Pollution-linked health insurance claims rise 4.3 times in 3 years; Over half of claims came from working professionals

Pollution-linked health insurance claims have surged fourfold in three years, with cardiovascular and respiratory conditions accounting for 78% of all such claims, according to data shared by insurance marketplace Policybazaar.

The average claim amount touched ₹62,662, highlighting the growing health burden of deteriorating air quality, especially around Diwali when people burst crackers, and its impact beyond conventional respiratory illnesses.

According to the data, cardiovascular conditions account for 43.5% of all pollution-associated claims, followed by other respiratory infections at 35%. Pneumonia contributes another 11.2%, while bronchitis accounts for 6%.

The figures are specific to the Policybazaar’s customer base and does not represent the wider health insurance market trend. The analysis is based on a sample size of 50,000, the insurance marketplace said.

Pollution takes a toll on working professionals

Working professionals aged between 31 and 55 years account for the largest share of pollution-associated health insurance claims, contributing 59% of the total. Senior citizens aged 55 and above, meanwhile, make up another 31%, indicating a significant concentration of claims among older age groups.

Young adults aged 21–30 account for 6.7% of claims, while children below 20 contribute 3.7%. The numbers highlight how pollution-associated health concerns feature prominently among economically active individuals and older populations, according to the Policybazaar report.

Which cities made more insurance claims?

Delhi recorded the highest number of pollution-associated health insurance claims, followed by Pune, Bengaluru, Mumbai and Hyderabad.

The trend extends beyond metros, with Tier-2 and Tier-3 cities accounting for 27% each, indicating that pollution-associated health concerns are not restricted to major metros and are increasingly reflected in insurance claims across smaller urban centres of the country. Cities such as Ernakulam and Faridabad also feature among the top 10.

Nearly 1 in 2 consumers in polluted cities opt for higher health insurance coverage. This claim can be substantiated by the data, which shows that 48% of consumers in highly polluted cities opt for higher sum insured amounts.

This reflects growing awareness of adequate health coverage as consumers’ factor in the greater financial protection against potential healthcare expenses.

Winter months drive 56% of claims

Pollution-linked health insurance claims peak between October and March, coinciding with worsening air quality across several parts of India.

In FY26, these six months accounted for nearly 56% of annual claims, highlighting the seasonal concentration of pollution-related health concerns.

Speaking on the rise in insurance claims due to medical issues caused by air pollution, Rohan Goel, Business Head of Health Insurance at Policybazaar, said: “These trends highlight the growing importance of preventive healthcare, timely medical attention and adequate health insurance coverage to manage the financial impact of unexpected medical needs.”