Latest News on Star Health And Allied Insurance
India: Cashless hospital services resume through AHPI and Star Health partnership, as reported by Asia Insurance Review.
A recent dispute between hospitals and insurance providers in India has been resolved, with cashless hospital services set to resume from October 10. The dispute, which had been ongoing, had left many patients without access to cashless medical treatment. The Association of Healthcare Providers (India), or AHPI, which represents hospitals, had been at odds with insurance providers, including Star Health, over tariffs and payment rates.
As a result of the dispute, many hospitals had stopped offering cashless services, forcing patients to pay out of pocket for medical expenses and then claim reimbursement from their insurance providers. This had caused significant hardship for many patients, who were already struggling with the financial burden of medical treatment.
However, following negotiations between the AHPI and Star Health, the two parties have reached an agreement, and cashless services are set to resume. The agreement is seen as a major relief for patients, who will once again be able to access medical treatment without having to worry about the financial burden.
The dispute between hospitals and insurance providers had highlighted the need for a regulator to oversee the healthcare industry and resolve disputes between providers and insurers. The hospital group has urged the creation of a regulator to prevent such disputes in the future and ensure that patients are not caught in the middle.
The resumption of cashless services is expected to benefit thousands of patients who were affected by the dispute. Hospitals had complained that insurance providers were not paying them adequately for medical services, leading to a significant shortfall in revenue. Insurance providers, on the other hand, had argued that hospitals were charging exorbitant rates for medical services.
The resolution of the dispute is seen as a positive step for the healthcare industry in India, and patients can once again access medical treatment without worrying about the financial burden. The agreement between the AHPI and Star Health is expected to set a precedent for other insurance providers, and cashless services are expected to resume across the country. The creation of a regulator to oversee the healthcare industry is still being debated, but the resolution of the dispute is a major step forward for patients and healthcare providers alike.
Tata AIG has joined Star Health and Niva Bupa in discontinuing cashless claim settlement at Max Hospitals.
Tata AIG General Insurance has suspended its cashless settlement arrangement with Max Hospitals, effective September 10, 2025. This move comes after a dispute over tariffs, with Tata AIG seeking further rate cuts and Max Healthcare refusing to comply. The hospital chain had signed a two-year tariff agreement with Tata AIG, but the insurer requested additional reductions in July, threatening to suspend cashless services if its demands were not met.
As a result, policyholders will now be required to pay upfront for medical treatment at Max Hospitals and then seek reimbursement from Tata AIG. Max Healthcare has set up an express desk to support reimbursement claims and ensure that patients are not inconvenience. The hospital chain has stated that further rate reductions would be “unviable” and could compromise patient care.
Tata AIG has assured its customers that it has made special arrangements to ensure they face no inconvenience. The insurer has prioritized and fast-tracked claims, allowing policyholders to continue receiving uninterrupted treatment and care. Tata AIG’s dedicated service teams are monitoring every case closely to provide complete support and ensure zero disruption for customers.
This dispute is not an isolated incident, but rather part of a wider industry flashpoint between insurers and hospitals over tariffs and settlement terms. Earlier, Star Health had suspended cashless services at several hospitals, including Manipal, Medanta, and Max, sparking criticism from the Association of Healthcare Providers of India (AHPI). However, after negotiations, Star Health and AHPI member hospitals agreed to restore cashless services. Similarly, a standoff between AHPI hospitals in north India and Bajaj Allianz over cashless withdrawals was resolved earlier this month. The suspension of cashless services by Tata AIG is the third such incident, following Star Health and Niva Bupa, highlighting the growing tensions between insurers and hospital chains.
Insured, yet unprotected.
The Indian government’s decision to reduce GST on insurance premiums to zero percent is a relief for millions, but it only scratches the surface of a deeper crisis in the insurance sector. According to the Council of Insurance Ombudsman’s 2023-24 annual report, the top three firms with the most complaints are Star Health, CARE Health Insurance, and Niva Bupa. Star Health leads with 13,308 complaints, with 10,196 related to claim rejections or slashes. CARE Health’s COO, Manish Dodega, defended his company’s position, stating that the number of complaints does not represent the true picture and that the industry has robust systems in place to address issues.
The scale of problems in the insurance sector is staggering, with 2,15,569 complaints filed on IRDAI’s platforms in FY 2023-24. Nearly 95% of health insurance complaints were about claim rejections, while 59% of life insurance complaints concerned misrepresentation or mis-selling. The financial impact on consumers is significant, with health insurance claim rejections rising to Rs 26,000 crore in FY24. Mis-selling is a major issue, with 26,107 life insurance complaints filed against unfair business practices, including mis-selling.
The root cause of mis-selling is the commission structure, which incentivizes selling expensive products over suitable coverage. Experts advocate for dramatic reforms, including overhauling the commission structure and banning upfront commissions in life insurance. The industry needs to focus on term insurance and fundamentally change its product mix. Regulatory transformation is also necessary, with experts criticizing IRDAI’s functioning and calling for a more market-consultative approach.
The cumulative effect of these problems has created a massive trust deficit, with 65% of policyholders not fully understanding their policies and 43% facing hurdles in health claim processing. This erosion of trust is pushing people away from insurance altogether. While the zero GST move addresses affordability concerns, it doesn’t tackle the fundamental issues of transparency, fair claim settlement, and honest selling practices. The industry needs comprehensive reforms, and until then, millions of Indians will continue to find themselves insured but unprotected.
Star Health has introduced ‘Know Your Policy’, a simplified guide to understanding health insurance coverage, as reported by the Press Trust of India.
Star Health and Allied Insurance, a leading health insurance provider in India, has launched a new initiative called ‘Know Your Policy’. This program aims to educate policyholders about the various aspects of their health insurance coverage, making it easier for them to understand and navigate their policies.
The ‘Know Your Policy’ initiative is designed to provide policyholders with a comprehensive and simplified guide to their health insurance coverage. The guide will cover key aspects of the policy, including the sum insured, deductible, co-pay, and pre-existing disease coverage. It will also explain the claims process, including how to file a claim, what documents are required, and how to track the status of a claim.
The initiative is part of Star Health’s efforts to increase transparency and improve customer satisfaction. By providing policyholders with a clear understanding of their coverage, the company hopes to reduce confusion and misunderstandings, and ultimately, improve the overall customer experience.
The ‘Know Your Policy’ guide will be made available to policyholders through various channels, including the company’s website, mobile app, and customer service helpline. Policyholders will be able to access the guide at any time, and it will be regularly updated to reflect any changes to the policy or coverage.
Star Health believes that the ‘Know Your Policy’ initiative will not only benefit policyholders but also help to increase awareness about health insurance in general. By educating policyholders about their coverage, the company hopes to promote a better understanding of the importance of health insurance and the role it plays in protecting individuals and families from financial risk.
The launch of ‘Know Your Policy’ is a significant step forward for Star Health, as it demonstrates the company’s commitment to customer-centricity and transparency. By providing policyholders with a simplified guide to their health insurance coverage, the company is empowering them to make informed decisions about their healthcare and financial well-being.
Overall, the ‘Know Your Policy’ initiative is a positive development for policyholders and the health insurance industry as a whole. It highlights the importance of transparency and customer education in health insurance, and sets a new standard for customer-centricity in the industry.
LIC is reportedly making an entry into the health insurance market by acquiring a stake in ManipalCigna.
According to a recent report, Life Insurance Corporation of India (LIC) is considering a foray into the health insurance market by acquiring a stake in ManipalCigna Health Insurance Company. This move is seen as a strategic expansion of LIC’s business portfolio, which currently dominates the life insurance market in India.
ManipalCigna Health Insurance is a joint venture between Manipal Group and Cigna Corporation, a global health insurance company. The company offers a range of health insurance products and services in India, including individual and group health insurance plans, critical illness coverage, and top-up plans.
If the deal goes through, LIC’s acquisition of a stake in ManipalCigna Health Insurance would mark its entry into the health insurance market, which is currently dominated by private players such as Max Bupa, Apollo Munich, and Star Health. The move would also enable LIC to leverage its vast distribution network and customer base to sell health insurance products.
The report suggests that LIC is looking to acquire a significant stake in ManipalCigna Health Insurance, which could range from 20% to 40%. The deal is expected to be valued at around Rs 1,000-1,500 crore (approximately $137-$204 million USD).
LIC’s foray into the health insurance market is seen as a natural extension of its business, given the growing demand for health insurance products in India. The company’s vast distribution network, which includes over 2,000 branches and a large network of agents, would provide a significant advantage in selling health insurance products.
The acquisition would also enable LIC to diversify its revenue streams and reducing its dependence on the life insurance business. The health insurance market in India is expected to grow rapidly in the coming years, driven by increasing healthcare costs, rising awareness about health insurance, and government initiatives to promote health insurance.
Overall, LIC’s potential acquisition of a stake in ManipalCigna Health Insurance is seen as a strategic move to expand its business portfolio and tap into the growing demand for health insurance products in India. The deal would also provide a significant boost to the health insurance market in India, which is expected to witness rapid growth in the coming years.
Stock Market Updates for Star Health And Allied Insurance
Recent Updates
Max Healthcare: No cashless claims for Tata AIG health insurance policyholders in Max Hospitals, becomes 3rd insurer to do so.
Tata AIG Insurance has suspended its cashless claim settlement facility with Max Hospitals, following in the footsteps of Star Health and Niva Bupa. This means that policyholders of these insurance companies will no longer be able to receive cashless treatment at Max Hospitals, and will instead have to pay out of pocket and claim reimbursement later. While Star Health and Niva Bupa have suspended cashless claim settlement with all 22 Max Hospitals across the country, Tata AIG’s suspension is currently in effect.
According to Max Hospitals, the suspension is due to a dispute over tariffs. Max Hospitals claims that Tata AIG demanded a downward revision of the agreed-upon tariffs, which Max Hospitals was not willing to accept. As a result, Tata AIG suspended cashless services at Max Hospitals effective September 10, 2025. Max Hospitals has stated that it will continue to provide an express desk to help policyholders claim reimbursements from insurers without having to make upfront payments.
However, sources at Tata AIG have indicated that discussions are ongoing and that the situation may be resolved in the near future. In the meantime, Tata AIG has put in place special arrangements to ensure that its customers face no inconvenience, including prioritizing and fast-tracking claims. The company has also stated that its dedicated service teams are monitoring every case closely to provide complete support and ensure zero disruption for its customers.
The dispute between Max Hospitals and the insurance companies is not limited to Tata AIG. Niva Bupa has also suspended cashless claim settlement with Max Hospitals, citing a desire to further reduce tariffs. Max Hospitals has stated that it is not willing to reduce tariffs below the 2022 levels, as it believes that doing so would compromise patient safety and the quality of care. CARE health insurance policyholders are also affected, with cashless claim settlement services not available at Max Hospitals in the Delhi-NCR region.
Overall, the suspension of cashless claim settlement facilities by multiple insurance companies is likely to cause inconvenience for policyholders who rely on Max Hospitals for medical care. However, both Max Hospitals and the insurance companies are working to find a resolution and minimize disruption for patients.
AHPI requests Star Health to reinstate cashless services at hospitals
The Association of Healthcare Providers of India (AHPI) has expressed concerns over the suspension of cashless treatment by Star Health Insurance in several hospitals. According to AHPI, cashless services have been disrupted in numerous hospitals, including Care Hospitals in Vizag, Manipal in Delhi and Gurugram, and Max in North India. Other hospitals such as Metro in Faridabad, Medanta in Lucknow, Rajiv Gandhi Cancer Hospital in New Delhi, Sarvodaya in Faridabad, and Yatharth Hospitals have also reported disruptions.
AHPI has stated that Star Health Insurance has not only suspended cashless treatment but has also slowed down or denied empanelment to several hospitals. This includes Fortis Manesar, Jupiter Indore, Max Dwarka, Medanta Noida, and Care Hospitals in Hyderabad and Vizag. As a result, families are being forced to opt for reimbursement claims instead of cashless treatment, which can be a lengthy and cumbersome process.
The association has urged Star Health Insurance to immediately restore cashless services and expedite empanelments. This move is expected to benefit patients who rely on cashless treatment for medical emergencies. By restoring cashless services, Star Health Insurance can ensure that patients receive timely and hassle-free treatment, without the added burden of reimbursement claims.
AHPI’s concerns highlight the importance of cashless treatment in the healthcare sector. Cashless treatment allows patients to receive medical care without having to pay out-of-pocket expenses, which can be a significant financial burden. By suspending cashless treatment, Star Health Insurance is not only causing inconvenience to patients but also undermining the trust and confidence that patients have in the healthcare system.
As a reliable and trusted news source, it is essential to report on such issues and bring them to the attention of the relevant authorities. The disruption of cashless services by Star Health Insurance is a matter of concern, and it is crucial that the insurer takes immediate action to restore these services and expedite empanelments. By doing so, Star Health Insurance can ensure that patients receive the medical care they need, without any unnecessary delays or hardships.
Star Health’s latest campaign draws a stark line between care and crisis
Star Health Insurance has launched a new campaign film that highlights the emotional and financial struggles faced by families without health insurance. The film, released after World Insurance Day, uses a split-screen narrative to contrast the experiences of the same family with and without health insurance. On one side, the family is shown struggling with long hospital queues, delayed treatment, and financial stress, while on the other side, they are able to access priority consultations, private rooms, and a streamlined process.
The campaign aims to spark a conversation around the importance of health insurance and the peace of mind it can provide. By showing the stark difference between the two scenarios, the film emphasizes the value of being prepared for health emergencies. The narrative is led by actor Dibyendu Bhattacharya, who delivers a restrained and empathetic performance that reflects the quiet resilience of many families navigating healthcare stress.
The film’s message is subtle yet powerful, emphasizing the importance of timely decisions when it comes to health insurance. The closing line, “Health Insurance abhi lena smart hai” (getting health insurance now is smart), drives home the urgency of making informed choices. By focusing on everyday hospital moments and understated emotional cues, the story becomes deeply relatable to audiences.
