Quick Take: To compare health insurance companies in India, you’ll have to look at claim settlement numbers, network hospitals, operational efficiencies, net promoter score, company track record, the scale of business and product portfolio. Once you have this data, you can then rank insurers based on the metrics you want to prioritize.
We did this based on our subjective assessment and according to us, these are the best health insurance companies in India in 2024
Company | CLAIM SETTLEMENT RATIO (avg. of last 3 years) | Network Hospitals | Gross Written Premium (2020-21) | Track Record | Rating out of 5 |
---|---|---|---|---|---|
HDFC Ergo | 97.5% | 11,300+ | ₹4,281.6 Cr | 20 years | 4.42 |
Care | 90.75% | 9,400+ | ₹2,559.75 Cr | 10 years | 4.3 |
Niva Bupa (erstwhile Max Bupa) | 90.66% | 9,100+ | ₹1,750.78 Cr | 14 years | 4 |
Bajaj Allianz | 94.04% | 8,000+ | ₹2,301.74 Cr | 21 years | 3.92 |
ICICI Lombard | 85.53% | 7,500+ | ₹3,021.35 Cr | 21 years | 3.65 |
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Introduction
There are 31 health insurance companies in India. 5 Stand Alone health insurers and 26 General Insurers.
Standalone health insurance companies are insurance companies that only sell health policies and nothing else. In 2012, Star Health Insurance became the first institution to set up a standalone health insurance company in India. Since then, 4 other companies have gone down the same route. And together they market over 15 policies with a whole host of features and coverage.
General Health Insurance companies are those that dabble with health, motor, and other non-life policies. In this section, however, we will restrict the analysis to general health insurance companies that market at least one health insurance policy.
Difference between Standalone health insurance companies and general insurance companies
From a buyer’s perspective, there isn’t a lot of difference when you compare health policies marketed by general insurance companies and standalone health insurers. For instance, you can’t automatically assume that a standalone health insurer will offer a better experience since they specialize in this domain. In our experience, we’ve seen general insurance companies do far better than standalone health insurance companies on several occasions. So that analysis is fraught with issues.
However, it must be noted that a standalone health insurer will likely have a better suite of products for a wide audience base, whereas a general insurance company may not have as many products. So if you’re looking to buy a policy for a very specific use case you’d be better off picking a standalone health insurance company.
Now that we have the basics sorted, let’s look at the next item.
How to compare health insurance companies?
When you are comparing different health insurance companies you have to rank them along a series of objective metrics before you take the final call. What do these metrics look like? Let’s start with the basics.
1
Historical Track Record:
Imagine a company that’s only been in business for a few odd months. It’s almost impossible to assess if the insurer holds potential. So you’re likely taking a gamble when you pick a policy from their basket. However, if you have a company that already has an extensive track record, then you can build a comprehensive assessment.
For instance, a young company with only a track record of a couple of years could post stellar claim settlement numbers, and offer amazing customer service. But it’s entirely possible that these numbers may go for a toss as they scale their business. On the flip side, if you have an insurance company that has been in the business for a while posting consistent numbers, you could expect them to do similar figures going ahead. You also don’t have to worry about potential issues that could crop up when they scale their business. So our suggestion is to always look at a company’s track record before you zero in on an insurer.
And if you have trouble doing this yourself, here’s a list of the top 5 insurance companies in India with the longest track record.
Company | Track Record |
---|---|
National Insurance | 116 years |
New India Assurance | 103 years |
United Insurance | 84 years |
Oriental Insurance | 75 years |
IFFCO Tokio | 22 years |
If you look at the table above, you will see a peculiar pattern. All these companies are state-run, because the insurance sector in India was only privatized in 2000. Meaning most private companies have a track record of less than 22 years. However, any company with a track record of 10 years or greater would be a good bet. A company with a track record of 5 years and above is decent. And we generally urge people to avoid any company with a track record of less than 5 years.
2
Operational proficiency:
Based on the ranking above, you’d think that state-run companies are a better bet, considering their extensive track record. But the truth is that state-run companies usually have a bad reputation within the industry. They’re very slow in processing applications. It’s extremely hard to get a hold of customer care executives in these large public enterprises. And the claim settlement process is laborious. So you could argue that the table above is meaningless unless you take into account other metrics–like operations efficiencies.
But what do we really mean when we say operational proficiency? Well, operational proficiency deals with the end-to-end process–right from filling out the application to making the claim. If an insurer offers a smooth journey throughout, then you could argue that they’re operationally robust. On the other hand, if you see customer complaints, poor response time and sub-par claim settlement processes, it’s safe to say that they won’t rank well on operational efficiency.
And as a general rule of thumb, private insurers do better than state-run insurers in this department.
But even amongst private insurers, you have some who are more in tune with their customers and others who don’t care as much. Once again, it’s not easy to tell them apart. But you could scour the web for some data points. You’ll find information on customer complaints, performance surveys, social media acceptance online. And you may have to put them all together to form an opinion. On the flip side, you could also talk to insurance experts, like our and take our help in this matter.
3
Product Portfolio:
Product portfolio matters if you are looking to buy policies for a specific use case. For instance, some companies offer products for a wide range of use cases. They offer affordable policies with bare minimum features, they offer comprehensive policies with a whole host of must-have features and premium policies that cover everything– right from dental complications to maternity expenses. Even others offer policies for special use cases i.e. senior citizens, cancer patients, diabetics and those with serious health complications.
