"Claim size shows a year-on-year increase for most diseases. Eighteen per cent claims received for critical illness in 2013 exceeded Rs 2 lakh," said ICICI Lombard Vice- President (health underwriting and claims) Amit Bhandari.
End-stage liver failure with an average claim size in 2013 at Rs 3,90,661 clocked the highest compound annual general growth rate (CAGR) at 98.4 per cent for the past three years. Paralysis with an average claim size of Rs 1,41,682 and CAGR of 28.4 per cent was the second highest, he said.
Other diseases with high average claim size during the year included heart valve replacement (Rs 3,44,560), stroke (Rs 1,71,273), myocardial infarction (Rs 2,44,620), end-stage renal failure (Rs 38,491) and major organ failure (Rs 1,10,725), the insurer said.
Out of the 27 general insurance companies, only 22 offer health products.
"Twelve per cent corporate claims received for critical illness in 2013 was over Rs 2 lakh," Bhandari said, adding, here too the claim size shows Y-o-Y increase for most of the diseases.
ICICI Lombard's internal data shows that average claim size for the insured with pre-existing disease is almost double than those without these ailments. Hence, it is material information for insurers to price the risk appropriately, he said.
Half of the customers with health cover believe that health insurance means hospitalisation, accordig to the data.
Around 52 per cent of the 1,005 respondents, who had been sent a set of questions by us recently as part of a survey, said health insurance pays only after hospitalisation, he added.
The respondents were asked to send their replies either by e-mail, Facebook or Twitter.