But how can you determine the effectiveness of your health or general insurer when it comes to settling your claims on time? How can you find out if your health or general insurer is fair when it comes to claim payouts or has a track record of delaying or denying claim payments? After all, having a health insurance policy would not be of much help if your insurer does not honor your claims adequately, preferably in the shortest possible time, i.e., in less than 30 days.
Hence, checking the claim settlement ratio, particularly within 30 days of your claim intimation, of your general or health insurer is a good way to track this. Insurance regulator IRDAI (Insurance Regulatory and Development Authority of India) releases a list of claim settlements done by all health and general insurers every year, and it has released the latest data in 2025.
Check the latest health and general insurance claims settlement ratio of health and general insurers in 2025
Claim settlement ratio refers to the proportion or percentage of the number of claims that an insurer pays, out of the total number of claims that it receives during a certain period. So, say a health insurer has a claim settlement ratio of 93%; it implies that it typically pays only around 93 of every 100 claims it receives.
However, note that while checking the claim settlement ratio is necessary, this should not form the sole basis of finalising your health or general insurance company. Take into account the sum insured, the waiting period for various illnesses, and the network of hospitals offered while taking a health insurance policy.
STATUS OF CLAIMS OF GENERAL AND HEALTH INSURERS 2023-2024
Source: IRDAI Handbook of Indian Insurance Statistics, 2023-2024
# Demerger of general insurance business of Bharti AXA General Insurance Co.Ltd. to ICICI Lombard General Insurance Co.Ltd. w.e.f April 01, 2021.
$ Formerly known as Edelweiss General Insurance Company Limited
Notably, this year, IRDAI has not given percentage data separately for claims settled by stand-alone health insurers in less than 30 days. Our mail to IRDAI seeking this data remained unanswered at the time of publishing this story.
To calculate the total number of claims on which the stand-alone health insurers took action during the year FY2023-24, we added the claims outstanding at the start of the period (A) and the claims that were intimated/booked by the insurance company during the period (B). From this figure, we subtracted all the claims outstanding with the insurer at the end of the period (D)
Hence, the total number of claims on which a stand-alone health insurance company took action during the year equals A+B-D.
This figure (A+B-D) was then divided by the absolute number of claims paid in less than 30 days by the respective stand-alone health insurer (F) and multiplied by 100 to arrive at the final figure.
Hence, A+B-D/F X 100 = % of claims settled by stand-alone health insurers in less than 30 days.
Amongst all private general insurers, Acko General Insurance took the lead with 99.91% claims paid within 30 days in 2023-24. Navi General Insurance Ltd also had a ratio of 99.97% for claims settled within 30 days.
Amongst private sector insurers, Zuno General Insurance Co. Ltd. (formerly known as Edelweiss General Insurance Company Limited) emerged with the lowest claim settlement ratio (paid out within 30 days) of 83.12%. Amidst public insurers, The Oriental Insurance Co. Ltd. was only able to settle 65.08% of its claim in a span of less than 30 days.
Overall, during 2023-24, general insurers paid out a total of 71,200,854 as claims during FY2023-24. Insurers (both public and private) paid out around 81.13% of total claims within 30 days of claim intimation, while 16.3% of the total claims were paid out between 3-6 months.
As for stand-alone health insurers, Aditya Birla Health Insurance Company had the highest claim settlement ratio within 30 days at 92.97%. It was followed by Care Health Insurance with 92.77% and Niva Bupa Health Insurance with 92.02%.
While Star Health and Allied Insurance Co. Ltd. had the lowest claim settlement ratio within 30 days among the standalone health insurers, it paid out the most claims (16,80,171) within 30 days in FY2023-24. In terms of number of claims, it was followed by Aditya Birla Health Insurance, which settled 12,24,376 claims in less than 30 days.