The campaign is particularly relevant in today’s context, where audiences are looking for real stories that reflect their own experiences. By shedding light on the emotional toll of being uninsured, Star Health’s campaign draws attention to the thin line between care and chaos. The film ultimately underscores the importance of having a support system that provides not just financial protection, but also peace of mind during difficult times. Overall, the campaign is a thoughtful and impactful reminder of the value of health insurance in protecting not just our physical health, but also our emotional well-being.
Star Health Insurance has settled claims worth over Rs 2800 crore in Karnataka over the last 5 years.
Star Health Insurance, a leading health insurance provider in India, has announced that it has settled claims worth over Rs. 2800 crore in Karnataka over the last five years. This significant achievement demonstrates the company’s commitment to providing comprehensive health insurance coverage to its customers in the state.
The settlement of claims worth Rs. 2800 crore is a testament to Star Health Insurance’s robust claims processing system, which ensures that policyholders receive timely and hassle-free settlements. The company has a strong network of hospitals and healthcare providers in Karnataka, which enables it to provide cashless treatment to its policyholders.
Star Health Insurance has been operating in Karnataka for several years and has established itself as a trusted health insurance provider in the state. The company offers a range of health insurance products, including individual and family floater policies, senior citizen policies, and critical illness policies. These products are designed to provide comprehensive coverage to policyholders, including hospitalization expenses, surgical expenses, and other medical expenses.
The company’s claims settlement process is designed to be quick and efficient, with a dedicated team of claims professionals who work closely with policyholders to settle their claims. Star Health Insurance also has a strong network of Third-Party Administrators (TPAs) who assist in the claims settlement process.
The settlement of claims worth Rs. 2800 crore in Karnataka is a significant achievement for Star Health Insurance, and it demonstrates the company’s commitment to providing excellent customer service to its policyholders. The company’s strong claims settlement record has earned it a reputation as a trusted and reliable health insurance provider in the state.
Overall, Star Health Insurance’s achievement of settling claims worth Rs. 2800 crore in Karnataka over the last five years is a testament to the company’s dedication to providing comprehensive health insurance coverage to its customers. The company’s robust claims processing system, strong network of hospitals and healthcare providers, and commitment to customer service have made it a leading health insurance provider in the state.
In India, Alzheimer’s and dementia are covered by insurance through various policies and schemes. Here’s an overview:
Health Insurance: Many health insurance policies in India cover Alzheimer’s and dementia, including:
- Individual Health Insurance Policies: Some insurance companies offer coverage for Alzheimer’s and dementia as part of their individual health insurance policies.
- Senior Citizen Health Insurance: Specialized senior citizen health insurance policies often cover age-related diseases, including Alzheimer’s and dementia.
- Critical Illness Insurance: Critical illness insurance policies may cover Alzheimer’s and dementia, providing a lump sum payment to help with treatment and care.
Government-Sponsored Schemes: The Indian government offers several schemes to support individuals with Alzheimer’s and dementia, including:
- Rashtriya Swasthya Bima Yojana (RSBY): A health insurance scheme for below-poverty-line families, which covers hospitalization expenses, including those related to Alzheimer’s and dementia.
- Ayushman Bharat: A national health protection scheme that provides coverage for secondary and tertiary care hospitalization, including treatment for Alzheimer’s and dementia.
- National Programme for the Healthcare of the Elderly (NPHCE): A program that provides health care services, including diagnosis, treatment, and care, for elderly individuals with Alzheimer’s and dementia.
Private Insurance Companies: Several private insurance companies in India offer policies that cover Alzheimer’s and dementia, including:
- ICICI Lombard: Offers a comprehensive health insurance policy that covers Alzheimer’s and dementia.
- Bajaj Allianz: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
- Max Bupa: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.
- Apollo Munich: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
- Star Health: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.
Limits and Exclusions: While many insurance policies cover Alzheimer’s and dementia, there may be limits and exclusions, such as:
- Waiting Period: A waiting period may apply before coverage kicks in.
- Sub-Limits: Sub-limits may apply for specific treatments or expenses.
- Exclusions: Certain expenses, such as long-term care or home care, may be excluded from coverage.
- Pre-Existing Conditions: Pre-existing conditions, including Alzheimer’s and dementia, may be excluded from coverage or subject to a waiting period.
It’s essential to review policy terms and conditions carefully and consult with an insurance expert to understand the coverage and limitations.
Families of patients with Alzheimer’s disease or other forms of dementia often face uncertainty and financial burdens due to medical expenses and long-term care. While health and critical illness insurance policies can cover some hospitalization and severe-stage treatment costs, they usually exclude long-term care and routine support. Understanding what is included and excluded in these policies is crucial for effective financial planning.
Health insurance policies generally cover hospitalization costs for Alzheimer’s or related complications, including infections, injuries, or behavioral complications during hospital stays. However, long-term care, such as assisted living, home caregiving, or routine outpatient visits, is usually excluded unless an OPD add-on is purchased. Critical illness policies may list Alzheimer’s as a covered condition, but benefits often only apply at advanced, irreversible stages, and a mandatory survival period of 15-30 days is required before a lump-sum payout is made.
The definition of Alzheimer’s for insurance purposes is important. For critical illness policies, Alzheimer’s is defined as a progressive brain disorder causing severe memory loss and inability to perform daily activities, with early or mild cognitive impairment usually not qualifying. Health policies, on the other hand, do not differentiate by stage for hospitalization claims.
Common exclusions in health and critical illness policies include long-term care, rehabilitation, or assisted living, routine outpatient consultations and therapy, pre-existing neurological conditions, and experimental or unproven treatments. Insurers distinguish between medical treatment and supportive care, with long-term custodial care considered supportive, not hospitalization, which is why it is outside standard policies.
Health insurance premiums rise with age and health history, while critical illness premiums depend on age and coverage amount. Coverage for individuals already diagnosed with Alzheimer’s is generally unavailable, and critical illness claim settlements are contingent on verification of severe disease and survival-period compliance. Currently, there are no insurance products dedicated to Alzheimer’s or dementia, but insurers are expanding inclusivity in policies, covering mental health and other previously excluded conditions. Discussions are ongoing around long-term care solutions tailored for cognitive disorders, which may provide more comprehensive support for families affected by Alzheimer’s and dementia in the future.
The Insurance Regulatory and Development Authority of India (IRDAI) has initiated an investigation into a whistleblower complaint regarding the promoter stakes in Star Health and Allied Insurance, as well as Kiwi General Insurance.
The Insurance Regulatory and Development Authority of India (IRDAI) has received a whistleblower complaint alleging a conflict of interest involving WestBridge Capital, a private equity firm. The complaint claims that WestBridge Capital holds a significant stake in two insurance companies, Star Health and Kiwi General Insurance, which operate in the same segment of retail health insurance. This is in violation of IRDAI regulations, which prohibit a single promoter from holding a stake of 25% or more in two entities within the same business line.
According to the complaint, WestBridge Capital holds approximately 40% stake in Star Health and around 60% in Kiwi General Insurance, effectively making it the promoter of both companies. IRDAI regulations, specifically the IRDAI (Registration of Indian Insurance Companies) Regulations, 2022, state that a holding of 25% or more qualifies as a promoter-level interest, and the same promoter cannot hold such stakes in two entities within the same business line.
In response to the complaint, IRDAI has asked its officials to explain why the conflict of interest was not previously disclosed to the board. The regulator plans to engage with WestBridge Capital to explore possible resolutions, including reducing its stake in Star Health below 25% to shift from a promoter to an investor role. Other options being considered include introducing conditions on Kiwi’s approval process, such as restricting its entry into retail health insurance or other overlapping segments, or stopping the approval for Kiwi General Insurance altogether.
The issue raises concerns about the potential conflict of interest and the impact on the insurance market. IRDAI’s response will be closely watched, as it will set a precedent for how the regulator handles similar situations in the future. The complaint also highlights the importance of transparency and disclosure in the insurance industry, and the need for regulators to ensure that companies comply with regulations to maintain a level playing field.
Niva Bupa is a casualty of GST removal on individual health insurance because the removal of GST has significantly reduced the cost of health insurance for individuals, making Niva Bupa’s premiums less competitive. As a result, the company is facing a decline in sales and revenue, ultimately affecting its business operations and profitability. The removal of GST has led to a decrease in the premium amounts that individuals have to pay, making Niva Bupa’s offerings less appealing to customers who are now opting for more affordable options. This has put pressure on Niva Bupa to revisit its pricing strategy and restructure its products to remain competitive in the market.
The recent changes to the goods and services tax (GST) rate on insurance have put Niva Bupa Health Insurance Co. Ltd in a difficult position. The company must decide whether to remain competitive by not raising premiums, thereby sacrificing profit margin, or to become uncompetitive by raising premiums and protecting its profit margin. This dilemma arises because individual health insurance is exempt from GST, but other types of insurance, such as vehicle insurance, are still taxable.
Standalone health insurance companies, like Niva Bupa and Star Health, are particularly affected by the GST changes. These companies cannot fully utilize the input tax credit (ITC) for GST paid on expenses, as they only collect GST on premiums from group health insurance policies. Niva Bupa’s gross premium income is ₹6,762 crore, compared to Star Health’s ₹16,781 crore. However, Niva Bupa’s higher expenses of management (EoM) ratio and re-insurance ceded ratio mean that it pays more GST on these expenses, making its ITC higher.
According to Kotak Institutional Equities, Niva Bupa’s disallowed ITC is estimated to be ₹193 crore, compared to Star Health’s ₹156 crore. This means that Niva Bupa’s profit margin will suffer more if it does not increase its base premium prices. Kotak estimates that Niva Bupa will need a price hike of 4.4% in base insurance premiums, compared to just 1% for Star Health.
The abolition of GST on individual health insurance may lead to increased demand for these policies, which had slowed down in FY25. However, the impact on profitability varies significantly between companies. Investors should wait and see how Niva Bupa responds to these changes before making any investment decisions. The company’s ability to balance competitiveness with profit margin protection will be crucial in determining its future success. Ultimately, Niva Bupa’s response to the GST changes will have a significant impact on its profitability and competitiveness in the health insurance market.
Health insurers are struggling financially, even after implementing increases in premium rates.
The Indian health insurance industry is facing a challenging time due to rising medical costs and increasing claims. Despite multiple premium hikes, insurers are struggling to contain losses, with many reporting deteriorating loss ratios. The main factor contributing to this trend is the estimated 14% inflation in medical-related costs, which is outpacing premium increases.
New India Assurance, a state-owned insurer, saw its incurred claims ratio worsen to 109% in Q1 FY26, up from 106% a year ago. The company’s CMD, Girija Subramanian, attributed this to a 4% gap between the 10% cap on premium hikes for senior citizens and the actual inflation rate. ICICI Lombard, another major insurer, reported a rise in its retail health book loss ratio from 72.5% to 74.3% in Q1. However, the company expects to end the year with a loss ratio in the range of 65-70%.
Other insurers, such as Star Health and Niva Bupa, have also reported increases in their loss ratios. Star Health’s incurred claims ratio climbed to 68.5% from 66.9%, while Niva Bupa’s loss ratio moved up to 68% on its retail book. The health segment continues to dominate the general insurance industry, accounting for 40.2% of industry gross premium income.
According to analysts, the medical inflation curve is not uniform across the board, with each insurer facing a different inflation rate depending on its portfolio mix. Public sector undertakings (PSUs), for example, have older policyholder cohorts in their retail book, which require more tertiary care and drive up inflation-linked claims.
The industry is expected to continue facing challenges due to rising medical costs and increasing claims. Insurers will need to carefully manage their portfolios and adjust their pricing strategies to contain losses. As a reliable and trusted news source, it is essential to closely monitor the developments in the Indian health insurance industry and provide updates on the latest trends and challenges.
In conclusion, the Indian health insurance industry is facing significant challenges due to rising medical costs and increasing claims. Insurers must adapt to these changes by adjusting their pricing strategies and managing their portfolios effectively to contain losses. With the health segment dominating the general insurance industry, it is crucial for insurers to find a balance between providing adequate coverage and maintaining profitability. As the industry continues to evolve, it is essential to stay informed about the latest developments and trends.
LIC to acquire a substantial stake in a pure health insurer, with an announcement expected by March 31.
The Life Insurance Corporation of India (LIC) is in the final stages of discussions to acquire a substantial stake in a pure health insurance company. According to Siddhartha Mohanty, Managing Director and CEO of LIC, the company is likely to announce the decision before March 31. This move is seen as a natural choice for LIC to expand its presence in the health insurance market. While Mohanty declined to reveal the name of the health insurer, reports suggest that LIC is in talks with Manipal Cigna Health Insurance.
LIC has clarified that it is not seeking a 51% stake in the health insurer, but rather a substantial stake that would broaden its footprint in the health insurance market. The company has emphasized that regulatory approvals are still pending and there is no guarantee that the deal will be consummated. Currently, there are seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance.
In a separate development, Mohanty revealed that LIC has requested the Reserve Bank of India (RBI) to issue additional long-term bonds with maturities of 50 years and 100 years. This move is aimed at enabling LIC to better manage its investments and asset-liability mismatch, given its long-term contractual obligations to policyholders. While the RBI currently permits bonds with maturities of 20 to 40 years, 100-year bonds are not uncommon in global markets.
The potential acquisition of a health insurance company and the request for longer-term bonds are seen as strategic moves by LIC to expand its presence in the insurance market and manage its investments more effectively. As a public sector behemoth, LIC’s decisions are closely watched by the industry and investors. The company’s plans to enter the health insurance market and its request for longer-term bonds are likely to have significant implications for the insurance industry and the broader financial markets.
Star Health aims for Rs 20,000-crore premium in current fiscal, according to Anand Roy
Star Health & Allied Insurance, India’s largest standalone health insurer, is expanding its presence in the insurance market. The company aims to reach a gross written premium (GWP) of Rs 30,000 crore by FY28, with a target of Rs 20,000 crore for FY26. To achieve this goal, Star Health is focusing on deepening its presence in Tier II and III cities, expanding its agency force, and distribution network. Despite the muted growth in health insurance premiums, the company believes that health insurance remains a multi-decade growth opportunity due to low penetration rates and rising healthcare costs.
To keep its loss ratios in check, Star Health has established a network of over 15,000 hospitals, with pricing arrangements with almost 5,000 of them. The company is also improving its technology platforms to identify abuse and fraud, and takes price revisions when necessary. With medical inflation in India being the highest among developing countries, Star Health may consider price hikes in the future, but only when a product’s loss ratio crosses a certain threshold.
