Insurance Regulatory & Development Authority of India has published its Annual report on 8th January,2015. Based on this report I have listed down the best Health Insurance and Motor Insurance Companies in India. The criteria for selection is Incurred Claims Ratio ( this can be compared with Claim Settlement Ratio of Life Insurance).
What is Incurred Claims Ratio (ICR)?
ICR is net incurred claims to net earned premium. For Non-Life insurance, the Incurred Claims ratio (or Incurred Loss Ratio) is the ratio of total losses incurred (paid and reserved) in claims plus adjustment expenses divided by the total premiums earned. As an example a 70 percent incurred claims ratio means that for every Rs 1000 of premium earned in a given accounting period, Rs 700 is paid back in the form of benefits (claims). So, Incurred Claim ratio is the ratio of the claims settled to the premium received.
Non-Life Insurance companies provide products under various segments like Motor, Health, Home, Personal Accident, Travel, Marine and other types of Insurances. I have selected only two segments for analysis purpose. They are Health and Motor Insurances.
Best Health Insurance Companies Based on Incurred Claims ratio (2013-14)
(Click on the image to enlarge and open it in a new browser window)
As per above table you can see all Public Sector Non-Life companies (except New India Assurance) have more than 100% Incurred Claims Ratio. That means they are good at claim settlement but this may have serious impact on their profitability. Generally they cover up the losses from one segment (Health insurance) with other business segments. Because of high ICR most of the non-life insurance companies are requesting IRDA to consider hiking the health insurance premiums to sustain profitability.
Non-Life Private Insurance Companies like ICICI Lombard, HDFC Ergo, L& T and Reliance have claims ratio of more than 90%.
Private Insurance companies have total incurred claims ratio of 87.62% when compared to public sector player’s 106.19%.
(You may like reading – ‘Best Life Insurance Companies in India 2016 & Latest Incurred Claims Ratio 2014-15 data’)
Best Motor Insurance Companies Based on Incurred Claims ratio (2013-14)
(Click on the image to enlarge and open it in a new browser window)
As per above table New India Assurance has Incurred Claim Ratio of 86.83% which is the highest among the public sector companies.
HDFC Ergo, Reliance and Shriram have ICR of more than 90%. Private Insurance companies have total incurred claims ratio of 81.40% when compared to public sector player’s 77.51% (with respect Motor insurance segment).
Generally Life insurance policy premiums remain same through out the policy tenures. Whereas non-life insurance premiums of health or motor insurance policies may change on a yearly basis. In the last few years you might have noticed that the insurance premiums on your health insurance policies might have increased drastically.
The insurance underwrites look at these claim incurred ratios and re-calculate the premiums on the policy renewals.
Hope this post in informative. Do share your comments or queries. Cheers!
((Image courtesy of digitalart at FreeDigitalPhotos.net)
Dear Mr. Sreekanth,
Good Afternoon!
Recently my mom got admitted due to heart disease. My mother has personal medicalim with National Insurance. I found so many deduction in her claim mostly for ICU charge, Nursing charge beyond 2% of SI & CB. Also deduction made for RMO/Doctor like that.
I would like to get advice from you regarding 2 points.
1) Does these deductions which made by TPA are obvious in all health insurance? If not how to select insurance where deductions will be low.
2) Do you advice to take paid health insurance broker who can work for me to get less deduction in insurance. If yes can you pls adviceany insurance broker based out Kolkata,
With Warm Regards,
Suman
Dear Suman,
1 – Do you mean by low sub-limits? You can consider plans which do not have any sub-limits.
Kindly read:
Best portals to compare health plans.
Evaluate these factors when buying a health plan.
Best Health insurance Plans for parents.
Hi sreekanth,
Can you please suggest me a good health insurance policy for me and my family, i have a health insurance which is provided by my company for me and my wife its about 3 lakhs . now i just wanted to purchase a personal health insurance policy which covers my parents too….
my self 30yrs old and i am a diabetic
my wife 28yrs old
my father 60yrs old
my mother-in-law 55yrs old diabetic.
kindly suggest me whether shall i go for a family floater or individual for me and my mother-in-law and suggest me available plans too
thanks in advance
Dear raghavendra,
You may consider below suggestions;
Father : Individual mediclaim policy. Kindly read: Best Health insurance plans for Senior citizens or Elderly parents.
Mother in Law : Can consider Diabetic specific health plan offered by Apollo Munich / Star health / Max Life.
