Health Insurance Claim Settlement Ratio

The Claim Settlement Ratio (CSR) is a crucial metric used to measure an insurer's credibility and reliability. This ratio represents the percentage of claims settled versus the total number of claims filed with the insurance company. It also helps you gauge your chances of having a seamless experience on filing a claim.

On Bajaj Markets, you can choose from insurance companies with some of the best settlement ratios in health insurance of up to 99.41%.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Consider this example: Say a company settles 98 claims against 100 claims filed. Then the CSR will be 98%. Choose insurers with high ratios as it indicates a higher likelihood of benefitting from your health coverage during times of need.

The Insurance Regulatory and Development Authority of India (IRDAI) publishes this ratio of registered insurance companies every year. You can also find this information on the insurer’s official website.

Before buying a medical policy, compare the CSR of your shortlisted insurers. Check the table below to see these details about some of the top insurance providers whose health plans available on Bajaj Markets:

Disclaimer: The information is subject to change as per updates from insurance companies.

Before buying a medical policy, compare its inclusions, exclusions, waiting period, and other terms. Don’t miss checking the claim settlement ratio of health insurance companies either as this number:

• Serves as an efficient metric for comparing various health insurance companies

• Provides details about the company's capability and willingness to settle claims

• Examines how consistently insurance companies process claims

Here is the CSR of insurance companies for 2024-25, according to the latest IRDAI report:

Disclaimer: The CSR figures listed above consider the claims settled within the first 3 months of initiating the claim in 2024-25. 

Health Insurance Plans Available at Bajaj Markets