Claims Intelligence
Claims Transparency Dashboard
Real claims performance data across India's health insurers. We combine IRDAI settlement ratios, incurred claim data, and complaints analysis to give you a complete picture of who actually pays when you file a claim.
Avg. Settlement Ratio
86.7%
across 10 insurers
Avg. Incurred Ratio
72.3%
healthy range: 60-80%
Low Difficulty
3
of 10 insurers rated low
Total Network
1,10,200
hospitals combined
Understanding Claims Data
Claim Settlement Ratio
The percentage of claims paid out of total claims received. A ratio above 90% is excellent, 80-90% is acceptable, and below 80% warrants caution. This tells you how likely the insurer is to actually pay your claim.
Incurred Claim Ratio
The total claims paid divided by premiums earned. A ratio of 60-80% is considered financially healthy. Above 100% means the insurer is paying more than it earns, which can lead to premium hikes or benefit reductions.
Claims Difficulty
Our editorial assessment combining settlement ratio, average processing time, documentation requirements, and IRDAI complaint data. "Low" means smooth processing, "High" means expect friction and follow-ups.
Insurers Ranked by Claim Settlement
Sorted by claim settlement ratio (highest first). Click any insurer to see their full profile with gotcha alerts and plan details.
Star Health & Allied Insurance
StandaloneSettlement
91.3%
Incurred
68.4%
Difficulty
Low
Niva Bupa Health Insurance
StandaloneSettlement
89.7%
Incurred
62.1%
Difficulty
Low
Niva Bupa (Max Bupa legacy plans)
StandaloneSettlement
89.1%
Incurred
63.7%
Difficulty
Low
HDFC ERGO General Insurance
GeneralSettlement
88.2%
Incurred
71.8%
Difficulty
Medium
Tata AIG General Insurance
GeneralSettlement
87.1%
Incurred
69.5%
Difficulty
Medium
Care Health Insurance
StandaloneSettlement
86.5%
Incurred
65.3%
Difficulty
Medium
ICICI Lombard General Insurance
GeneralSettlement
85.8%
Incurred
74.2%
Difficulty
Medium
Aditya Birla Health Insurance
StandaloneSettlement
84.9%
Incurred
67.8%
Difficulty
Medium
Bajaj Allianz General Insurance
GeneralSettlement
83.4%
Incurred
76.9%
Difficulty
High
New India Assurance
GeneralSettlement
81.2%
Incurred
103.5%
Difficulty
High
Data Methodology & Disclaimer
Claims data is sourced from the Insurance Regulatory and Development Authority of India (IRDAI) Annual Report for FY2024-25 and individual insurer disclosures. Claims difficulty ratings are Oquilia's editorial assessment combining settlement ratios, average processing times, documentation requirements, and IRDAI grievance data.
Oquilia Scores are not financial advice. They are editorial opinions intended to help consumers make informed decisions. Always read the actual policy wording and consult a licensed insurance advisor before purchasing a policy.
Last updated: March 2026 · IRDAI Annual Report FY2024-25
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