Employee insurance claims reveal mismatch with actual health needs: Report

Plum’s Employee Health Report 2025 highlights critical insurance and healthcare challenges facing corporate India’s workforce. The report analysed over 25,000 insurance claims alongside 1 lakh telehealth consultations, uncovering a worrying disconnect between employee health needs and current insurance benefits.

Men account for 47% of insurance claims but only 46% of telehealth users, suggesting many delay seeking early care.

When men do seek help for mental health, symptoms are often more severe, pointing to a gap in timely intervention.

Additionally, the report revealed that median age for cardiology consults is just 33, indicating early onset of heart disease. Diabetes, cancer, and other chronic illnesses follow soon after, often striking before employees turn 40.

Mental health problems account for 20% of telehealth consultations, with 40% of employees taking at least one sick day monthly due to mental health reasons. Burnout is so widespread that 1 in 5 employees think about leaving their jobs.

Despite these risks, only 20% of companies offer regular health check-ups. Even then, less than 40% of employees use them. The report found 71% of employees are at moderate risk for non-communicable diseases (NCDs).

Abhishek Poddar, Co-founder of Plum, said, “Traditional insurance coverage alone cannot solve the health crisis. Companies must shift toward preventive, personalized healthcare solutions that support mental, physical, and social well-being.”

Poddar added, “For every ₹100 invested in employee health, companies save ₹296 in healthcare costs. This proves that investing in employee wellness is both ethical and economical.”

The report calls for a transformation in how companies approach employee benefits—moving from transactional insurance to holistic care models that improve productivity, reduce burnout, and cut long-term costs.