Self : Can consider Diabetic specific health plan offered by Apollo Munich / Star health / Max Life.
Spouse : Can consider stand-alone mediclaim policy.
You may find below articles useful;
Best portals to compare Health insurance plans.
Important factors that need to be kept in mind when buying health insurance plans.
Hi Sreekanth,
Thanks for your response and can you please suggest me a plan which covers maternity benefit from day one instead of waiting period or which having less waiting period(2 years).
Thanks
raghavendra
Dear raghavendra,
Most of the health insurance plans are very stringent with respect to waiting period ( generally 3 years to 5 years) for claiming maternity related expenses.
Kindly check out Religare Joy Plan – It has 9 months of waiting period for claims related to maternity. (This is maternity specific plan).
Cigna TTK’s Pro Health Premier has waiting period of 2 years.
(health insurance with no or less waiting period for maternity )
Hello Sreekanth,
Very informative articles .Seek your advice on having 2 health plans in place simultaneously i.e. co/personal.
While there is a subsidised employer policy in place and also a option of continuing the same (at existing market rate) in the event of exiting the co.
Considering the above scenario is it advisable to have a parallel health insurance in place and if so which health insurance policies should i look at considering a family of four (husband+wife+ 2 children age 47/37/6/11 respectively)
Thank you
Roy
Dear Roy,
Let’s your employer changes the insurance company this FY and you have to opt for it?? and that insurance co does not have this clause.
So, it is always better to have independent health insurance cover.
(or) alteast consider buying a Super Top-up policy.
Kindly read:
Best Super Top Up health insurance plans.
Best Family floater health insurance plans.
Hi,
How is L&T Classic insurance??
I have already taken it for my mom.But,I think it has very less Claim Settle Ratio this year.
I am thinking of taking new one for my dad.Should i go with L&T ??
or can you suggest some other plan with Rent waiver and Critical illness.
Dear mithun,
Kindly go through these articles:
Best health insurance plans for parents.
Best portals to compare health insurance plans.
will you pls provide the details of Incurred Claims ratio (2015-2016) of top 10 health insurance provider company.
Dear Mahebub..Kindly go through : Latest Incurred Claims Ratio & Best Health insurance companies.
I am currently having ICICI Lombard Policy due for renewal on 30-Dec. I got a call from 2 health insurance companies (mainly Star Health Insurance) offering more benefits including what ICICI Lombard offers currently at 70% of ICICI Lombard premium. ICICI Lombard claims that its settlement is hassle free as compared to star or many other other insurance companies. Can someone share their experience of dealing with Star health insurance and suggest whether switching from ICICI to Star make sense? Thanks!
Dear Omprakash..Firstly, are you happy & satisfied as a customer of icici lombard?
You may look at super top up plans to enhance your sum-assured. Kindly read: Super Top up plans & benefits.
Hi i am planning to buy max bupa formy parents and me but u havent listed d claim settlement ratio for Max bupa .
Dear Anuj,
The above list does not include stand-alone health insurance companies like max-bupa / apollo munich etc.,
Don’t worry, go ahead and buy that plan. Do disclose all the required information in the proposal form.
HI Sreekanth
I am looking for a health insurance policy for my parents with their details as below:
Father: 59 years Pre-existing illness: Diabetes (on insulin)
Mother: 55 years Pre-existing illness: NIL
I am looking for a policy cover of around 5-10 lakhs for my parents. I am ready for a waiting period of 2-4 years for treatments related to pre-existing diseases as my father has maintained a very good health till date.
Please advice a suitable policy with good coverage of diabetes related issues, low/no co-payments, no preferable no sublimits, a large no. of day care procedures covered and then reasonable premium.
Thank you.
Dear Shivanshu,
The last sentence in your comment is not realistic.
Check out Star health’s ‘Diabetes Safe Insurance Policy’. You can opt for floater plan.
Kindly read my artilces – “Health insurance plans for parents or senior citizens‘ (>60 years) & “Super Top up health insurance plans“.
Hi- For newly married couple- which health insurance plan is better which is covering maternity expenses
Dear Mahesh,
Most of plans do provide coverage for maternity expenses..but watch-out for sub-limits and waiting period. It is tough to identify best health insurance plan.
First of all thanks for sharing insurance companies list. Before taking any policy comparison is most important thing because Now a days so many insurance comparision websites have come to the market. But before buying car or health or any we should enquire about all the details like IDV, premium, Cliam and whether that website is IRDA approved or not.
