Latest health and general insurance claim settlement ratios of companies in India

If you are planning to buy a new insurance policy or port your existing health insurance policy to a new insurer, do remember to check the latest claim settlement ratio of all insurers before finalising one. Irdai has released the claims payment details of general and health insurance companies for the financial year 2021-22.

Before buying, renewing, or porting an insurance policy, the most basic aspect you need to check, among many other things, is how the insurer settles claims. The claim settlement track record of a general or a health insurance company gives you an idea of how many claims it pays out during a financial year as a percentage of the total number of claims it gets.

The Insurance Regulatory and Development Authority of India (Irdai) has released the claims payment details of general and health insurance companies for the financial year 2021-22. Apart from health insurance claims, the percentage claim paid in general insurance companies also includes other insurance verticals like motor, fire, marine, and other insurances.

Other than checking how many claims were settled by an insurance company, it is important to see how quickly the claims were processed and when the claimant received the money.

Though Irdai’s claims settlement data lists the details of the claim paid in various periods, what is most important for the policyholder is whether it was cleared within the first three months or not.

Latest claims settlement ratio of general insurers and health insurers
Among the private general insurance companies, Navi General Insurance (erstwhile DHFL General Insurance) tops the list with 99.99 per cent of claims settled in the first three months of initiating the claim. This is closely followed by Reliance General Insurance and HDFC Ergo General Insurance with 98.65 per cent and 98.49 per cent, respectively, within the first three-month period.

Source: IRDAI Annual Report 2021-22

Public sector general insurance companies have a relatively lower claim-settlement ratio compared to private insurance companies within the first three-month period. United India Insurance tops the chart with a 97.25 per cent claim-settlement ratio. The New India Assurance and Oriental Insurance have recorded 92.93 per cent and 90.18 per cent claim-settlement ratios, respectively, in the first three months.

Public sector general insurers

Source: IRDAI Annual Report 2021-22

Among stand-alone health insurance companies, Care Health Insurance settled 100 per cent of claims within the first three months. Four stand-alone health insurers including Aditya Birla Health Insurance, ManipalCigna Health Insurance, Niva Bupa Health Insurance and Star Health Insurance also recorded over 99 per cent claim-settlement ratios in the first three months in the financial year 2021-22.

Stand-alone health insurers

Source: IRDAI Annual Report 2021-22

What is claim settlement ratio?
The claim settlement ratio indicates the overall risk management ability of the insurance company, said experts. The ratio indicates the number of claims paid by the insurer out of 100 claims that the insurance company receives. So, if the settlement ratio of an insurance company is 95 per cent, it means that the insurer has made payments against 95 claims out of the 100 claims. It also implies that the company did not pay for the remaining 5 claims.

So, if you are planning to buy a new insurance policy or port your existing health insurance policy to a new insurer, do remember to check the latest claim settlement ratio of all insurers before finalising one.

Check how quickly your insurance company is processing claims
As mentioned above, along with the settlement ratio, you will also need to check how swiftly your insurance company is processing your claims. For the general and health insurance companies, the insurance regulator has mentioned claims settled in different periods such as less than three months, three months to six months, etc. This helps policyholders to understand how quickly the insurance company decides on the claims it received during the financial year. The most critical data is for a period of less than three months. So, if your insurance company has the highest claim settlement ratio within the first three-month period, then it means that the company settles more claims in the shortest possible time.