IRDA Health Insurance Claim Settlement Ratio

The Insurance Regulatory and Development Authority of India (IRDAI) is an apex body which governs the workings of the life and non-life insurance companies operating in the market. Every insurance company is required to follow the rules and guidelines laid down by the IRDAI. IRDA also publishes regular reports on the performance of insurance companies.

The amount of business done by insurers, their claim settlement ratios, incurred claim ratios, etc. are computed and published by IRDA regularly. Amongst these publications, the claim settlement ratio of insurance companies is very widely used. Let’s understand what this is.

Claim settlement ratio

The claim settlement ratio of an insurance company measures the proportionate claims which the company has settled from the total number of claims made on it in a financial year. The ratio is calculated using the following formula –

Claim settlement ratio = (total claims paid by the company / total claims made on it) * 100

The ratio is expressed as a percentage. Higher the percentage the better are the chances of the claims being settled by the insurance company.

IRDA health insurance claim settlement ratio

IRDA also publishes the claim settlement ratio and incurred claim ratio of health insurance companies. The ratios and calculated and published after the completion of each financial year. The ratio shows policyholders the probability of their health insurance claims being settled.

Since health insurance policies are important and have also become quite popular, a potential customer can judge the performance of a health insurance company based on the claim settlement ratio published by the IRDA. This makes choosing the health insurance company easy.

There are more than twenty health insurance companies in the insurance market. Comparing and selecting the best insurer, therefore, becomes quite difficult. However, with IRDA’s health insurance claim settlement ratios, this comparison becomes easy. Individuals can choose a company after choosing the best health insurance plan and then comparing the claim settlement ratios.