The market figures CaladriusHealth.AI relies on for India's health insurance and revenue cycle economy, traced to named public sources.
In the financial year 2023-24, health insurers in India processed claims worth approximately ₹1.17 lakh crore. About 71% of that value was paid out within the year. The rest was disallowed, repudiated, or still pending when the year closed. Numbers like these circulate widely in health technology, often without attribution. This article consolidates the figures we rely on, explains what each one measures, and traces each figure to a named source.
A market growing on two fronts
India’s health insurance market reached USD 15.06 billion in gross written premium (GWP) in 2024, and Grand View Research projects growth at a compound annual growth rate (CAGR) of 20.9% between 2025 and 2030, reaching USD 46.37 billion by the end of the decade [1].
The regulator’s own data points the same direction. According to the Insurance Regulatory and Development Authority of India (IRDAI), health insurance premiums grew 20.32% year on year in FY 2023-24, with insurers collecting ₹1,07,681 crore [2]. In FY 2024-25, premiums crossed ₹1.27 lakh crore, growing a further 9.19%, and health insurance now accounts for 41.42% of India’s non-life insurance business [3].
Premium growth, however, is only half the picture. What happens after a claim is filed is the more operationally revealing measure.
Where the claims went in FY 2023-24
FY 2023-24 is the most recent year for which IRDAI has published a complete crore-level breakdown of claims outcomes by category, which makes it the natural reference year. Of the roughly ₹1.17 lakh crore in health claims processed by general and standalone health insurers, the outcomes by claims value were as follows [2][4][6]:
| Outcome | Amount | Share of claims value |
|---|---|---|
| Paid | ₹83,493 crore | 71.29% |
| Disallowed | ₹15,100 crore | 12.9% |
| Repudiated | ₹10,937 crore | 9.34% |
| Pending at year end | ₹7,585 crore | 6.48% |
Percentages are computed from IRDAI’s reported crore amounts and may not sum to exactly 100% due to rounding.
Two derived figures follow from this breakdown. Disallowed and repudiated claims together represent about ₹26,037 crore, or 22.3% of claims value. Adding pending claims, approximately ₹33,622 crore, or 28.7%, was not paid within the reporting year. These totals are arithmetic sums of the IRDAI-reported categories rather than independently published figures, and we present them as such.
The distinction between the categories matters. A disallowed claim is one the insurer declines to process because of issues with its validity, such as documentation gaps or procedural discrepancies. A repudiated claim is one denied after review because it did not meet the policy’s terms and conditions [5]. Both outcomes arise from a range of causes across the system, including policy exclusions, waiting periods, and coding inconsistencies. The figures describe settlement outcomes across the ecosystem as a whole and do not assign responsibility to any single stakeholder.
Measured by claim count rather than value, insurers received about 3.26 crore health claims in FY 2023-24 and settled 2.69 crore of them, a settlement rate of 82.46%, with an average payout of ₹31,086 per claim [4].
The FY 2024-25 picture
The IRDAI Annual Report 2024-25, released in late December 2025, shows the settlement trend improving. General and health insurers processed 3.26 crore health claims and paid ₹94,248 crore during the year. By claim count, roughly 87% of registered claims were settled, up from 82.46% the previous year. Around 8% were repudiated, down from about 11%, and about 5% remained pending as of 31 March 2025. The average claim paid was ₹28,910, and close to 58% of claims were settled through cashless channels [3].
One caution when comparing years: the FY 2024-25 settlement, repudiation, and pending rates are shares of claim count, while the crore-level FY 2023-24 breakdown above is by claims value. The two bases tell related but different stories, and mixing them produces misleading comparisons. The FY 2024-25 report also does not yet provide the category-level financial breakdown that the FY 2023-24 report did, which is why the earlier year remains our granular reference and the later year our directional update.
