Claim settlement ratio or CSR is the percentage of claims an insurance company settles in a given year out of the total claims received. Typically, the claim settlement ratio serves as a reliable indicator of credibility. In fact, the industry believes that the higher the CSR, the more reliable the insurance provider is. This is why most individuals make it a point to check the CSR of their choice of insurance providers. Let’s take a look at some of the best claim settlement health insurance companies in India.
Take a look at the table below to gain an insight into the best claim settlement ratio in the health insurance list:
|Insurer||Policies||Amount in Crores (In Rs)||Amount in Crores (In Rs)||Percentage of Total Claims||Amount in Crores (In Rs)|
|Navi Health Insurance||68,137||98%*|
Insurance providers offer cashless claims and reimbursement claims.
Given below are the documents required to make a health insurance claim:
Claim Settlement Ratio = (Total claims settled in a year/ Total claims received in a year) X 100
For instance, an insurance company, say XYZ, settled 9,000 claims out of 10,000 claims for 2020-2021. Based on the formula XYZ’s CSR will be,
= (9,000/10,000) x 100
The claim settlement ratio of insurance providers comes in handy in more than one way. These are among the top benefits:
The claim settlement ratio serves as an indicator of the insurer’s credibility. In other words, it indicates that the insurance provider is capable of paying the sum assured to the policyholder or his/her nominee. Typically, an insurance provider with a consistently high CSR is more likely to meet their commitment, and pay a sum assured as and when a claim is raised.
Insurance providers with the most claim settlement track records are most likely to follow a transparent claim process. In such an arrangement, it is expected that the claim process will be hassle-free. As a result, the policyholder or his/her family will be able to access the sum assured without going through any rigorous formalities.
Here are the details:
A high claim settlement ratio is significant because it indicates that the claim settling ability of the insurance provider is high.
For example, a Claim settlement ratio of 96% indicates that the insurer has settled 96 claims out of 100.
An investor needs to be aware of the following ratios before investing in a health insurance policy:
Given below are the factors affecting the claim settlement ratio:
The claim settlement ratio should never be the sole factor when it comes to selecting a particular health insurance provider.
Individuals should also keep these points in mind when glancing through the best claim settlement ratio in the health insurance list to select an insurer:
Given below are the top reasons for claim rejection for health insurance policies:
Given below are the ways to avoid health insurance claim rejection:
The disadvantages of the claim settlement ratio are as follows:
The policy-holder can study reviews of insurance policies before zeroing in on one.
While looking for the best claim settlement insurance company, keep these pointers in mind to select a suitable policy plan:
First, one should identify whether an individual insurance policy or a family floater policy plan is more suited in his/her case. Accordingly, one should proceed to find out whether he/she will be well off with a general insurance policy or a health insurance plan.
To make the most of an insurance policy, it is always best to choose a policy plan with extensive coverage. Individuals should always look for an insurance policy that extends a high sum insured/assured and offers multiple features that benefit them in case of a financial emergency.
For example, in case of a medical emergency, having a health insurance policy that comes with a short waiting period and follows a quick claim settlement process will allow the policyholder to avail of the best quality treatment.
Individuals can make sure that their insurance policy does not burn a hole in their pocket by comparing the premium and sum insured of the leading health insurance policies online.
They can easily compare quotes online by simply entering relevant personal and policy requirement related details and selecting a plan that matches their investment intent and requirement perfectly. Also, with the help of an online insurance premium calculator, they can easily plan their finances and streamline financial obligations easily.
An insurance policy that accompanies a quick claim settlement process is ideal when it comes to availing of such a plan. These policies allow the insured to avail of cashless treatment from the best network hospitals or get promptly reimbursed for their medical bills.
For example, Navi Health Insurance helps insured individuals to get their claims settled in 20 minutes and receive cashless treatment from more than 10,000 network hospitals. This allows the policyholder to avail the best of medical assistance at the earliest and without straining available savings.
It is important to check the TPAs and network hospitals under the third-party administrators to ensure a hassle-free claim process when availing of a health insurance policy. Also, checking the network hospital coverage in advance will help individuals analyse whether they can get quality treatment from leading hospitals located nearby in case of emergency.
Individuals must make it a point to check out the exclusions of an insurance policy before availing it. Typically, leading insurance providers follow a standardised list of exclusions set by the IRADI and third-party regulators.
Regardless, many insurance providers go above and beyond those exclusions and include additional ones to the existing list. Not having a proper idea about those exclusions can jeopardise insureds’ chances of settling a claim.
Subsequently, they should check details about exclusions related to pre-existing conditions and other related limitations on coverage to gain a better idea about the policy and its extent of coverage.
The following features and offerings make Navi a viable insurance provider in more than one way:
Download the Navi app today and sign up for a comprehensive health insurance plan to protect yourself and your family from life’s uncertainties.
Selecting an insurance provider by looking at just the best claim settlement list may not be a smart move. However, supplementing the same by scrutinising the features, terms of claims, offerings, and limitations could prove an effective way of selecting an insurance provider.
