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Recent data from the Office of the Council for Insurance Ombudsmen reveals that over 55% of the total health insurance complaints filed with ombudsman were either resolved in favour of policyholders or recommended for mutual settlement (largely in favour of policyholders).
Between April 2023 and March 2024, a total of 29,276 complaints were disposed of. Of these, 6,233 complaints were resolved in favour of the complainants, which is about 21% of all complaints.
Also, the ombudsman recommended 10,135 complaints for mutual settlement.
Further, the ombudsman withdrew 2,087 complaints, put 6,699 complaints as non-entertainable and resolved 4,122 complaints in favour of the insurance companies.
Additionally, there were 4,927 outstanding complaints. The total number of complaints received during the period was 34,203.
|
Category |
Number of Complaints |
Percentage (%) |
|---|---|---|
|
Total Complaints Disposed of |
29,276 |
85.7% |
|
Resolved in Favour of Complainants |
6,233 |
21% |
|
Recommended |
10,135 |
34.6% |
|
Withdrawn |
2,087 |
7.1% |
|
Non-Entertainable |
6,699 |
22.9% |
|
Resolved in Favor of Insurance Companies |
4,122 |
14.1% |
|
Outstanding Complaints |
4,927 |
14.4% |
|
Total Complaints |
34,203 |
100% |
The data also revealed the companies which received the highest number of complaints in the health insurance sector.
According to the data, Star Health and Allied Insurance topped the list with 13,308 complaints. Care Health Insurance and Niva Bupa Health also received large number complaints with 3,718 complaints and 2,511 complaints, respectively. All three are standalone health insurance providers.
|
Rank |
Company Name |
Total Complaints |
|---|---|---|
|
1 |
Star Health and Allied Insurance Co. Ltd. |
13,308 |
|
2 |
Care Health Insurance Ltd. |
3,718 |
|
3 |
Niva Bupa Health Insurance Co. Ltd. |
2,511 |