Insurance claims for seasonal illnesses are soaring. Recent data highlights a 150% increase in the average claim size for seasonal illnesses over the past three years.

During peak months, the treatment costs for common seasonal illnesses have soared.

Dengue, malaria, and gastroenteritis are particularly notable, pushing the average treatment costs to ₹1.5 lakh.

These illnesses now account for 33-40% of all seasonal illness claims.

Top Seasonal Illnesses and Claim Trends

Dengue and Malaria

• Claim Share: 15% of seasonal illness claims.
• Treatment Costs: ₹50,000 to ₹1.50 lakh
• Claim Surge: July and August.
• Details: Warm, humid conditions create ideal breeding grounds for mosquitoes, leading to a rise in claims.

Gastroenteritis

• Claim Share: 18% of seasonal claims.
• Treatment Costs: ₹50,000 to ₹1.80 lakh
• Claim Surge: Monsoon season (July and August).
• Details: Increased waterborne diseases during the monsoon lead to more gastroenteritis cases.

Allergies

• Claim Share: 10% of seasonal illness claims.
• Treatment Costs: ₹30,000 to ₹90,000.
• Claim Surge: Spring and monsoon seasons.
• Details: Allergies peak during seasonal changes, varying by region.

Influenza

• Claim Share: 20% of health insurance claims.
• Treatment Costs: ₹25,000 to ₹1,00,000.
• Claim Surge: November to February.
• Details: Cold weather and indoor gatherings increase flu cases.

Bronchitis

• Claim Share: 12% of seasonal illness claims.
• Treatment Costs: ₹40,000 to ₹1,20,000.
• Claim Surge: Winter months (November to February).
• Details: Cold weather worsens respiratory conditions.

Rising Costs

Treatment costs for seasonal illnesses have surged:

llness	FY 21-22 Cost (₹)	FY 22-23 Cost (₹)	FY 23-24 Cost (₹)
Dengue and Malaria	0.60 lakh	0.97 lakh	1.40 lakh
Influenza	0.36 lakh	0.57 lakh	0.95 lakh
Allergies	0.31 lakh	0.50 lakh	0.86 lakh
Bronchitis	0.47 lakh	0.75 lakh	1.28 lakh
Gastroenteritis	0.64 lakh	1.02 lakh	1.73 lakh

Claims breakdown

Prescriptions: 50-60% of claims, covering medications.

Outpatient visits: 30-40% of claims, including doctor consultations.

Hospitalisations: 15-20% of claims, for severe cases needing extended treatment.

Geographic and Age Distribution

Geographic Distribution: Mumbai (20%), Delhi (18%), Bangalore (15%), Chennai (12%), Hyderabad (10%).

Age-wise distribution

Children and Adolescents (<18 years): 20-25%.

Young Adults (18-30 years): 15-20%.

Adults (30-45 years): 10-15%.

Middle-aged Adults (45-60 years): 20-25%.

Senior Citizens (60+ years): 25-30%.

Siddharth Singhal, Head of Health Insurance at Policybazaar, says, “The rise in health insurance claims for seasonal illnesses highlights the need for comprehensive health insurance. Such plans can cover high costs for prescriptions, outpatient visits, and hospitalisations.”