Recently i have seen Irda approved web aggregators : https://goo.gl/zIiCCn
Thank you dear Aditya for sharing the link.
Hi,
Age (Me and My wife ) -34
I have company provided Health Insurence . But as I am working in private company hence I need to get Good Health Insurence ASAP with in age 35 for our future.
I visited the office of New India Ass. and refer the “New India Floater Mediclaim” http://www.newindia.co.in/downloads/ProspectusNewIndiaFloaterMediclaim.pdf
regraidng premium, OFFICER told me Premium is increased with your AGE.
He clarifies,
1) June 2015 (Age 34) I took 8L Coverage.
2) I am paying premium every year (7900 for Zone 2) when I cross 35 year – premium will increase to 9660 and this will remain fixed upto 40 years.
3) Now when I reach 55 (After giving 20 years constant premium) My yearly premiun will be 20,630.
Hence premium is increasing with respect to age …. that means AT the age of 20 , when i give premium 7000/~ after giving CONSTANT premium for 40 years, when I will give 60 yrs premium (41 th Premium) this will be 43000/~.
Please correct me, if this understanding is correct or not.
Dear Sankha,
Yes, the health insurance plans are typically renewable on yearly basis. The premiums will vary.
How Can I maximize my health Insurence benifit? Do you have any writings on that.
I can take max 6-8 L SA for my family.
Me and My wife both are 34 and no children till now.
** Also most of the nationalised company provides Max 10L
1) 8 L SA for entire Family
Or
2) X amount of SA + super top up
Can you explain how can I maximize ?
Thank you
Dear Sankha,
Kindly read my article on ‘Top-up & Super Top up Health Insurance plans‘.
Dear Sreekanth,
(1) I already have an existing New India Assurance Mediclaim policy of with Sum assured for:
My Father (57 years) : Rs 4 Lakh
Mother (55 years) : Rs 2 Lakh
Myself (22 years) : Rs 1 Lakh
Brother (29 years): Rs 1 Lakh.
I am keen on increasing the Sum assured of my parents and me and my brother to a substantial amount, say atleast Rs 10 Lakhs.
How should I select my policy:
(a) A Family floater taken by my elder brother covering my parents + I take a separate policy for myself
OR
(b) My brother takes a separate policy + I take a separate policy + A separate policy is taken for parents (to avoid family floater higher premium)
Which one would be a better option to go for to avoid high premiums?
How can a Top up premium plan be useful and will it be cost effective than going for new policy as stated above? Please guide.
(2) How is Star Health review of its Comprehensive plan covering both life and medical insurance in one policy? Is it preferable to go for the same?
(3) How do I calculate ideal medical sum assured for the policy to be taken? Any particular standards, agewise?
Dear Sanchit,
Suggest you to opt for Super-Top up plan.
Complete details are available in my article – “Top up & Super top up Health insurance plans“.
Hi,
I have medical insurance from my office but as long as I with the office. Hence I want to take mediclame for me (34 age) and my wife (34).
I check the prospectus from New India Assurance – Family Floater Mediclaim Policy for both of us.
http://www.newindia.co.in/Content.aspx?pageid=1182
In the prospectus page no 17, PREMIUM CHART for Zone 2 for SA Rs 8 L , I need some clarifications.
http://www.newindia.co.in/downloads/ProspectusNewIndiaFloaterMediclaim.pdf
Officer from NA told me , PREMIUM will be increased with your age. I have doubt on that.
They told If you took 8L SA for zone 2 (age 34) . yearly premium is 7900/~ in this moment.
Even if you are paying premium , and when you fall age of 44, your yearly premium will increase to 13,710.
In this way after giving 30 YEARS OF CONSTANT PREMIUM – at age 64 , yearly premium will be 42,830.
IS this TRUE for every other Other policy ?
IS my understanding is Correct ?
I am not telling about the ENTRY age of Mediclaim.
They told this is not Like LIC policy.
My understanding is – IF I took this Policy, and paying premium for coming 30 years , then at the age of 60, I have to paid same amount what I paid today (at age 34) 7900.
Please correct me.
More than 100% Incurred Claims Ratio? What does this exactly mean? Well articles says, it means good at claim settlement but this may have serious impact on their profitability. Means, we can underrated that these companies gave claims to all their claims-customer? Correct me am wrong.
