Top 10 Claim Settlement Ratio Health Insurance Companies in India

The claim settlement ratio is an important consideration while selecting health insurance because it shows the probability of the claim being accepted. The greater the claim settlement ratio, the greater the chances of a smooth claim process. For your reference, we have listed the top 10 health insurance providers in India with the highest claim settlement ratios. These insurers are famous for their fast and seamless claim settlement, providing policyholders with prompt help.

Introduction

Selecting an appropriate health insurance company is the key to becoming financially secure during medical crises. One of the most important points to keep in mind is the claim settlement ratio (CSR), which indicates how efficiently the insurer settles claims. The higher the CSR, the greater the probability of your claim being settled.

With the increasing cost of healthcare in India, it is important to have a health insurance policy with a good claim settlement ratio. In this blog, we shall see the top 10 claim settlement ratio health insurance companies in India that provide an effortless claim procedure.

What is Claim Settlement Ratio in Health Insurance?

Claim Settlement Ratio (CSR) is a measure of proportion of claims an insurance company settled in relation to the total received during a given time. CSR shows the dependence of the insurer in settling claims and approving the same. Assume a company to have a 95% CSR; it will have settled 95 out of every 100 claims received.

Why Claim Settlement Ratio Matters?

• Increased Approval Rate: Increased claim settlement ratio in health insurance raises the possibility of your claim being settled easily.
   
• Trustworthiness and Credibility: A good CSR company is more credible.
   
• Speedy Claim Settlement: Insurers with a high CSR ensure prompt disbursal of claims.

Also Read: Factors Affecting Your Health Insurance Premium & Coverage Explained

Top 10 Claim Settlement Ratio Health Insurance Companies in India

1. OneAssure Health Insurance

Claim Settlement Ratio: 98.5%

OneAssure is one of the top health insurance companies with a reputation for hassle-free claim settlement and clear policies. With customer satisfaction as their priority, OneAssure provides one or multiple health plans for individuals, families, and corporate customers.

Key Features:

• Rapid claim settlement with real-time monitoring
• Large hospital network with cashless services
• 24/7 customer care for claim support
• Clear policies with no surprise charges
• Low premium rates for individuals and families.

2. Max Bupa (Niva Bupa) Health Insurance

Claim Settlement Ratio: 96%

Niva Bupa (previously Max Bupa) is a reputed organization in health insurance and has been well defined in the provision of comprehensive plans with high claim settlement ratios.

Key Features:

• Network of 8000+ hospitals
• Cashless in-patient treatment
• Wellness plans with premium discounts
• No sub-limits on room rent for premium plans.

3. HDFC ERGO Health Insurance

Claim Settlement Ratio: 97%

HDFC ERGO purveys many health insurance plans and ensures fast claims settlement and good customer service.

Key features:

• AI-driven, paperless claim processing
• Comprehensive coverage, such as critical illness
• Free preventive health check-ups
• OPD and daycare treatment coverage.

4. ICICI Lombard Health Insurance

Claim Settlement Ratio: 96.8%

ICICI Lombard is a reliable and affordable insurer offering health insurance plans with flexibility.

Key Features:

• AI-based approval to facilitate speedy claim processes
• Annual health check-up for free
• Claim for hospitalization pre- and post-expenses
• Tax benefits under Section 80D

5. Star Health and Allied Insurance

Claim Settlement Ratio: 98%

Health Insurance plans that include senior citizen and maternity benefits are some special features of Star Health Insurance.

Key Features:

• Direct claims settlement without TPAs from the plan
• Special plans for senior citizens and maternity benefits
• Complete critical illness covers
• Cashless hospitalization at over 14,000 network hospitals.

6. New India Assurance Health Insurance

Claim Settlement Ratio: 95.4%

Health insurance plans that are trusted and reliable but still affordable. 

Key Features:

• Affordable Government Plans. 
• Corporate Group Coverage. 
• Cashless Treatment in Extensive Hospitals. 
• Dedicated Claims Assistance Team.

7. Bajaj Allianz Health Insurance

Claim Settlement Ratio: 96.3%

Bajaj Allianz Insurance Company is an innovative health insurance company with extensive coverage for family and individual health care.

Key Features:

• Coverage for AYUSH treatment
• Free medical checkups and consultations through telemedicine
• No room rent cap in premium plans
• Online claim processing is easy.

