India’s pollution crisis is no longer just an environmental issue as it is now reshaping the country’s health insurance landscape. A new analysis of insurance claim patterns shows that children under 10 are driving a major spike in pollution-linked claims, placing fresh pressures on insurers, hospitals, and policymakers.

A recent industry study found that children make up nearly half of all pollution-related claims about 43% of the total. This means that for every 10 claims that were filed due to illnesses related to pollution, four are for children, who are much more vulnerable to the effects of pollution compared to adults.

The financial impact is also rising. Experts say treatment costs for respiratory and cardiac illnesses have gone up about 11% compared to last year, and the average claim size is now reportedly around Rs 55,000. Estimates show that a single day in the hospital costs families roughly Rs 19,000, making pollution a financial burden as much as a health one.

With pollution-linked illnesses rising every year, India must fundamentally redesign its approach to health, says Jitin Bhasin, Founder & CEO, SaveIN. He notes that the surge in pollution-driven diseases has revealed the limitations of a system anchored in traditional health insurance.

“Insurance is inherently reactive, it steps in only after someone has fallen ill, often when the financial and emotional burden is already high,” Jitin said. “But pollution-related respiratory and cardiac conditions are not episodic anymore. They’re chronic, persistent, and demand continuous preventive care which insurance was never built to support

Jitin highlights that the real transformation lies in shifting focus from processing claims to preventing illness. He stresses the need for clinics, schools and employers to build integrated programs around early detection, regular monitoring and behavioural health interventions to catch risks before they escalate.

In line with this preventive-first philosophy, Jitin shared that SaveIN is expanding its SaveIN Pay Later offering to include essential preventive healthcare products such as air purifiers, which now play a crucial role in safeguarding respiratory health. Making these products more accessible is key to ensuring households can proactively protect themselves against worsening air quality.

Doctors explain that pollution creates health problems which extend past the basic symptoms of coughing and breathing difficulties. Hospitals are now treating more heart patients, including younger adults, during peak pollution months. “We are seeing a clear link between poor air quality and rising cardiac complaints,” says Dr Aashish Chaudhry, Managing Director of Aakash Healthcare.

From a public health perspective, we need long-term planning. “Children are the biggest sufferers today. We need strong government policies for early diagnosis. These include mandatory school health screening, subsidized pollution-related tests, and better emergency readiness in winter months,” says Dr Chaudhry.

Diagnostic centers are now witnessing heavier load during pollution months, especially for children with wheezing, chest congestion, and recurrent infections. “Early diagnosis is now the biggest factor in reducing treatment costs,” further said Dr Chaudhry.

“If we detect lung inflammation or heart strain early, the treatment is simpler, and insurance claims remain modest. But late diagnosis pushes cases into ICU care, which dramatically raises claim amounts. Insurers must work with diagnostic networks to make screenings more accessible and affordable.”

Children remain the most vulnerable, and without long-term preventive strategies, they will continue to bear a disproportionate health burden,” Jitin added. “The future of healthcare in India cannot be claim-drive, it has to be care-driven.