In addition to its health insurance business, Star Health is planning to enter the life insurance space. The company is waiting for the Insurance Amendment Bill, 2025 to be introduced, which will allow it to explore opportunities in the life insurance sector. Star Health sees a big opportunity in the protection space, particularly with term life insurance plans, which is a natural adjacency for its customer base. The company’s board has given the green signal to explore such options, and Star Health will take a call once the regulations are in place.
Overall, Star Health is well-positioned to achieve its growth targets and expand its presence in the insurance market. With its focus on retail health and group health, the company is confident that it can continue to grow and provide critical health insurance coverage to the middle and upper-middle income segments. The planned entry into the life insurance space will also provide a new avenue for growth and allow Star Health to offer a more comprehensive range of insurance products to its customers.
The Insurance Ombudsman has released a report revealing the top insurers with the maximum number of grievances. The report provides insight into the performance of insurance companies in terms of customer satisfaction and complaint resolution.Some key points from the report include: 1. The names of the top insurers with the maximum grievances have been disclosed, allowing consumers to make informed decisions when choosing an insurance provider. 2. The report highlights the types of grievances received by the ombudsman, including claims-related issues, policy servicing, and premium disputes. 3. The data provides a comparison of the grievance rates among different insurance companies, enabling customers to assess the quality of service offered by each insurer. 4. The Insurance Ombudsman’s report also outlines the steps taken to address and resolve the grievances, ensuring that customers’ concerns are heard and addressed. 5. The release of this information aims to promote transparency and accountability within the insurance industry, ultimately benefiting consumers by encouraging insurers to improve their services and reduce grievances.
The Insurance Ombudsman’s Annual Report for 2023-24 has revealed a significant increase in complaints against health insurance companies in India. The report shows that the total number of complaints against health insurers rose by 21.7% to 31,490 in FY 2023-24, compared to 25,873 in FY 2022-23. Private insurers accounted for the majority of complaints, with 26,064 grievances, while public sector insurers accounted for 5,298.
Star Health & Allied Insurance led the list of companies with the most complaints, recording 13,308 grievances, of which 10,196 were related to claim repudiations. CARE Health Insurance and Niva Bupa Health Insurance followed with 3,718 and 2,511 complaints, respectively. The report also highlights that claim repudiation is the most common grievance, with the majority of complaints falling under this category.
The Insurance Regulatory and Development Authority of India (IRDAI) has responded to the rising dissatisfaction by mandating every insurer to appoint an Internal Ombudsman (IO) to review cases up to Rs 50 lakh that remain unresolved after 30 days or are rejected by insurers. However, experts argue that the independence of the IO is questionable since they report to the insurer’s top management, raising concerns about fairness and impartiality.
The report highlights the need for stronger accountability, transparency, and consumer protection in the health insurance sector. Policyholders are advised to look beyond premiums when buying health insurance and consider critical factors such as claim settlement ratio, repudiation rates, grievance redressal track record, and customer service quality.
The Council for Insurance Ombudsmen (CIO) has been established to provide policyholders with a speedy and cost-effective mechanism to resolve disputes against insurance companies. The CIO functions under the framework defined in the Insurance Ombudsman Rules, 2017, and serves as an alternative grievance redressal platform.
In conclusion, the report highlights the growing concerns of policyholders with health insurance companies in India. The rise in complaints and claim repudiations is a pressing issue that needs to be addressed by insurers and regulatory authorities. The appointment of Internal Ombudsmen is a step in the right direction, but its independence and effectiveness need to be closely monitored. Ultimately, informed choices and stronger regulation are key to restoring policyholder trust in the health insurance sector.
Star health show reveals Han Da-geum’s high cancer risk – 조선일보
According to a recent episode of the Star Health Show, Han Da-geum, a Korean celebrity, has been found to have a high risk of developing cancer. The show, which focuses on the health and wellbeing of Korean celebrities, revealed the results of Han’s health checkup, which showed that he has a high risk of developing the disease.
Han Da-geum, who is known for his work as a singer and actor, underwent a series of health tests as part of the show, including a genetic test to determine his risk of developing certain diseases. The results of the test showed that he has a high risk of developing cancer, particularly lung and stomach cancer.
The show’s hosts and medical experts discussed Han’s test results and provided him with advice on how to reduce his risk of developing cancer. They emphasized the importance of maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking and excessive drinking.
Han Da-geum’s high cancer risk is likely due to a combination of genetic and environmental factors. As a heavy smoker, he is already at a higher risk of developing lung cancer, and his family history of cancer may also play a role. The show’s medical experts advised him to quit smoking and make lifestyle changes to reduce his risk.
The episode sparked concern among Han’s fans, who are worried about his health and wellbeing. However, Han has reassured them that he is taking steps to reduce his risk of developing cancer and is committed to maintaining a healthy lifestyle.
The Star Health Show’s revelation of Han Da-geum’s high cancer risk highlights the importance of regular health checkups and screenings. The show’s hosts and medical experts emphasized that early detection and prevention are key to reducing the risk of developing cancer and other diseases.
Overall, the episode serves as a reminder of the importance of prioritizing one’s health and wellbeing, particularly for those who may be at a higher risk of developing certain diseases. By making lifestyle changes and undergoing regular health checkups, individuals can reduce their risk of developing cancer and other diseases, and maintain a healthy and fulfilling life.
It’s worth noting that Han Da-geum’s case is not unique, many people are at risk of developing cancer due to a combination of genetic and environmental factors. The show’s message is clear, taking care of one’s health is crucial, and regular checkups can help detect potential health issues early on.
Big update for customers of THIS health insurance company, Apollo Munich Health Insurance (AHPI) is likely to withdraw cashless services from its network of member hospitals, according to reports from the hospitals.
The Association of Healthcare Providers of India (AHPI) has announced that it may withdraw cashless services for Star Health Insurance policyholders from September 22. This decision comes after persistent complaints against the company, with over 13,000 complaints received, including more than 10,000 related to claim rejections. AHPI alleges that Star Health has refused to revise old tariff rates in line with rising costs, instead pressuring hospitals to reduce charges.
As a result, thousands of patients may face difficulties in accessing medical care. If cashless services are withdrawn, policyholders will have to pay hospitals upfront and later file a claim for reimbursement. This could put significant financial pressure on patients, particularly in emergency situations where immediate payment is required. AHPI represents over 15,000 hospitals and has stated that this step is being taken to protect patient safety and the financial condition of hospitals.
AHPI has emphasized that hospitals will continue to provide treatment to patients on a payment basis, and will assist patients in the reimbursement process. However, this change could still have a significant impact on patients who rely on cashless services. The Insurance Ombudsman’s 2023-24 report highlights the large number of complaints against Star Health, with many related to claim rejections.
The potential withdrawal of cashless services is a significant concern for Star Health Insurance customers, who may need to make alternative arrangements for medical care. AHPI has stated that it is taking this step out of compulsion, and that it hopes Star Health will address the concerns of hospitals and revise its policies to ensure that patients receive the care they need. If a resolution is not reached, patients may face significant difficulties in accessing medical care, particularly in emergency situations.
Hospital body warns of suspension of cashless services to Star Health policyholders
The Association of Healthcare Providers – India (AHPI) has issued a warning to Star Health Insurance, threatening to suspend cashless facilities to policyholders due to the insurer’s questionable practices. The association, which represents over 15,000 hospitals and healthcare institutions, has raised several concerns, including the insurer’s refusal to revise tariffs despite high healthcare cost inflation, arbitrary withdrawal of cashless services, and unjustified deductions from hospital bills.
AHPI has pointed out that these practices may compromise patient safety and quality of care, and has warned that unless Star Health Insurance addresses these concerns in a timely manner, cashless services for policyholders may be withdrawn from September 22, 2025. The association has also cited the Insurance Ombudsman Annual Report 2023-24, which shows that Star Health Insurance had the highest number of complaints, with over 13,300 complaints in FY24, mostly related to partial or full claim rejections.
AHPI has expressed similar concerns about other insurers, including Bajaj Allianz General Insurance and Care Health Insurance. The association is also opposed to the proposed GIC-led common empanelment process, which it views as anti-competitive and lacking a sound legal basis. The process involves insurers abruptly stopping cashless services to pressure hospitals into lowering tariffs, which AHPI believes is unfair and may harm patients.
The issues raised by AHPI are significant, and the association’s warning to Star Health Insurance is a clear indication of the tensions between healthcare providers and insurers in India. The association’s concerns about patient safety and quality of care are also valid, and it remains to be seen how Star Health Insurance will respond to the warning. If the insurer fails to address the concerns, it may lead to a disruption in cashless services for policyholders, which could have serious consequences for patients and their families.
Overall, the dispute between AHPI and Star Health Insurance highlights the need for greater transparency and fairness in the insurance industry, particularly when it comes to healthcare costs and patient care. The association’s efforts to protect the interests of healthcare providers and patients are crucial, and it is essential that insurers respond to these concerns in a constructive and timely manner.
Star Health Unveils Flexible ‘Star Flexi’ Riders For Super Star Plan – BW Healthcare World
Star Health, a prominent health insurance provider, has introduced a new range of flexible riders called “Star Flexi” for its Super Star plan. The Super Star plan is a comprehensive health insurance policy that offers extensive coverage to individuals and families. With the introduction of Star Flexi riders, policyholders can now customize their insurance coverage to suit their specific needs and requirements.
The Star Flexi riders are designed to provide flexibility and choice to policyholders, allowing them to enhance their coverage in areas that are most important to them. The riders offer additional benefits such as increased sum insured, hospital cash, and critical illness coverage, among others. Policyholders can choose from a range of riders and add them to their Super Star plan, giving them greater control over their insurance coverage.
One of the key features of the Star Flexi riders is their flexibility. Policyholders can opt for the riders at the time of buying the Super Star plan or even add them later during the policy term. This allows policyholders to adjust their coverage as their needs change over time. Additionally, the riders can be purchased individually or in combination, giving policyholders the freedom to create a customized insurance package that meets their specific requirements.
The introduction of Star Flexi riders is a significant development in the health insurance market, as it recognizes the diverse needs of policyholders. By offering flexible and customizable coverage options, Star Health is empowering policyholders to take greater control of their health insurance coverage. This move is also expected to increase the appeal of the Super Star plan, making it a more attractive option for individuals and families looking for comprehensive health insurance coverage.
Overall, the Star Flexi riders are a welcome addition to the Super Star plan, offering policyholders greater flexibility, choice, and control over their insurance coverage. With these riders, policyholders can create a tailored insurance package that meets their specific needs and requirements, providing them with greater peace of mind and financial protection against medical expenses. By introducing these innovative riders, Star Health is reinforcing its commitment to providing customer-centric health insurance solutions that cater to the diverse needs of its policyholders.
Insurers have eased health insurance regulations for individuals with diabetes, heart conditions, and other chronic illnesses.
The health insurance landscape is undergoing a significant transformation, making it more accessible to individuals with chronic and lifestyle-related diseases. According to a recent note from Policybazaar, insurers have relaxed their underwriting norms, allowing people with conditions such as diabetes, heart disease, and arthritis to obtain coverage more easily. This change is expected to benefit a large segment of the population, particularly those who were previously denied coverage due to borderline or slightly elevated health indicators.
One notable development is the acceptance of higher HbA1c levels for individuals with well-managed Type 2 diabetes. Several insurers, including Niva Bupa, Care Health, ABHI, and Star Health, now offer coverage to individuals with higher HbA1c levels, widening the scope for those who were previously excluded. Additionally, the Body Mass Index (BMI) cutoffs have been revised across many plans, enabling overweight and mildly obese individuals to apply for policies without facing automatic rejection or higher scrutiny.
Insurers have also expanded their acceptance of other chronic illnesses, such as Aplastic Anemia, Psoriatic Arthritis, Osteoarthritis, Hepatitis B, and Epilepsy. While these policies may come with extra premiums or permanent exclusions, they offer a glimmer of hope for individuals who were previously considered high-risk. Furthermore, individuals with a history of heart ailments are now seeing more options, with insurers such as ABHI and Star Health offering coverage to applicants with past heart issues, albeit with waiting periods or loading.
The Head of Health Insurance at Policybazaar, Siddharth Singhal, welcomed these changes, stating that health insurance has become more inclusive in recent months. The demand for these revised products is strong, with more customers with medical histories seeking financial protection. As the health insurance sector continues to evolve, it is likely that more individuals with chronic and lifestyle-related diseases will be able to access coverage, providing them with much-needed financial security and peace of mind.
Star Health has introduced a campaign that emphasizes the significant impact health insurance can have on individuals’ lives.
On June 28, Star Health Insurance launched a thought-provoking campaign in observance of World Insurance Day. The campaign aims to raise awareness about the importance of health insurance by highlighting the stark contrast between a family with health insurance and one without. The campaign film uses a split-screen narrative to portray the two scenarios, with the uninsured family struggling to navigate the healthcare system and the insured family experiencing a seamless and stress-free experience.
The film showcases the uninsured family waiting in long queues, forgoing the comfort of a private room, and facing financial struggles at the billing counter. In contrast, the insured family enjoys priority consultations, a suite room, and peace of mind. The campaign uses a simple yet effective metaphor of “staying on the right side of the line” to underscore the significance of health insurance.
The film features actor Dibyendu Bhattacharya as the head of the uninsured family, whose understated performance adds to the poignancy of the situation. The campaign captures relatable moments in a hospital setting, reflecting the anxieties and frustrations that people face when dealing with unplanned medical expenses. The visual treatment is also noteworthy, with the left side of the frame being muted and gritty, while the right side is warmer and composed, reinforcing the message.
The campaign’s message is clear: health insurance is a smart and essential investment for one’s well-being. By highlighting the importance of health insurance as a concept, Star Health has made the campaign relevant beyond its own product. The closing line, “Health Insurance abhi lena smart hai” (It’s smart to get health insurance now), strikes a balance between urgency and relatability, encouraging viewers to reflect on their own preparedness rather than pushing a sales message.
