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Original Article | Volume 2 Issue 3 (ACR, 2025) | Pages 203 - 210
A Cost-Benefit Analysis of Mediclaim Policies in Maharashtra: Evaluating the Financial Impact and Benefits for Individuals
 ,
1
Research Scholar, Assistant Professor, Department of Accountancy, KES’ Shroff College of Arts and Commerce,
2
Research Guide, HOD Accountancy, Prahladrai Dalmia Lions College of Commerce and Economics
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Open Access
Abstract

This research paper presents a comprehensive cost-benefit analysis of Mediclaim health insurance policies in Maharashtra, with a focus on Mumbai. Using secondary data from authentic sources, including the Insurance Regulatory and Development Authority of India (IRDAI), National Family Health Survey, and peer-reviewed research studies, this paper evaluates the financial implications and benefits of different types of Mediclaim policies for Maharashtra residents. The study analyses premium structures, claim settlement ratios, coverage benefits, and policyholder satisfaction across different demographic segments. The findings reveal significant variations in the financial impact based on policy type and demographic factors, with family floater policies offering favourable cost-benefit ratios for middle-income households. The study identifies key challenges in the claim settlement process and highlights the need for greater transparency in policy terms. This research contributes valuable insights for policy formulation, consumer decision-making, and insurance product development in Maharashtra's healthcare financing landscape..

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