Pollution-related illnesses are accounting for an increasing share of health insurance claims in India, with the number of such claims rising 4.34 times over three years. Working professionals aged 31–55 constitute 59% of these claims, while senior citizens account for another 31%, according to data released by Policybazaar.
The findings point to a health burden that extends beyond respiratory conditions, with cardiovascular ailments emerging as the largest contributor to pollution-associated insurance claims. Cardiovascular conditions account for 43.5% of the claims, followed by other respiratory infections at 35%. Pneumonia makes up 11.2%, while bronchitis contributes 6%.
The age-wise distribution shows that people between 31 and 55 years account for the highest proportion of claims at 59%. Senior citizens aged 55 and above contribute 31%, taking the combined share of the two groups to nearly 90%. Young adults in the 21–30 age bracket account for 6.7% of claims, while children below 20 make up the remaining 3.7%.
The rise in claim volumes has also been accompanied by an increase in the overall financial burden. Pollution-linked health insurance claims grew 67% in FY24, followed by a 70% increase in FY25 and a further 53% rise in FY26. The average claim amount increased 9% in FY24 and has remained above FY23 levels.
Meanwhile, the total amount paid out against these claims rose 4.5 times between FY23 and FY26. The average health insurance claim stood at ₹62,662, according to Policybazaar data.
The geographical spread of claims also indicates that the trend is not confined to major metropolitan centres. Delhi recorded the highest number of pollution-associated claims, followed by Pune, Bengaluru, Mumbai and Hyderabad. Tier-2 and Tier-3 cities together account for 55% of the claims, with each category contributing 27%.
Ernakulam and Faridabad are also among the top 10 cities in the data, pointing to the presence of pollution-related health concerns across smaller urban centres.
The findings also indicate a shift in health insurance coverage preferences among consumers in areas with high pollution levels. Around 48% of consumers in highly polluted cities opt for higher sum insured amounts, reflecting the preference for greater financial protection against potential medical expenses.
Seasonal trends form another part of the analysis, with pollution-associated health insurance claims concentrated during the winter months. October to March accounted for 56% of the annual claims recorded in FY26, coinciding with the period when air quality deteriorates across several parts of the country.
Rohan Goel, Business Head – Health Insurance at Policybazaar, said the company’s data showed a 4.3-fold increase in pollution-associated claims, with cardiovascular conditions accounting for 43.5% and respiratory infections contributing 35%.
He added that working professionals aged 31–55 represented nearly 59% of claims, while senior citizens accounted for another 31%. Goel also highlighted the growing contribution from smaller cities and said the preference for higher health insurance coverage in highly polluted locations underscored the importance of preventive healthcare, timely medical attention and adequate insurance protection.
Pollution-related claims surge 4.3 times in three years: Policybazaar data shows who is most affected