New India, Aditya Birla Health and IFFCO Tokio top the health insurance claim payout chart

Claim paid report card: How health insurers stack up

Public sector general insurer New India Assurance has emerged as the company with the best record of paying health insurance claims, followed by Aditya Birla Health Insurance, IFFCO Tokio and Bajaj Allianz General, according to the Insurance Brokers’ Association of India’s (IBAI) claim analysis for the period ended March 31, 2023.

New India paid out 95.04 percent of the claims it received, followed by Aditya Birla at 94.52 percent, though its record in terms of claim amounts paid was much lower at 71.56 percent. IFFCO Tokio (91.7 percent) and Bajaj Allianz General Insurance (90.29 percent) were the other two players that settled over 90 percent of the claims received, as per the claim insights report.

SBI General took the fifth spot with claim paid ratio (by policy count) of 88.86 percent. In addition, its ratio in terms of the amount paid out was also much higher at 88.30 percent. According to IBAI officials, one of the reasons why the claims paid ratio in terms of amount settled tends to be lower is because insurers tend to pay out smaller claims without much ado, but take much longer to process larger claims.

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SBI General was followed by three standalone health insurers – Niva Bupa (88.57 percent), Manipal Cigna (88.48 percent) and CARE Health (88.06 percent). However, their claims paid record in terms of amounts settled were significantly lower at 67.76 percent, 56.14 percent and 67.55 percent respectively, as per IBAI claim insights report. Star Health and Allied Insurance, the biggest standalone insurer, paid out 75.1 percent of claims received, while its claim paid ratio by amount settled was even lower at 54.61 percent.

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Public sector insurers, overall, fared better than their private counterparts as far as claims paid (by amount) ratio was concerned. Oriental Insurance and National Insurance paid out 97.35 percent and 87.95 percent of the claim amounts received respectively.