The rising medical inflation has made it challenging for individuals to bear medical expenses without a comprehensive health insurance policy. In India, the Insurance Regulatory and Development Authority (IRDAI) releases an annual list of claim settlements by health and general insurance companies. The claim settlement ratio, which refers to the percentage of claims paid or settled by an insurer, is a reliable way to assess an insurer’s efficiency.<\/p>\n
According to the latest figures for 2023-2024, the general insurers paid out a total of 71,200,854 claims, with 81.13% of total claims paid within 3 months of claim intimation. Among private general insurers, Acko General Insurance and Navi General Insurance Ltd led with claim settlement ratios of 99.91% and 99.97%, respectively. Zuno General Insurance Co. Ltd had the lowest claim settlement ratio among private sector insurers, with 83.12% of claims paid within 3 months.<\/p>\n
Among public insurers, The Oriental Insurance Co. Ltd had the lowest claim settlement ratio, with only 65.08% of claims paid within 3 months. United India Insurance Co. Ltd had the highest claim settlement ratio among public insurers, with 96.33% of claims paid within 3 months.<\/p>\n
For stand-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 followed closely, with claim settlement ratios of 92.77% and 92.02%, respectively. Star Health and Allied Insurance Co. Ltd had the lowest claim settlement ratio among stand-alone health insurers, with 82.31% of claims paid within 3 months.<\/p>\n
While checking the claim settlement ratio is necessary, it should not be the sole basis for finalizing a health or general insurance company. Other factors such as the sum insured, waiting period for various illnesses, and network of hospitals offered should also be considered.<\/p>\n
The IRDAI data also reveals that during 2023-24, 16.3% of total claims were paid out between 3-6 months, indicating that some insurers may have delayed claim settlements. It is essential for policyholders to review the claim settlement ratio and other factors before selecting an insurer to ensure they receive adequate and prompt financial assistance in case of medical emergencies.<\/p>\n
Overall, the claim settlement ratio is a crucial factor in assessing an insurer’s efficiency, and policyholders should carefully evaluate this metric along with other factors before making an informed decision. By doing so, they can ensure that they have a comprehensive health insurance policy that provides them with the necessary financial protection in case of medical emergencies.<\/p>\n","protected":false},"excerpt":{"rendered":"
The rising medical inflation has made it challenging for individuals to bear medical expenses without a comprehensive health insurance policy. In India, the Insurance Regulatory and Development Authority (IRDAI) releases an annual list of claim settlements by health and general insurance companies. The claim settlement ratio, which refers to the percentage of claims paid or […]<\/p>\n","protected":false},"author":1,"featured_media":221269,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"fifu_image_url":"","fifu_image_alt":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[41,31,22,53,37,39],"tags":[],"class_list":["post-222526","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aditya-birla","category-care","category-insurance","category-niva-bupa","category-star-health-and-allied-insurance","category-united-india-insurance"],"jetpack_featured_media_url":"https:\/\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/united-india-insuracne.jpg","jetpack_shortlink":"https:\/\/wp.me\/p9ibIB-VT8","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":222771,"url":"https:\/\/smallnews.in\/insurance\/2026\/02\/05\/latest-claim-settlement-ratio-of-health-and-general-insurers-released-by-irdai-in-2026-acko-aditya-birla-galaxy-lead-shriram-iffco-tokio-fall-below-90\/","url_meta":{"origin":222526,"position":0},"title":"Latest claim settlement ratio of health and general insurers released by IRDAI in 2026: Acko, Aditya Birla, Galaxy lead; Shriram, IFFCO Tokio fall below 90%","author":"Team Small News","date":"February 5, 2026","format":false,"excerpt":"When it comes to health and general insurance policies, policyholders expect prompt claim settlements from insurers in times of emergency. The real test of any insurance policy lies in how fairly and quickly claims are settled. To gauge an insurer's efficiency, checking the claim settlement ratio is a reliable way.\u2026","rel":"","context":"In "Aditya Birla"","block_context":{"text":"Aditya Birla","link":"https:\/\/smallnews.in\/insurance\/category\/aditya-birla\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/idgbAPyeiA_1745728715242.jpeg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/idgbAPyeiA_1745728715242.jpeg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/idgbAPyeiA_1745728715242.jpeg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/idgbAPyeiA_1745728715242.jpeg?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":222409,"url":"https:\/\/smallnews.in\/insurance\/2025\/12\/13\/star-health-under-irdai-scrutiny-over-health-insurance-claim-settlement-practices\/","url_meta":{"origin":222526,"position":1},"title":"Star Health under IRDAI scrutiny over health insurance claim settlement practices","author":"Team Small News","date":"December 13, 2025","format":false,"excerpt":"The Insurance Regulatory and Development Authority of India (IRDAI) has discovered significant lapses in the claim settlement practices of Star Health and Allied Insurance, a stand-alone health insurer. The regulator is likely to take action against the company, although official investigations are still ongoing. IRDAI has also scrutinized 8-10 other\u2026","rel":"","context":"In "Insurance"","block_context":{"text":"Insurance","link":"https:\/\/smallnews.in\/insurance\/category\/insurance\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=525%2C300&ssl=1 1.5x"},"classes":[]},{"id":222778,"url":"https:\/\/smallnews.in\/insurance\/2026\/02\/11\/top-health-insurance-plans-in-india-for-2026-a-comprehensive-comparison-of-coverage-and-premiums\/","url_meta":{"origin":222526,"position":2},"title":"Top