The State of Insurance and Healthcare in India

August 3, 2023
Abhishek Poddar
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Every national holiday is an opportunity for us to reflect on the progress we’ve made as Indians. At a mission-driven company like Plum, this is a time to reflect on the development of the insurance and healthcare infrastructure in the country.

A statistic that startles everyone who sees it is the juxtaposition of the approximate population of Europe with the number of people in India who do not have health insurance – 700 million.1

To be fair, India is massive and digging hard enough will unearth plenty of similar stats, which may not mean much.

So, why is this concerning?

Let me set the scene and zoom in.

  • India has the highest medical inflation rate in Asia, 14%, that’s more than China (12%), Indonesia (10%), Vietnam (10%), and the Philippines (9%).2
  • 50% of healthcare expenses in India are paid out-of-pocket. The global average is 20%.3
  • 1 in 4 urban Indian households that have taken loans took them to cover medical expenses.4

The expenses are only increasing, and it’s a matter of grave concern. There’s a type of tweet that we spot every few months as more people realize the gravity of our situation:

An average Indian household is just one serious medical incident away from slipping into poverty.

But wait, are Indians healthy enough for this to not matter? Let’s find out:

  • 1 in 4 Indians have hypertension, a major cause of heart disease5
  • 1 in 4 deaths is due to a cardiovascular disease6
  • 1 in 6 couples is impacted by infertility7
  • 1 in 5 adults have diabetes or are pre-diabetic8
  • 1 in 2 Indians, above the age of 60, suffer from a chronic condition like diabetes, or cardiovascular disease9

I hope it’s clear that this is a serious challenge. One that cuts across our collective health, well-being, and finances.

Can we overcome this challenge?

I have reason to be optimistic.

The answer is at the core of Plum’s beliefs – making insurance and healthcare simple, inclusive, and accessible for all.

For the challenges, I listed above; there’s an equally firm resolve today to change the way things are. We’ve seen time and again talented, and ambitious Indians are keen to tackle the challenges in this space. Often because they’ve had a bitter experience with the crumbling healthcare systems themselves.

For the abysmal levels of insurance penetration in the country, there’s also rapidly increasing financial awareness among every class of Indians.

To their credit, the IRDAI has been matching pace with these developments. They’re playing an excellent role as a progressive and proactive regulator facilitating innovation and efficiency in the sector.

These factors give us the hope and optimism to change a lot of the legacy infrastructure from the ground up and overcome the challenges that plague us.

They are also a big reason why we decided to build Plum for India first.

What can you do to help?

As we celebrate Republic Day, all I request is to take a simple pledge for your health by reflecting on these questions.

  • Have you done something good for your health and well-being in the last 3 days?
  • Do you know the health issues you may be prone to?
  • Have you scheduled a health checkup recently?
  • Have you protected yourself and your dependents adequately with health insurance?
  • Have you checked the details of your employer-provided health insurance and benefits?
  • Have you encouraged your family and friends to get health insurance?

This is all we need to take a big, collective step towards a healthier and financially secure India.

Watch: The state of insurance and healthcare in India (2023)

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Note: The numbers and statistics are approximate and rounded off for simple visualization and representation.


  1. "Even after adjusting for PMJAY (since the survey was done before PMJAY), estimates based on the survey suggest that nearly 50% of the population does not have health insurance" – Health Insurance for India's Missing Middle | 2021, NITI Aayog
  2. India's medical inflation in 2021 highest among Asian countries: Report | 2021, Mint
  3. 2018-2019, exact: 48.2% and 18.1% – India’s persistently high out-of-pocket health expenditure continues to push people into poverty | 2022, DownToEarth
  4. Longitudinal Ageing Study in India, Wave 1 | 2017-18, International Institue for Popular Sciences
  5. India Hypertension Control Initiative, a high impact and low-cost solution | 2022, WHO
  6. 2016, Tackling the Burden of Cardiovascular Diseases in India
  7. Across India, women are struggling to deal with the growing infertility problem | 2022, HerStory
  8. India Diabetes Report 2000-2045 | International Diabetes Federation
  9. 55 per cent of Indians above the age of 60 suffer from a chronic disease, shows study | 2021, The Economic Times