Summary of this article
Health insurance is meant to offer protection, but for many women in India, it often comes with a hidden penalty. From maternity loading and higher premiums to tighter claim scrutiny around reproductive and hormonal conditions, women frequently end up paying more while receiving less coverage. As the market evolves, insurers, regulators, and consumers all have a role to play in rewriting the rules to make health cover genuinely inclusive.
When a 29-year-old woman bought a health policy this year, she was puzzled. Her premium was almost 20 per cent higher than her male colleagues despite choosing the same sum insured. The reason? Extra charges called maternity loading, stricter rules around “women’s illnesses,” and a greater chance of rejection for certain claims. This case reflects a bigger reality in India’s health insurance market: women often end up paying more, while getting less.
What’s Driving This Gap?
Maternity loading: Having a child is a predictable health event, yet only few policies in India cover maternity benefits, usually as expensive add-ons with long waiting periods.
Higher risk tags: Conditions like PCOS (polycystic ovarian syndrome), thyroid, osteoporosis, and breast cancer are common among women. Instead of being included as standard, they are often treated as ‘high-risk’ and priced up.
Tighter claim scrutiny: Industry data suggests women face stricter checks on claims linked to reproductive or hormonal health, which can delay or reduce payouts.
The irony? Women are more disciplined healthcare consumers with regular check-ups, more compliant with treatments, and less likely to make reckless claims.
Sanjiv Bajaj, joint chairman and MD, BajajCapital, says this is a moment of opportunity for insurers.
“Rather than seeing maternity or reproductive health as liabilities, we have an opportunity to design products that genuinely support women’s lifelong health journey. It’s about creating fairness, not special treatment,” he says.
Bajaj adds that the shift won’t just benefit women, it will strengthen trust across the industry.
What Can Change?
More gender-inclusive products: Some insurers have started offering women-centric plans that cover conditions like PCOS, breast cancer, and maternity. Wider adoption could bring down costs.
Regulatory push for transparency: The Insurance Regulatory and Development Authority of India (Irdai) has already introduced simpler policy documents and standardised terms. This makes it easier to compare what’s included and excluded.
Consumers Asking the Right Questions: Bajaj points to the power of awareness. “When women carefully compare policies, check waiting periods, and question exclusions, it pushes insurers to respond with better-designed products. In a way, demand is the strongest driver of change,” he says.
Here are three questions every woman should ideally ask before buying health insurance
Does this plan cover maternity and what’s the waiting period?
Are women-specific conditions like PCOS, breast or cervical cancer included without extra loading?
What are the exclusions, and how often are claims for women’s health needs honoured?
The Bottom Line
For women, the issue isn’t about discounted premiums, it’s about fairness and peace of mind. A health insurance policy should cover the realities of women’s lives, not penalise them.
The good news? The conversation has begun, and insurers who step up with transparent, inclusive products won’t just win customers, they will trust.
