IRDA Incurred Claim Ratio-How To Choose The Best Health Insurance

8/10/15
IRDA Incurred Claim Ratio-How to choose the best health Insurance?
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You are here: Home / Insurance Planning / IRDA Incurred Claim Ratio-How to choose the best health Insurance?
IRDA Incurred Claim Ratio-How to choose

the best health Insurance?
January 12, 2015 by Basavaraj Tonagatti 201 Comments
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When it comes to purchasing health insurance either for you or to family, then you will come across many more
doubts, like how much insurance is suffice for you, whether you can afford it or not, which one to buy and much
more. The answer to this is a simple tool developed by POLICYADVISOR. Let us look how it works and help
you.
Before proceeding further, let us look at recent annual report of IRDA Annual Report 2013-14. This will also
give you some inputs about whom to believe and how they are doing business.
What is the Incurred Claims Ratio?
It is the ratio of claim incurred by the insurance company to actual premium collected for that period. You may
also say it as a net claim settlement cost incurred to the net premium collected for a given accounting period.
Formula for calculating is as below.
Incurred Claim Ratio=Net claims incurred/Net earned premium.
For example, let us say an insurance companys incurred claim ratio is 90%. Then what it indicates is, for
every Rs.100 earned as premium, Rs.90 spent on the claims settled by the insurer. Therefore, Rs.10 is the
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profit to the company. If this incurred claim ratio is over and above 100%, then it indicates that they suffered a
loss in their business.
What this ratio indicates?
This indicates how much you can believe in insurance companies, when it comes to claim. Usually higher the
incurred claim ratio then it is good for you. This is how the health insurance companys performance is gauged.
However, when it comes to insurance company point of view, then if higher the incurred claim ratio means the
company is in loss. That is the reason usually insurance companies load your premium when they incur a
higher loss in particular age group segment (even though you do not have any claims in previous years).
What this ratio doesnt indicate?
When company A and company B have a same incurred claim ratio then it is hard for you to judge who settled
claims quickly. So even though it may give a clear picture about an insurance company, but still hard to find
who is efficient in claim settlement.
What is the difference between incurred claim ratios to claim settlement ratio?
You can confuse yourself between incurred claim ratios to claim settlement ratio. The claim settlement ratio is
the ratio of settled claims to the total claims filed in a given accounting period. Therefore, if claim settlement
ratio indicates 90%, then it means that out of 100 claims filed 90 claims are settled. Remaining 10% claims are
either rejected or pending with the insurance company.
Below is the latest IRDA Annual Report for 2013-14 for individual Health Insurance Companies Incurred
Claim Ratio for 2013-14.
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As I said above, this CIR will give you an indication of believing on these insurance companies. You may notice
that none of the private health insurance companies (including standalone health insurance companies) has
CIR of more than their collected premium.
Now let us move to the next step of selecting the health insurance product by using the tool of
POLICYADVISOR. Here in the first place you need to enter your date of birth and city you currently live. The
name of the city is important to identify the cost of health in these cities. They did some research on this to
arrive at the final figures on this.
Next, you need to enter your marital status, your monthly income, whether you want to add family members
or not. If yes, then add the number of members you want to cover in this policy.
Last step is to specify whether you have any existing health insurance or not. This is required to arrive at the
required Sum Insurance. Along with that, you need to enter information about any health issues. Finally share
the information, whether you have any major hospital expenses in last 1 year or so.
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That is all what you need to do. The result will show you whether you require any health insurance or not
(based on your current health insurance), ideal cover required for you (based on current requirement, the city
you stay, family members you want to cover and your health status.) and the required cover which excludes
the existing insurance coverage.
If you need quotes for this insurance, then you can fill up your personal data like name, email id and mobile
number. This will give you the list of products.
Few assumptions that were made to arrive at required quote are as below.
You are the eldest member of the family.
You have an annual surplus of 3% to 4% to pay towards your health insurance premium.
You have not exhausted the Sec.80D limit.
Your premium affordability may vary to actual calculation. However, it is considered based on industry
average.
This is not a final recommendation. Before buying a product, consult insurance adviser or financial
planner.
I know that buying health insurance involves too many data like apart from said information you may require
information like co-payment clause, pre-existing diseases or many more. But by going through IRDA ICR and
using the POLICYADVISOR tool at least you may come to nearer of your selection.
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Anonymous
Basavaraj Tonagatti
I am a Certified Financial Planner by qualification and currently living in Bangalore. I am using
this platform to spread knowledge about Personal Financial Planning. Hope you too join me in
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Comments
siddharth says
August 5, 2015 at 8:57 PM
Could you suggest a good Health Insurance provider for myself ( 32 ) and my Brother ( 26) .Thanks
Sir.
Reply
Basavaraj Tonagatti says

