Health insurance is typically seen as a safety net that comes into use during hospitalisation only. However, this phenomenon has undergone a sea change this year with a shift towards consumption-first covers. Policyholders of health insurance have shifted towards consumption-led policies, which they could use in real-time, as per a report by Policybazaar.
The report provided some interesting insights into health insurance after evaluating a large number of policies over a one-year period. These are some of the insights: maternity adoption grew 150-180% year-on-year. OPD remained strong with 10–15% adoption and 40% utilisation. Also, Health Wallets saw early traction and 96% of maternity buyers turned out to be first-time buyers. Over three-fourths of buyers are aged between 18 and 35, whereas 84.4% are women buyers, noted the report.
Reason for the surge
The report noted that the surge can be attributed to rising delivery costs. While a normal delivery costs anywhere between ₹25,000 and ₹50,000 in Tier I cities and ₹15-30K in Tier 2/3, a C-section costs ₹78K to ₹1 lakh in Tier I and ₹50-75K in Tier 2/3.
OPD adoption
OPD adoption held a 10–15% share of all policies, driven heavily by households that incur monthly medical expenses. It is primarily driven by policyholders in the 45- to 60-year-old age group, who comprise the largest cohort (31.6%), followed by the 18–to 35–year–old segment (21.8%), as they are increasingly health-conscious, the report shows.
Health Wallets
Health Wallets are believed to be the next consumption wave as they solve three emerging needs: pre-funded OPD costs, non-payable expenses and reward-backed renewal support.
Additionally, 8% of maternity customers opt for Health Wallet. This indicates willingness among young, financially savvy households to adopt tools that smooth out medical spending beyond hospitalisation.
While expressing his views on 2026, Siddharth Singhal, Head of Health Insurance at Policybazaar, says, “As we look ahead, it’s clear that India’s health insurance industry is entering a consumption-first era. OPD will increasingly become a non-negotiable part of every health plan, as consumers seek value they can use throughout the year. Maternity covers will continue to bring in a large share of new buyers. We also expect Health Wallet models to grow rapidly, as they mirror the way households prefer to manage healthcare budgets - through prepayment, reward accumulation, and reuse.”