Dear Aparna,
Kindly understand the meaning of ‘Incurred Claims ratio’ (or Incurred Loss Ratio). It is the ratio of total losses incurred (paid and reserved) in claims plus adjustment expenses divided by the total premiums earned.
So, if a company has >100% incurred claims ration means, sum of total claims + expenses is more than the premium that is earned by the company. They may be good at servicing all the claims but they are making losses.
Dear Mr. Sreekanth,
Please suggest me an optimal (with sufficient cover, competitive premium, reasonably good claim serviceability & a good name) comprehensive family floater health insurance plan which should be a one-time selection & should be there for a lifetime.
We are 3 in family – me, wife & daughter with me being the eldest of 35 years of age. Our total family income ranges from 6-8 lacs p.a. primarily from business activities. None of us have any medical condition & pre-existing diseases till date.
I am specifically looking for a comprehensive policy with:
1) No (negligible) caps (like – cap on room rent, domiciliary hospitalization, organ donor expenses etc)
2) Good Sufficient Cover considering renewal for life time & health complications that may occur in future
3) Reliable name (insurer) & claim serviceability
4) Competitive premium
For this, I have been studying & comparing various health plans & insurers for more than a month and have listed down following plans & insurers in my choice:
1) Max Bupa – 4 lacs SA + 6 lacs SA with 4 lacs deductible L&T super top-up plan – total SA would be 10 lacs with premium of approx 11500 p.a. currently; additional SA of 4 lacs towards NCB & 4 lacs towards reinstatement of SA in Max Bupa
2) Max Bupa – 3 lacs SA + 12 lacs SA with 3 lacs deductible L&T super top-up plan – total SA would be 15 lacs with premium of approx 12000 p.a. currently; additional SA of 3 lacs towards NCB & 3 lacs towards reinstatement of SA in Max Bupa
3) Max Bupa – 3 lacs SA + 7 lacs SA with 3 lacs deductible L&T super top-up plan – total SA would be 10 lacs with premium of approx 10500 p.a. currently; additional SA of 3 lacs towards NCB & 3 lacs towards reinstatement of SA in Max Bupa
4) Max Bupa – 5 lacs SA with premium of approx 10900 p.a. currently; additional SA of 5 lacs towards NCB & 5 lacs towards reinstatement of SA
The reasons for selecting Max Bupa for main policy is because of competitive premium, no caps, NCB benefits, non-reduction in NCB even in case of a claim, reinstatement of base SA & comprehensive cover (like – ayurveda etc)
The reasons for selecting L&T Super top-up plan is because of cheapest premiums for good amount of SA, no caps & consideration of total claims (& not claim-wise) in a year for deductible for triggering of the SA under it.
Thus, I seek your expert advice to help me make a best & optimal choice (it can be plans other than as listed above) since I want it to be for lifetime & am not looking for any additional insurance plans.
Awaiting your early reply.
Thanks & regards,
Hetal Soni
Dear Hetal,
Appreciate your research work and analysis.
Your choices, Max & L&T are good ones. You may consider a Regular plan with Rs 5 Lakh SA + LT Super Top up plan. (Kindly let me know the plan name of MAX?)
You may read my article on “Top up & Super top up health insurance plans“.
Dear Mr. Sreekanth,
Thanks for your expert advice; however my only concern is the relatively low Incurred Claims Ratio of Max Bupa (59%) as compared to Public Sector Insurers (like – Oriental,New India etc – more than 90%) & Private Sector General Insurers (like – Reliance, HDFC Ergo etc – more than 90%) for FY 2013-14.
So kindly advice if it will any bearing on the serviceability of claims in Max Bupa.
Also, please note the plan name of Max Bupa as requested in your reply – HEALTH COMPANION PLAN FOR NUCLEAR FAMILY.
Requesting your advice on my aforesaid concern at the earliest.
Thanks & regards,
Hetal Soni
Dear Mr. Sreekanth,
Also, if you can clarify if there would be any difficulty in settlement of claims in case of clubbing of 2 plans & 2 insurers (like – Max Bupa + L&T Super Top-up).
Thanks & regards,
Hetal Soni
Dear Hetal,
Claim ratio / Incurred claims ratio are important factors. But, kindly note that as long as you submit all the required information in your proposal form, i believe the claims (if any) will be serviced. Provide accurate information and do not hid any facts.
