Paisa Vaisa with Anupam Gupta Why Your Insurance Claim Might Be Rejected (And How to Ensure 100% Payout) | Paisa Vaisa
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Jan 19, 2026 Mayank Bathwal, CEO of Aditya Birla Health Insurance, dives into the complexities of health insurance. He reveals that 15-20% of claims are tied to fraud, which impacts premium costs. Learn why cashless claims are the preferred choice and how personal involvement in your claims process can prevent rejections. Mayank also discusses wellness-linked policies that reward healthy lifestyles with potential premium returns. Plus, hear about the role of technology in evolving health management and the future of health coaching.
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Health Insurance Growth Momentum
- Health insurance is the fastest-growing retail insurance in India and now forms over a third of the general insurance market.
- Growth is driven by larger ticket sizes and expanding product coverage after COVID raised awareness.
The 'Missing Middle' Opportunity
- India has a clear "missing middle" of about 400 million not effectively covered by private or public schemes.
- Cracking this requires affordable, relevant products targeted at younger consumers.
Fraud, Waste And Rising Premiums
- Around 15–20% of claim costs are linked to fraud, waste, or abuse and inflate premiums for honest customers.
- Waste and abuse are harder to detect than outright fraud and require industry-level data and tech to manage.
