CoverSure has released insights from its Policy Health Check, based on an analysis of more than one lakh policyholders, revealing that a large proportion of India’s insured population is either unable to upgrade to better health insurance plans or has not reviewed their coverage despite being eligible to do so.
According to the study, 63 per cent of policyholders who wanted to switch to a more suitable health insurance plan were unable to do so because they had developed pre-existing medical conditions, making portability or migration difficult. At the same time, nearly 49 per cent of policyholders without pre-existing conditions continue to hold basic, non-comprehensive plans despite being medically eligible to upgrade, highlighting a gap in awareness and engagement.
The findings also indicate that while around one-third of policyholders have a sum insured of approximately Rs 10 lakh, most individuals above the age of 50 continue to have coverage below Rs 5 lakh. Among policyholders living with chronic conditions, 17 per cent also hold less than Rs 5 lakh in coverage, despite facing a higher likelihood of hospitalisation.
The study further found that around 35 per cent of assessed policyholders reported having at least one medical condition. Of those with lifestyle-related ailments such as diabetes, hypertension, high cholesterol, and thyroid disorders, nearly 69 per cent fall within the 30 to 54 age group, with the 50 to 54 age bracket accounting for the highest share at 18.1 per cent.
The report also highlighted encouraging signs of greater awareness among younger consumers. Around 41 per cent of users who undertook the Policy Health Check were between 30 and 40 years old, while another 10 per cent were below the age of 30, indicating growing interest in proactively reviewing health insurance adequacy.
Commenting on the findings, Saurabh Vijayvergia, Founder & CEO, CoverSure, said, “Buying insurance is a starting point, not a destination. A policy that was right at 32 may leave someone dangerously underprotected at 35. Healthcare costs are rising, and lifestyle conditions are arriving earlier than most people expect. The problem is that policyholders rarely discover these gaps on their own; they discover them during a medical event, when it is already too late to change anything. The most dangerous period in insurance is not before you buy. It is the years after, when life has moved and the policy has not. The Policy Health Check exists to surface that gap before it becomes a crisis.”
According to CoverSure, the Policy Health Check evaluates the adequacy of health insurance coverage by assessing factors such as sum insured, plan comprehensiveness, pre-existing disease implications, and portability, helping policyholders better understand whether their existing insurance aligns with their current healthcare needs.
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