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January 20, 2014

IRDA Insurance claim settlement ratio/data 2012-13.

Online term insurance is getting quit popular day by day . Most important criteria to compare are ...
  1. Claim settlement ratio 
  2. Size of insurance Company / No of yearly policies issued .
  3. The Fine Print – Terms & Conditions.
  4. Insurance Premium 

Some of the insurance companies give late surprises of increase in premium after medical test . So , before applying make sure how much refund you will receive in case you gets late surprise of hike in insurance premium and not wish to continue with same policy .

I think most important data to compare is claims repudiated data instead of plain claim settlement ratio . Most of the insurance companies repudiate claims with higher amount which give them two befits first improves their bottom line(profit) in P&L accounts and secondly it does not harm much to their claim settlement ratio since claim settlement ratio is based on number claims . Generly, claim settlement ratios is mostly looked by insurance buyer while comparing policies.

So , if you are buying term insurance with comparatively low sum assured then you should look into claims repudiated Number (declined) percentage . But if your sum assured is high then you should look into claims repudiated benefit amount percentage instead of just plain Claim settlement ratio while comparing policies  .


IRDA Claim settlement data for FY 2012-13 .





If you are investor of Max India Ltd then you will see last year company has improved lot on Claim settlement parameter . It will bring more business to them if they maintain it for coming years as well . No doubt Max India need to improve on repudiated(rejected) benefit amount percentage front .

One more interesting observation about ICICI Prudential and HDFC Standard . ICICI Prudential is claiming best pvt sector insurance settlement claim ratio of 96.29 but rejected claims count percentage of I HDFC  Standard(2.62%)  is better than ICICI Prudential (3.63%) and claims repudiated(rejected) benefit amount of HDFC  Standard(6.22%)  is far better than ICICI Prudential (8.57%) . Almost all the major insurance companies are having claims repudiated benefit amount percentage is higher than repudiated (rejected) Numbers of policies count  percentage . However , There is only one major exception is SBI Life which has  repudiated (rejected) Numbers of policies count  percentage (3.69 %) vs claims repudiated(rejected) benefit amount percentage (2.68%)

Note : Claim Settlement Ratio refers to the % of claims settled by an Insurance Company against the number of claims submitted . Ideally it should be 100 - repudiated (rejected) Numbers of policies count percentage but some policies goes on hold or carry forward to next year.




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