India may be detecting cancer earlier than ever before — but a new study reveals a troubling truth: patients are now fighting two battles at once — the disease itself, and a failing insurance system that cannot support modern cancer care.
A landmark analysis by Plum Data Labs, based on one lakh cancer insurance claims filed between 2023 and 2025, paints a stark picture of the rising financial distress facing households across the country. While early detection has surged sharply, insurance payouts have steadily declined, leaving families exposed to spiralling medical bills and fragmented, multi-stage treatment costs.
Early Detection Rising, But Financial Protection Falling
India has recorded a dramatic rise in stage 0 or in-situ cancer detection.
The share has jumped from 29% in 2023 to almost 50% in 2024,
stabilising at 47% in early 2025 — a rise of 72% in early-stage diagnoses in just three years.
This is excellent news for medical outcomes — but devastating for family finances.
Why? Because modern cancer care requires longer treatment cycles, multiple therapies, and repeated claims. The average cancer patient in India today files nearly four claims per year, each subject to fresh deductions, co-pays, restrictions, and exclusions.
The Real Crisis: Insurance Coverage Hasn’t Evolved
The study exposes a structural failure at the heart of India’s health insurance system:
● 50% caps on oral chemotherapy and targeted therapies
● Room rent limits that reduce eligible claim amounts
● Co-pay clauses that force patients to pay 10–30% from their pocket
● Off-label treatment exclusions — even when clinically necessary
● Sub-limits on procedures, drastically shrinking payouts
As a result, while many patients see manageable median costs, a significant number encounter bills five to ten times higher, pushing families into debt.
“Insurance products were built for yesterday’s cancer, not today’s treatment”: Plum CTO
Explaining the mismatch, Saurabh Arora, Co-Founder & CTO of Plum, said:
“The decline in cancer payouts reflects a structural mismatch between how cancer is treated today and how insurance products were built years ago.”
He identified three key drivers of the crisis:
1. Rise of advanced therapies
Targeted drugs, oral chemo, and immunotherapy are now standard — but many are prescribed off-label and not covered by most policies.
2. Sub-limits that leave patients paying half the bill
Even when covered, 50% caps force families to fund the remaining costs.
3. Legacy insurance features that dilute coverage
Room-rent caps, co-pays and outdated sub-limits dramatically reduce payouts.
Cancer in India: A Medical Problem Turning Into a Financial Catastrophe
India now faces a dangerous paradox:
●Patients are diagnosed earlier
●Treatment is more advanced
●Survival rates are improving
But out-of-pocket expenditure is rising faster than ever before
Households are increasingly funding critical care from savings, loans, crowdsourcing, and asset liquidation — defeating the purpose of insurance.
What Must Change: Experts Call for a Major Policy Reset
The study concludes that India’s health insurance architecture needs an urgent overhaul. Experts recommend:
● Realistic sum-insured levels
● 100% coverage for modern modalities
● Coverage for off-label oncology use
● Bundled, stage-wise cancer pathways
● Elimination of outdated exclusions
● Greater focus on preventive screening & early detection
Saurabh Arora emphasised:
“For insurance to remain a true financial safety net, it must evolve in step with today’s clinical reality, not yesterday’s policy frameworks.”
A Turning Point for India’s Health Security
With cancer cases rising and treatment becoming more sophisticated, India stands at a decisive moment. Without major reforms, millions could slip into medical debt despite having insurance.
The study’s message is clear:
To win the fight against cancer, India must fix its broken insurance ecosystem — and fast.
