Nowadays it has become very easy to get health insurance but taking claim at the time of treatment is still a big headache. According to Policybazaar’s new ‘Health Claims Experience Index’ (HCX) report, delay in receiving claims and rejection of claims without concrete reasons is the biggest problem for customers. The survey, conducted between August 2024 and September 2025, included the experiences of 2,228 people. HCX score has been used in this report which tells on a scale of 100 how good is the company’s service. India’s average score is 82.8 which shows that the claims process still needs a lot of improvement.
The survey has found that most people want cashless facility so that the company can pay the money directly to the hospital. Sixty percent of people choose the method of paying the money themselves instead of cashless and asking for it back later. They fear that getting cashless approval will take a lot of time and treatment will be delayed. When people pay money themselves they face a lot of trouble. According to the survey, 76 percent people have to exhaust their savings or take a loan to pay the hospital bill.
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Companies’ Performance and Score
The report divides customer experience into three levels. The first category is excellent where the score is above 90, the second category is average where the score is between 70 to 89.9 and customers are harassed during the process, while the third category is difficult where it is extremely difficult to get a claim due to the score being below 70. According to the data, the experience of customers who choose cashless facility is much better than those who choose the process of filling the money themselves and getting it back later.
The report clarifies that a large portion of claim rejections are solely due to paperwork deficiencies. Another important data from the survey is that for customers who took more than 15 days to receive their claim, their HCX score dropped below 65, which is considered a very poor experience. The biggest problem of the customers is that they do not get timely information about the status of their claim, due to which they remain troubled all the time.
demand for necessary reforms
The customers included in the survey have demanded some major changes from the insurance companies. If insurance companies pass any claim within seven days, it can increase customer happiness and satisfaction by 15 percent. Customers also say that the list of hospitals they have should be completely clear and precise so that they do not have any doubts.
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Along with this, customers have also demanded that the entire process of filling the claim form should be made so easy and online that anyone can use it very easily. This entire report is like a big warning to the insurance companies that if they do not do the work of paying claims very quickly and honestly, then it will be completely impossible for them to maintain the trust of their customers in the future.
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