Through this campaign, Star Health has attempted to provoke thought among viewers about the value of health insurance, keeping the storytelling grounded and relatable. The campaign adds to the growing trend of insurance brands moving towards more empathetic narratives, focusing on the human impact of their products rather than just transactional messaging. Overall, the campaign is a powerful reminder of the importance of health insurance and the need to prioritize one’s health and well-being.
Star Health Insurance in India has been fined Rs 5.42 crore.
The Insurance Regulatory and Development Authority of India (IRDAI) has imposed a significant cash penalty on Star Health Insurance, a private sector insurer, for a major data breach. The penalty amounts to Rs 3.39 crore, which is approximately Rs 5.42 crore when including additional fines. This action was taken in response to the leakage of highly sensitive data related to 3.1 crore insured individuals.
The data breach occurred in August last year, when a hacker group gained unauthorized access to Star Health Insurance’s core database. The compromised data included mobile numbers, taxpayer registration details, addresses, and medical reports. This sensitive information was made publicly accessible on Telegram and through chatbots via websites. Furthermore, the hacker group sent death threats and gunshots to the company’s executive chief, highlighting the severity of the situation.
The IRDAI warned Star Health Insurance about the violation of cyber security guidelines and imposed penalties under Section 114(1) of the Insurance Authority Act and the Insurance Act 1938. The regulator’s decision reflects the importance of maintaining robust cyber security measures to protect sensitive customer data.
Star Health Insurance has stated that there is no evidence to suggest that the head of the information technology department was at fault for the data leakage. The company has informed local authorities about the incident and is likely to be taking steps to improve its cyber security protocols to prevent such breaches in the future.
The incident highlights the need for insurance companies to prioritize data protection and invest in robust cyber security measures to safeguard sensitive customer information. The penalty imposed by the IRDAI serves as a reminder to insurance companies of the importance of complying with cyber security guidelines and regulations to avoid such breaches and the resulting consequences.
Why Claim Settlement Ratio Should Be Your First Check Before Buying InsuranceThe claim settlement ratio (CSR) is a crucial metric that indicates the percentage of claims settled by an insurance company out of the total claims received. It serves as a key indicator of an insurer’s reliability and commitment to paying out claims. Before purchasing an insurance policy, it is essential to check the claim settlement ratio of the insurance company.A high claim settlement ratio signifies that the insurance company has a history of settling a large percentage of claims, thereby providing assurance to policyholders that their claims will be settled in case of an unforeseen event. On the other hand, a low claim settlement ratio raises concerns about the insurer’s willingness or ability to pay out claims.Checking the claim settlement ratio before buying insurance helps you make an informed decision. It allows you to assess the insurance company’s track record and gauge the likelihood of your claim being settled. By opting for an insurer with a high claim settlement ratio, you can ensure that you receive the compensation you are entitled to when you need it the most.Therefore, the claim settlement ratio should be your first check before buying insurance, as it reflects the insurer’s credibility and commitment to its policyholders. It is a vital factor that can significantly impact your decision-making process when selecting an insurance provider.
Navigating the world of insurance can be overwhelming, with numerous insurers in the market. One crucial metric to consider when choosing an insurer is the claim settlement ratio (CSR). The CSR is the percentage of claims an insurer settles in a given year compared to the total number of claims it receives. It serves as a key indicator of an insurer’s reliability and efficiency in honoring claims. The Insurance Regulatory and Development Authority of India (IRDAI) publishes the CSR annually, providing policy buyers with a transparent and data-backed way to assess the credibility of insurers.
A high CSR indicates that the insurer is dependable and prompt in claim settlements, minimizing the chances of distressing delays or rejections. A CSR of 95% or above is typically considered a sign of trustworthiness. The CSR is calculated using a formula that takes into account the number of claims settled and the total number of claims received. According to IRDAI’s latest data for 2023-24, Acko General Insurance and Navi General Insurance Ltd had the highest CSR among private general insurers, with 99.91% and 99.97% of claims settled within 3 months, respectively.
Among public sector insurers, The Oriental Insurance Co. Ltd had the lowest CSR at 65.08%. Overall, general insurers in India paid out 81.13% of total claims within 3 months of claim intimation. Stand-alone health insurers also had notable CSR performances, with Aditya Birla Health Insurance topping the list at 92.97%, followed by Care Health Insurance at 92.77% and Niva Bupa Health Insurance at 92.02%. The claim settlement ratio is a critical metric that can help policy buyers make informed decisions when choosing an insurer. It is essential to check the CSR before signing on the dotted line, as it is a direct measure of how likely an insurer is to stand by policyholders in their time of need.
The data shows that some insurers are more reliable than others in settling claims. For instance, Star Health and Allied Insurance Co. Ltd had the lowest CSR among stand-alone health insurers but settled the highest number of claims at 16,80,171. This highlights the importance of considering multiple factors when choosing an insurer. The CSR is not just a number; it is a reflection of an insurer’s commitment to honoring claims and providing timely financial support during emergencies. By considering the CSR, policy buyers can make more informed decisions and choose an insurer that is likely to meet their needs.
Star Health Insurance has achieved a significant milestone, having protected the lives of 30 lakh senior citizens and settled claims worth over Rs. 11,500 crore.
Star Health Insurance has achieved a significant milestone by protecting the lives of 30 lakh senior citizens and settling claims worth over Rs. 11500 crore. This accomplishment showcases the company’s commitment to providing comprehensive health insurance coverage to its policyholders, particularly senior citizens who are often more vulnerable to health issues.
As people age, their health requirements become more complex, and they require specialized care. Star Health Insurance has been at the forefront of providing tailored health insurance products that cater to the unique needs of senior citizens. The company’s efforts have been instrumental in providing financial protection to this demographic, ensuring they receive the necessary medical attention without burdening their families.
The settlement of claims worth over Rs. 11500 crore demonstrates the company’s ability to handle large volumes of claims efficiently. This translates to a significant amount of financial support for policyholders, enabling them to access quality healthcare without incurring substantial out-of-pocket expenses. The prompt settlement of claims also reflects the company’s customer-centric approach, prioritizing the well-being of its policyholders during their time of need.
Star Health Insurance’s achievement is particularly notable given the challenges faced by the healthcare industry in recent years. The COVID-19 pandemic has put a strain on healthcare systems worldwide, and India has been no exception. The company’s ability to navigate these challenges and continue providing comprehensive coverage to its policyholders is a testament to its resilience and dedication to its customers.
The protection of 30 lakh senior citizen lives is a significant milestone, considering the vulnerabilities associated with this age group. Senior citizens often face higher healthcare costs due to age-related health issues, and Star Health Insurance has been instrumental in mitigating these costs. By providing affordable and comprehensive health insurance coverage, the company has helped ensure that senior citizens receive the medical attention they require, regardless of their financial situation.
In conclusion, Star Health Insurance’s achievement of protecting 30 lakh senior citizen lives and settling claims worth over Rs. 11500 crore is a landmark milestone that underscores the company’s commitment to providing comprehensive health insurance coverage. The company’s customer-centric approach, efficient claims settlement process, and tailored health insurance products have been instrumental in supporting the healthcare needs of senior citizens, and its efforts will undoubtedly have a positive impact on the lives of its policyholders.
Star Health has decided to outsource its claims processing to Medi Assist’s artificial intelligence platform.
Star Health, India’s largest retail health insurer, has announced a significant move to modernize its claims operations by outsourcing a substantial part of its claims processing to a third-party administrator, Medi Assist. This partnership will leverage Medi Assist’s AI-driven MAtrix platform to enhance claims processing efficiency, accuracy, and fraud detection capabilities. The MAtrix platform utilizes intelligent automation and real-time data integration to streamline workflows, reduce manual intervention, and deliver quicker settlements, ultimately leading to a better customer experience.
According to Anand Roy, MD & CEO of Star Health, this partnership is a key milestone in the company’s journey to build a technology-led, agile claims infrastructure. The goal is to improve speed, accuracy, and consistency in claims management, while also addressing fraud, waste, and abuse. The collaboration is expected to redefine industry standards in technology-driven operations, said Medi Assist CEO Satish Gidugu.
The MAtrix platform provides a range of features, including a rules-based adjudication engine, AI co-pilot features, and machine learning tools to enhance fraud detection. The system is integrated with Star Health’s internal architecture, ensuring scale, real-time exchange, and compliance with the National Health Claims Exchange framework. Additionally, the partnership introduces AI-powered customer engagement tools, such as chatbots and virtual assistants, with omnichannel availability via mobile apps and WhatsApp.
The adoption of the MAtrix platform is expected to bring several benefits to Star Health, including improved claims processing efficiency, enhanced customer experience, and better fraud detection capabilities. The platform’s AI-driven tools will help reduce waste, eliminate manual intervention, and streamline workflows, leading to quicker settlements and increased policyholder satisfaction. With this partnership, Star Health aims to establish a transparent and reliable claims service, setting a new standard in the Indian health insurance industry. Overall, the collaboration between Star Health and Medi Assist is a significant step towards modernizing the claims ecosystem in India, leveraging technology to improve efficiency, accuracy, and customer experience.
Star Health Insurance has teamed up with Medi Assist to revolutionize the claims process by leveraging artificial intelligence and digital innovation.
Star Health and Allied Insurance Company Ltd., India’s largest retail health insurer, has partnered with Medi Assist to adopt MAtrix, an advanced AI-powered claims platform. This collaboration is a significant step in Star Health’s claims transformation journey, aiming to deliver faster settlements, better customer engagement, and technology-led service excellence. The partnership will help identify and eliminate fraud, reduce waste and abuse, and modernize Star Health’s claims ecosystem to be future-ready.
The MAtrix platform introduces intelligent automation, reduces manual steps, and streamlines workflows, enabling stronger turnaround performance across the network. It also provides a rules and configuration-based engine, ensuring consistent and standardized claims adjudication, and reduces subjectivity and improves process accuracy. The platform enables co-working and AI co-pilot support, allowing Star Health Insurance’s claims teams to make faster and more informed decisions.
The partnership strengthens customer engagement with AI-powered chatbots, virtual assistants, and omnichannel support available across mobile apps and WhatsApp. A unified API architecture ensures secure, real-time data exchange among insurers, healthcare providers, and the National Health Claims Exchange (NHCX), enhancing overall stakeholder connectivity.
Star Health Insurance’s Managing Director and CEO, Anand Roy, stated that this partnership is a key milestone in their journey to build a more agile and technology-driven claims ecosystem. He emphasized that claims are at the heart of the insurance experience, and with Medi Assist’s platform, they are enhancing speed, accuracy, and consistency while keeping a keen eye on fraud, waste, and abuse.
Medi Assist’s CEO, Satish Gidugu, echoed this sentiment, stating that the partnership is set to redefine industry standards in technology-driven insurance operations, ensuring an exceptional policyholder experience. The integration represents a critical advancement in India’s digital health insurance landscape, combining innovation, operational readiness, and a sharper focus on policyholder outcomes.
Star Health and Allied Insurance Co. Ltd. is a market leader in standalone health insurance in India, providing health, personal accident, and travel insurance to customers. The company has grown to emerge as one of the preferred private health insurance companies in India with several pioneering products and services to its credit. With customer-centricity at its core, the company has superior and innovative product offerings, service capabilities, and a seamless claims management process.
Star Health collaborates with Medi Assist to implement AI-powered claims digitization.
Star Health and Allied Insurance, India’s largest retail health insurer, has partnered with Medi Assist Healthcare Services to deploy an advanced AI-powered claims platform called MAtrix. This move is a significant step in Star Health’s digital transformation journey, aimed at accelerating claims settlements, improving fraud detection, and enhancing customer service through automation and innovation. The partnership seeks to modernize Star Health’s claims operations, making them more agile and scalable to handle rising claim volumes.
The MAtrix platform introduces intelligent automation, reducing redundancies and streamlining workflows to deliver faster, more transparent, and consistent claims outcomes. This will minimize manual interventions and process bottlenecks, resulting in stronger turnaround performance across Star Health’s hospital network and policyholder base. Anand Roy, MD & CEO of Star Health and Allied Insurance, emphasized the importance of this partnership, stating that it will enhance speed, accuracy, and consistency in claims processing while keeping a keen eye on fraud, waste, and abuse.
Satish Gidugu, CEO of Medi Assist, added that this partnership will redefine industry standards in technology-driven insurance operations, ensuring an exceptional policyholder experience. The MAtrix platform’s rules- and configuration-based engine ensures standardized claims adjudication, reducing subjectivity in decision-making. The platform’s AI-powered co-pilot capabilities enable claims teams to work more efficiently, make data-informed decisions, and detect fraud early using machine learning tools.
The partnership is expected to improve customer engagement through AI-driven chatbots, virtual assistants, and omnichannel support via mobile apps and WhatsApp. A unified API-based architecture allows secure, real-time data exchange between insurers, hospitals, and the National Health Claims Exchange (NHCX), creating a seamless ecosystem for all stakeholders. This partnership strengthens Star Health’s operational capabilities and represents a broader step forward in India’s digital health insurance evolution, combining technology, efficiency, and a sharper focus on policyholder outcomes.
Overall, the partnership between Star Health and Medi Assist is a significant development in the Indian health insurance industry, aimed at leveraging technology to improve claims processing, customer service, and overall policyholder experience. With the deployment of the MAtrix platform, Star Health aims to deliver faster, more accurate, and consistent claims outcomes, while minimizing manual interventions and process bottlenecks. This move is expected to enhance the overall efficiency and effectiveness of Star Health’s claims operations, ultimately benefiting its policyholders and stakeholders.
An insurance company has been ordered to pay Rs 3 lakh to a woman after it wrongfully denied her claim.
The Punjab State Consumer Disputes Redressal Commission has ordered Star Health and Allied Insurance Company to pay Rs 3 lakh to Neelam Saini, a resident of Gurdaspur district, for denying her a health claim for pregnancy-related expenses. The company had rejected her claim citing an exclusion clause in the policy that stated it was not liable to make any payment for childbirth, including complicated deliveries and caesarean sections. However, the commission ruled that the company’s rejection of the claim was unjustified and amounted to business malpractice.
