Summary of this article
Pollution-linked health insurance claims rose 4.34 times in three years.
Cardiovascular and respiratory conditions account for 78 per cent of claims.
Working professionals contribute 59 per cent of pollution-related claims.
Pollution-related health insurance claims in India have increased more than fourfold in three years, with working professionals and senior citizens accounting for nearly 90 per cent of the total claims, according to Policybazaar data.
The average claim amount has touched Rs 62,662. On the other hand, the total value of claims has grown 4.5 times between FY23 and FY26. The rise in medical expenses linked to pollution-associated illnesses can also be gathered from the data, with claims concentrated in the winter months.
Pollution-Related Illnesses Drive Most Claims
Cardiovascular conditions account for 43.5 per cent of pollution-associated health insurance claims, making them the largest category. Other respiratory infections contribute 35 per cent, followed by pneumonia at 11.2 per cent and bronchitis at 6 per cent.
Together, cardiovascular and respiratory conditions account for 78 per cent of the claims. The figures indicate that pollution-related health problems are not limited to breathing difficulties, with heart-related conditions also forming a substantial part of hospitalisation claims.
Working Professionals Account For 59 Per Cent Of Claims
Individuals aged 31-55 contribute 59 per cent of pollution-associated health insurance claims, making working professionals the largest affected age group in the data.
Senior citizens aged 55 and above account for another 31 per cent. Young adults between 21 and 30 contribute 6.7 per cent, while children below 20 make up 3.7 per cent.
The figures show that seniors and those in their working years account for the bulk of insurance claims linked to pollution-related illnesses.
Pollution-Linked Claims Increase 4.34 Times In Three Years
The number of pollution-associated health insurance claims has grown 4.34 times between FY23 and FY26. Claims increased 67 per cent in FY24, followed by a 70 per cent rise in FY25 and another 53 per cent increase in FY26.
The average claim amount rose 9 per cent in FY24 compared with FY23. The total claim payout also increased 4.5 times over the three-year period, reflecting the combined impact of higher claim volumes and average costs.
Smaller Cities Contribute 55 Per Cent Of Claims
Delhi accounts for the highest number of pollution-linked claims, followed by Pune, Bengaluru, Mumbai and Hyderabad. However, the data points to a substantial share from smaller urban centres.
Tier-2 and Tier-3 cities contribute 27 per cent each, taking their combined share to 54 per cent, or roughly 55 per cent. Ernakulam and Faridabad also feature among the top 10 cities.
Winter Months Account For 56 Per Cent Of Claims
The October-March period accounts for nearly 56 per cent of annual pollution-related health insurance claims in FY26. This coincides with the months when air quality deteriorates in many parts of the country.
The seasonal concentration of claims indicates a higher demand for medical care during the winter period. Data has also shown that 48 per cent of consumers in highly polluted cities opt for higher health insurance coverage.
