Cashless claims deliver better health insurance experience, scores higher than reimbursements: Policybazaar

Policybazaar on Monday launched the Health Claims Experience (HCX) Index, introducing what it describes as India’s first benchmark designed to measure customer experience across the health insurance claims journey.

The index was unveiled as part of the second edition of Policybazaar’s nationwide consumer study, Is India Happy with Health Insurance Claims? 2.0, with the aim of addressing a longstanding gap in assessing customer outcomes beyond conventional industry metrics.

While claim settlement ratios remain the most widely tracked measure of insurer performance, the report noted that there has been no standard framework to evaluate how policyholders experience the claims process. The HCX Index has been developed to capture both operational efficiency and customer sentiment across the claims journey.

The study surveyed 2,228 respondents across metropolitan, Tier-2, and Tier-3 cities who had either undergone hospitalisation themselves or for family members and filed a health insurance claim between August 2024 and September 2025. The sample also included non-Policybazaar customers who filed claims through various channels.

India’s inaugural HCX score was recorded at 82.8 out of 100, placing the country’s overall health insurance claims experience in the “moderate” category.

Cashless claims drive better customer experience

According to the findings, cashless claims are emerging as the strongest contributor to positive customer experiences in health insurance.

Seven in 10 respondents opted for cashless treatment, with such claims registering an HCX score of 86.7—significantly higher than reimbursement claims, which scored 73.7. Respondents identified reduced paperwork, faster approvals, and easier access to network. Sarbvir Singh, Joint Group CEO, Policybazaar, said health insurance ultimately demonstrates its value at the time of claim settlement and that existing metrics do not fully reflect customer experiences. “While claim settlement ratios provide an important view of insurer performance, they do not fully capture what customers experience during the claims journey,” Singh said.

He added that the HCX Index is intended to bring greater transparency and customer-centricity to health insurance by establishing a common benchmark for evaluating claims experiences.

Singh also highlighted that regulatory initiatives introduced by IRDAI in recent years have improved customer outcomes and accelerated the adoption of more consumer-friendly claims processes.

According to him, the next phase of industry evolution will extend beyond faster settlements to ensuring customers better understand claim decisions and have greater confidence in the process.

Based on the findings, the report recommended measures such as clearer communication on claim decisions, detailed explanations for claim rejections, stronger verification at the time of policy purchase, real-time claim tracking, deeper integration between hospitals and insurers, and reduced documentation requirements to make claims faster, simpler, and more reliable for customers.