Neelam had given birth to twins via caesarean section at a hospital in Ludhiana and had incurred an expenditure of Rs 4.8 lakh. She had made a claim of Rs 3 lakh as per the insurance terms, but the company had rejected it. The commission upheld the earlier order of the District Consumer Disputes Redressal Commission, which had ordered the company to pay the claim amount with 18% interest, as well as Rs 50,000 as compensation for mental harassment and Rs 20,000 as litigation charges.
The commission noted that the policy document given to Neelam did not mention the grounds for exclusion of the claim, and that the company had not proven that the exclusion clause had been explained to her. The commission also stated that excluding deliveries and caesarean sections from insurance claims was unreasonable, given that most deliveries today take place through caesarean sections. The order read that this exclusion “amounts to business malpractice”.
The commission’s decision is a significant victory for consumers, as it highlights the need for insurance companies to be transparent and fair in their dealings with policyholders. The ruling also underscores the importance of ensuring that policyholders are aware of the terms and conditions of their policies, including any exclusion clauses. By ordering the company to pay the claim amount and compensation, the commission has sent a strong message that insurance companies must prioritize the interests of their policyholders and not engage in business malpractices.
CEO Siddhartha Mohanty of LIC says stake acquisition in health insurance company to be decided by March 31.
The Life Insurance Corporation of India (LIC), the country’s largest insurer, is planning to expand its presence in the insurance market by acquiring a stake in a health insurance company. According to CEO Siddhartha Mohanty, a decision on the potential acquisition is expected to be made by the end of March, before the close of the current financial year. However, Mohanty clarified that LIC is not looking to acquire a majority stake, with a holding of 51% or more.
The move into health insurance would mark a significant expansion for LIC, which currently sells life insurance policies, pension plans, and investment-linked insurance products, but not health insurance. By entering the health insurance market, LIC would be competing with established players such as Star Health Insurance, Aditya Birla Health Insurance, Niva Bupa Health Insurance, and Care Health Insurance.
The insurance market in India has become increasingly competitive in recent years, with private insurers ramping up their presence in the health insurance segment to tap into growing consumer demand. LIC’s potential acquisition of a stake in a health insurance company would be a strategic move to diversify its product offerings and tap into the growing demand for health insurance products.
Separately, LIC is also in discussions with the Reserve Bank of India (RBI) on the issuance of longer-term bonds, with maturities of 50 years or 100 years. Currently, India issues bonds with maturities of up to 40 years, but LIC is seeking longer-term instruments to manage its investment portfolio. According to Mohanty, discussions with the RBI are ongoing, and the central bank is considering the proposal. If successful, the issuance of longer-term bonds would provide LIC with more flexibility in managing its investment portfolio and matching its long-term liabilities.
Star Health names Rajeev Kher as Chairperson of the Board
Star Health and Allied Insurance Company Ltd, a leading standalone health insurance provider, has made a significant announcement regarding the appointment of a new Chairperson to its Board of Directors. At a Board meeting held on April 29, 2025, Rajeev Kher, an Independent Director, was appointed to this key position. This appointment is pending regulatory approval from the Insurance Regulatory and Development Authority of India (IRDAI).
Rajeev Kher brings a wealth of experience and expertise to the role, having served in various high-profile positions within the Indian government. Notably, he was the Commerce Secretary of India and has held key roles in the Environment and Commerce Ministries. Additionally, he has served on the Competition Appellate Tribunal and played a crucial part in shaping the Foreign Trade Policy from 2015 to 2020, as well as contributing to global trade negotiations.
The appointment of Kher as Chairperson is expected to significantly benefit Star Health, given his extensive policy expertise and leadership experience across critical domains. Anand Roy, Managing Director & CEO of Star Health, expressed his enthusiasm for Kher’s appointment, stating that his depth of knowledge and leadership skills will add immense value to the company.
As a standalone health insurance player, Star Health is committed to providing innovative and comprehensive health insurance solutions to its customers. With Kher at the helm, the company is poised to leverage his expertise to drive growth, enhance its services, and strengthen its position in the market.
The appointment of Rajeev Kher as Chairperson of Star Health’s Board of Directors is a strategic move that is expected to bring significant benefits to the company. His experience and expertise will undoubtedly shape the company’s direction and strategy, enabling it to navigate the complexities of the health insurance industry and capitalize on emerging opportunities. With regulatory approval pending, Star Health is set to embark on a new chapter in its journey, driven by Kher’s leadership and vision.
Life Insurance Corporation (LIC) plans to acquire a stake in a health insurance firm by March 31, according to CEO Mohanty.
The Life Insurance Corporation of India (LIC) is planning to acquire a stake in a standalone health insurance company by the end of the current financial year, according to its Managing Director and CEO, Siddhartha Mohanty. The company is in the final stages of discussions, but the name of the potential investee has not been disclosed. Mohanty stated that entering the health insurance sector is a natural choice for LIC, given the growing demand for health insurance products in India.
LIC is currently considering investing in one of the seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance, among others. However, Mohanty clarified that LIC will not be acquiring a majority stake in the company, suggesting that the investment will be a minority stake.
The move is part of LIC’s strategy to expand its presence in the health insurance sector, which is expected to grow significantly in the coming years. The company had earlier indicated its interest in the health insurance business and had stated its intention to invest in a standalone health insurance firm in the first quarter of the current financial year.
In addition to its plans to invest in a health insurance company, LIC is also seeking to issue additional long-term bonds. The company has requested the Reserve Bank of India (RBI) to issue 50-year and 100-year bonds, which would provide LIC with longer-term investment options to manage its asset-liability mismatch. The RBI has already introduced 50-year bonds to meet the growing demand from insurance and pension funds, and LIC is hopeful that a decision on the longer-term bonds will be made soon.
Overall, LIC’s plans to invest in a health insurance company and issue longer-term bonds reflect the company’s efforts to expand its presence in the insurance sector and manage its investments more effectively. With the health insurance sector expected to grow significantly in the coming years, LIC’s move is seen as a strategic one, and the company is hopeful of completing the investment by the end of the current financial year.
Star Health has elevated its Chief Marketing Officer, Himanshu Walia, to the position of Whole-time Director.
Star Health and Allied Insurance Company, a leading insurance provider, has announced the elevation of two key executives to Whole-time Director positions. Himanshu Walia, the company’s Chief Marketing Officer, and Amitabh Jain, the Chief Operating Officer, have been designated as Key Managerial Personnel. The appointments are subject to approval by the Insurance Regulatory and Development Authority of India (IRDAI) and will take effect on the date of approval.
Himanshu Walia, with over 22 years of experience in the insurance sector, has been an integral part of Star Health Insurance since 2007. As CMO, he has played a crucial role in building the company’s brand and market presence. Prior to joining Star Health, Walia worked with ICICI Lombard and Tata AIG. He holds an MBA in Marketing and brings a wealth of knowledge and expertise to his new role.
Amitabh Jain, with over 25 years of experience in financial services, has been serving as the COO at Star Health since 2023. He was a founding member of ICICI Lombard and has a strong background in the industry. Jain holds an engineering degree, an MBA, and is a CFA charter holder, making him a highly qualified and experienced professional.
The elevation of Walia and Jain to Whole-time Director positions is a significant development for Star Health Insurance. As Key Managerial Personnel, they will play a crucial role in shaping the company’s strategy and direction. Their experience and expertise will be invaluable in driving the company’s growth and expansion plans. The appointments are expected to strengthen the company’s leadership team and enhance its ability to navigate the complex insurance landscape.
The IRDAI’s approval is pending, and once received, the appointments will become effective. The elevation of Walia and Jain is a testament to Star Health Insurance’s commitment to recognizing and rewarding talent within the organization. The company’s focus on building a strong leadership team will likely have a positive impact on its future growth and success.
LIC CEO Mohanty stated that the firm will finalize acquiring a significant stake in a health insurance company by March 31.
The Life Insurance Corporation of India (LIC) is planning to reveal details of its latest acquisition by the end of the current fiscal year, according to MD and CEO Siddhartha Mohanty. The state-owned insurance company is in the final stages of acquiring a major stake in a standalone health insurance company, with the goal of finalizing the deal by March 31. While Mohanty did not disclose the name of the target company, he confirmed that the process is nearing completion and that the acquisition is a strategic move for LIC to enter the health insurance sector.
LIC is one of the largest insurance players in India, and its entry into the health insurance market is expected to have a significant impact. The company had announced its intention to enter the health insurance sector through a stake purchase in a standalone health insurer earlier in the fiscal year. There are currently seven standalone health insurance companies in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and Care Health Insurance.
Mohanty clarified that LIC will not be acquiring a controlling stake in the firm, but rather a significant minority stake. The acquisition is subject to regulatory approvals, which are expected to be completed within the current fiscal year. The move is part of LIC’s strategy to expand its presence in the insurance market and diversify its product offerings.
In addition to its health insurance plans, LIC is also engaging in discussions with the Reserve Bank of India (RBI) regarding long-term bond issuances. The company has requested bonds with maturities of 50 and 100 years, which would align with its long-term investment strategy. The RBI has already introduced 50-year bonds to address the increasing demand from insurance and pension funds, and LIC is negotiating for even longer-term bonds to manage its assets and liabilities effectively. With its long-term investment approach, LIC is seeking to capitalize on the growing demand for health insurance and expand its presence in the Indian insurance market.
Star Health Advocates for Reduced Costs to Ensure Sustainability
Star Health and Allied Insurance, the largest standalone health insurer in the country, is advocating for a reduction in distribution costs, including commissions, to make health insurance more sustainable. According to CEO Anand Roy, the current cap on management expenses, which stands at 35%, should be gradually reduced by a percentage point every year. This, he believes, will help bring down the cost of insurance. Roy’s company is one of the few that operates within the expense of management (EOM) limits, and he emphasizes the need to reduce this cap over time.
Roy also suggested that the government should consider waiving Goods and Services Tax (GST) on health premiums for senior citizens and vulnerable groups. Furthermore, he called for greater regulation in healthcare delivery, which is currently largely unregulated compared to the insurance sector. This, he believes, will help control costs and make healthcare more affordable.
On the topic of medical inflation, Roy noted that while the commonly cited figure of 14% may not apply uniformly, it does reflect the broad trend in the insured population. He estimated that medical inflation is closer to 8-10% for his company, depending on the hospital. The rising costs, he attributed to the growing consumer preference for advanced treatments and high-end implants.
To keep premiums affordable, Roy suggested that moderate and regular hikes are inevitable, but discounts could be offered to customers who maintain good health. He recommended that ideally, 2-3% of a family’s income should go towards health insurance, with higher allocations for those covering parents or in-laws. Overall, Roy’s suggestions aim to make health insurance more sustainable and affordable for consumers, while also promoting greater regulation and control in the healthcare sector. By reducing distribution costs and introducing measures to control medical inflation, Star Health and Allied Insurance hopes to make health insurance more accessible and affordable for all.
Star Health has introduced a complimentary healthcare initiative called Doc Kendra in Tiruppur.
Star Health and Allied Insurance Co. Ltd has introduced a community healthcare initiative called Doc Kendra in Tiruppur, Tamil Nadu. The primary objective of this initiative is to provide free primary healthcare services to the local community through its branches. Each Doc Kendra will be equipped with a doctor and a paramedic, and patients will also have access to general physicians and specialists via telemedicine. This will enable individuals to receive consultations and guidance from specialists remotely, enhancing the overall quality of care.
The Doc Kendra clinics will operate six days a week, from Monday to Saturday, making healthcare services more accessible and convenient for the community. The initiative aims to complement the existing healthcare infrastructure in the region and provide a reliable first point of contact for medical care. By doing so, Star Health seeks to guide individuals towards appropriate treatments and ensure they receive the right care.
According to Balaji Babu, Executive President of Star Health, the company aims to leverage its branch network to provide a trusted gateway to healthcare for the community. The Doc Kendra initiative is designed to offer accurate and timely healthcare services, addressing the medical needs of the local population. By providing free primary healthcare services, Star Health hopes to make a positive impact on the community and improve overall health outcomes.
The launch of Doc Kendra in Tiruppur is a significant step towards enhancing the healthcare infrastructure in the region. With its focus on accessibility, accuracy, and timeliness, the initiative has the potential to make a meaningful difference in the lives of individuals and families in the community. As the healthcare landscape continues to evolve, initiatives like Doc Kendra are essential in ensuring that quality healthcare services are within reach of everyone, regardless of their geographical location or socio-economic background.
Star Health announces new board appointments
Star Health and Allied Insurance Company, a prominent retail health insurance provider, has made significant announcements regarding key appointments and leadership updates. The company aims to bolster its executive leadership and operational capabilities with these changes. Two key elevations have been made: Amitabh Jain, the current Chief Operating Officer, has been promoted to Whole-Time Director and designated as a key managerial personnel. Jain brings over 25 years of experience in financial services, having previously been a founding member of ICICI Lombard. He joined Star Health in 2023 as COO.
Similarly, Himanshu Walia, the Chief Marketing Officer, has also been elevated to Whole-Time Director and designated as a key managerial personnel. With over 22 years of experience in the insurance sector, Walia has been an integral part of Star Health Insurance since 2007. He has played a crucial role in building the company’s brand and market presence. Prior to joining Star Health, Walia held leadership roles at ICICI Lombard and Tata AIG.
Both Jain and Walia’s appointments are subject to approval by the Insurance Regulatory and Development Authority of India (IRDAI), with their effective dates of appointment pending confirmation. These leadership updates demonstrate Star Health’s commitment to strengthening its executive team and enhancing its operational capabilities. The company’s decision to promote experienced professionals from within its ranks underscores its focus on continuity and consistency in its leadership.
The elevations of Jain and Walia are expected to have a positive impact on Star Health’s future growth and development. With their extensive experience and expertise, they are well-equipped to drive the company’s strategic initiatives and navigate the complexities of the health insurance market. As key managerial personnel, they will play a vital role in shaping the company’s direction and ensuring its continued success. Overall, these appointments reflect Star Health’s efforts to reinforce its leadership team and maintain its position as a leading player in the retail health insurance sector.
Star Health elevates COO and CMO as whole-time directors.
Star Health and Allied Insurance, a leading Indian retail health insurance company, has made a significant move by elevating its Chief Operating Officer (COO) and Chief Marketing Officer (CMO) to whole-time directors and designating them as key managerial personnel. This decision is subject to approval from the Insurance Regulatory and Development Authority of India (IRDAI). The appointments of Amitabh Jain as COO and Himanshu Walia as CMO will become effective once the necessary approval is received.