Clubbing of plans may not attract any issues.
Hi Srikanth Reddy,
good to be here in this website.
Could you please suggest best Health Insurance for myself(35)+spouse(32)+daughter(5) and
which coverage amount and company and premium.
Claim ratio & best one…
Dear Srinivas Reddy,
To be frank, it is very tough to identify the best health insurance plan.
Suggest you to go through the Family floater plans offered by Star health, Max bupa & Apollo Munich.
Also, kindly read my article on “Top up & Super Top up health insurance plans“.
This article is very informative. It will be useful for us because before choosing any company we can check the net earned premium and incurred claim ratio details of that particular company given in the table.
Dear Abhidev,
Thank you for your appreciation.
Hi,
where do we get IRDA claim settlement ratio for 2012-13 for health insurance policy.
~Prasanna
Dear Prasanna,
IRDA in its annual report provides data on “Incurred Claims Ratio” only. You can download old reports (2001 to 2015) @ http://goo.gl/L5Xhly .
Thanks for this link. Its really complex to read.
Hi Sreekanth,
Where do we find “Claim Settlement Ratio” every blogger has shown only “Incurred Claims ratio”, doesn’t IRDA provide the “Claim Settlement Ratio”?
Prasanna
Hi Sreekanth,
I’m planning to leave for US for higher studies. So I may have to leave my job and will lose my corporate health insurance coverage(floater policy for my parents). Hence, I’m planning to buy a family floater for 10L which will cover my parents, my younger brother & younger sister. And I want to buy it on my brother’s name(who’s also working) so he can manage even If I’m not in India. Please let me know whether to take it from a Govt or a private insurance company? If private, can I take it from Star health, as you did? And why’s it not listed in the above table?
Thanks & Regards,
Sai Rama Raju
Dear Sai,
Kindly let me know your parents’ age..??
STAR health is a stand alone medical insurance company. The above table has details of composite players (they provide accident / marine / fire/house/motor etc insurance plans besides health insurance plans)
Hi Sreekanth,
Sorry for the delayed reply. My father is 55 and mother around 47.
Thanks & Regards,
Sai Rama Raju
Dear Sai,
Suggest you not to take a Family Floater plan. The premium amount of a family floater plan depends on the eldest member of the family, in your case your father’s age (55 years) will be considered to arrive at the premium amount. So, it is better you take individual personal policies.
You may also consider Topping up the Regular mediclaim policies. Kindly read my article – ” Top up & Super Top up Health Insurance Plans – Details & Benefits“.
Revert to me if you need any clarifications.
Hi Sreekanth,
Thanks for the reply !
If I take separate policies for each individual, I think the total premium for all the 5 policies will exceed the family floater’s premium. So, in this case it’s better to take a family floater, right? Please correct if my thinking is wrong.
Thanks & Regards,
Sai Rama Raju
Dear Sai,
Yes, the total premium amount can be high. If it is not affordable, kindly go ahead with family floater.
The total sum assured (coverage) may not be sufficient in case if you opt for a family floater.
You may also consider another option, take a separate family floater for your parents alone & top it up with extra Sum Assured.
Dear sir, I am 38 year old I am going to buy Hdfc click to protect with extra life of 75 lac but many expert says that don’t take rider with term plan,buy personal accident sperate ly but if i take both term plan of hdfc & personal accident policy of Bharti Axa or max Bupa.will it better for me suggest me
Dear Nilesh,
If you are buying a Term plan through online mode, suggest you to buy a simple basic cover. Yes, it is better to buy an independent cover for personal accident / critical illness risks.
Hi Sreekanth, our company provides health insurance. But can you please suggest, which is the health insurance which is good that we can take on top of insurance as additional coverage. I see many people suggest to go for additional coverage. THanks.
Dear Kalyan,
Are you married? How many dependent do you have? What about your parents’ medical coverage? Are they covered?
Hi Sreekanth,
Yes I am married and have 3 dependents. My company covers 7lakhs. For parents I took a retail policy (from my company’s insurance company only) for 3 lakhs (family floater). ON top of this I would like to take additional coverage.
Thanks.
Dear Kalyan,
Consider taking a Family floater for yourself and your wife. Opt for a min coverage of Rs 5 Lakh. I have taken family floater from Star health and I am happy with their service till date. (This is just a suggestion and personal opinion)
Thanks a lot Sreekanth. Appreciate quick and prompt response.