Physical health
Physical health
Section titled “Physical health ”Physical health is the largest section of this handbook. We’ve broken it into 14 major areas of health concern. For each, we follow a consistent structure: hospitalization claims, diagnostic warning signs, implications and actions.
Summary of hospitalization claims
Section titled “Summary of hospitalization claims”By family member
Section titled “By family member”Employees themselves account for the largest share of claims, but parents file the costliest ones.
Share of claims, by family member
- Share of claims
- Highlighted
View as table
| Category | Share of claims |
|---|---|
| Employee (self) | 35% |
| Spouse | 23% |
| Parents | 28% |
| Children | 14% |
Average amount claimed and settled, by family member
- Average claimed
- Average settled
View as table
| Category | Average claimed | Average settled |
|---|---|---|
| Employee (self) | ₹54,000 | ₹44,000 |
| Spouse | ₹55,500 | ₹37,500 |
| Parents | ₹77,500 | ₹59,000 |
| Children | ₹39,500 | ₹28,000 |
By ailment
Section titled “By ailment”Share of claims, by health area
- Share of claims
- Highlighted
View as table
| Category | Share of claims |
|---|---|
| Maternity | 20% |
| General symptoms | 11% |
| Accident & injury | 10% |
| Infections | 9% |
| Eye disorders | 8% |
| Liver & digestive | 7% |
| Heart & circulatory | 5% |
| Kidney & urinary | 5% |
| Musculoskeletal | 4% |
| Cancers | 4% |
| Respiratory | 4% |
| Sexual & reproductive | 3% |
| Endocrine & diabetes | 1% |
By age
Section titled “By age”Share of claims and of claim value, by age
- Share of claims
- Share of claim value
View as table
| Category | Share of claims | Share of claim value |
|---|---|---|
| 0–20 | 13% | 8.5% |
| 21–30 | 31% | 25% |
| 31–40 | 22% | 22.5% |
| 41–50 | 7.5% | 8% |
| 51–60 | 12% | 14% |
| 61+ | 15% | 22.5% |
By gender
Section titled “By gender”Share of claims and of claim value, by gender
- Share of claims
- Share of claim value
View as table
| Category | Share of claims | Share of claim value |
|---|---|---|
| Female | 52% | 51% |
| Male | 45% | 45.5% |
Summary of diagnostic health check-ups
Section titled “Summary of diagnostic health check-ups”Abnormal results, by test
- Share of all abnormals
- Aged under 35
- Aged over 40
View as table
| Category | Share of all abnormals | Aged under 35 | Aged over 40 |
|---|---|---|---|
| Cholesterol / lipids | 40% | 63% | 37% |
| Blood health (CBC) | 30% | 63% | 37% |
| Kidney | 11% | 50% | 50% |
| Liver | 9% | 70% | 30% |
| Urine | 6% | 75% | 25% |
| Thyroid | 3% | 50% | 50% |
| Diabetes | 1% | 25% | 75% |
The screening-to-claims connection
Section titled “The screening-to-claims connection”The parents filing today’s costliest claims (heart, kidney, cataract) were once employees with the same cholesterol, liver and kidney red flags that are now showing up in screening. The 10-year pipeline from abnormal screening result to hospitalization claim is visible, and it’s repeating.
Each of the 14 subsections answers four questions:
- What does the data show today?
- Why does it matter for cost?
- Who carries the most risk?
- And where is this heading?