Health Insurers Cut Delay: India has seen a clear drop in the number of health insurance complaints where companies did not settle cashless claims on time. Finance Minister Nirmala Sitharaman told the Parliament that this number has fallen to 0.39% in the first half of the financial year 2025-26. She shared this update in a written reply in the Lok Sabha and said the situation is improving as companies follow stricter rules.
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The minister explained that during 2024-25, people filed 2,57,790 complaints on the Bima Bharosa portal. Out of these, companies failed to meet the fixed time limit in 4,811 cases. She said this delay made up 1.87% of all complaints that year. She repeated the exact number in her reply: “a total of 2,57,790 complaints were received in the Bima Bharosa portal, out of which, for 4,811 complaints, the insurers have not provided the resolution within the stipulated time, constituting 1.87 per cent.” reported Zee news
Complaint Count Drops in 2025-26
During the current year, from April to September 2025, people filed 1,36,554 complaints. Out of these, companies delayed decisions in only 532 cases. This made up 0.39% of the total complaints. The minister kept this information exact as well, saying, “a total of 1,36,554 complaints were received, out of which, for 532 complaints, the insurance companies have not provided the resolution within the stipulated time, constituting 0.39 per cent of the total complaints received.”
The Insurance Regulatory and Development Authority of India, or IRDAI, had already ordered all insurance companies to upgrade their systems so they could meet new strict timelines by July 31, 2024. The rules set one hour for the first approval of a cashless claim and three hours for the final discharge approval. The reply clearly said these were “the mandatory timelines” for claim settlements.
How the Complaint System Wworks?
The minister also explained how the Bima Bharosa system connects with the insurance companies’ Complaint Management Systems. She said, “the Bima Bharosa platform is integrated with the Complaint Management Systems (CMS) of the Insurers.” This allows complaints to appear in both systems in real time. IRDAI has given companies 14 days to fix any complaint.
However, she added that Bima Bharosa does not automatically send complaints to the Insurance Ombudsman. She said the system “is not integrated with the Insurance Ombudsman System,” but people can still go to the Ombudsman if they feel the insurer did not help them properly. They can file these complaints online or in-person.
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During 2024-25, people filed 53,102 complaints with the Ombudsman offices to seek further help.
Regulatory Action Against Violations
The Finance Minister also said the regulator issued eleven show-cause notices in 2024-25. These notices related to rule violations linked to health claims, wrong claim deductions and improper claim rejections.
