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Product Portfolio
When considering purchasing a policy, it's important to take into account the company's product portfolio. Some companies provide a wide range of options, with policies that vary in terms of coverage and cost. These can include budget-friendly policies with minimal features, comprehensive policies with a variety of important features, and premium policies that cover a wide range of expenses. Other companies may specialise in offering policies for specific groups, such as senior citizens, those with chronic health conditions, etc.
When you choose a health insurance company, check if their plans provide comprehensive coverage benefits. A health insurance plan must cover a wide range of medical conditions and pre and post-hospitalisation expenses, inpatient care expenses, domiciliary treatment expenses, daycare treatment costs, ambulance costs, etc.
You need to first understand your medical needs, compare the available plans, check for affordable premiums with comprehensive coverage, and choose the best insurance company that offers an all-in-one plan.
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Check if the company is approved by the IRDAI
To tick the first level of authenticity of a health insurance company, make sure that it is registered under the Insurance Regulatory and Development Authority of India IRDAI. The IRDAI is a regulatory body established to oversee and regulate the insurance industry. A health insurance company registered under this body must follow all its guidelines and be transparent in its insurance activities.
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Extensive Network Hospitals
The next factor that you must consider while choosing the best health insurer is to check if they have an extensive hospital network.
When you need medical treatment, whether planned or unplanned, it is obvious you would want to get treated at a good hospital.
So, once you have narrowed down the best plan, check if the insurance provider has tie-ups with hospitals where you prefer to get treatment. It is best to choose a health insurance company that has a large number of network hospitals to ensure that you can avail of quick and hassle-free cashless claim settlements.
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Claims Incurred Ratio
This is the ratio of the total claims paid by the insurance company against the total premiums collected in a financial year. Suppose the ICR of a health insurer is 90%, it shows that the insurance company pays a claim payment of Rs. 90 for every Rs. 100 of the premium amounts collected. The balance of Rs. 10 is the insurer’s profits.
The credibility of the insurer can be assessed with its ICR as it shows the financial health of the company. Let us understand this better.
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If the ICR is more than 100% - It means that the health insurer is paying claims beyond the bandwidth of the premiums collected. It also shows that there is a risk that the insurer might face financial losses. This might result in a future premium hike or the insurer rejecting borderline claims.
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If the ICR is between 50-100% - It means that the insurance company is simultaneously making profits and people are also preferring to buy from them.
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If the ICR is below 50% - It means that the health insurer is making enormous profits while paying or approving only fewer claims. It shows that the insurer is either rejecting more claims or charging comparatively higher premiums.
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Solvency Ratio
The solvency ratio of an insurance company assesses whether it has enough capital and assets to pay off claims and also meet its long-term financial liabilities. It reflects an insurer’s ability to pay claims. As per IRDAI regulations, insurers are required to maintain a solvency ratio of at least 150%.
A higher solvency ratio indicates that the insurance company has better or higher control over its asset holdings. It is an added advantage because in case there are bulk claims, the insurer has enough funds to pay off claims to its customers.
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Claim Settlement Ratio
You should also check the Claim Settlement Ratio (CSR) of a health insurance company. It is the ratio of claims settled by the insurer against the number of claims raised by policyholders in a given financial year. Choose an insurance company that has a higher claim settlement ratio - as this will increase the probability of your claim being honoured.
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Efficient Customer Care
Efficient customer care means that the health insurance company provides quick and satisfactory information and assistance to its customers. This is possible only if the insurer has a dedicated customer support team who is easily accessible through various platforms like phone, email, live chat, and social media. This will ensure that you will not be left unattended at the time of need or assistance.
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Reviews
Last but not least, you must also check the insurer’s reviews on social platforms, forums, etc. You could also converse with past and current customers about how efficiently the company handles the claim process and solves queries.
You could also ask about the time taken by the health insurance company to resolve cases and the rapport they hold with its customers. This will give you a better idea of their service and how well they treat their customers.