The revenue cycle management opportunity
Revenue cycle management (RCM) is the end-to-end financial process of healthcare billing, running from patient registration and eligibility verification through claim submission, adjudication, and payment reconciliation. Every disallowed or delayed claim in the figures above passes through this cycle, which is why the RCM market grows alongside the insurance market it serves.
Published estimates of India’s RCM market vary by research house and vintage. KenResearch (December 2024) values the market at USD 4 billion [7]. IMARC’s base-case series estimates USD 5.4 billion in 2025 and projects USD 15.6 billion by 2034, a CAGR of 12.1% over 2026-2034 [8]. Taken together, the published range is USD 4 to 5.4 billion, or roughly ₹33,600 to ₹45,400 crore at an exchange rate of ₹84 per US dollar.
The growth drivers cited across this research are consistent: the shift from manual to digital claims processing, the standardisation being built under the National Health Claims Exchange (NHCX), and the expanding digital health infrastructure of the Ayushman Bharat Digital Mission (ABDM).
How to read these numbers
Three practices shape how we present data on this page. First, regulatory figures come from IRDAI annual reports, available in the Annual Reports section of irdai.gov.in, and where a figure was reported through press coverage of those reports, the specific article is linked. Second, market sizing figures come from independent research houses whose methodologies differ, which is why the RCM market appears as a range rather than a single number. Third, any figure we calculate ourselves, such as the combined disallowed and repudiated total, is labelled as a calculation rather than presented as a published statistic.
India’s health claims economy is growing quickly, settling more of what it receives each year, and building the digital rails to process claims with less friction. Read on the right basis, the verified numbers support each part of that picture.
Sources
| Ref | Source | Figures cited in this article |
|---|---|---|
| [1] | Grand View Research, India Health Insurance Market Report (last updated August 2025) | Market size USD 15.06 billion GWP (2024); CAGR 20.9% (2025-2030); USD 46.37 billion by 2030 |
| [2] | Business Standard, “Health insurers reject claims worth Rs 15,100 crore in FY24: Irdai” (31 December 2024) | FY24 premiums ₹1,07,681 crore (+20.32% YoY); total claims processed ~₹1,17,000 crore |
| [3] | Outlook Money, “IRDAI 2024-25 Annual Report: Health Premiums Cross Rs 1.27 Lakh Crore Mark” (December 2025) | FY25 premiums ₹1.27 lakh crore (+9.19%; 41.42% of non-life); 3.26 crore claims processed; ₹94,248 crore paid; ~87% settled; ~8% repudiated; ~5% pending; average claim ₹28,910; ~58% cashless |
| [4] | Business Standard, “Health insurers disallowed claims worth Rs 15,100 cr during FY24: Irdai” (30 December 2024) | FY24 outcomes by value: paid ₹83,493 crore (71.29%); disallowed ₹15,100 crore (12.9%); pending ₹7,585 crore (6.48%). By count: 2.69 of 3.26 crore claims settled (82.46%); average payout ₹31,086 |
| [5] | Business Standard, “Health insurance claims rejection up 19.10% in FY24: Irdai report” (27 December 2024) | Definitions of disallowed and repudiated claims; combined disallowed and repudiated ~₹26,000 crore |
| [6] | Business Today, “Health insurance claim rejections went up by 19.10% in FY24” (26 December 2024) | FY24 repudiated claims ₹10,937 crore (9.34%) |
| [7] | KenResearch, India Revenue Cycle Management Market Outlook (December 2024) | India RCM market USD 4 billion |
| [8] | IMARC Group, India Revenue Cycle Management Market Report (base-case series, current edition) | RCM market USD 5.4 billion (2025); USD 15.6 billion by 2034; CAGR 12.1% (2026-2034) |
| [9] | IRDAI, Annual Reports 2023-24 and 2024-25 (Annual Reports section) | Primary regulatory source underlying references [2] to [6] |
Derived figures in this article (disallowed plus repudiated ₹26,037 crore; total not paid within year ₹33,622 crore; INR conversion at ₹84 per US dollar) are calculated from the categories above and are labelled as calculations in the text.