Here is why getting a policy from a company with a high health insurance claim settlement ratio is crucial!
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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:
Insurance Partner |
Health Insurance Plan |
Premium Price (Starting From) |
Claim Settlement Ratio |
TATA AIG |
TATA AIG |
₹612/month |
96.43% |
Aditya Birla Health Insurance |
Group Activ Health |
₹575/month |
99.41% |
Bajaj Allianz Health Insurance |
Health Guard Gold |
₹492/month |
98% |
Aditya Birla Health Insurance |
Base Policy |
₹683/month |
99.41% |
Bajaj Allianz General Insurance |
Family Health Care Gold |
₹266/month |
98% |
Care Health Insurance |
Care Health Insurance |
₹672/month |
87.1% |
Aditya Birla Health Insurance |
Enhanced Policy |
₹732/month |
99.41% |
Aditya Birla Health Insurance |
Super Top Up |
₹433/month |
99.41% |
Bajaj Allianz Health Insurance |
Health Guard Silver |
₹333/month |
98% |
Bajaj Allianz Health Insurance |
Health Guard Platinum |
₹546/month |
98% |
Bajaj Allianz General Insurance |
Extra Care Plus |
₹160/month |
98% |
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 2025-26, according to the latest IRDAI report:
Public Sector Companies |
CSR |
The Oriental Insurance Co. Ltd. |
91.62 |
National Insurance Co. Ltd. |
91.31 |
United India Insurance Co. Ltd. |
91.10 |
The New India Assurance Co. Ltd. |
90.73 |
Private Sector Companies |
|
Reliance General Insurance Co. Ltd. |
98.75 |
HDFC ERGO General Insurance Co. Ltd. |
98.59 |
Zuno General Insurance Co. Ltd. |
98.54 |
ICICI Lombard General Insurance Co. Ltd. |
98.53 |
Acko General Insurance Ltd. |
97.68 |
Kotak Mahindra General Insurance Co. Ltd. |
97.61 |
Liberty General Insurance Ltd. |
97.46 |
Raheja QBE General Insurance Co. Ltd. |
97.30 |
Go Digit General Insurance Ltd. |
96.83 |
SBI General Insurance Co. Ltd. |
96.47 |
Royal Sundaram General Insurance Co. Ltd. |
96.17 |
Tata AIG General Insurance Co. Ltd. |
95.46 |
Navi General Insurance Ltd. |
95.13 |
Future Generali India Insurance CO. Ltd. |
94.98 |
Magma HDI General Insurance Co. Ltd. |
94.72 |
Cholamandalam MS General Insurance Co. Ltd. |
93.63 |
Bajaj Allianz General Insurance Co. Ltd. |
93.54 |
Universal Sompo General Insurance Co. Ltd. |
91.58 |
IFFCO Tokio General Insurance Co. Ltd. |
90.65 |
Shriram General Insurance Co. Ltd. |
86.86 |
Specialised Insurers |
|
Agriculture Insurance Co. of India Ltd. |
47.17 |
ECGC Ltd. |
58.98 |
Stand-alone Insurers |
|
Care Health Insurance Ltd. |
100.00 |
Niva Bupa Health Insurance Co. Ltd. |
100.00 |
ManipalCigna Health Insurance Co. Ltd. |
99.96 |
Star Health and Allied Insurance Co. Ltd. |
99.21 |
Aditya Birla Health Insurance Co. Ltd. |
99.01 |
Reliance Health Insurance Ltd. |
87.50 |
Disclaimer: The CSR figures listed above consider the claims settled within the first 3 months of initiating the claim in 2025-26.
Health Insurance Plans Available at Bajaj Markets
Frequently Asked Questions
Which health insurance has the highest claim settlement ratio?
As per the latest report of the IRDAI, Care Health Insurance Ltd., and Aditya Birla Health Insurance Co. Ltd. are a few companies with high CSR for 2025-26. These companies have a health insurance claim settlement ratio of 100% and 99%, respectively.
Which company is best for health insurance?
The best insurer for you will depend on what you need. Some factors to consider are customer reviews, the claim process, and the claim settlement ratio. In 2025, the Aditya Birla Activ Fit Health Insurance is considered to be one of the top plans for individuals. The Bajaj Allianz Criti Care Policy is one of the best covers for critical illness.
What is the best claim settlement ratio as per the IRDA?
There is no set CSR that indicates that the insurer is the best. That said, if the claim settlement ratio of health insurance companies is over 85%, they are considered to be good. If the ratio is above 90%, they are considered to be exceptional.
What is a good claim settlement ratio?
Ideally, a health insurance claim settlement ratio of over 85 is considered good because it implies the insurer is reliable. There are several insurance companies that have a CSR of over 90%. They include Bajaj Allianz General Insurance Co. Ltd., TATA AIG Health Insurance, Care Health Insurance Ltd., and Aditya Birla Health Insurance Co. Ltd.
How to understand the claim settlement ratio?
CSR denotes how many claims the insurer settles against the claims filed. If the ratio is 99%, the insurer has cleared 99 claims out of 100, meaning only one was rejected. This shows that the probability of your claim being cleared is high.
Is there a specific CSR to look for when choosing a health insurance company?
While there is no fixed CSR to go for, choose one with a high health insurance claim settlement ratio to be on the safer side. Consider customer reviews, the claim process, and policy inclusions, along with your needs, to make your final decision.
