Aditya Birla Sun Life Insurance (ABSLI) is a 51:49 joint venture between the Aditya Birla Group and Sun Life Financial Inc., a Canadian financial services organization. Incorporated on August 4, 2000, it commenced operations on January 17, 2001. ABSLI offers a wide array of life insurance products, including Protection Plans like ABSLI DigiShield Plan and ABSLI Life Shield Plan, providing financial security to the family in case of the policyholder’s death with options for tailored coverage and predictable payouts, and some plans like Return of Premium plans that may return premiums if the policyholder survives the term. Wealth with Protection Plans include Unit Linked Insurance Plans (ULIPs) such as ABSLI Wealth Max Plan and ABSLI Fortune Elite Plan, combining investment and insurance. Savings Plans like ABSLI Nishchit Aayush Plan and ABSLI Assured Savings Plan offer guaranteed income or additions along with life cover. They also provide Retirement and Pension Solutions designed for post-retirement income, Children’s Future Plans to secure financial futures, Health Plans covering hospitalization and critical illnesses, and Traditional Term Plans. ABSLI has a nationwide presence through a multi-channel distribution network including branches, bancassurance partners, direct selling agents, corporate agents, brokers, and its website. As of June 2022, it had over 340 branches, 8 bancassurance partners, and over 49,000 direct selling agents. As of June 2022, the total Assets Under Management (AUM) of ABSLI stood at around ₹606,604 million. In Q1 FY 2022-23, it recorded a gross premium income of ₹26,197 million, showing significant year-on-year growth. ABSLI serves over 1.6 million active customers and has a large employee base. The company boasts a high claim settlement ratio, indicating its commitment to honoring claims promptly; for individual business, the claim settlement ratio was reported as 98.40% in a recent report.
Aditya Birla Health Insurance (ABHICL) is a joint venture between Aditya Birla Group and MMI Holdings of South Africa. Incorporated in 2015, it commenced operations in October 2016. ABHICL focuses on offering a range of health insurance products with unique offerings, including chronic care and incentivized wellness programs. Their offerings include individual and family health insurance plans, critical illness insurance, personal accident insurance, and group health insurance. Some plans offer features like HealthReturns™ where policyholders can earn back a portion of their premium by staying healthy. They also cover modern treatments and a wide range of daycare procedures. ABHICL has a growing distribution presence across India through branches, partner offices, bancassurance partners, and direct selling agents, covering over 2800+ cities. As of Q1 FY22, ABHICL covered more than 22 million lives. ABHICL emphasizes a ‘Health First’ approach, motivating customers to engage in wellness activities through programs and digital platforms.
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Latest claim settlement ratio of health and general insurers released by IRDAI in 2026: Acko, Aditya Birla, Galaxy lead; Shriram, IFFCO Tokio fall below 90%
When it comes to health and general insurance policies, policyholders expect prompt claim settlements from insurers in times of emergency. The real test of any insurance policy lies in how fairly and quickly claims are settled. To gauge an insurer’s efficiency, checking the claim settlement ratio is a reliable way. The Insurance Regulatory and Development Authority of India (IRDAI) releases a list of claim settlements by all health and general insurance companies every year.
According to the latest figures for FY 2024-25, the claim settlement ratio of various insurers has been revealed. Among private general insurers, Acko General Insurance took the lead with 99.98% of claims paid within 3 months, followed by Reliance General Insurance Co. Ltd. with a ratio of 99.32%. On the other hand, Kshema General Insurance Co. Ltd. had the lowest claim settlement ratio of 26.88% among private sector insurers.
Among public insurers, The Oriental Insurance Co. Ltd. settled 90.17% of its claims within 3 months. The New India Assurance Co. Ltd. and National Insurance Co. Ltd. had a claim settlement ratio of 91.75% and 91.79%, respectively.
In the standalone health insurance sector, Aditya Birla Health Insurance Co. Ltd., Galaxy Health Insurance Co. Ltd., Narayana Health Insurance Co. Ltd., and Niva Bupa Health Insurance Co. Ltd. each reported a 100% claim settlement ratio, with all claims settled within three months.
The claim settlement ratio refers to the percentage of claims that an insurer pays or settles out of the total number of claims it receives during a certain period. For instance, a health insurance company with a claim settlement ratio of 95% typically pays around 95 of every 100 claims it receives.
