Health Insurance

Which health insurance company is most widely accepted?

by SMCIB on Monday, 02 January 2023

Which health insurance company is most widely accepted?

Health insurance is an essential aspect of modern healthcare, providing coverage for medical expenses and protecting individuals and families from financial hardship. It ensures that your and your family’s healthcare needs will be covered, giving better peace of mind. All that you need to ensure is to choose a comprehensive and reliable plan to help protect you from the jarring medical bills.

When you search for the best health insurance plan, you will come across different plans from different insurance providers. Choosing a credible, good insurance company that is widely accepted is also an important part of the process.

How do you do that? This article aims at answering that for you. So, let’s kick off!
 

Health Insurance Companies in India

The Indian Health & Medical Insurance Market Summary expects a CAGR growth rate of 8% in the health insurance sector by 2028. The prime reasons for this surge would be the increasing awareness about getting quality healthcare, increasing life expectancy, ever-rising medical inflation, etc.

In India, health insurance is sold by standalone health insurance companies as well as general insurance companies.

  1. General insurance companies are those that provide several types of insurance policies like motor insurancelife insurance, non-life insurance, along with health insurance.

  2. Stand-alone health insurance companies exclusively sell health insurance policies. Collectively, they provide a variety of health insurance plan options to you with plenty of features and coverage options.
     

Factors To Consider While Deciding Which Health Insurance Company to Buy From

  1. 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.

  2. 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.

  3. 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.

  4. 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.

    • 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.

    • 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.

    • 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.
     

Top Health Insurance Companies in India

Listed below are some of the leading insurance companies that sell health insurance in India. Let us look at each in detail –
 

Aditya Birla Health insurance

Founded in 2015, Aditya Birla Health Insurance Company is one of the top health insurance companies in India. Here’s a brief analysis of the company’s stats –

  1. The claims incurred ratio for FY 2021-22 is 78.36%
  2. The solvency ratio for FY 2021-22 is 177%
  3. The claim settlement ratio for FY 2021-22 is 92.25%
  4. It has tie-ups with 10,051+ network hospitals.
     

Bajaj Allianz General Insurance

Bajaj Allianz General Insurance Company was established in the year 2000 and its statistical data stands as such –

  1. The claims incurred ratio for FY 2021-22 is 96.88%
  2. The solvency ratio for FY 2021-22 is 344%
  3. The claim settlement ratio for FY 2021-22 is 91.93%
  4. It has tie-ups with 6,500+ network hospitals.
     

Care Health Insurance

This standalone health insurance company is continuing to garner positive reviews from its customers since its inception in 2012. Some of its statistical reports are –

  1. The claims incurred ratio for FY 2021-22 is 53.32%
  2. The solvency ratio for FY 2021-22 is 185%
  3. The claim settlement ratio for FY 2021-22 is 74.37%
  4. It has tie-ups with 19,000+ network hospitals.
     

HDFC Ergo General Insurance

HDFC Ergo General Insurance, previously known as Apollo Munich Health Insurance, was founded in 2002. It is widely accepted among customers in the insurance market because –

  1. The claims incurred ratio for FY 2021-22 is 82.40%
  2. The solvency ratio for FY 2021-22 is 164%
  3. The claim settlement ratio for FY 2021-22 is 92.10%
  4. It has tie-ups with 13,000+ network hospitals.
     

ICICI Lombard General Insurance

ICICI Lombard General Insurance was established in 2001. Some of its stats are –

  1. The claims incurred ratio for FY 2021-22 is 101.63%
  2. The solvency ratio for FY 2021-22 is 246%
  3. The claim settlement ratio for FY 2021-22 is 80.43%
  4. It has tie-ups with 6,700+ network hospitals.
     

Niva Bupa Health Insurance

Founded in 2008, Niva Bupa Health Insurance stands strong in the insurance market with the following statistics –

  1. The claims incurred ratio for FY 2021-22 is 47.92%
  2. The solvency ratio for FY 2021-22 is 172%
  3. The claim settlement ratio for FY 2021-22 is 89.07%
  4. It has tie-ups with 8,600+ network hospitals.
     

Tata AIG General Insurance

Tata AIG General Insurance was established in the year 2001 and is a widely accepted company by insurance buyers. It shows statistical data as such –

  1. The claims incurred ratio for FY 2021-22 is 90.22%
  2. The solvency ratio for FY 2021-22 is 197%
  3. The claim settlement ratio for FY 2021-22 is 83.17%
  4. It has tie-ups with 7,200+ network hospitals.
     

Conclusion

We have now come to the end of this article. We hope you have a better understanding of some health insurance companies that are widely accepted among insurance buyers. Always check and research as much as possible before buying your insurance policy to avoid any confusion and hassles later.

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