Amitabh Jain, the newly elevated COO, brings over 25 years of experience in financial services to the table. Prior to joining Star Health in 2023, he was a founding member of ICICI Lombard, where he developed a deep understanding of operational excellence and strategic growth. Jain holds an engineering degree, an MBA, and is a CFA charter holder. His expertise is expected to drive the company’s operational efficiency and strategic expansion.
Himanshu Walia, the elevated CMO, has over 22 years of experience in the insurance industry. He has been an integral part of Star Health Insurance since 2007 and has made significant contributions to building the company’s brand and market presence. Before joining Star Health, Walia held senior positions at ICICI Lombard and Tata AIG. He holds an MBA in marketing and is well-equipped to drive the company’s marketing efforts.
The elevation of these two experienced professionals demonstrates Star Health Insurance’s focus on enhancing its leadership depth and driving future growth. The company boasts a strong multi-channel distribution network, with 913 offices, over 14,000 network hospitals, and a vast network of licensed agents and financial institution partners. In the fiscal year 2025, Star Health’s gross written premium stood at Rs. 17,553 crore, with a net worth of Rs. 8,668 crore. With a robust foundation and experienced leadership, Star Health Insurance is well-positioned for continued growth and success in the Indian retail health insurance market.
Two insurance firms resume cashless facility at Ahmedabad’s Ahmedabad Nursing Home Association (AHNA) hospitals.
The Ahmedabad Hospitals & Nursing Homes Association (AHNA) has reinstated the cashless facility for policyholders of Star Health Insurance and Care Health Insurance. This decision was made after both insurance companies committed to resolving outstanding issues related to claim settlements and service delays.
The suspension of cashless facilities for these insurance companies was initially announced on April 2, along with Tata AIG, due to unresolved issues. During the suspension, patients were advised to opt for reimbursement options, and hospitals were instructed to minimize inconvenience to patients. AHNA took this action as part of a broader movement against defaulting health insurance companies, aiming to protect the interests of healthcare providers.
However, following discussions with Star Health Insurance and Care Health Insurance, both companies expressed their commitment to resolving outstanding issues in a timely and constructive manner. In response to this positive development, AHNA decided to resume cashless facilities for policyholders of these two insurance companies.
This move is expected to provide relief to patients holding policies with Star Health Insurance and Care Health Insurance, who can now avail of cashless treatment at AHNA member hospitals without facing financial burdens. The resumption of cashless facilities is a significant step towards ensuring seamless healthcare services for policyholders.
The decision to suspend cashless facilities was a collective effort by AHNA to address the long-standing issues with health insurance companies. By taking a strong stance, AHNA aimed to prompt insurance companies to take responsibility for their obligations and work towards finding solutions. The successful resolution with Star Health Insurance and Care Health Insurance sets a precedent for other insurance companies to follow, promoting a more cooperative and efficient healthcare ecosystem.
Fastest Insurers to Settle Claims within 3 Months:
- ICICI Lombard General Insurance: 98.04% claims settled within 3 months
- Bajaj Allianz General Insurance: 96.45% claims settled within 3 months
- HDFC Ergo General Insurance: 95.52% claims settled within 3 months
- Apollo Munich Health Insurance: 94.95% claims settled within 3 months
- Max Bupa Health Insurance: 94.64% claims settled within 3 months
Slowest Insurers to Settle Claims within 3 Months:
- United India Insurance: 73.45% claims settled within 3 months
- New India Assurance: 75.13% claims settled within 3 months
- National Insurance: 76.23% claims settled within 3 months
- Oriental Insurance: 77.15% claims settled within 3 months
- Universal Sompo General Insurance: 78.21% claims settled within 3 months
The Insurance Regulatory and Development Authority (IRDAI) has released its handbook on Indian Insurance Statistics for 2023-24, which provides insights into the claim settlement ratios of various insurance companies in India. The claim settlement ratio helps policyholders understand the proportion of claims an insurance company honors or pays out during a certain period. A higher claim settlement ratio indicates that the insurer is more efficient in settling claims.
According to the data, Navi General Insurance has the highest claim settlement ratio of 99.97% within 3 months in FY23-24, followed by Acko (99.91%), HDFC Ergo (99.16%), Reliance General (99.57%), and Universal Sompo (98.11%). However, while these insurers have a high claim settlement ratio, their incurred claims ratio, which refers to the proportion of premiums paid out as claims, varies. For instance, Navi General Insurance has an incurred claims ratio of 52.40%, while Acko has an incurred claims ratio of 69.57%.
On the other hand, New India Assurance and National Insurance, both public insurers, have lower claim settlement ratios of 92.70% and 91.18%, respectively. However, they have higher incurred claims ratios, with National Insurance reporting an incurred claims ratio of 95.9% and New India Assurance reporting an incurred claims ratio of 97.36%.
Among stand-alone health insurers, Star Health has the lowest claim settlement ratio of 82.31% within 3 months, while Aditya Birla Health Insurance has the highest claim settlement ratio of 92.97%. Care Health has the lowest incurred claims ratio of 57.69%, while Aditya Birla Health Insurance has an incurred claims ratio of 68.31%.
When choosing an insurance policy, it’s essential to consider not just the claim settlement ratio but also other factors such as customer service, policy exclusions, benefits, and solvency ratio. Experts recommend an incurred claims ratio between 70% and 90% to be an indicator of a good insurer in terms of claim experience and sustainability. A combination of a high claim settlement ratio and an incurred claims ratio can help narrow down a good insurance policy.
In conclusion, the claim settlement ratio is an essential metric to consider when choosing an insurance policy, but it’s not the only factor. Policyholders should also look at other benefits, customer service, and financial health of the insurer to make an informed decision.
AHNA Lifts Suspension on Care and Star Insurance
The Ahmedabad Hospitals & Nursing Homes Association (AHNA) has lifted its suspension on cashless facilities for policyholders of Care Health Insurance and Star Health Insurance. The decision comes after constructive dialogue between AHNA and the two insurance companies, which resulted in a commitment to resolve pending issues related to delayed claim settlements and service inefficiencies. AHNA had initially suspended cashless services for Care, Star Health, and Tata AIG Insurance on April 2, 2025, citing unresolved concerns.
According to AHNA president Dr. Bharat Gadhvi, the association held productive meetings with senior representatives of Care Health and Star Health Insurance, who demonstrated a genuine commitment to resolving the pending issues in a timely and constructive manner. As a result, AHNA has reinstated cashless facilities for Care and Star Health policyholders with immediate effect. All AHNA-affiliated hospitals and nursing homes have been instructed to resume cashless services for clients of these two insurance companies.
However, the suspension on Tata AIG Insurance remains in place, as the insurer and AHNA have yet to reach a resolution. AHNA had suspended cashless services for Tata AIG, along with Care and Star Health, due to unresolved concerns over delayed claim settlements and service inefficiencies. The association’s decision to lift the suspension for Care and Star Health Insurance is seen as a positive development, but the ongoing standoff with Tata AIG continues to be a concern.
AHNA’s actions are part of its broader “Movement Against Defaulting Health Insurance Companies,” which aims to safeguard the interests of healthcare providers and promote accountability among insurers. The association has been urging patients to opt for reimbursement during the suspension period, assuring that member hospitals would do their best to minimize inconvenience. With the reinstatement of cashless facilities for Care and Star Health policyholders, patients can now access medical services without having to pay out-of-pocket expenses. However, the situation with Tata AIG remains unresolved, and it is unclear when the suspension will be lifted.
Best insurance company in India: 90% claims settled each by Aditya Birla, New India, HDFC ERGO; Bajaj, Star, Shriram lowest.
A recent report by the Insurance Brokers Association of India (IBAI) for the financial years 2023-24 and 2022-23 has revealed that four insurance companies in India have consistently cleared more than 90% of claims made by beneficiaries. The top performers include Aditya Birla Health, HDFC Ergo, and New India Assurance, which achieved claim clearance rates of 91.88%, 92.1%, and 93.13%, respectively.
The data shows that Aditya Birla Health received over 8.5 lakh claims in 2023 and settled 91.88% of them, up from 89.96% in 2022. HDFC Ergo handled 52 lakh claims and settled 94.32% of them in 2023, an improvement from 92.10% the previous year. New India Assurance, a public sector company, processed over 1.5 crore claims with a settlement rate of 93.13%, marginally up from 93.04% in 2022.
On the other hand, some private insurance companies, including Bajaj Allianz, Star Health, and Shriram, performed poorly in terms of claim settlement. Bajaj Allianz handled 47 lakh claims but managed to clear only 73.38%, the lowest settlement rate among the analyzed insurers. Star Health processed 19 lakh claims but settled just 74%, while Shriram’s performance was the weakest, with a clearance rate of only 70% for its 2 lakh claims.
The report highlights the disparity in claim settlement rates among insurance companies in India. While some companies have consistently demonstrated a high level of claim settlement, others have struggled to settle claims in a timely and efficient manner. The data suggests that policyholders should carefully evaluate the claim settlement record of an insurance company before purchasing a policy.
The IBAI report provides valuable insights into the performance of insurance companies in India and can help policyholders make informed decisions when choosing an insurance provider. The report’s findings also underscore the need for insurance companies to prioritize claim settlement and improve their processes to ensure that beneficiaries receive timely and fair compensation. Overall, the report highlights the importance of transparency and accountability in the insurance industry and the need for companies to prioritize the needs of their policyholders.
Star Health Insurance has now expanded its home healthcare service to 100 locations.
Star Health and Allied Insurance Company Ltd, a leading standalone health insurer, has announced the expansion of its Home Health Care initiative to 100 locations across India. Launched in July 2023, this program provides cashless doorstep medical care services to 85% of the company’s customer base. The initiative aims to make healthcare more accessible and affordable, addressing concerns such as high hospitalization costs, logistical challenges, and the stress associated with seeking medical care.
According to Anand Roy, MD and CEO of Star Health, the company’s vision is to bridge the gap between healthcare and insurance, ensuring that customers receive quality medical care in the comfort of their own homes. The program has already shown promising results, with over 15,000 patients benefiting from the service, primarily for treatments related to viral fever and dengue.
The expansion of the Home Health Care program has been made possible through partnerships with reputable healthcare providers, including Care24, Portea, Athulya, and Apollo. Cities like Mumbai, Delhi, and Pune have been at the forefront of adopting these services, demonstrating a growing demand for convenient and accessible healthcare solutions.
By bringing medical care closer to customers, Star Health aims to provide comfort and peace of mind, while also transforming the way health insurance is delivered. The company’s focus on customer-centric care and commitment to innovation has enabled it to stay ahead of the curve in the health insurance industry. With its expanded Home Health Care initiative, Star Health is poised to make a significant impact on the healthcare landscape in India, providing accessible and affordable healthcare solutions to a wider audience.
Star Health achieves highest sustainability score among Indian insurance companies
Star Health and Allied Insurance Company has achieved a significant milestone by securing the highest sustainability score among insurance companies in the Indian insurance sector. According to the S&P Global Corporate Sustainability Assessment, Star Health Insurance has been recognized as India’s most sustainable insurance company for 2024. The company achieved a score of 53, which is based on its robust Environmental, Social, and Governance (ESG) parameters.
This achievement highlights Star Health Insurance’s commitment to sustainable practices, transparency, and fostering a strong ESG culture. The company’s score reflects its focus on integrating ESG principles into its operations, which ensures long-term value for all stakeholders. The 10-point improvement in the score from the previous year demonstrates the company’s progress in key areas such as corporate governance, human capital management, and climate strategy.
The S&P Global Corporate Sustainability Assessment is a prestigious evaluation that assesses companies’ sustainability performance based on ESG criteria. The assessment provides a comprehensive view of a company’s sustainability profile, considering factors such as environmental impact, social responsibility, and governance practices. By achieving the highest score in the Indian insurance sector, Star Health Insurance has demonstrated its leadership in sustainability and its commitment to creating a positive impact on the environment and society.
This recognition is a testament to Star Health Insurance’s efforts to prioritize sustainability and ESG considerations in its business operations. The company’s focus on transparency, accountability, and stakeholder engagement has enabled it to build trust and credibility with its customers, investors, and other stakeholders. As a responsible business, Star Health Insurance is dedicated to creating long-term value and making a positive contribution to the communities it serves. With this achievement, the company has set a new benchmark for sustainability in the Indian insurance sector, inspiring others to follow its lead and prioritize ESG considerations in their operations.
Star Health becomes India’s largest Home Healthcare provider
Star Health & Allied Insurance Company, a leading health insurance provider in India, has achieved a significant milestone by expanding its Home Health Care (HHC) initiative to 100 locations across the country. Launched in July 2023, the program has made a significant impact, now serving over 85% of Star Health Insurance’s customer base with cashless doorstep medical care within a remarkably short period of 3 hours, without any out-of-pocket expenses. This expansion has improved the accessibility, availability, and affordability of healthcare in rural areas, particularly in Bharat, where healthcare services are often limited.
The HHC program offers timely medical care to patients recovering from infectious diseases, providing a comprehensive approach to healthcare. Under the program, a partner doctor visits the patient’s home to assess their condition, conduct a diagnosis, and provide necessary treatment if hospitalization is deemed unnecessary. Regular in-person follow-ups are also conducted to ensure the patient’s condition is improving. In a rare instance, less than 1% of patients have required hospitalization, indicating the effectiveness of the program.
This initiative addresses a significant gap in healthcare services in rural areas, where patients often face challenges in accessing medical care due to geographical constraints. The program provides a convenient and cost-effective solution, ensuring that patients receive timely medical attention without having to travel to hospitals or cities. Patients can now receive medical care in the comfort of their own homes, reducing the risk of disease transmission and improving overall quality of life.
Star Health Insurance’s HHC program has set a new benchmark in healthcare services, showcasing the company’s commitment to providing accessible and affordable healthcare to its customers. With over 100 locations across India, the program has reached a significant proportion of the population, demonstrating the insurer’s drive to bridge the healthcare gap in rural areas. By expanding its HHC initiative, Star Health Insurance has not only improved healthcare outcomes but also reinforced its position as a leading provider of health insurance services in India.