It’s essential for policyholders to check the claim settlement ratio of their insurer to ensure they are getting fair and prompt claim settlements. The IRDAI’s annual list of claim settlements provides a reliable source of information for policyholders to make informed decisions. By checking the claim settlement ratio, policyholders can gauge their insurer’s efficiency and make informed decisions about their insurance policies.
In conclusion, the claim settlement ratio is a crucial factor to consider when choosing a health or general insurance policy. Policyholders should check the claim settlement ratio of their insurer to ensure they are getting fair and prompt claim settlements. The IRDAI’s annual list of claim settlements provides a reliable source of information for policyholders to make informed decisions about their insurance policies.
Insurers to charge 18% GST on agents’ commission, Input Tax Credit issue
The Indian government’s decision to reduce the Goods and Services Tax (GST) on health insurance premiums from 18% to 0% has had an unintended consequence on the insurance industry. Insurers are now imposing an 18% GST on commissions paid to agents and distributors to offset losses from the withdrawal of input tax credit (ITC). This move has come as a major blow to insurance intermediaries across the country.
The GST cut means that insurers can no longer claim ITC on commissions, rewards, and other corporate expenses such as rent, technology, and manpower. As a result, insurers are passing on the GST cost to agents and distributors, which could squeeze smaller distributors and individual agents. For example, if the commission for a sale is Rs 100, the amount payable will reduce by 18% to Rs 84.74.
Industry experts warn that this new structure could make health insurance distribution less profitable or unviable for many agents, unless companies revise commission structures or offer alternative incentives. While customers may gain marginally from lower premiums, the ripple effects are being felt sharply across the industry. Insurers face higher operating costs, and distributors face lower earnings.
The problem stems from how the GST framework treats exemptions. For a company to claim input tax credit, there must be a GST component on its output. With the health insurance sector’s GST set to nil, insurers lose this offset mechanism, and expenses on rent, IT systems, advertising, outsourcing, and agent commissions will add up as unrecoverable costs.
Several insurance companies, including Aditya Birla Health Insurance, Care Health Insurance, Star Health Insurance, and ICICI Lombard General Insurance, have acknowledged the challenge and are passing on the GST cost to distributors. They have reiterated their commitment to passing on the entire GST benefit to customers, but noted that the exemption benefits customers while simultaneously increasing operational costs for insurers. The companies have stated that they will absorb the impact of GST on expenses, but will pass on the GST on commissions to distributors to maintain equilibrium and protect customer interests.
Bombay High Court’s stay brings GST relief to over a dozen insurers
The Bombay High Court has granted a temporary stay on a substantial demand and associated penalties by the Goods and Services Tax (GST) authorities, providing relief to over a dozen insurance companies. The insurance companies, including Aditya Birla Health Insurance, Oriental Insurance, and ICICI Lombard General Insurance, among others, had approached the court challenging the demand raised by the GST authorities, which totaled over Rs 10,000 crore. The court’s stay order brings immediate relief to the insurance companies, which had been facing significant uncertainty due to the GST demands.
The insurance companies had argued that the demand was in contravention of circulars issued by the Central Board of Indirect Taxes and Customs (CBEC) on October 11, 2024, and January 28, 2025, which were issued in pursuance of a decision taken by the GST Council. The companies’ counsel, Senior Advocates Arvind Datar and Rohan Shah, pointed out that in six cases, similar demands had been dropped by jurisdictional officers in Meerut, Delhi, and Pune, and two cases in Mumbai, and argued that the same approach should be adopted in the present case.
The court’s decision is seen as a significant relief for the insurance industry, which had been facing challenges due to the GST demands. The insurance regulator had changed the expense of management guidelines post the tax notices, giving relief to insurers. The GST Council had already recommended a clear position on co-insurance premium and ceding commission, which was subsequently implemented through CBIC circular clarifications. The court’s order reinforces that such circular-based guidance cannot be disregarded in assessment proceedings.
The matter will now be tested on its merits, but the interim protection itself is a meaningful safeguard for the insurance companies facing legacy exposes. The court will hear the matter further on February 18. The temporary stay on the GST demand is expected to provide a significant reprieve to the insurance companies, allowing them to continue their operations without the uncertainty of the substantial tax demand hanging over them.