Health Insurance Plans in India for 2026: A Comprehensive Comparison of Coverage and Premiums","author":"Team Small News","date":"February 11, 2026","format":false,"excerpt":"Choosing the right health insurance plan can be a daunting task, but it's essential to prioritize finding a plan that provides the most value for your money and meets your unique requirements. Value for money in health insurance means that the premiums you pay are justified by the benefits the\u2026","rel":"","context":"In "Care"","block_context":{"text":"Care","link":"https:\/\/smallnews.in\/insurance\/category\/care\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/smallnews.in\/insurance\/wp-content\/uploads\/sites\/5\/2025\/04\/Star-Health-Insurance-logo.jpg?resize=525%2C300&ssl=1 1.5x"},"classes":[]},{"id":222450,"url":"https:\/\/smallnews.in\/insurance\/2025\/12\/18\/the-insurance-regulatory-and-development-authority-of-india-irdai-has-imposed-a-fine-of-rs-1-crore-on-care-health-insurance-due-to-lapses-in-health-insurance-claim-settlements\/","url_meta":{"origin":222526,"position":3},"title":"The Insurance Regulatory and Development Authority of India (IRDAI) has imposed a fine of Rs 1 crore on Care Health Insurance due to lapses in health insurance claim settlements.","author":"Team Small News","date":"December 18, 2025","format":false,"excerpt":"The Insurance Regulatory and Development Authority of India (IRDAI) has imposed a penalty of Rs 1 crore on Care Health Insurance due to lapses in health insurance claim settlements. This significant penalty highlights the regulatory body's commitment to ensuring that insurance companies comply with the rules and regulations governing the\u2026","rel":"","context":"In "Care"","block_context":{"text":"Care","link":"https:\/\/smallnews.in\/insurance\/category\/care\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":222563,"url":"https:\/\/smallnews.in\/insurance\/2026\/01\/01\/the-kerala-high-court-has-stated-that-the-mere-presence-of-alcohol-in-a-persons-system-does-not-necessarily-imply-that-they-were-intoxicated-and-therefore-should-not-be-a-grounds-for-denying-health\/","url_meta":{"origin":222526,"position":4},"title":"The Kerala High Court has stated that the mere presence of alcohol in a person’s system does not necessarily imply that they were intoxicated, and therefore, should not be a grounds for denying health insurance claims. When selecting a suitable health policy, consider the following factors: \n\nCoverage and Benefits: Assess the extent of coverage, including the types of medical expenses covered, and any additional benefits such as critical illness coverage or maternity benefits.\nPremium Costs: Evaluate the cost of premiums in relation to the coverage provided, considering both the amount and the frequency of payments.\nDeductibles and Copays: Understand the out-of-pocket expenses you’ll need to pay before insurance coverage kicks in, including deductibles, copays, and coinsurance.\nNetwork Providers: Check if your preferred healthcare providers are part of the insurer’s network to avoid out-of-network costs.\nPre-existing Conditions: If you have any pre-existing medical conditions, look for policies that offer coverage with minimal waiting periods.\nClaim Process: Research the ease and efficiency of the claim filing and settlement process.\nPolicy Flexibility: Consider policies that offer flexibility in terms of coverage options, premium payment modes, and the ability to make changes as your health needs evolve.\nInsurer Reputation: Evaluate the insurance company’s reputation for customer service, claim settlement ratio, and overall reliability.\nRiders and Add-ons: Assess any additional riders or add-ons that can enhance your policy, such as accidental death benefit or waiver of premium.\nRenewal and Lifelong Coverage: Check the policy’s renewal terms and whether it offers lifelong coverage without any upper age limit for renewal.","author":"Team Small News","date":"January 1, 2026","format":false,"excerpt":"The Kerala High Court has made a significant ruling that insurance companies cannot reject accident-related claims solely because the driver had alcohol in their system at the time of the incident. The court stated that insurers must prove actual intoxication or impairment of faculties to deny compensation. This ruling came\u2026","rel":"","context":"In "Insurance"","block_context":{"text":"Insurance","link":"https:\/\/smallnews.in\/insurance\/category\/insurance\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":222422,"url":"https:\/\/smallnews.in\/insurance\/2025\/12\/14\/edelweiss-life-achieves-its-highest-claim-settlement-ratio-of-99-29-in-fy25\/","url_meta":{"origin":222526,"position":5},"title":"Edelweiss Life achieves its highest claim settlement ratio of 99.29% in FY25.","author":"Team Small News","date":"December 14, 2025","format":false,"excerpt":"Edelweiss Life Insurance, based in Mumbai, Maharashtra, India, has announced its highest-ever Claim Settlement Ratio of 99.29% for the fiscal year 2025. This ratio measures the percentage of death claims paid out compared to the total number of claims received, serving as a key indicator of an insurer's reliability and\u2026","rel":"","context":"In "Edelweiss Tokio"","block_context":{"text":"Edelweiss Tokio","link":"https:\/\/smallnews.in\/insurance\/category\/edelweiss-tokio\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/posts\/222526","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/comments?post=222526"}],"version-history":[{"count":0,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/posts\/222526\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/media\/221269"}],"wp:attachment":[{"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/media?parent=222526"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/categories?post=222526"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/smallnews.in\/insurance\/wp-json\/wp\/v2\/tags?post=222526"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}