Star Health Tops Health Insurance Grievance List in FY24

Health insurance continues to face trust issues as policyholders struggle with claim settlements. According to the Insurance Ombudsman’s 2023–24 annual report, grievances against health insurers rose by 21.7% year-on-year, even as complaints in life and general insurance declined. The data shows a handful of insurers repeatedly attracting the highest number of complaints.

Star Health Leads the List

Star Health & Allied Insurance emerged as the insurer with the most complaints, recording 13,308 cases in FY24. Strikingly, over 10,000 of these were related to partial or complete claim repudiations.

This figure alone exceeded the combined complaints of the next four insurers in the top five.

Responding to the report, a senior official of Star Health and Allied Insurance, told Business Standard that the higher complaint volumes to its heavy focus on retail business, which naturally results in greater customer interactions compared to peers with stronger group insurance portfolios.

Top 5 Insurers by Complaints

The top five insurers with the most grievances were Star Health (13,308), CARE Health (2,511), Niva Bupa (2,511), National Insurance (2,196), and New India Assurance (1,602).

Complaints per Policyholder

When adjusted for customer base, Star Health again topped with 63 complaints per lakh policyholders. In comparison, Niva Bupa and CARE Health had 17 and 16, respectively. Public sector insurers fared significantly better, with National Insurance reporting 5 and New India Assurance just 1 complaint per lakh policyholders.

Nature of Disputes

The majority of cases fell under Rule 13(1)(b) of the Insurance Ombudsman Rules, 2017, which covers disputes over claim repudiation. Star Health alone accounted for more than 10,000 such cases, followed by CARE (2,393) and Niva Bupa (1,770).

Awards in Favour of Customers

In FY24, the Ombudsman directed Star Health to compensate customers in 7,506 cases, amounting to over ₹6,000 crore. CARE Health, Niva Bupa, and National Insurance also featured prominently in awards issued to policyholders.

Also Read: LIC Delivers ₹7,324 Crore Dividend Cheque to Finance Minister for FY25!

Conclusion

The surge in health insurance complaints highlights deep-rooted dissatisfaction, particularly with claim settlement practices. With IRDAI planning to introduce internal ombudsmen within insurers from 2025, faster redress for disputes up to ₹5 million is expected. However, concerns over the independence of these mechanisms remain, keeping policyholder trust in focus for the industry.

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