8. Oriental Health Insurance

Claim Settlement Ratio: 94.6%

Oriental Health Insurance provides affordable coverage solutions for a single person or the entire family.

Key Features:

• Special coverage for diabetes and cardiac problems
• Cheaply priced policies supported by the government
• Fast claim processing, devoid of hassle
• Pre-existing conditions covered after a waiting period.

9. Reliance Health Insurance

Claim Settlement Ratio: 94.9%

Reliance Health Insurance provides an all-expenses-paid program with affordability and high claim approval being paramount. 

Key Features: 

• Merit-high premium; maximum coverage 
• Artificial Intelligence claim tracking system 
• Coverage for treatment modes other than modern medicines
• Pre and Post-hospitalization expense coverage.

10. Tata AIG Health Insurance

Claim Settlement Ratio: 95.7%

TATA AIG stands out amongst the most trusted names in the insurance domain and offers health insurance plans that are reliable and have a high rate of claim acceptance. 

Key Features: 

• A comprehensive network of cashless hospitals 
• Health Plans for Families and Senior Citizens 
• Fast and Seamless Claim Process 
• High Claim Settlement Ratio with Customer Support.

Factors to Consider When Choosing a Health Insurance Provider

When selecting a health insurance company, consider the following factors:

• Claim Settlement Ratio (CSR): Higher ratio means better chances at being successful in claims. Opt for insurers that have a CSR of more than 90% to guarantee fewer rejects and delays in claims settlement.
   
• Cashless Hospital Network: The more the number of hospitals, the easier the treatment is without cash assistance. A larger network allows easy access to good healthcare services without having to part with cash upfront.
   
• Customer Support: 24/7 assistance will ensure a smooth claim journey. Check with your insurer that they provide a dedicated helpline, chat support on the website, and quick response during emergencies.
   
• Policy Offerings and Rejections: Go through all the clauses on coverage, be it against critical illness, pre-existing ailments, and OPD expenses. Be up-to-date with every term and condition so that claims are not rejected on account of exclusions.
   
• Premium versus Benefits: Budget-orientate weighing of plans against benefits. Look for insurers offering maximum coverage at reasonably priced premiums along with some extra benefits like maternity coverage and wellness programs.

Why Choose OneAssure for Health Insurance?

Among India's leading claim settlement ratio health insurance companies, OneAssure has been bestowed with the most prominent highlights as follows:

Claim Settlement Ratio: 98.5% – A higher likelihood of settling claims. OneAssure makes its policyholders confident with its proven track record of prompt and successful claims settlement. The whole process is efficient and done within the least time frame so that policyholders get all their benefits.

Instant Claim Support – 24/7 customer assistance for easy claims with any help you may need for documentation, claim tracking, or questions; their support team is dedicated to helping you anytime. Their timely response system ensures you never feel abandoned in trouble.

Cashless Network – Thousands of hospitals across India. Now with a solid network, you can opt for cashless treatment at empanelled hospitals without worrying about heavy medical expenses. 

Affordable plans – Customized plans for individuals, families, and corporations. OneAssure curates its plans for every different requirement and budget while providing benefits at lower prices.

Transparent Method – There are no hidden costs, thus, clear indications regarding the benefits and exclusions of the policy. The company clearly describes in a detailed policy document all the inclusions and exclusions that the policy covers upfront.

Why Choosing the Right Health Insurance Provider Matters

Choosing a good health insurance provider is paramount to your financial safety and the timely availability of medical treatment. The good insurance provider would cover as much as it could while making the overall claim process hassle-free in times of emergency. Insurance seekers should check whether insurance providers have high claim settlement ratios, a long list of hospitals they work with, and decent customer service. 

Besides considering the waiting period of the company and coverage for pre-existing diseases, also check the premiums that each plan charges, thereby enabling you to make an informed decision as to what works for you. The decision you make now will safeguard your health and monetary interests later.

Final Thoughts

Selecting a health insurance company with the best claim settlement ratio in health insurance is essential for financial stability in case of medical emergencies. OneAssure, Star Health, ICICI Lombard, and HDFC ERGO are some of the companies that provide high CSR, making the experience smooth for policyholders.

If you are looking for complete protection along with quicker and more efficient processing for claims, OneAssure will be the one-stop shop for you. Get your health and financial security today.