August 6, 2015 at 10:01 AM
Siddharth-The list with data already available in above post.
Reply
Sandeep Singh says

August 3, 2015 at 11:43 AM
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Dear Sir
I want to buy health insurance for me & my wife. pl suggest which is best for for me keeping in mind
service, Claim settlement ratio, support & premium.
I want following things to be covered :
1. Minor operations like herina, cattract eye sight issues etc. ( immediately after 30 to 90 days after i
buy policy)
In most of polices , this benefits they give after 24 months.
2. Maternity benefits
3. Critical illness coverage
4. Pre diseases cover
5. Reimbursement if i use non-network hospital like Fortis, PGI chandigarh etc.
i have gone through Max Bhupa (family first plan )- for 15 lakh premium is 18222/- , it is too high.
Apollo is also there but i do not know much about their service, performance. CIR etc.
Pl give me ur valuable advice.
regards
Sandeep Singh
Reply

August 3, 2015 at 12:20 PM
Sandeep-It seems you are going for surgery or hospitalization soon and that is the reason looking
for a health insurance. No one can protect you in such situations.
Reply
Gaurav Malik says

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Sir,
I have Max Bupa Gold Heartbeat Gold 10 Lakhs for 2 Adults ( 36 and 32) and one Child 2 Years. My
this years premium is 27,500. I have checked our Religare the same is 16359 for Super No Claim
Bonus. What would you advice? Max Bupa claims that within my policy they also cover Critical Illness
to the SA but I do not see it written anywhere within the policy. Please advice.
Best Regards
Gaurav Malik
Reply

Gaurav-Dont combine critical illness with health insurance. Just buy it separately.
Reply
Gaurav Malik says

August 2, 2015 at 10:14 PM
But do you advice that I discontinue the Max Bupa and go in for the Religare Policy. I feel a
premium for 27,000 is unjustified almost for a similar policy.
Regards
Reply

August 3, 2015 at 12:42 PM
Gaurav-I am not suggesting either to discontinue or continue. I just said separate the
health insurance with critical. If the Religare is matching your features requirement
and also within budget then you can go with Religare. You are the right person to judge
it.
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Reply
Srivatsav says
August 1, 2015 at 12:16 AM
Dear Basu,
Thank you for this wonderful blog !
Basu, Just need your advice
I am planning to take a family floater with Sum Assured of Rs 10 Lacs where the NCB could go upto
20 Lacs if there is no claim ( 2 Adults + 1 Child )
I have found Max Bupa Companion and Royal Sundaram Lifeline Supreme quite attractive. However
I am not quite sure of their services in the long run and I have also found their premium low
compared to others.
Whats your take on this ? Which one do you suggest or is there any alternative ?
Regards,
Srivatsav
Reply

August 1, 2015 at 10:06 AM
Srivatsav-I am not sure about Royal Sundaram but I feel MaxBupa provides good service.
Reply
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Malhari salunkhe says

July 30, 2015 at 10:20 AM
I want to buy Health Insurance for my Parents. Father Age 52 & Mother Age 49.
Mother is having joint pain .is this considered in preexisting disease ?
Please suggest which Insurance Provider is best for SI 4-5 lacks ?
Shall i go with Religare or ICICI lomard ?
Reply