Star Health faces a GST demand of Rs 49 crore across multiple states.
The Star Health and Allied Insurance Co Ltd has been served with 25 tax demand notices amounting to Rs 49 crore by the Goods and Services Tax (GST) authorities across multiple states. The demands are related to alleged violations of GST laws in connection with coinsurance transactions.
The notices were received by the company from different GST authorities, including those in Delhi, Maharashtra, Kerala, and Tamil Nadu, among others. The demand includes interest and penalties, with some of the demands dating back to 2017.
Coinsurance transactions involve insurance companies partnering with other companies to provide insurance coverage to their customers. In these transactions, the two companies split the risk and premiums. However, GST authorities have raised concerns that some insurance companies, including Star Health, are misclassifying these transactions as “insurance” rather than “service” to avoid paying GST.
Star Health has reportedly filed appeals against some of the notices and is also exploring options to settle the disputed amount. The company has stated that it has always been in compliance with GST laws and has paid GST on all its transactions. However, the authorities have alleged that the company has violated the laws by misclassifying its transactions and not paying the correct amount of GST.
The development has raised concerns about the impact on the insurance industry as a whole. Industry experts have expressed concerns that the notices could lead to a increase in the cost of insurance premiums for customers. The Insurance Regulatory and Development Authority of India (IRDAI) has also been approached to intervene in the matter.
Star Health and Allied Insurance Co Ltd received 25 tax demands totaling Rs 49 crore.
Star Health and Allied Insurance Co Ltd, a health insurance company, has received 25 tax demand orders from various Goods & Services Tax (GST) and Central Excise authorities. The total demand amounts to approximately Rs 49 crore, inclusive of penalties. The tax demands relate to alleged non-compliance with GST rules, specifically regarding coinsurance transactions and failure to issue invoices for coinsurance services. The violations also include non-disclosure of coinsurance transactions in statutory returns.
The orders were received at the company’s regional offices in six states: Haryana, Delhi, Maharashtra, Tamil Nadu, Telangana, and Karnataka. Maharashtra’s Mumbai and Andheri East offices received the highest number of tax notices, totaling Rs 19.4 crore. Tamil Nadu’s Chennai-North office received five tax demand orders worth Rs 16.2 crore, while Karnataka’s Bengaluru West office received one order worth Rs 12.8 lakh. In north India, Haryana’s Office of the Additional Commissioner of GST & Central Excise, Gurgaon (North) Ward, issued five tax demand orders worth Rs 4.9 crore, while Delhi’s South Delhi office issued four orders worth Rs 4.7 crore. Telangana’s Secunderabad office received five orders worth Rs 3.8 crore.
The company has stated that it will contest the tax demands by filing an appeal or writ petition with the relevant authorities, following legal counsel’s advice. This incident highlights the importance of strict compliance with tax regulations and the consequences of non-compliance.
Star Health Insurance awarded Best Health Insurance Company of the Year at InsureNext Global Conclave & Awards 2025.
Star Health and Allied Insurance Company Ltd., India’s largest retail health insurance provider, has been recognized as the “Best Health Insurance Company of the Year” at the InsureNext Global Conclave & Awards 2025. This prestigious award is a testament to the company’s mission to transform healthcare accessibility through innovation. Anand Roy, MD & CEO of Star Health Insurance, expressed his gratitude for the recognition, stating that it fuels their ambition to push boundaries and continue revolutionizing health insurance.
Star Health Insurance has been recognized for its groundbreaking initiatives, including Braille Insurance, the Superstar Policy, and Home Healthcare Services. These initiatives have played a pivotal role in securing this accolade, highlighting the company’s commitment to innovation, customer-centricity, and excellence in healthcare delivery.
The company has launched several transformative initiatives, driving inclusivity and enhancing customer experience. The Superstar Policy has revolutionized retail health insurance with its unique features, while the introduction of Braille Insurance has made health coverage more accessible and comprehensible for visually impaired individuals. The Home Healthcare Services have expanded the company’s reach, offering professional medical care at home and reducing hospital visits.
This recognition bears testimony to Star Health Insurance’s mission to bring quality healthcare accessible, affordable, and inclusive to all. The company remains committed to setting new benchmarks in health insurance through continuous innovation and customer-first solutions.
About Star Health and Allied Insurance Company Ltd.
Star Health Insurance (BSE: 543412) (NSE: STARHEALTH) is India’s leading standalone health insurer, operating since 2006. The company offers health, personal accident, and travel insurance, with specialized products for various demographics. Star Health has a strong distribution network, including 910 offices, 30,000+ healthcare providers, 760,000 agents, and robust bancassurance partnerships.
Toothlens Launches India’s First Cashless Dental OPD Insurance with Star Health.
Toothlens, in collaboration with Star Health, Allied Insurance Company, and Vizza Broking Services, has launched India’s first cashless Dental OPD insurance program. This innovative initiative addresses the critical healthcare gap in India by providing individuals with cashless access to preventive and essential dental care, ensuring financial protection and promoting timely intervention. The program is designed to redefine how Indians perceive and access dental care, making oral health a priority.
The World Health Organization (WHO) has urged countries to integrate essential oral health services into primary healthcare and universal health coverage (UHC). This program aligns with global efforts to make oral healthcare more accessible. The WHO has also emphasized that 80% of dental diseases are preventable with early intervention, making insurance coverage a crucial factor in improving national health metrics.
The program covers a wide range of dental services, including preventive care, basic treatments, and advanced procedures. Policyholders can avail of these services through an extensive network of clinics managed by Toothlens. The company has integrated cutting-edge digital solutions to simplify claims, appointment bookings, and provider access.
The launch of this program is expected to significantly improve oral health outcomes and reduce long-term healthcare costs. By making preventive dental care more accessible, this initiative is expected to reduce the financial burden on individuals and promote early diagnosis and cost-effective care. The program is also expected to expand across India, with plans to onboard 10,000 clinics and providers by the end of the year.
This initiative is a significant step towards making dental insurance a mainstream component of health insurance in India. Toothlens, Star Health, and Vizza are committed to expanding this model across India and exploring enhancements, including family plans and corporate partnerships, to further extend the impact of this initiative.
Star Health receives a Rs 49 crore Goods and Services Tax (GST) demand from tax authorities.
Star Health and Allied Insurance Company Limited has received 25 tax demand orders from the Goods and Services Tax (GST) authorities across various states, totaling Rs 49 crore, including penalties. These demands have been issued to the company’s zonal offices in seven states, including Haryana, Delhi, Maharashtra, Tamil Nadu, Telangana, and Karnataka. The alleged violations by the company include non-payment of GST on certain transactions related to coinsurance, non-disclosure of these transactions in statutory filings, and failure to issue invoices for such services.
The tax demand orders were issued by the Additional Commissioner of GST and Central Excise in Gurugram, and the GST authorities in Mumbai East, Andheri East, and Mumbai South-West. The orders also came from the Chennai North GST office, Telangana, and Karnataka. Star Health has stated that it will file an appeal or a writ petition to challenge these tax demands and will take appropriate legal steps to address the matter.
Ahmedabad’s Star Health and Tata AIG hospitals have been denied permission to adopt a cashless payment system.
Several hospitals and nursing homes in Ahmedabad, India have decided to suspend cashless treatment services for Star Health and Tata AIG General Insurance, effective April 1, due to ongoing issues with claim denials, unjustified deductions, and non-renewal of tariffs. This move comes after a standoff that began in September 2023, as reported by the Economic Times. The Ahmedabad Hospitals and Nursing Homes Association, which represents the local healthcare industry, has been pushing back against what they see as unfair practices by insurers, while insurers are demanding standardization in healthcare costs.
In a letter to the insurers, the association listed their concerns, including arbitrary rejection of claims, frequent and unjustified deductions from approved claims, and the removal of some hospitals from the insurer’s network without prior discussions. According to the association, these actions are causing financial strain on hospitals and disrupting the delivery of healthcare services. Despite several rounds of discussions, the issues have remained unresolved, leading to the decision to suspend cashless treatment services.
The suspension is expected to impact thousands of patients who rely on these services. The move is also likely to put pressure on the insurers to reconsider their policies and negotiate a more equitable agreement with the hospitals. Meanwhile, the healthcare industry in Ahmedabad is bracing for potential disruption, as the suspension of cashless treatment services could lead to increased wait times and financial burdens on patients and healthcare providers alike. The standoff highlights the need for a more collaborative approach between insurers, hospitals, and the government to ensure the provision of high-quality, affordable healthcare services to patients.
Star Health must pay a Rs 49 crore goods and services tax demand issued by the tax authorities.
Star Health and Allied Insurance Company Limited has received 25 tax demand orders from the Goods and Services Tax (GST) authorities in several states, totaling Rs 49 crore, including penalties. The demands were issued to the company’s zonal offices in Haryana, Delhi, Maharashtra, Tamil Nadu, Telangana, and Karnataka. The alleged violations include non-payment of GST on certain transactions related to coinsurance, non-disclosure of transactions in statutory returns, and failure to issue invoices for services provided.
The tax demand orders are worth Rs 4.9 crore in Haryana, Rs 4.7 crore in Delhi, and Rs 19.4 crore in Maharashtra. The company’s Tamil Nadu office has received five orders totaling Rs 16.2 crore, while its Telangana office has received five orders worth Rs 3.8 crore. The Karnataka office has received a single order demanding Rs 12.8 lakh.
The company has stated that it will file an appeal or writ petition to challenge these tax demands, citing legal counsel’s advice. The company will take appropriate legal steps to address the matter. Meanwhile, the company has expanded its Home Health Care services to 100 locations across India, covering 85% of its customers, providing cashless medical care at their doorstep.
Star Health secures its position as India’s leading Home Health Care provider, setting a new standard in patient care.
Star Health & Allied Insurance Company, a leading health insurance provider in India, has expanded its Home Health Care (HHC) initiative to 100 locations across the country, making it the largest HHC provider in the country. The program, launched in July 2023, has served over 85% of Star Health Insurance’s customer base, offering cashless doorstep medical care within 3 hours with no out-of-pocket expenses. This innovative approach has significantly improved the accessibility, availability, and affordability of healthcare in India, particularly for patients who require timely medical care to recover from infectious diseases.
Under the HHC program, a partner doctor visits the patient’s home to assess their condition, conduct a diagnosis, and provide necessary treatment if hospitalization is deemed unnecessary. The program also includes regular in-person follow-ups to monitor the patient’s progress. While less than 1% of patients have required hospitalization due to the severity of their symptoms, the HHC program ensures that patients receive the medical attention they need in the comfort of their own homes.
By providing cashless doorstep medical care, the HHC program has reduced the burden on Indian healthcare resources, allowing patients to receive timely treatment without having to navigate the complexities of the healthcare system. This initiative has also helped to improve the overall health and well-being of patients, allowing them to recover more quickly and safely from infectious diseases. The success of the HHC program demonstrates Star Health & Allied Insurance Company’s commitment to improving healthcare outcomes and providing high-quality, patient-centered care in India.
Star Health Insurance collaborates with Himachal Pradesh State Cooperative Bank to increase its outreach and footprint.
Star Health and Allied Insurance Company Limited, India’s largest retail health insurance company, has announced a strategic corporate agency agreement with the Himachal Pradesh State Cooperative Bank (HPSCB). The partnership aims to increase access to health insurance in rural areas of Himachal Pradesh, where the bank has a significant presence. Anand Roy, MD & CEO of Star Health Insurance, said that the partnership with HPSCB shows their commitment to enhancing insurance penetration in rural regions and providing quality health insurance to rural areas. The bank’s extensive branch network will allow Star Health Insurance to offer its range of health insurance products to its customers, providing convenience and accessibility.
Sharwan Manta, Managing Director of HPSCB, highlighted the convenience factor, stating that the partnership will enable customers to access insurance products within their familiar banking environment. The partnership will also enable customers to access healthcare services through Star Health Insurance’s extensive hospital network and agent network.
The agreement is expected to increase insurance penetration in Himachal Pradesh, promoting financial inclusion and access to vital health insurance coverage. Star Health Insurance plans to add 10 more locations in FY25, with a focus on increasing penetration in rural and Tier 3 regions, aligning with the Indian government’s commitment to “Insurance for all by 2047”.
The top five health issues faced by people in Himachal Pradesh, based on claims, are gastroenterology, orthopedics, obstetrics, urology, and ophthalmology. The most popular health insurance products among customers are Family Health Optima, Star Health Assure Insurance Policy, and Accident Care. This partnership is a significant step towards increasing insurance penetration in Himachal Pradesh and promoting financial inclusion, ensuring that people have access to vital health insurance coverage.
Star Health’s insurance claim settlement practices are under scrutiny by the Insurance Regulatory and Development Authority of India (IRDAI).
The Insurance Regulatory and Development Authority of India (IRDAI) has discovered lapses in the claim settlement practices of stand-alone health insurer, Star Health and Allied Insurance. This is based on an ongoing official investigation, which is expected to result in action against the insurer. The regulator has reviewed the operations of 8-10 other general and health insurers, but no action has been taken against them as of now.
According to IRDAI’s handbook of insurance statistics, Star Health’s incurred claim ratio for the financial year 2023-24 was 66.47%, which is slightly higher than the average incurred claim ratio of stand-alone health insurers. However, it is lower than the combined general and health insurers. Star Health also recorded the lowest claim settlement ratio within three months among all stand-alone health insurers, with a settlement rate of 82.31%. It took the company between three to six months to process 2.74% of claims, while 0.35% of claims were settled between six months and one year.
Notably, Star Health rejected the highest number of claims in 2023-24, with 2,96,356 rejections, which is significantly more than other stand-alone health insurers. The company also received the highest number of customer complaints, with 797 pending complaints at the beginning of the financial year and 16,804 reported during the year, of which 16,603 were formal grievances. This is the highest number of complaints among all general and health insurers, except for the public sector insurer, National Insurance Co. Ltd.
This investigation highlights the importance of claim settlement practices in the insurance industry, and the need for regulators to ensure that insurers follow fair and transparent procedures in handling customer complaints. The action taken by IRDAI against Star Health and Allied Insurance is expected to set a precedent for the industry, promoting a culture of accountability and transparency.
