It’s not easy to discover a health insurance provider that works for everyone because each provider is unique. Which health insurance provider is ideal for you will depend on your specific needs and objectives. Some customers may choose one insurance provider over another due to the breadth of its cashless claim network, while others may choose based on the quality of their coverage or the accessibility of their customer care representatives. There are several health insurance providers in India, each of which provides a comprehensive selection of health coverage options suitable for individuals of varying ages. To ensure that their clients are adequately covered, health insurance companies tailor each policy they sell.
To attract and retain clients, health insurance providers provide a wide range of plans with different options and perks. In addition, we know it might be challenging to locate a health insurance provider that covers all your requirements. The claims settlement ratio is a useful ratio since it indicates how dependable the health insurance provider will be if you ever need to file a claim.
For the fiscal year 2019-20, the Insurance Regulatory and Development Authority of India (Irdai) has made public the claims settlement information of general and health insurance providers operating in the country. HDFC Ergo General Insurance has the fastest claim settlement time in the private general insurance industry at 99.8 per cent within the first three months after filing a claim. After that, Edelweiss General and Go Digit come in at 99.72% and 99.65%, respectively, during the first three months.
In contrast, Edelweiss General Insurance, a young firm, ranked first in the industry with an incurred claims ratio of 113.05% in the 2019-2020 fiscal year. For the fiscal year 2019-2020, just six private insurers have an incurred claims ratio between 75% and 90%, the optimal range indicated by experts. At 21.08, Acko General Insurance had the lowest ratio. Since the insurer’s health insurance division had only been operational for a month as of the IRDA annual report’s cutoff date, this was presumably the reason.
Navi General Insurance (formerly DHFL General Insurance), at 34.69%, Cholamandalam MS General Insurance, at 40.67%, and Kotak Mahindra General Insurance, at 49.22%, are the other three insurers whose registered ratios are below 50%. Comparatively, the claims settlement ratio (during the first three months) of public sector general insurers is significantly lower than that of private insurers. When it comes to resolving claims, Oriental Insurance is ahead of the pack at 92.71 per cent, while New India Insurance comes in at 91.99 per cent.
In contrast, every public sector insurer has reported an incurred claims ratio for 2019–20 that is greater than 100%, indicating a policy of generously covering claimants. In the individual health insurance market, competition is fierce, with six out of seven providers posting a claims settlement ratio of greater than 99% throughout the study period. Reliance Health is alone with a 97% success rate. Only HDFC Ergo (formerly Apollo Munich Health Insurance) has an incurred claims ratio higher than 70%, at 73.69%.
Insurance companies that used to go by the names *Erstwhile DHFL General Insurance Co. Ltd., **Erstwhile Apollo Munich Health Insurance Ltd., @Erstwhile CignaTTK Health Insurance Co. Ltd., #Erstwhile Cign Effective November 15, 2019, under an IRDAI Order dated November 6, 2019, Reliance Health Insurance Ltd.’s business portfolio was transferred to Reliance General Insurance Co. Ltd.