Polluted air, pricier cover: Why health insurance costs more in big cities
Last Update Date: 06-10-2026
Published by India Today
Abhishek Kumar's role: Quoted
Abhishek Kumar explained that insurers group cities into zones and price by local treatment costs and claims data. He said most comprehensive policies already cover pollution-linked illnesses, suggested enhancing them through riders, and cautioned that zone pricing may penalise vulnerable metro residents.
What Abhishek Kumar said
Why does health insurance cost more if I live in a metro?
Many insurers sort Indian cities into zones, broadly metros, other large cities and the rest of the country, and price premiums on the actual cost of care in each, so metro residents typically pay around 10 to 20 per cent more. The inputs are hospitalisation and treatment costs, how common lifestyle diseases are locally, pollution and other environmental risks, the presence of advanced hospitals and historical claims data. The logic is that people in smaller towns should not subsidise far costlier metro claims.
Do I need a separate policy for pollution-related illness?
Not immediately, in my view. Most comprehensive health policies in India already cover pollution-linked conditions such as asthma, bronchitis, COPD and some lung cancers under their standard benefits. Rather than a new product, I would look at strengthening the existing policy through riders: shorter waiting periods where a respiratory condition already exists, OPD cover for ongoing treatment, and regular preventive screening of the lungs and heart.
Is it fair to charge metro residents higher premiums?
The data may well support the insurers' position, but I think it must not disadvantage people who are already exposed. Charging more for living in a polluted city penalises residents for systemic problems beyond their control, and can price essential cover out of reach for those least able to bear it: outdoor workers, children and older people. IRDAI's rules require transparent premiums, pricing that can be justified for groups such as seniors, and evidence linking a risk factor like pollution to claims before differential pricing is applied.
In our words, from what he said in the piece. General information, not personal advice.
More of Abhishek's views on insurance
The article explains why health insurance can cost more in metro cities, citing higher hospital costs, more frequent claims, lifestyle diseases and pollution-related illness. It discusses zone-based pricing, whether pollution needs a separate cover, and how insurers can balance fair pricing with access.
Publisher source
Polluted air, pricier cover: Why health insurance costs more in big cities