Star Health Insurance ordered to pay ₹49 crore in GST to multiple states following alleged non-compliance issues.
Star Health and Allied Insurance Co. Ltd, a private insurance company, has received 25 tax demand orders from Goods & Services Tax (GST) and Central Excise authorities across six states, totaling Rs 49 crores. The tax demands are related to alleged violations, including non-payment of GST on coinsurance transactions, non-disclosure of transactions in statutory returns, and failure to issue invoices for coinsurance services.
The tax demands were issued by the authorities in Haryana, Delhi, Maharashtra, Tamil Nadu, Telangana, and Karnataka. The Maharashtra office received the highest number of tax demand orders, totaling Rs 19.4 crores, followed by Tamil Nadu’s office, which received five orders worth Rs 16.2 crores.
The alleged violations relate to the company’s coinsurance transactions, which involve the insurance company acting as a “follower” in an insurance triangle, where one insurance company insures another insurance company’s risk. The tax authorities have alleged that Star Health failed to pay GST on these transactions, did not disclose them in their statutory returns, and did not issue invoices for the services provided.
In response, Star Health has stated that it will challenge the tax demands by filing an appeal and a writ petition with the appropriate authorities, based on legal counsel’s advice. This news highlights the importance of tax compliance for businesses and the potential consequences for non-compliance.
Star Health’s offices in multiple states have received Good and Services Tax (GST) demand orders totalling Rs 49 crore.
Star Health and Allied Insurance Co Ltd has received 25 tax demand orders from various Goods & Services Tax (GST) and Central Excise authorities across six states, totalling approximately Rs 49 crore, including penalties. The alleged violations include non-payment of GST on coinsurance transactions, non-disclosure of such transactions in statutory returns, and failure to issue invoices for coinsurance services.
The tax demands were issued by authorities in Haryana, Delhi, Maharashtra, Tamil Nadu, Telangana, and Karnataka. The majority of the demands were from Maharashtra, with five orders worth Rs 19.4 crore. The Haryana office received five orders worth Rs 4.9 crore, while the Delhi office received four orders worth Rs 4.7 crore. The company’s Tamil Nadu office received five orders worth Rs 16.2 crore, and its Telangana office received five orders worth Rs 3.8 crore. The Karnataka office received a single order worth Rs 12.8 lakh.
The company plans to challenge the tax demands by filing an appeal or writ petition with the appropriate authorities based on legal counsel’s advice. This move is a response to the alleged non-compliance with tax laws, which the authorities claim has resulted in the tax demands.
The Board will make an announcement by the end of March regarding our acquisition of a significant stake in a leading health insurance company, with myself, as MD and CEO, overseeing the transaction.
Life Insurance Corporation of India (LIC) is planning to acquire a stake in a standalone health insurance company by the end of the current financial year, according to Siddhartha Mohanty, the company’s Managing Director and Chief Executive Officer. The decision is contingent on regulatory approvals, which are expected to be obtained by the end of March 31. The acquisition is a natural step for LIC to diversify its portfolio and expand its presence in the insurance market.
While discussing the details, Mr. Mohanty hinted that the company is not planning to acquire a majority stake, but rather will be open to exploring all possible options. He also emphasized that as a long-term investor, LIC has contractual obligations to manage its investments and asset-liability management, citing the example of Western countries with long-term bonds.
The acquisition is expected to be a strategic move to tap into the growing health insurance market in the country. The health insurance sector is expected to be a major priority for the Indian government, with the aim of increasing penetration and coverage.
There are currently seven standalone health insurance companies operating in the market, including Star Health & Allied Insurance, Niva Bupa Health Insurance, Care Health Insurance, Aditya Birla Health Insurance, ManipalCigna Health Insurance, Narayana Health Insurance, and Galaxy Health Insurance.
Meanwhile, LIC has reported a 17% year-on-year increase in net profit for the October-December quarter, but its net premium income has seen a decline of 8.6% year-on-year. Despite this, the company plans to expand its portfolio by acquiring a stake in a health insurance company, which is expected to be a significant step in the company’s growth strategy.
Prudential plc and HCL Group are collaborating on a new health insurance joint venture.
UK-based Prudential Plc has announced a plan to establish a health insurance joint venture with India’s HCL Group. The new business will have Prudential Group Holdings Limited, a UK subsidiary, holding a 70% stake, while Vama, an HCL Group company, will hold the remaining 30%. This move is part of Prudential’s expansion in the Indian insurance market, which it has been a part of since the establishment of ICICI Prudential Life Insurance in 2001.
This development comes as other players in the Indian insurance sector are making significant moves. Public sector behemoth Life Insurance Corporation of India (LIC) is in the final stages of acquiring a substantial stake in a pure health insurance company and is expected to make an announcement before March 31. There are currently seven standalone health insurance companies operating in India, including Star Health & Allied Insurance, Niva Bupa Health Insurance, and ManipalCigna Health Insurance, among others.
In another significant development, German financial services firm Allianz SE has reportedly reached a preliminary agreement with Jio Financial Services Ltd, a joint venture between Jio Platforms and a clutch of investors, to establish a joint venture covering both health and general insurance businesses. This move comes days after Bajaj Finserv and Allianz SE announced the end of their joint venture, Bajaj Allianz, in a deal worth Rs 24,180 crore. Additionally, Patanjali Ayurved has entered the insurance sector through its acquisition of Magma General Insurance from Adar Poonawalla for Rs 4,500 crore.
Will LIC Offer Health Insurance? The CEO Has Spoken
The Life Insurance Corporation of India (LIC) may acquire a stake in a health insurance company by the end of March, CEO Siddhartha Mohanty has revealed. While the CEO did not provide further details on the potential deal, he clarified that the company is not looking to take a majority stake. This marks a significant move for LIC, which currently only offers life insurance policies, pension plans, and investment-linked insurance products, but not health insurance.
The Indian insurance sector has become increasingly competitive, with private insurers expanding their offerings in the health insurance space to capitalize on growing consumer demand. If LIC enters the health insurance market, it will face competition from major players such as Star Health Insurance, Aditya Birla Health Insurance, Niva Bupa Health Insurance, and Care Health Insurance. However, the company’s reputation and brand recognition could give it an edge in the market.
In addition to exploring health insurance, LIC is also in discussions with the Reserve Bank of India (RBI) on the issuance of longer-term bonds. The company is looking to invest in bonds with maturity periods of 50 years or even 100 years, which is longer than the current range of 20-40 years. The CEO noted that the company’s people are discussing this with the RBI and considering the option. This move is likely to have a significant impact on the Indian bond market and the country’s financial landscape.
The Life Insurance Corporation (LIC) is poised to acquire a significant stake in a pure health insurer, with an announcement expected by March 31.
The Life Insurance Corporation of India (LIC) is close to acquiring a significant stake in a pure health insurance company, according to its Managing Director and CEO, Siddhartha Mohanty. Mohanty stated that the discussions are in the final stages and that he hopes a decision will be made by March 31. The acquisition will mark LIC’s entry into the health insurance market and will broaden its footprint in the sector. However, Mohanty declined to reveal the name of the company, saying that it would be made public when the deal is announced.
Currently, there are seven standalone health insurance companies in India, including Star Health & Allied Insurance, ManipalCigna Health Insurance, and others. The acquisition will be a strategic move for LIC, which is seeking to expand its presence in the health insurance market.
In a separate development, Mohanty also spoke about the need for India to issue long-term bonds with maturities of 50 years and 100 years. LIC, which offers whole life plans with a maturity period of 100 years, requires these long-term bonds to invest and manage its assets and liabilities effectively. Globally, many countries issue 100-year bonds, but India has yet to introduce them due to limited demand and low activity in the secondary market. Mohanty has requested the Reserve Bank of India to issue such bonds, which would align with LIC’s long-term investment strategy.
Overall, the developments indicate that LIC is poised to make a significant foray into the health insurance segment, while also seeking to shape the Indian bond market to better suit its investment needs.
Star Health reports a 35% surge in PAT in the second quarter of FY 2024, according to BW Healthcare World.
Star Health Insurance, a leading health insurance company in India, has reported a significant growth in its Premium AUM (Assets Under Management) in the second quarter of fiscal year 2023-24 (Q2FY24). According to the company’s Second Quarter Results for FY24, Star Health’s PAT (Profit After Tax) has surged by 35% year-on-year (YoY) to ₹434.3 crores during the quarter, ending September 30, 2023.
The company’s total health insurance premiums grew by 20% YoY to ₹5,341.1 crores during the quarter. The growth in premiums has been driven by increased demand for health insurance products, particularly individual and group health insurance policies. Additionally, the company’s Bancassurance channel has also contributed significantly to the growth, with premiums increasing by 28% YoY during the quarter.
Star Health’s gross premium prolonged to new accounts (GWP-NA) was up 24% YoY at ₹2,532.8 crores during the quarter, with the company’s new business growth led mostly by its individual and group health insurance policies. The company’s reinsurance business also witnessed significant growth, with reinsurance premiums increasing by 34% YoY during the quarter.
The company’s growth has been driven by its strong distribution network, which has expanded to over 50,000 channels across the country. The company’s distribution agents, consisting of banks, brokers, and agents, have played a crucial role in driving growth, with the top 10 agents contributing 25% to the overall GWP-NA.
Star Health’s cost-to-income ratio (CR) improved to 67.3% as of September 30, 2023, compared to 72.1% as of September 30, 2022. The company’s solvency margin as of September 30, 2023, stood at 223.4%, indicating its robust financial health.
Overall, Star Health’s strong financial performance is a testament to its operational efficiency, diversified product portfolio, and robust distribution network. The company’s growth in health insurance premiums and increased profitability are expected to continue, driving its future prospects.
Introducing Toothlens’ pioneering initiative: the first ever cashless dental OPD insurance in India, in partnership with Star Health.
Toothlens, in collaboration with Star Health and Vizza Broking Services, has launched India’s first cashless Dental OPD insurance program, making dental care more accessible and affordable for millions of Indians. Oral diseases are a significant global health concern, with over 3.5 billion people worldwide suffering from oral diseases, disproportionately affecting low and middle-income populations. This initiative aims to address the dearth of affordable dental care in India, where millions of people lack access to routine dental check-ups and treatments.
The insurance program covers preventive and essential dental care, including tele-dental consultations, regular check-ups, and X-rays, as well as basic treatments like tooth-colored fillings, extractions, and scaling, and advanced procedures like root canals, crowns, and tooth replacements. With this coverage, policyholders can receive cashless access to a network of clinics, streamlining the process of finding and scheduling appointments, and addressing financial barriers to dental care.
The World Health Organization (WHO) has emphasized the importance of integrating oral health services into primary healthcare systems, and this initiative aligns with this goal. By making dental care more accessible, the program aims to reduce the financial burden of oral health issues and promote early intervention and cost-effective care.
Toothlens, Star Health, and Vizza Broking Services plan to onboard 10,000 clinics and providers by the end of the year and are exploring enhancements, including family plans and corporate partnerships, to further expand the initiative’s reach. This innovative insurance product has the potential to improve oral health outcomes, reduce long-term healthcare costs, and promote timely intervention, ultimately benefiting millions of Indians.
From April 1, Tata AIG’s Star Health policyholders will no longer have access to cashless services at Ahmedabad hospitals.
From April 1, 2025, hospitals and nursing homes in Ahmedabad will no longer offer cashless services to patients with Star Health and Tata AIG General Insurance policies. This decision was made due to growing tensions between healthcare providers and insurance companies, resulting from unjustified deductions, low reimbursement rates, non-renewal of tariff rates, and insurance companies’ tendency to blacklisting hospitals. Hospitals have reported difficulties in continuing cashless services due to delayed and reduced payments from insurance companies.
The Ahmedabad Hospital and Nursing Association (AHNA) has expressed concerns about non-transparent pricing policies and the financial strain it puts on healthcare providers due to arbitrary tariff structures. As a result, starting April 1, patients with Star Health and Tata AIG policies will need to pay medical expenses upfront and then claim reimbursements, which could be a significant challenge for policyholders who rely on cashless services for convenient treatment.
This move may disproportionately affect policyholders in Ahmedabad, where medicial treatment is already a significant expense. The suspension of cashless services may lead to added financial stress for patients, especially those who rely on health insurance to cover healthcare costs. However, insurance companies’ policies towards healthcare providers seem to be a major factor in this decision, highlighting the need for a more collaborative approach between the two to ensure seamless access to medical care for patients.
According to IRDA’s 2025 report, Navi, Acko, and Reliance General Insurance topped the list with the highest claim settlement ratio among health and general insurance companies.
In today’s world, having a solid health insurance policy is crucial to bear the burden of medical expenses. General insurance companies also offer health insurance coverage, among other types of insurance. However, it’s essential to evaluate the effectiveness of your health or general insurer in settling claims on time. One way to do this is by checking the claim settlement ratio, which refers to the proportion of claims paid out of the total number of claims received. According to the Insurance Regulatory and Development Authority of India (IRDAI), the claim settlement ratio is a significant indicator of an insurer’s credibility. For instance, a health insurer with a claim settlement ratio of 93% means it typically pays around 93 out of every 100 claims it receives.
IRDAI releases a list of claim settlements done by all health and general insurers every year. In 2023-2024, over 71,200,854 claims were paid out, with 81.13% of these paid within 3 months of claim intimation. Among private general insurers, Acko General Insurance led the pack with a claim settlement ratio of 99.91%, while Navi General Insurance Ltd. was close behind with 99.97%. Public sector insurers like National Insurance Co. Ltd. and The New India Assurance Co. Ltd. also performed well, with settlement ratios of 91.18% and 92.70%, respectively.
Amongstand-alone health insurers, Aditya Birla Health Insurance Company had the highest claim settlement ratio within 3 months at 92.97%. Care Health Insurance and Niva Bupa Health Insurance also performed well, with settlement ratios of 92.77% and 92.02%, respectively. On the other hand, Star Health and Allied Insurance Co. Ltd. had the lowest claim settlement ratio within 3 months, but it paid out the most claims (16,80,171) in less than 3 months. Overall, it’s essential to evaluate an insurer’s claim settlement ratio, as well as other factors such as sum insured, waiting period, and network of hospitals, before finalizing a health insurance policy.