₹55,263 avg claim cost as pollution hospitalisations rise, kids make up 43%

Post-Diwali Illness Spike: Pollution-Related Claims Up 14%, Children Worst Affected

In an alarming trend for households and insurers alike, children are emerging as the most vulnerable to pollution-related health damage—with nearly half of all pollution-linked health insurance claims filed for those under the age of 10, according to fresh data from Policybazaar. Meanwhile, treatment costs for respiratory ailments have increased by 11 % and cardiac complications by 6% in the last year.

 

Key findings

 

• Children under 10 years file 43 % of pollution-related claims in major cities. 
• Among five metro cities studied (Delhi, Hyderabad, Bengaluru, Pune, Mumbai), Delhi alone accounted for 38 % of pollution-related claims. 
• The average claim size for pollution-linked ailments stands at ₹55,263, with the average daily hospital cost being ₹19,076. 
• Post-festive season (around Diwali) pollution spikes correlate with a 14 % jump in claims in previous years. 
• Pollution-linked illnesses now constitute more than 8 % of total hospitalization claims in the claims sample.

 

Why kids are especially at risk

 

Children’s lungs are still developing, and they breathe more air relative to their body weight. Pollutants such as fine particulate matter (PM₂.₅), nitrogen oxides and ground-level ozone are known to aggravate asthma, bronchitis, sinusitis and even cardiac irregularities in young patients. The post-Diwali spike in air pollution in Delhi and other North-Indian cities exacerbates this risk, triggering more hospital visits and insurance claims.

 

Post-Diwali claims up 14%

 

The report shows a consistent spike in health insurance claims during the post-Diwali period. Pollution-linked claims rose from 6.4% in 2022 to 9% in 2025, a 14% relative increase.

 

In September 2025 alone, nearly 9% of hospitalisation claims were tied to pollution-related ailments — ranging from respiratory infections and cardiac complications to eye and skin allergies.

 

Children under the age of ten made up nearly half (43%) of all pollution-linked claims, five times higher than any other age group. Adults aged 31–40 years accounted for 14% of such claims, while senior citizens (above 60) made up just 7%.

 

The data suggests that younger, more outdoor-active populations are exposed to the effects of poor air quality.

 

Impact spreading beyond Delhi

 

While Delhi continues to record the highest volume of pollution-linked claims at 38%, the trend is spreading nationwide. Hyderabad (8.34%) and Bengaluru (8.23%) now report higher claim ratios than Delhi, stressing the southward drift of India’s air pollution crisis. Pune (7.82%) and Mumbai (5.94%) have also seen rising cases, while tier-2 cities including Jaipur, Lucknow, Indore, and Nagpur are reporting growing numbers of pollution-related ailments.

 

What this means for urban residents and policy-holders

 

If you live in a high-pollution city such as Delhi, Bengaluru or Hyderabad:

 

Evaluate your health insurance policy now — ensure you have sufficient sum insured and paediatric cover.

Look into family-floater health plans or add-ons that cover children’s respiratory illnesses and seasonal spikes.

 

Consider shorter waiting periods and check policy exclusions related to chronic respiratory diseases.

 

Keep track of seasonal pollution spikes (winter, Diwali, stubble-burning seasons) and plan preventive care such as air purifiers, masks, and medical check-ups.

 

"Health insurance, especially family and OPD-inclusive covers, has become an essential safeguard during India’s pollution months,” said Siddharth Singhal, Head of Health Insurance at Policybazaar.