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How to evaluate best Health Insurance companies in India

IRDAI is the regulatory body that manages the rules and regulations set for health insurance companies in India, while regulating the health insurance companies it also aims at educating the people on the importance of health insurance in India, yet a vast majority of India still doesn’t have health insurance. 

The one main reason for it is a lot of Indians still don’t think health insurance is necessary.

Most financial experts believe a health insurance policy is considered to be an essential part of all financial portfolios, as most often the savings of an individual are drained in the expensive treatments of medical illnesses. People without sufficient savings, compromise on such expensive treatments. Hence, to be able to fulfil all other financial goals, a health insurance policy is a must.

Even when you make up your mind to get a health insurance policy, finding a policy that would match your insurance needs isn’t an easy task as there are over hundreds of policies available in India. New policy buyers are confused and unable to decide which is the right health insurance policy for them.

The first step in finding the right health insurance policy is to evaluate the best Health Insurance companies in India by comparing them on the below mentioned attributes:

  1. Based on Ratios
  2.  Claim Settlement Ratio (CSR) 

Claim settlement ratio is one of the most important points of comparison. You can get the CSR figure of every health insurance company in India from the IRDAI annual reports, it denotes the percentage of claims settled by an insurance company against all claims received in a year.

It is recommended to select insurance companies having higher CSR for the purchase of a health insurance policy.

10 Best Health Insurance Companies based on Claim settlement ratio:

Sr No.Insurance CompanyClaim Settlement Ratio
1Care Health Insurance Co.95%
2Niva Bupa Health Insurance Co.96%
3Star Health Insurance Co.90%
4Aditya Birla Health Insurance Co.94%
5DIGIT Health Insurance Co. 96%
6Reliance Health Insurance Co.100%
7Royal Sundaram Health Insurance Co.89%
8Oriental Health Insurance Co.89%
9Liberty Health Insurance Co.94%
10Future Generali Health Insurance Co.92%
  1. Incurred Claim Ratio (ICR)

ICR indicates the financial ability of the health insurance companies to pay claims. The ICR value is calculated using the value of claims paid against the total premiums received in a year. 

It is recommended to select insurance companies having higher ICR for the purchase of a health insurance policy.

Sr No.Insurance CompanyICR
1Edelweiss General Insurance Co. Ltd.113.05%
2National Insurance Co. Ltd.101.09%
3The Oriental Insurance Co. Ltd.112.51%
4United India Insurance Co. Ltd.104.24%
5Acko General Insurance Ltd.84.64%
6Future Generali India Insurance C. Ltd.90.04%
7IFFCO Tokio General Insurance Co. Ltd.99.49%
8Raheja QBE General Insurance Co. Ltd.97.22%
9Reliance General Insurance Co. Ltd.93.96%
10Universal Sompo General Insurance Co. Ltd.111.23%
  1. Solvency Ratio

Solvency ratio indicates the financial stability of an insurance company as it compares all assets and inflows against the liabilities and outflows. 

It is recommended to select insurance companies having higher Solvency ratio for the purchase of a health insurance policy. 

10 Best Health Insurance Companies based on solvency ratio:

Sr No.Insurance CompanySolvency Ratio
1Bajaj Allianz General Insurance Co. Ltd.3.45
2Raheja QBE General Insurance Co. Ltd.3.66
3Shriram General Insurance Co. Ltd.3.63
4ICICI Lombard General Insurance Co. Ltd.2.90
5Star Health and Allied Insurance Co. Ltd.2.22
6Care Health Insurance Ltd.2.45
7Tata AIG General Insurance Co. Ltd.2.22
8Liberty General Insurance Ltd.2.92
9The New India Assurance Co. Ltd2.13
10Navi General Insurance Ltd.2.12
  1. Cashless Hospital Network:

Health Insurance companies in India have tie ups with a list of national and international hospitals for providing cashless medical treatments to the policyholder.

It is recommended to select insurance companies having a long list of network hospitals for the purchase of a health insurance policy.

10 Best Health Insurance Companies based on network hospital:

Sr No.Insurance CompanyNetwork Hospitals
1Star Health and Allied Insurance Co. Ltd.12000+
2Care Health Insurance Ltd.19000+
3Niva Bupa Health Insurance Co.8600+
4Bajaj Allianz Health Insurance Co.7,600+
5HDFC Ergo Health Insurance Co.13000+
6Aditya Birla Health Insurance Ltd.10000+
7Reliance Health Insurance Ltd.8000+
8Royal Sundaram Health Insurance Co.11000+
9Tata AIG Health Insurance Co.7000+
10ICICI Lombard Health Insurance Co.6500+
  1. Based on Other Factors:
  2. Sum assured and the cost of coverage:

Since the sum assured and premiums are directly related, you get lower sum assured for lower premiums and vice versa.

You can evaluate different health insurance companies by comparing the premiums for a certain sum assured and then select the health insurance policy which offers a certain sum assured at lowest premium.

  1. Check the scope of coverage:

It is very essential to check the scope of coverage of the health insurance policy you buy as it contains details related to specific inclusions and exclusions within the policy like pre- and post-hospitalization coverage, COVID-19 coverage, day-care treatment, etc.

You can evaluate the best health insurance companies in India by comparing their scope of coverage and select the health insurance policy which offers limited exclusions or specific exclusions that you want an insurance provider to cover in a policy you buy.

  1. Check the waiting period for specific diseases:

Health Insurance policies don’t cover you against all illnesses from day one. For a few predetermined diseases, you need to wait a particular period (days/months/years) to be eligible to raise a claim for treatment. 

You can evaluate the best health insurance companies in India by comparing the predetermined medical treatments they cover under the waiting period clause and select the health insurance policy which has no waiting period for it.

  1. Check the sub-limits for specific diseases:

The health insurance policy might have sub-limits on certain treatments. A sub-limit means the insurance provider will provide partial coverage for treatment of a predetermined illness, even though your sum assured is higher than the total cost of treatment.  

For example, if a policy has a 50% sub-limit on cataract treatments, then irrespective of your claim amount being under the total sum assured limit, the settlement amount will be for 50% of the cost of treatment.

You can evaluate the best health insurance companies in India by comparing the predetermined medical treatments they cover under a sub-limit clause and select the health insurance policy which has no sub-limit for specific diseases you want a full medical coverage.

  1. Additional Benefits:

All health insurance companies have some form of additional benefits like one free annual check, free medicines, additional top-up, top-up refill, etc. which may vary from company to company.

 You can evaluate the best health insurance companies in India by comparing the additional benefits they offer and if you see these benefits useful to you.

  1. Customer service and online reviews:

It’s difficult to evaluate the quality of customer service before you have purchased a health insurance policy. You may view the ratings and read reviews of the customer service experience on the internet for any Insurance company, however that does not guarantee a good customer service.

Hence, it’s recommended that you buy a health insurance policy from an insurance agent or advisor who can be your point of contact for most of your customer service requirements and also guide you in choosing the best health insurance in India.

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