July 30, 2015 at 12:31 PM
Malhari-Joint pain is considered as existing disease. For me both are fine. Also, suggest to check
for Apollo or some public sectors like National and New India.
Reply
Nitin says
July 28, 2015 at 3:06 PM
Mr Basavaraj,
First, thank you for such informative post.
I noticed, mostly youre suggesting buying health insurance from standalone companies e.g. Star,
Apollo, Max or Religare even though their CIR is much less than other private sector companies e.g.
ICICI, HDFC etc. I undersntad that public insurers can sustain on loss (with high CIR) but what are
the advantage you see going with standalone insurers compared to private insurers? I feel ICICI with
93% CIR is very good compared to Apollos 65%.
Reply
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July 29, 2015 at 12:32 PM
Nitin-First of all, I am not sticking my recommendations to any particular company. Second
thing is, CIR is not a sole criteria to select a company. There are millions of reasons for getting
hospitalized. Hence, we cant generalize and say that based on CIR we must buy an insurance.
We have to look for efficiency in claim settlement (adopting fast approach), features we are
looking forward, premium affordability and comfort with company.
Reply
Nitin says
July 31, 2015 at 12:15 PM
No particular to a company but to group of standalone insurerstwo of your replies here
prove it
June 29, 2015 at 11:56 AM
Sujit-You can check with Star, Apollo, Max or Religare.
Basavaraj TonagattiBasavaraj Tonagatti says
May 6, 2015 at 10:14 AM
Sunny-Go with Apollo, Max or Religare (I am not aware about TTK). There is no
advantage. But in case of settlement they may be bit generous.
Reply

July 31, 2015 at 1:51 PM
Nitin-I consider service as a major issue when it comes to health insurance. Hence, I
am fan of standalone companies. You may think of I am biased and you are free to
interpret it. Because I have any profit from recommending public, private or
standalone companies
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Reply
Nitin says
July 31, 2015 at 2:38 PM
Yes, youre not sticking a particular company but to group of standalone insurers. This is
evident from your replies below. CIR is not only criteria but most important because delay
in claim (public company) is better than denying claim (private standalone company). Will
you prefer efficiency in claim settlement than increasing probability of claim denial ?
Reply

July 31, 2015 at 2:46 PM
Nitin-There are million reasons to be sick and at the same time insurance companies
have million reasons to reject. Hence, depending solely on CIR is not best. Also, for
companies point of view, approving is easy than rejecting. Because rejecting leads to
proper answer to client or in some cases either court or IRDA. Hence, they must take
into notice of that point. The data which IRDA publishes itself not indicate what are the
major reasons for rejection. Then it is wrong to generalize and say that if a company
rejection ratio is more than it rejects your claim too. You are saying PROBABILITY.
Hence, I will not indulge in predictions. For me what matters more is complete
disclosure from my end, understand the plan features and exclusions.
Reply
Amit Mo says
July 27, 2015 at 6:10 PM
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Hi, Do you have latest updated table of ICR published in current year?
Thanks
Reply

July 27, 2015 at 7:08 PM
Amit-This is the updated one.
Reply
Ravi says
July 26, 2015 at 1:51 AM
Dear Mr. Basavaraj,
Thank you for the detailed guide on how to choose the best health insurance, which is of great value
to all of us.
I have a question: I have a Religare Care floater policy for Rs.5 lakhs, which is one year old, and a
Religare Enhance I floater policy for Rs. 5 lakhs which I have taken on 18 July 2015. Both these
policies are for me and my wife. The Enhance I policy has Deductible: Rs.5 lakhs.
Now suppose that I or my wife incurs a medical expense of say Rs.8 lakhs , does Deductible mean
that I can claim Rs.5 lakhs from the Care policy, and the balance Rs.3 lakhs from the Enhance I
policy? This way can I claim the full Rs.8 lakhs from the two policies?
Secondly, if say the other person in these policies have any medical expenses in the same year, how
much will be left to claim for the other person in the same year?
Your reply shall be highly appreciated. Just want to be clear about how these policies will operate.
Thanks
Ravi Kumar
Reply
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July 26, 2015 at 12:43 PM
Ravi-Care policy is treated as separate than the Enhance. Please read the definition provided by
Religare about Deductible as Deductible Plan works on the simple principle of Policy Deductible,
which is the pre-defined amount that you will bear, through your own finances or any other
source, during a medical event Any amount over and above policy deductible will be borne by us.
The pre-specified deductible can be reduced/exhausted using the principle of aggregation.
Simply put, if you opt for a 6 lac Sum Insured with deductible of 2 lac, then 2 lac will be borne by
you and 6 lac over and above the deductible of 2 lac will be borne by us..
Reply
ravi says
July 26, 2015 at 3:11 PM
As you said, Care policy is treated as separate from Enhance policy, but suppose that I or
my wife incurs a medical expense of say Rs.8 lakhs for hospitalisation, can I can claim Rs.5
lakhs from the Care policy, and the balance Rs.3 lakhs from the Enhance policy? This is the
idea of the Enhance policy, is it not, as a top-up policy?
Ravi
Reply