Ans: The policy-holder needs to inform the insurance company at least 3 days before planned hospitalization, in case of cashless claims. For medical emergencies, policyholders need to inform the insurer within 24 hours of hospitalization. The insured person needs to raise a reimbursement claim within 7-15 days of getting discharged from the hospital. Please check the time-frames of the insurance policy minutely as it might vary from one insurer to another.
Ans: Usually, the claim settlement period varies among companies mostly because of the process they follow. Regardless, Navi allows cashless claim settlement in as fast as 20 minutes.
Ans: It is advisable to raise a claim at the earliest for prompt settlement. However, the time frame varies for critical illness, disability and death claim.
Ans: Yes, the claim settlement ratio of an insurance company keeps changing every year, with the change in its total number of claims received and the actual number of claims settled.
How about an affordable health insurance policy 👨⚕️ starting at a monthly premium of just ₹235? Install the Navi app now and get your policy in under 2 minutes.
Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
|Karunya Health Scheme||Niramaya Health Insurance Scheme||Best Health Insurance Repositories|
|Pradhan Mantri Suraksha Bima Yojana||Best Personal Accident Insurance Plans||Best Insurance Policy For New Born Baby|
|Third Party Administrator (TPA)||What is Super Top Up Health Insurance Plan||Deen Dayal Swasthya Seva Yojana (DDSY)|
|Best Health Insurance Plan For Parents||Incurred Claim Ratio In Health Insurance||Chief Minister Comprehensive Health Insurance Scheme|
|Best Health Insurance Policies In India||Best Health Insurance Policies In India||Best Family Floater Health Insurance Plans in India|
|No Claim Bonus in Health Insurance||IRDAI Guidelines For Health Insurance||OPD Cover in Health Insurance|
|Maternity Health Insurance Plans||Health Insurance Plans For Senior Citizens||What is Portability Of Health Insurance|
TPA in Health Insurance – Meaning, Full Form, Functions and RolesTPA (full form - Third Party Administrator) is a licensed intermediary between health insurance pol... Read More »
5 Best Cancer Insurance Policy in India 2023 – Types and BenefitsCancer insurance plans can give individuals and families financial protection from expensive cancer... Read More »
10 Best Cashless Health Insurance Policy in India 2023 – Taxation and CoverCashless health insurance plans are policies that provide medical coverage to policyholders without... Read More »
6 Best Critical Illness Insurance Companies in India 2023Critical illness insurance is a type of health insurance policy that protects against fatal illness... Read More »
10 Best Personal Accident Insurance Policy in India 2023Accident insurance plans provide financial assistance to the policyholder in the event of an unfort... Read More »
Best Health Insurance for Parents in India 2023 and How to Buy?Health insurance for parents offer several perks, including a higher insured sum and full coverage ... Read More »
Best Dental Insurance Plans in India 2023: Benefits, Types and How to Claim?Dental insurance plans are policies that provide cover for expenses arising out of standard dental ... Read More »
7 Best Health Insurance for Newborn in India 2023 – Benefits and CoverHealth insurance for newborns are crucial in today’s time. When you are a new parent, the safety ... Read More »
Yeshasvini Health Insurance Scheme: Apply for Yeshasvini Health Card OnlineEveryone should have access to quality, affordable healthcare. Yeshasvini Health Insurance Scheme i... Read More »
5 Best Diabetes Health Insurance in India 2023 – Top Plans, Cover and Benefits OfferedDiabetes Health Insurance plans are specifically designed insurance covers for people who have diab... Read More »
Best Family Floater Health Insurance Plans in India (2023)A family floater health insurance plan covers the medical expenses of the entire family. It is more... Read More »
10 Best Cashless Network Hospitals in India 2023 – Benefits and Claim ProcessCashless Network hospitals are accredited hospitals that have partnered with a health insurance com... Read More »
Top 10 Chit Fund Schemes in India in 2023Chit funds are one of the most popular return-generating saving schemes in India. It is a financial... Read More »
10 Best Gold ETFs in India to Invest in April 2023Gold ETFs or Gold Exchange Traded Funds are passively managed funds that track the price of physica... Read More »
10 Best Demat Accounts in India for Beginners in 2023Creation of Demat accounts revolutionised the way trades were conducted at the stock exchanges. It... Read More »
20 Best Index Funds to Invest in India in April 2023What is an Index Fund? An index fund is a type of mutual fund or exchange-traded fund (ETF) that... Read More »
Best Arbitrage Mutual Funds to Invest in India in April 2023Arbitrage funds are hybrid mutual fund schemes that aim to make low-risk profits by buying and sell... Read More »
10 Best SIP Plans in India to Invest in April 2023What is SIP? SIP or Systematic Investment Plan is a method of investing a fixed amount in ... Read More »
10 Best Corporate Bond Funds in India to Invest in April 2023Corporate bond funds are debt funds that invest at least 80% of the investment corpus in companies ... Read More »
10 Best Bank for Savings Account in India [Highest Interest Rate 2023]Savings account is a type of financial instrument offered by several banks. It lets you safely depo... Read More »