Pollution-Linked Health Insurance Claims Surge Over Fourfold in Three Years, Insurer Data Shows

Pollution-linked health insurance claims have increased significantly over a three-year period, according to figures released by the insurance marketplace Policybazaar. The data indicates that the average claim amount reached ₹62,662, while total claim payouts multiplied by 4.5 between fiscal year 2023 and fiscal year 2026. Annual growth figures showed a 67 percent increase in FY24, a 70 percent rise in FY25, and a further 53 percent jump in FY26.

Cardiovascular and Respiratory Conditions Drive Claims

Heart and respiratory ailments account for roughly 78 percent of all pollution-associated insurance claims. Specifically, cardiovascular conditions represent 43.5 percent of the total, followed by other respiratory infections at 35 percent, pneumonia at 11.2 percent, and bronchitis at 6 percent. Rohan Goel, Business Head of Health Insurance at Policybazaar, noted that these trends emphasize the necessity of preventive healthcare, prompt medical care, and proper insurance protection to cope with unexpected medical expenses.

Working Professionals and Seasonal Spikes

Working adults aged between 31 and 55 account for 59 percent of the total claims, while senior citizens aged 55 and older comprise 31 percent. Younger adults aged 21 to 30 make up 6.7 percent, and children under 20 contribute 3.7 percent. Geographically, New Delhi recorded the highest number of claims, followed by Pune, Bengaluru, Mumbai, and Hyderabad. Tier-2 and Tier-3 cities combined account for 55 percent of the total, with locations like Ernakulam and Faridabad also appearing in the top ten. Additionally, claims peak between October and March, accounting for 56 percent of annual claims in FY26 due to worsening air quality. Furthermore, 48 percent of consumers residing in heavily polluted cities choose higher sum insured amounts.