Heart Health Shift: Cardiac Claims Surge in India's Smaller Cities

Universal Sompo reports a surge in cardiac claims from non-metro areas, with Tier 2 city claims more than doubling in three years.

Ravi Pandey29 September 20262 min read1 viewIndia
Heart Health Shift: Cardiac Claims Surge in India's Smaller Cities

On the occasion of World Heart Day, Universal Sompo General Insurance has brought to light a significant shift in the landscape of cardiac healthcare in India. The insurer's data reveals that cardiac-related claims are increasingly originating from non-metro locations, moving the focus away from traditional metropolitan hubs.

According to the company's findings, nearly seven out of every ten cardiac claims received are now coming from outside major metros. This trend underscores a changing geographical pattern in how heart-related ailments are being diagnosed and treated across the country.

The Rapid Rise of Tier 2 and Tier 3 Cities

The data highlights a dramatic increase in medical needs within smaller urban centers. Over the last three financial years, cardiac claims from Tier 2 cities have more than doubled. Meanwhile, Tier 3 cities continue to represent a substantial portion of the insurer's cardiac-related claims outside the major metropolitan areas.

Several factors are driving this shift in cardiac healthcare utilization, including:

  • Improved Diagnostics: Better access to advanced diagnostic facilities in smaller towns.
  • Specialized Treatment: Increased availability of specialized medical care outside metros.
  • Rising Awareness: Greater health consciousness leading to more frequent screenings.
  • Increased Utilization: More people seeking medical intervention for cardiac symptoms.

The Financial Burden of Heart Care

While medical access is improving, the cost of treating cardiac conditions remains a heavy burden for many Indian households. Cardiac issues such as coronary artery disease, rhythm disorders, and congenital heart diseases often require long-term management, regular medication, and repeated medical interventions.

The financial implications of these procedures can be substantial. While actual costs vary based on the hospital and the complexity of the case, indicative costs include:

  • Coronary Angiography: Approximately Rs. 1 lakh to Rs. 2.5 lakh.
  • Coronary Angioplasty: Approximately Rs. 2.5 lakh to Rs. 4 lakh.
  • Bypass Surgery: Approximately Rs. 4.5 lakh to Rs. 6.5 lakh.
  • Aortic Valve Replacement: Approximately Rs. 12 lakh to Rs. 16 lakh.

Emphasis on Prevention and Insurance

Varsha Gujarathi, Chief Customer Officer at Universal Sompo General Insurance, noted that the emergence of cardiac needs in smaller towns reflects the evolving healthcare landscape. She emphasized that while better access to treatment is a positive sign, it reinforces the critical need for prevention, regular health screenings, and early intervention.

Furthermore, she highlighted the importance of financial preparedness. Having adequate health insurance is essential to help families manage the sudden financial impact of a serious cardiac event, allowing them to focus on recovery rather than the stress of unexpected medical expenses.

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