What Is Health Claim Settlement Ratio?

It is rightly said that health is wealth and with health insurance, individuals can get financial protection against health emergencies as well as quality treatment. However, in order to buy the best health insurance plan, there are certain factors that need to be kept in mind and one such factor is the health claim settlement ratio. Scroll through the section below to know all about the claim settlement ratio in health insurance.

What is Claim Settlement in Health Insurance?

Claim settlement in health ratio or CSR refers to the ratio between the total number of claims settled to the total number of claims made in a year. Insurance Regulatory and Development Authority,  IRDAI is calculates the claim settlement ratio of different insurance companies every year. IRDAI also publishes the claim settlement ratio of the different insurance companies so that the policyholders are well-informed. Moreover, it is also important to note that the higher the claim settlement ratio, the more beneficial it will be for policyholders to get their claims settled. Thus, if a company has a 99% claim settlement ratio and another company has a 95% claim settlement ratio, then it is better to get a health insurance company with a 99% claim settlement ratio. 

How is Claim Settlement Ratio Calculated?

There is a specific formula that is used to calculate the health claim settlement ratio. The health claim settlement ratio is the ratio between the total number of claims settled to the total number of claims received. This ratio is then represented in percentages. 

Benefits of Higher Health Claim Settlement Ratio

It is very important to know the claim settlement ratio of an insurance company. So, listed below are some of the benefits of knowing the health claim settlement ratio:

• The health claim settlement ratio helps customers know about the insurance company’s efficiency in settling the claims. For instance, the higher the claim settlement more credibility the health insurance company has in settling the claims.
• A higher claim settlement ratio is an assurance that even in your absence, your family members can easily get their claims settled.

Other Factors To Consider While Buying Health Insurance Plans

Apart from the claim settlement ratio, there are several other factors that you need to consider while buying health insurance plans as listed below:

• You must check the coverage offered under the given health insurance plan. Also, check the exclusions of the health insurance plan.
• The waiting period in health insurance refers to the time period during which you cannot raise any health insurance claim. So, it is better to buy health insurance plans with a shorter waiting period. 
• You need to check the health insurance premium and buy a plan that is affordable for you.
• You must read the reviews of customers while buying health insurance plans with any insurance company. You must also keep a check on their overall ratings in the past few years. 
• You should also keep a check on the add-on covers that are available. Add-on covers will help you in enhancing the benefits of your health insurance plan. 
• Network hospitals in the health insurance help policyholders in getting cashless claims settled. So, the higher the number of network hospitals, the more beneficial it will be for policyholders.

Take Away

Thus, to conclude, we suggest you buy a health insurance plan with a company that has a higher claim settlement ratio. This will help you in getting your health insurance claims settled in a convenient manner.

Also read: Perks of Buying Health Insurance When You Are Young