July 26, 2015 at 5:54 PM
Ravi-In case the claim amount is less than sum insured then there will not be any
problem. You can approach any insurance company (in your case policy) and settle the
claim. However, if the claim amount is more than sum insured then insurance
companies may raise the Contribution Clause will come into picture and insurance
companies settle the claim based on the sum insured to % of cliam amount.
Reply
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ravi says
July 26, 2015 at 6:40 PM
thanks, but in the situation that I have mentioned, the claim of Rs.8 lakhs will
exceed the Rs.5 lakhs of our Care policy, so can the balance of Rs.3 lakhs be
claimed against the Enhance policy, since Deductible in Enhance policy is Rs.5
lakhs, and this Rs.5 lakhs I will claim against my Care policy.
This is basically what I would like to know.
Ravi
Reply

July 26, 2015 at 7:09 PM
Ravi-Yes, you are right. But I still suggest you to confirm this example with
Religare. Because whether Enhance deductible of Rs.5 lakh is treated on
whole claim amount of Rs.8 lakh or the left out claim amount (post claim
settlement from Care i.e Rs.3 lakh). If they consider on whole claim amount
then you can get it from Care and rest Rs.3 lakh from Enhance. However, if
enhance policy considered only Rs.3 lakh as claim amount which they need to
settle then they may turn up the claim stating that Rs.3 lakh will come under
deductable amount.
Reply
Sudhakar says
July 18, 2015 at 2:24 PM
Hello Sir,
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Please suggest me a best Health insurance plan & company for coverage of my entire family??
Me-27 years
Spouse-23year
My Son-8 months
My father-55 years
My mother-46 years old,
Sir pls Can you help me guide on which policy can be benificial?
Reply

July 18, 2015 at 7:16 PM
Sudhakar-In my view, better to separate your parents from you three. Let them have separate
insurance. One more insurance for you, wife and a kid. For this, I suggest to check out with Star,
Apollo, Religare, National, New India.
Reply
Sudhakar says
July 20, 2015 at 5:08 PM
Sir,
Please suggest me a best Health insurance plan & company for coverage of my parents??
Reply

July 20, 2015 at 8:44 PM
Sudhakar-First understand the requirement based on my earlier post Best Senior
Citizen Health Insurance in India-Product Comparison and then decide which is
BEST.
Reply
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anindya ghosh says

July 17, 2015 at 11:25 PM
Basavaraj jee, I am continuing my mother health insuarance poliicy for last 6 yrs, with star healh red
carpet, she is 73 yrs old. Can the policy claim still be rejected saying p.e.d and suppression of material
fact?
Reply

July 18, 2015 at 7:25 PM
Anindya-It hard for me to say that they not reject. But at the same time, if you are with them
since 6 years, I feel they not reject (again it depends on case to case).
Reply
Kp says
July 11, 2015 at 6:17 PM
Hi,
I want to buy a health insurance for my family(me,wife and 1 child). My and my wifes is age 31 and
child is 3 year old.
I have already a corporate health plan of 3 Lac SA which is provided by Employer. But I want to take
a personal one which i want to continue with whole life. I am living in Ghaziabad UP.
I have lot of confusions for choosing a Health Insurance company
1. Which Company i need to choose? like Public or Private
2. If answer is Private comp, which is best one?
3. What should be sufficient Sum Assured?
4. If i will take a plan from private comp and after some years comp shutdown their health insurance
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unit.
in this case can i continue my plan with other company OR I need to buy a fresh plan.
Thanks in Advance.
Reply

July 12, 2015 at 12:45 PM
KP-1) In my view both are same. 2) NA 3) Ideal sum insured in case of health insurance must be
around 50% of your yearly income. 4) Yes, you can move to public sector companies using
portability option.
Reply
siva says
July 11, 2015 at 10:37 AM
hello bro,
Im 37yrs old and my wife 32 yrs we have 2 kids 3months old. pls suggest a best insurance plan for
my whole family. I want 2 to 3 lahks cover. with critical illness rider and policy should be renewable
to life long or maximum age. thanks. pls reply.
Reply

