Star Health vs Manipal Cigna vs SBI General: Which health insurer stands out?
With 27 general and seven standalone health insurers selling a raft of policies, selecting the right one may become confusing. Beyond product-specific features, the claims experience is a crucial factor in choosing an insurer.
Many customers look at the claims settlement ratio or rely on anecdotal claims stories from acquaintances. However, the claims settlement ratio alone does not give a complete picture. Other data points, especially the claims paid ratio in terms of amount, hold the key.
«Claims settlement ratios in isolation can present a skewed narrative. For example, if an insurer processes 80 small claims of ₹100 but leaves 20 larger claims of ₹1 lakh unresolved, they might still boast an 80% claims settlement ratio,» said Sumit Bohra, president at Insurance Brokers Association of India (IBAI). “This metric fails to account for the proportion of claims paid in terms of total amount, which could be significantly lower."
What does a claims settlement ratio tell you about an insurer? It shows how many claims a year an insurer has settled or paid. If an insurer has a claims settlement ratio of 95%, it means it settled 95% of claims it received in a financial year. However, the devil is in the detail. What if an insurer only partially paid the claim? It would still be counted as a settled claim. That said, the amount of claims being settled by an insurer is more important. Higher the claims paid ratio, better is an insurance company in terms of the measured ratio.
However, this data point is not readily available. While insurers showcase their claims settlement ratios prominently, they hardly mention claims payout ratios based on the amount of claims. Though insurers declare total claims amount paid in a year in
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