued by the municipal authority or hospital will also be accepted to initiate the claim process, along with the nominee KYC and bank mandate. Claims can be notified, and details can be submitted through any of the following convenient modes:

• Call the company’s toll-free number 1800-209-7272
• Visit one of the nearest branches among the 596 branches across the country
• Email at: claims@bajajallianz.co.in

Bajaj Allianz Life Insurance remains committed to supporting its policyholders through challenging circumstances and will continue to provide prompt assistance to those affected by the Ahmedabad tragedy.

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The risk management solution was successfully piloted on motor theft claims by Clearspeed and ICICI Lombard. Motor theft is a sizeable issue in the Indian market, and some fraudsters use this opportunity to lodge fraudulent claims.

Nazeem Khan – Head – ICLM, Motor Third Party Claims & Litigation, ICICI Lombard, said, “This partnership with Clearspeed aligns perfectly with ICICI Lombard’s fraud prevention model that we have been developing and refining for several years. By integrating Clearspeed’s new approach to risk assessment with our extensive experience in the Indian insurance market, we are taking a significant step toward addressing fraudulent claims while ensuring our customers with genuine claims receive timely settlements.”

Clearspeed’s revolutionary approach to risk assessment differs fundamentally from traditional methods. Unlike traditional risk assessment methods that rely on extensive documentation validation, subjective evaluations, and lengthy processing times, Clearspeed’s solution is:

• Fast – providing real-time insights to enable quicker settlements
• Bias-free – operates independently of historical data or predictive models
• Frictionless – removes cumbersome steps for genuine customers

“We are excited to partner with ICICI Lombard to address its challenges unique to the Indian market,” said Alex Martin, CEO, Clearspeed. “We have supported some of the largest global insurance carriers in the U.K. and the U.S., delivering an overall reduction of 50% in average claims handling time and a 40% increase in immediate settlements to claimants. We look forward to helping ICICI Lombard unlock this type of efficiency while maintaining their excellent customer experience ratings.”

The initial focus of this partnership will be motor theft claims, which will benefit from expedited processing, with the collaboration slated to expand across additional insurance lines as the partnership evolves.

The post ICICI Lombard and Clearspeed Join Forces Through Aelius to Combat Claims Fraud in India appeared first on NRI News.

• Principal Secretary, of Public Health and Family Welfare advised instituting a departmental inquiry against Dr. Sharad Dwivedi, Member of the District Medical Board
• Medical Council of India advised to initiate appropriate action against Dr. Balkrishna Dang
• The matter was referred to the State Bar Council for taking action against Adv. Shri Manoj Shivhare
• The Director General of Police issued direction to constitute a high-level team in the form of S.I.T. to investigate the three-party nexus

JABALPUR: In a landmark judgment that could lay the rules for motor claims settlement, the Madhya Pradesh High Court has asked the DGP of the State to set up a Special Investigation Team (SIT) to probe a malicious nexus between doctors, lawyers, and police officials in motor claims cases. Shriram General Insurance Company (SGIC), part of the Shriram Group, won this landmark judgment in its favor from the High Court of Madhya Pradesh in a fraudulent Motor Insurance claim.

The case also exposed a nexus between a Hospital, Police Officials, and Lawyers to claim motor vehicle accident insurance money by submitting forged documents, fraudulent certificates, and medicine bills. The Hon’ble High Court taking cognisance of discrepancies in the claim documents submitted ruled that the claim was fraudulent and ruled in favour of Shriram General Insurance.

The Hon’ble Court in its Order (attached along with) has referred the matter to the Principal Secretary, Public Health and Family Welfare and Medical Council of India to initiate appropriate action against Dr. Sharad Dwivedi and Dr. Balkrishna Dang’s false and forged medical certificates.

The Hon’ble High Court has also referred the matter to the State Bar Council for taking action against Adv. Shri Manoj Shivhare for obtaining a forged and fabricated medical certificate as well as directed the Director General of Police to form a high-level S.I.T. to investigate cases of false implication involving the collusion of three parties: the claimant, police officials, and the doctors concerned.

The claimant, Rakesh Valtiya, had sought compensation for injuries sustained in a road accident involving a pickup vehicle. However, upon examination of the evidence, the court identified discrepancies, particularly with respect to a disability certificate provided by Dr. Sharad Dwivedi, a Member of the District Medical Board without actually examining the patient.

The discharge card by Dr. Balkrishna Dang submitted was from Sudha Hospital and not Suvidha Hospital where he worked. The glaring discrepancy between the date of admission and the date of discharge in the discharge card vis-à-vis the same on the bill proved beyond doubt that the discharge card was a forged document.

The Claimant’s own testimony that he had never visited the hospital and that all the necessary certificates, etc were organized by the Counsel further proved that Dr. Sharad Dwivedi has never examined the Claimant and all certificates issued by him, in conjunction with Adv. Shri Manoj Shivhare was fraudulent with the intent of defrauding the Insurance Company. The State Bar Council has been instructed to take appropriate action against the claimant’s counsel, Manoj Shivhare, for his role in obtaining the forged medical certificate.

The Court directed that the Director General of Police constitute a high-level team in the form of S.I.T. to investigate the cases of false implication where three parties are necessarily in connivance namely the claimant, police, officials of the region, and the concerned Doctors. Besides this, sometimes claimants act at the behest on provocation of their counsel who are practicing in the field of motor accident claim cases or in the field of criminal law. Thus, S.I.T. be requested to examine these frauds within the system which are being perpetuated day in and day out causing a dent in the credibility of the judicial system.

Commenting on the decision of the court, Ashwani Dhanawat Executive Director, Shriram General Insurance Company said, “This outcome is a testament to our ongoing efforts to safeguard policyholders and ensure the long-term stability of the state’s insurance system. As stewards of both policyholder and shareholder funds, we bear the responsibility of ensuring these resources are allocated to legitimate claims. This reinforces our commitment to a robust claims management framework, which is focused on identifying and preventing fraud while ensuring that our resources are directed towards those policyholders who genuinely require protection.

The High Court’s ruling underscores the critical importance of maintaining the highest standards of professional ethics and strict adherence to medical guidelines in the assessment and certification of disabilities. This decision serves as an important reminder that both the legal and medical professions must work collaboratively to uphold the values of integrity, transparency, and public trust.”

Additionally, Dhanawat highlighted, “The compensation to motor accident victims is a beneficial act, designed to support genuine claimants. However, scamsters often try to exploit this by indulging in fraudulent activities. The Hon’ble court recognized this in the case and took cognizance of the same, reinforcing the importance of safeguarding the integrity of such beneficial Act.”

Compensation Adjustments and Deductions:

While the court upheld the fact of the accident and compensation for loss of income, it made significant deductions from the total compensation due to the fraudulent bills. A total amount of ₹52,053/- was deducted from the claimant’s awarded compensation. After considering the deductions, the final compensation payable to the claimant is ₹2,22,043/-. SGI had appealed against the order of the tribunal for compensation of ₹2,74,096/-.

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