July 11, 2015 at 1:02 PM
Siva-Insurance is required on you but not on your wife (is she is not working) and in kids name.
Ideal insurance coverage must be around 15-20 times of yearly income. Now think how much
you need.
Reply
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Jai says
July 11, 2015 at 9:07 AM
Hi basu
I had national family floater 5 lac for last 5 yrs. I want portability to Apollo munikh optima restore 10
lac as I cannot increase my sum insured with national policy. But 1 yr back I got some ear surgery
and my son had some kidney disease 3 yr back which is now cured. These diseases were not there
when I had purchased national policy and I got claim for these two.
My question is that if do portability to Apollo ..these two will be preexisting disease.if I need any
claim for these two disease in future..will Apollo give claim..their customer care say Apollo will cover
these after portability as I am having previous running policy for 5 yrs..
Will it be ok or Apollo will look any excuse to cancel claim
Should I make it portable or keep these 2 policies for 3 years so that I take claim form national for
these 2 diseases
and then leave national ..after 3 yrs Apollo will in any case cover these
Kindly suggest
Thanks
Reply

July 11, 2015 at 1:09 PM
Jai-Yes, apollo give claim and what they are saying is correct.
Reply
Deepak says
July 3, 2015 at 5:15 PM
Hi,
Please suggest me a best Health insurance plan & company for coverage of my entire family me, my
wife and my parents?? Thanks.
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Reply

July 3, 2015 at 6:24 PM
Deepak-What are your requirements?
Reply
Subhasish says
July 2, 2015 at 10:33 PM
Hello sir
I have purchased the heath insurance from religare i.e. Care for a sum insured of 5 lakhs. My age and
my spouse age are 25 each. My question is when shall i consider increasing the sum insured ?
Both health condition are absolutely fine.
Also whether my decision is right to go with religare?
Reply

July 3, 2015 at 11:02 AM
Subhasish-You can consider increasing sum insured at the time of next premium payment.
Reply
Subhasish says
July 6, 2015 at 3:51 PM
Actually i am covered under corporate insurance, so i decided to go for a lesser sum insured
plan.
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Reply

July 6, 2015 at 6:44 PM
Subhasish-Ideal insurance cover must be around 50% of your yearly income. If both
the corporate and Religare combining cover is that much then no need to increase.
Reply
Sri says
July 1, 2015 at 2:00 PM
Hello Basavaraj
I follow your blogs actively. For health insurance, it is important to also share with the readers that
the premium increases over time. This is based on my analysis of the Apollo Munich and the ICICI
Lombard proposals. The premium table (as stated by the agent) is fixed when you take it for the first
year for the insured amount and so the consumer has to pay higher premium when they move into
the next bracket as they age. This is unlike a term insurance where the premium remains fixed over
the period of coverage.
It is likely that people end up paying an annual premium of Rs. 1 lakh for a coverage of Rs. 5 Lkahs.
Thanks
Sri
Reply

July 1, 2015 at 3:36 PM
Sri-Yes, it is known fact. Because loading will be based on age bracket the proposer or insured
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fall.
Reply
Sujit Roy says

June 28, 2015 at 4:59 PM
Hello,
I need your help for choosing a good health policy for me and my wife. I am 32 and my wife is 26. We
dont have any critical illness and any hospitalization before. Can you suggest me a good health policy
in terms their easy claim settlement and less premium. I need 4 lacs sum assured policy.
Thank you in advance
Reply

June 29, 2015 at 11:56 AM
Sujit-You can check with Star, Apollo, Max or Religare.
Reply
sambhu n jha says

July 2, 2015 at 5:21 PM
Sujit, for you couple you can try best in terms of maternity claim settlment and ped coverage
you cna try national teller made plan
Reply
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Ashraf says
June 26, 2015 at 12:39 PM
Hello,
I want to buy Health Insurance for my Parents. Father Age 65 & Mother Age 60.
Please suggest which Insurance Provider is best like: Star or Religare or any other option?
Reply

June 26, 2015 at 3:26 PM
Ashraf-Check first with public sector companies.
Reply
sambhu n jha says

July 2, 2015 at 5:25 PM
you must go with govt companies i.e oriental, national
Reply
Ravi Aswani says