So here we will list down companies who have an extensive product portfolio
Company | Affordable Option | Comprehensive Options | Premium Options | Diabetic Specific policy | Cancer Specific policy | Heart Specific policy | Senior Citizen Options |
---|---|---|---|---|---|---|---|
HDFC Ergo | myHealth Suraksha | Optima Secure, Optima Restore | None | Energy silver, Energy Gold | None | None | Optime Secure |
Care | Care Advantage | Care Plus | Care | Care Classic | Care Freedom | Care Heart | Care Senior |
Niva Bupa | ReAssure | ReAssure | Health Premia, Heartbeat | None | None | None | Senior First |
Bajaj Allianz | Health Guard Silver, Health Ensure Family | Health Guard Gold, Platinum | Health Care Supreme | None | None | None | Silver Health |
4
Network Hospitals:
Insurance companies partner and work with a few hospitals in the hope of offering customers a completely cashless journey during the claim settlement process. Meaning if you ever visited a network hospital, then you’d technically be able to make a claim without paying a single penny out of pocket. On the other hand, if you were hospitalized in a non-network institution, then you’d have to pay the bills yourself and wait for reimbursem*nt. Which once again, can be a painstaking process. So clearly, being admitted to a network hospital can save you a lot of time and money.
However, not every company partners with every hospital out there. Some companies have partnered with over 10,000 hospitals. Even others have less than a few thousand hospitals on their platform.
In our experience, any insurer with a hospital network spanning 8000+ hospitals is a decent bet. Anything between 5,000 and 8,000 is okay. And less than 5,000 is a no-no.
With that said, here’s a list of the top 10 insurers with the largest hospital network.
Company | Network Hospitals |
---|---|
HDFC Ergo | 11,300+ |
Star Health | 14,000+ |
SBI | 6,000+ |
Digit | 16,400+ |
Niva Bupa (erstwhile Max Bupa) | 9,100+ |
Care | 9,400+ |
Bajaj Allianz | 8,000+ |
Iffco Tokio | 7,000+ |
National Insurance | 3,200+ |
Royal Sundaram | 10,000+ |
5
Claim Settlement Ratio:
Claim settlement ratio tells you about the percentage of claims settled by an insurer during a specified period. Put another way, a claim settlement ratio of 90 tells you that the insurance company settled 90 claims for every 100 claims they book during the year.
The figure is calculated using the formula: Claims settled / (Claims booked + Claims outstanding at the beginning — Claims outstanding at the end)
In our opinion, a claim settlement ratio of 90% and above is stellar. A claim settlement ratio of 80-90% is decent. And anything less than 80% is a no-go.
Here’s a list of companies with the highest claim settlement ratios for FY2020-2021
Company | CLAIM SETTLEMENT RATIO (avg. of last 3 years) |
---|---|
New India Assurance | 99.88% |
Oriental Insurance | 97.6% |
HDFC Ergo | 97.5% |
Apollo Munich (now HDFC ERGO) | 97.5% |
Iffco Tokio | 97.02% |
Acko | 95.8% |
United India | 95.63% |
SBI | 94.94% |
Digit | 94.23% |
Bajaj Allianz | 94.04% |
National Insurance | 93.76% |
Edelweiss | 93.16% |
Royal Sundaram | 93.11% |
Aditya Birla | 92.99% |
Care | 90.75% |
Niva Bupa (erstwhile Max Bupa) | 90.66% |
Manipal Cigna | 90.08% |
TATA AIG | 89.07% |
Universal Sompo | 87.59% |
ICICI Lombard | 85.53% |
Bharti Axa | 85% |
Star Health | 82.01% |
Navi | 74.07% |
Conclusion: Once you take into consideration all the factors mentioned above, you can make your own list of the top insurers based on what attributes you prioritize. Based on our priorities we made a list and this is what it looks like.
Best Health Insurance companies in 2024:
1.
HDFC Ergo
2.
Care
3.
Niva Bupa (erstwhile Max Bupa)
4.
Bajaj Allianz
5.
ICICI Lombard
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List of Health Insurance Companies in India
FAQs about Health Insurance Companies:
1. How many Health Insurance companies are there in India?
India has 31 health insurance companies. Of these, 26 are general insurance providers and the rest 5 are standalone health insurance companies.
2. Can I port my policy from one Health Insurance company to another one?
Yes, you can.
Medical inflation and COVID-19 have led to the growing necessity and reliance on financial coverage options for healthcare expenses. Subsequently, now the insurance market has more players with diverse and lucrative offers and perks in the coverage plans.
To ensure that policyholders have the option to avail the most suitable policy cover, the IRDAI (Insurance Regulatory and Development Authority) enabled the portability option in 2011.
However, before you opt for the portability option, it’s crucial that you understand the why, the how, and the when! Here’s a detailed article that will be your perfect guide!
3. Which are the best Health Insurance companies on the basis of Claim Settlement Ratio (CSR)?
A higher CSR of a health insurance provider is indicative of the company’s claim settlement ability and history. This also serves as one of the pivotal determiners when choosing your healthcare insurance partner.
Here’s a look at the top 5 health insurance providers based on their CSR -
Company | CLAIM SETTLEMENT RATIO (avg of last 3 years) |
---|---|
New India Assurance | 99.88% |
Oriental Insurance | 97.6% |
Apollo Munich (now HDFC ERGO) | 97.5% |
HDFC Ergo | 97.5% |
Acko | 95.8% |