Complaints against health insurers in India are on the rise, indicating growing consumer awareness and the importance of effective grievance redressal mechanisms. According to Insurance Samadhan, a grievance platform, there was a 45% increase in complaints in Q2 2025 compared to the previous quarter, with 974 cases involving claims worth over ₹119 crore. The majority of these grievances (67.5%) related to health insurance, followed by life insurance (25.5%) and general insurance (6.9%). Endowment policies were the most commonly mis-sold products, often leaving policyholders with reduced returns or penalties.
The Council of Insurance Ombudsman (CIO) data for FY2023-24 provides further insight into the sector’s challenges. The ombudsman received the highest number of complaints against Star Health & Allied Insurance, with 13,308 cases, mostly regarding partial or complete claim rejection. Other insurers with high complaint volumes included CARE Health Insurance, Niva Bupa, and public sector insurers National Insurance and The New India Assurance. Star Health’s complaint volume was significantly higher than its peers, with 63 complaints per lakh policyholders.
Experts attribute the high complaint volume to mis-selling, driven by aggressive agent commissions and sales targets. Many consumers are sold unsuitable policies, which can lead to higher premiums or outright rejections due to pre-existing conditions. The data highlights the need for consumers to proactively evaluate their coverage and understand complaint mechanisms to ensure adequate protection. Additionally, the trend of Indians first experiencing insurance through employer-provided group health policies, and then purchasing retail policies triggered by claims or life events, emphasizes the importance of early adoption and careful policy selection.
The increasing complaints against health insurers in India underscore the need for improved grievance redressal mechanisms and consumer awareness. As the insurance sector continues to grow, it is essential for consumers to be aware of their rights and options for resolving disputes. By understanding the common issues and challenges in the sector, consumers can make informed decisions and ensure they have adequate protection. Ultimately, the rising complaints against health insurers in India highlight the need for a more transparent and consumer-centric approach to insurance sales and claims settlement.