A significant proportion of Indians aged above 50 years continue to remain underinsured despite having health insurance, exposing them to substantial financial risks during medical emergencies, according to a new analysis of more than one lakh health insurance policyholders. The findings highlight that inadequate coverage, delayed policy reviews and difficulties in upgrading insurance plans are emerging as major challenges amid rising healthcare costs.

The analysis found that a majority of policyholders above the age of 50 have a sum insured of less than ₹5 lakh, an amount that may be insufficient to cover the cost of a single hospitalization at a private hospital in a Tier I city. Among individuals already living with chronic illnesses, 17% were also found to have health insurance coverage below ₹5 lakh, increasing their vulnerability to out of pocket medical expenses.

The report, based on CoverSure’s Policy Health Check platform, also revealed that 63% of policyholders who attempted to switch to a more comprehensive health insurance plan were unable to do so because they had developed pre-existing medical conditions, making portability or policy upgrades difficult. Experts say this underscores the importance of reviewing insurance coverage early, before health conditions limit available options.

Another key finding was the lack of regular policy reviews among existing policyholders. Nearly 49% of individuals without any pre existing diseases who remain eligible to upgrade their health insurance continue to hold basic or non comprehensive plans. Insurance experts note that while many people purchase health insurance at a younger age, they often fail to increase their coverage as medical inflation and healthcare needs evolve over time.

The health assessment also pointed to the growing burden of lifestyle diseases. Around 35% of policyholders reported at least one medical condition, while 69% of lifestyle related illnesses, including diabetes, hypertension, thyroid disorders and high cholesterol, were identified among individuals aged 30 to 54 years. The 50 54 age group accounted for the highest share at 18.1%, indicating that chronic diseases are increasingly affecting people during their peak earning years.

The analysis also highlighted encouraging signs of growing awareness among younger consumers. Around 41% of users who opted for a policy health assessment belonged to the 30 40 age group, while 10% were below 30 years, suggesting that younger policyholders are becoming more proactive about evaluating the adequacy of their health insurance before major medical events occur.

With healthcare costs in India continuing to rise and medical inflation estimated to remain among the highest globally, industry experts recommend periodic review of health insurance policies to ensure adequate financial protection. They emphasize that timely policy upgrades and higher sum insured can play a crucial role in reducing out of pocket healthcare expenses and improving long term financial security.