Can prevention deliver both better health and better insurance outcomes?

India has 101 million people living with diabetes and another 136 million who are pre-diabetic, putting roughly one in five adults somewhere on this path, according to the ICMR study (1). Hypertension is just as widespread, affecting over 19 per cent of women and 22 per cent of men, as per NFHS-6 (2). Together, these numbers point to a larger shift in the nature of risk, where lifestyle-linked conditions are becoming more common, more persistent and more expensive to manage over time. Health insurance has traditionally been judged by how well it finances treatment and settles claims. But in the face of such long-term, preventable health risks, that yardstick is beginning to look insufficient.

While the scale of the problem has expanded, so has its speed and spread. (1) NFHS-6 shows obesity among women rising from 24 per cent to nearly 31 per cent in just about five years, while high blood sugar among men has climbed from under 16 per cent to almost 21 per cent. Lifestyle-linked conditions are also appearing earlier in life and reaching places that were once considered relatively less exposed, including smaller towns and rural areas.

For insurers, this increases the responsibility we carry. We are often connected with individuals well before a chronic condition is formally diagnosed, through routine health checks, screenings, wellness programmes and digital engagement. That relationship can enable earlier intervention, long before a health risk turns into a hospital admission or a claim.

From settling claims to shaping health outcomes

A health insurance company cannot be measured only by how efficiently it pays claims. It must also play a role in helping people avoid reaching the claims stage in the first place. That requires engagement much earlier in the health journey, during the years when risks are still forming and illness may still be preventable.

In practice, this means making prevention visible, measurable and rewarding in everyday life. A fitness tracker synced to an app can convert daily activity into a premium-linked reward. A wellness score built from heart health, activity and lifestyle indicators can help a customer track progress month after month. A coach can reach out over chat or a quick call to flag a borderline blood sugar reading before it becomes a diagnosis. The value lies not in one intervention, but in sustained engagement that keeps the customer connected to their health and fitness.

The link between preventive engagement and insurance outcomes is also becoming visible in portfolio experience. Our data shows that more than two lakh customers availed health-linked premium rewards in FY26 through active participation in wellness initiatives. This cohort recorded an 8 per cent lower loss ratio and 11 per cent higher persistency than the broader portfolio, indicating that sustained engagement can show up in the numbers insurers actually track. More than 2.7 lakh individuals are also enrolled in structured coaching for chronic and lifestyle-linked diseases.

Making prevention continuous

For prevention to work, it cannot remain a one-time health camp, a yearly test or a generic advisory message. Lifestyle-linked conditions develop over time, and therefore need repeated nudges, personalised feedback and timely support. Digital tools make this possible at scale by helping customers understand their risks, track their behaviour and act before a condition worsens.

There is growing evidence that this kind of engagement can influence clinical outcomes as well. A peer-reviewed study on ABHICL’s health coaching programme, offered by a proactive health management firm, found reductions in HbA1c, blood pressure, and cholesterol levels among patients engaged in the health coaching programme. Among 4,272 members who demonstrated health improvement, over 7,626 symptoms were reported as improved or resolved. Notably, across the broader customer base, only 155 preventable hospitalisations were recorded—pointing to more effective chronic disease management and fewer cases progressing to critical care. Additionally, customers who remained consistently engaged with the programme saw a 31 per cent reduction in preventable claims compared to non-engaged members. 

The larger lesson is clear: occasional advice rarely changes health behaviour. Consistent, personalised and digitally enabled engagement has a better chance of moving both habits and health indicators.

These conditions build gradually over years, which is precisely the window in which prevention can make a difference. For customers, early intervention can mean fewer hospital admissions, lower out-of-pocket spending and more productive years. For insurers, healthier customers can mean more stable risk pools, better persistency and more sustainable pricing.

Financial protection will always remain at the heart of health insurance. What is evolving is the role insurers play—going beyond settling claims to actively supporting people in staying healthy. Healthier policyholders strengthen the overall risk pool, creating a more sustainable system for all.

The industry that gets ahead over the next decade will not be defined only by the speed of claim settlement. It will be defined by how effectively it uses everyday engagement, data and preventive care to help customers stay healthier for longer. 

References

1. Indian Council of Medical Research (ICMR)–India Diabetes (INDIAB) Study: https://www.icmr.gov.in/pdf/press_realease_files/INDIAB_Study_Press_Release_10102023.pdf
2. National Family Health Survey (NFHS-6), Ministry of Health & Family Welfare, Government of India:
   https://www.pib.gov.in/PressReleasePage.aspx?PRID=2266600&reg=3&lang=1