Bombay High Court stays GST demands on co-insurance premiums.
The Bombay High Court has provided temporary relief to several insurance companies, including ICICI Lombard General Insurance, Aditya Birla Health Insurance, and Tata AIG General Insurance, by staying Goods and Services Tax (GST) demands on co-insurance premium and ceding commission. The court’s decision was based on the argument that the levy was contrary to circulars issued by the Central Board of Indirect Taxes and Customs (CBIC). The insurance companies had approached the court challenging orders passed by GST authorities in Palghar, Maharashtra, confirming the GST demands.
The petitioners, represented by senior advocates Arvind Datar and Rohan Shah, argued that the demands were in violation of CBIC circulars dated October 11, 2024, and January 28, 2025, which were issued pursuant to decisions made by the GST Council. They also pointed out that similar GST demands had been dropped by jurisdictional officers in other cases in Meerut, Delhi, Pune, and Mumbai, following the CBIC circulars. The court was shown an order from one such case to demonstrate the consistent departmental approach elsewhere.
The Directorate General of GST Intelligence had investigated over two dozen insurance companies for allegedly creating shell entities to pay excess commissions and misclassifying expenses to reduce GST liability. The Income Tax Department had also conducted parallel investigations into alleged tax evasion and violations of Insurance Regulatory and Development Authority of India rules. The GST probe focused on alleged fake input tax credit and misclassification of expenses, while the income tax investigation examined suspected tax evasion arising from commission payments in excess of regulatory limits.
The court’s decision has provided much-needed relief to the industry, according to Amit Maheshwari, managing partner at CA firm AKM Global. The court’s intervention highlights the importance of predictable tax administration and consistent field-level implementation. The ad-interim stay will remain in place until the next date of hearing, which is scheduled for after the respondents file their reply affidavits by February 12. The insurance companies will have to wait until then to know the final outcome of their petitions.
India’s Health Insurance Revolution: Insurers Now Prioritize Your Well-being with Preventive Care and Substantial Savings!
The Indian healthcare system is facing a significant challenge due to rising healthcare costs and the burden of out-of-pocket expenses, which account for over 60% of total healthcare spending. Traditional health insurance in India has primarily focused on hospitalization, leaving everyday medical needs uncovered. However, a strategic shift is underway, with insurers prioritizing preventive care and wellness. Mayank Bathwal, CEO of Aditya Birla Health Insurance, explains that this shift is crucial in addressing the core issue of healthcare costs.
The traditional model of health insurance in India has left a significant gap in coverage for regular doctor consultations, diagnostic tests, and medicine costs. These expenses place a heavy financial strain on Indian households. Expanding insurance to cover outpatient services and preventive check-ups can help manage health proactively, reducing avoidable hospital admissions and making healthcare expenses more predictable.
Digital innovation is key to increasing insurance penetration, with platforms like Bima Sugam streamlining policy purchase and servicing. Aditya Birla Health Insurance’s “HealthReturns” program incentivizes healthy lifestyles, rewarding policyholders for consistent healthy behavior. This approach transforms insurance from a financial product into an active partner in well-being, fostering customer loyalty.
A comprehensive health ecosystem requires collaboration between insurers, providers, and government bodies. Digital infrastructure like ABHA and NHCX fosters transparency and streamlines claims. Aditya Birla Health Insurance aims to transition from a reactive, hospital-centric model to a proactive, holistic health ecosystem. This includes managing chronic conditions with continuous monitoring and digital tools for customer health tracking.
The impact of this strategic shift could be significant, leading to a healthier population, reduced long-term healthcare costs, and increased insurance penetration in India. It may also spur innovation among competitors and influence regulatory frameworks. The shift towards preventive care and wellness is a crucial step in addressing the challenges faced by the Indian healthcare system, and Aditya Birla Health Insurance is at the forefront of this change.
The company’s vision is to create a proactive health ecosystem that manages customer health outcomes and aligns them with insurer sustainability goals. This approach has the potential to transform the healthcare landscape in India, making healthcare more accessible, affordable, and effective. With the use of digital tools, AI-powered technologies, and collaborative efforts between stakeholders, Aditya Birla Health Insurance is poised to make a significant impact in the Indian healthcare industry.
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