Unmasking insurance secrets: Understanding health insurance claim settlement ratios in 2024

The main purpose of having health insurance is that when the time comes, your medical bills will not dig into your hard-earned savings. At Zurich Kotak General Insurance, we want insurance seekers to make well-informed decisions. You need to be well aware of the health insurance claim settlement ratio. The claim ratio of health insurance provider gives you a basic idea of how well the company settles the claims that are raised.

Understanding the claim settlement ratios of health insurance in the year 2024

The health insurance claim settlement ratio is the percentage of the total number of insurance claims that were paid or settled by an insurer during a financial year. Let’s say in the year 2023-24, a company settled 192 claims out of the 200 that were raised. So, the company’s claim for the financial year 23-24 will be 86%.

The claim settlement ratio of health insurance and general insurance provider is released annually by the IRDAI (Insurance Regulatory and Development Authority of India). A higher health insurance claim settlement ratio reflects the insurer’s positive approach toward its customers.

Listed below are some reasons that make the claim ratio of health insurance provider an important factor to consider when buying health insurance.

1. Compare the options
   When buying a health insurance policy, there are numerous things that you need to keep in mind. The coverage you need, the benefits offered by a plan, the premium to be paid, etc. Along with these, you need to be clear about how likely the insurer is to settle the claim in case you raise one. The claim settlement ratio of health insurance should be considered an important factor.
   
   

2. The aim of a health plan is claim settlement
   Even with comprehensive medical insurance, if you are not able to get the expected coverage when you need it, the benefits don’t matter. Ultimately it is only through claim settlement that the benefits come into play.
   
   

3. A clear indicator of reliability
   It is often recommended that you choose only those health insurance providers whose claim settlement ratio is over 85%. Anything below this may be a clear indication that the premium that you are paying will go down the drain.

Conclusion

As a health insurance policyholder, you might feel doubtful whether your insurance provider will come to your rescue in your time of need. It is, therefore, always advised to check the claim settlement ratio of health insurance before you pick a plan.