Kids form 43% of pollution claims as winter respiratory cases rise: Reports

Health insurance claims data shows pollution-linked hospitalisations rising sharply nationwide

As India enters another smog-heavy winter, new health insurance data shows a clear rise in pollution-linked illnesses, with children aged between 0 and10 years accounting for 43 per cent of such claims.

 

Policybazaar’s latest report along with fresh insights from ManipalCigna health insurance revealed respiratory hospitalisations climbing sharply across metros and smaller cities, leading to higher winter claims and steeper treatment costs.

 

Seasonal spike: Claims rise every winter

 

Manipal Cigna’s six-year data shows a persistent surge in respiratory-related claims between October and January. Cases have quadrupled from 112 in 2020 to 472 in 2024, mirroring the country’s worsening winter pollution. Insurers say this pattern is no longer irregular, but a predictable seasonal peak closely tied to toxic air.

 

Policybazaar’s numbers also confirm the trend, with pollution-linked claims rising by nearly 14 per cent in the post-Diwali period every year. In September 2025 alone, 9 per cent of all hospitalisation claims came from pollution-related ailments, including respiratory distress, cardiac complications, and allergic reactions.

 

Children hit hardest

 

One of the most worrying insights from Policybazaar’s study is the impact on children. Those aged 0–10 years account for 43 per cent of pollution-linked claims, making them the most vulnerable demographic group. Outdoor activity, weaker immunity, and higher exposure to particulate matter make them five times more likely to be hospitalised compared to older adults.  ALSO READ | Short of breath this winter? Experts say it may signal worsening COPD

 

Not just Delhi: Tier-II cities feel the strain

 

Manipal Cigna’s data shows that Tier-II and Tier-III cities reported the highest respiratory claim count in 2024 with 1,090 cases, exceeding any single metro. Delhi NCR continues to lead among major cities with 84 full-year respiratory claims, but Mumbai, Bengaluru, Chennai and several Tier-II cities such as Jaipur, Lucknow, and Indore are seeing a steady rise.

 

Policybazaar’s numbers also highlight this shift: Bengaluru (8.23 per cent) and Hyderabad (8.34 per cent) now report higher pollution-claim ratios than Delhi (6.88 per cent).

 

COPD, asthma dominate disease mix

 

Manipal Cigna’s findings show Chronic Obstructive Pulmonary Disease (670 cases), asthma (415), and lung diseases due to external agents (156) as the top winter hospitalisations in 2024. These are precisely the conditions known to worsen when PM2.5 levels spike.

 

Policybazaar’s organ-level data echoes this, showing pollution’s growing impact on the lungs, heart, skin, eyes, and even pregnancy.

 

Rising treatment costs add to the burden

 

Policybazaar reports an 11 per cent rise in respiratory treatment costs and a 6 per cent increase in cardiac costs over the past year. The average daily hospital bill stands at Rs 19,076.

 

Siddharth Singhal, head of health insurance at Policybazaar, notes that every post-Diwali season now resembles “a healthcare emergency”, with claim volumes peaking between October and December.