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Health is considered to be wealth and this particular point is very well justified in the modern-day world.

The entire globe is facing a very huge pandemic and health insurance is very much important to be possessed by everybody. Health insurance and proper precautions are considered to be the best possible way of sailing through this particular pandemic and the pandemic has very well made people realise the importance of health insurance in India which was neglected by many people.

So, now it has become a matter of utmost necessity to have proper access to a health insurance plan and at the time of purchasing such a plan, it is further very important for people to be aware of the concept of claim settlement ratio of health insurance companies so that they end up making the perfect decisions.

Whenever it comes to the world of selecting an insurance policy individuals need to pick the best option from a wide range of available options and considering different kinds of factors like the process of claim, network hospitals, age limits, additional benefits, bonus and various other kinds of things is very important but most often there is a factor which is neglected by people and this is one of the most important factors to be taken into consideration.

The factor is the health insurance claim settlement ratio.

This particular issue is also referred to as CSR for simplicity and is the ratio of the claims settled against the total claims received by the insurance company and is a very common factor for comparison it makes it very easy for people to compare the different kinds of companies depending upon their ratios so that they can simplify the process accordingly.

Calculating this particular ratio is considered to be a complex element but there is no need to worry because the regulator of insurance in India which is the Insurance Regulatory and Development Authority of India or IRDAI annually publishes a report which includes the basic ratio of all the public sector and private sector companies including their claims made for different kinds of insurance segments even for the health insurance. The very basic mathematical formula for calculation of this particular issue has been explained as follows:

The claim settlement ratio is equal to all claims settled or paid/claims received during the year plus the previous year outstanding claims.

Suppose a company has received five lakh claims made by the consumers and the insurance company settles only four lakh claims. So, the ratio will come out to be 80% and the remaining ones will be rejected by the company because of any kind of issue throughout the process.

So, why it becomes very much important for the people to consider this point and following are some of the justification is why considering this point is very much essential:

  • It will allow people to understand how the insurer has been dealing with the handling of claims and the policyholders.
  • It will also help in providing people with a clear-cut idea about the credibility of the general insurance company so that they can indulge in the right kind of purchasing decisions of the policies without any kind of hassle and the best part is that it will become the best possible guide throughout the process.
  • It will help in providing people with a complete idea about the number of claims speed which will further make sure that a higher ratio is considered to be highly preferable by people because it will help in boosting the confidence of individuals at the time of purchasing the insurance cover so that people never have to face any kind of hassle throughout the process.

How purchasing a policy based upon claim ratio will benefit the individuals?

Once the individuals go deeper in terms of short listing the insurance company then they have to perfectly understand how the efficiency has been based upon dealing with this particular issue at the time of settling the claims of the insurer. Comparison of two kinds of companies will further help in making sure that organisations and people will be making the right kind of decisions based upon the claim settlement as the main metric.

It is further very crucial for people to compare different kinds of health insurance plans across different kinds of actors so that people end up making the best possible decision is in the whole process. Apart from this, depending upon the companies like Care health insurance in this particular industry is a wonderful idea because the company comes with a very good claim settlement ratio and helps in providing people with multiple advantages in the long run through its streamlined claim filing process.

Robert Malcolm

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