June 25, 2015 at 4:51 PM
Great, thanks a lot Basavaraj for speedy reply on my earlier query!
Could you also suggest for below:
1. Is critical illness better from Apollo, as it covers more no. of deseases? Or do you suggest some
other company?
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2. I have plan to take a total LI term cover of 2 Crores, out of which I have already taken 1 Cr. term
cover of Aegon Religare and am planning to take 2 more insurers policies of 50 Lacs each to
diversify. Could you please suggest which are better ones, considering low premium and better claim
settlement ratio?
3. I have taken a personal health cover of 5 Lacs (Family Floater) from Religare (Care, Super NCB)
policy due to its good features, especially Super No Claim Bonus (Super NCB) and recharge feature
wherein SI is doubled if base cover exhausted. Hopefully this is good?
Thanks.
Br, Ravi
Reply

June 25, 2015 at 6:07 PM
RAvi-If you feel it covers more illness then go with Apollo. Why not the further insurance from
Aegon? I feel no logic in splitting your sum assured. I too have my health insurance with Religare
Reply
Ravi Aswani says

June 25, 2015 at 3:04 PM
Hi Basavaraj,
Thanks for sharing this valuable information. Could you please suggest which personal accident policy
is better out of Apollo and Bajaj. Else, would you like to suggest any other better than these two?
Is personal accident cover included in the health policies itself for companies (from statistics
perspective) as I could not find Personal Accidental policy statistics from IRDA site? Thanks in
advance.
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Best Regards,
Ravi Aswani
Reply

June 25, 2015 at 3:14 PM
RAvi-I prefer Bajaj.
Reply
Raj Mehra says

June 25, 2015 at 1:50 PM
i want to take health insu. plan for my parents in which OPD should be cover.
my father is 54 yrs. and mother is 49 yrs old. There is no nay pre-existing condition.
i want to take 5 lacs cover for both. within 15-20 thousand,but not should be expensive more than
20k.
Please suggest me from which company i shoud take.
Thanks
Reply

June 25, 2015 at 2:03 PM
Raj-No insurer will offer you and cover the pre-existing diseases.
Reply
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sambhu n jha says

July 2, 2015 at 5:15 PM
Dear Raj, there is no any company whcih can wave you off ped waiting periodfo 4yrs and 3yrs .
but if you talk about opd you can try with icici lombard,star health ,cigna .
but i would suggest you also try for medhealth opd cards basically of opd only
Reply
Ashish m says
June 24, 2015 at 6:59 PM
Can you tell me which is the best between RD & FD
Reply

June 25, 2015 at 1:49 PM
Ashish-Both are meant for different usage. RD can used for monthly or quarterly investment.
Whereas, FD for one-time investment. Therefore, it is hard for me to say which suites to you.
Reply
Akshay says
June 22, 2015 at 2:17 PM
hi ,
I am 60 years old , planning to buy health insurance plan for me and spouse from any of nationalized
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banks health insurance products.

Can you please suggest is Andhra banks AB HEALTH Insurance product good to buy?
Reply

June 22, 2015 at 3:24 PM
Akshay-Andhra Bank is not a General Insurance company.
Reply
Ashish m says
June 24, 2015 at 6:40 PM
Which is the best health insurance,
Private Or Public Sector.
Reply

June 25, 2015 at 1:49 PM
Ashish-Both.
Reply
SHAMBHBU says
June 23, 2015 at 4:07 PM
yOU CAN BUY NATIONL TELLER MADE POLICY WHERE PED WHOULD BE COVERED
AND PREMIUM WOULD BE VERY LESS IN COPMPARISON OF OTHER HEALTH
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INSURANCE COMPANIES
Reply
Vaibhav says
June 21, 2015 at 6:38 PM
Hi
My retired parents have taken OBC mediclaim or 5 lacs in 7k. But i think limit is less ,especially 1%
sublimits
Please advise another policy of 5-10 lacs. We are most worried about claim settlement
Reply

June 22, 2015 at 4:00 PM
Vaibhav-You can check first with public sector companies.
Reply
SHAMBHU JHA says

June 23, 2015 at 4:12 PM
iF WORRIED ABOUT CLAIM SETTLEMENT PLEASE YOU CAN CONSIDER l&t,cIGNA,mAX
AND ICICI,AND IN PUBLIC SECTOR NATIONAL AND ORIENTAL
Reply
RAJESH SHETH says

July 18, 2015 at 4:26 PM
I want no which company is best in health policy ICICI Lombard or Religar .
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Reply

July 18, 2015 at 7:15 PM
Rajesh-I personally feel Religare offers more features than ICICI.
Reply
meena says
June 18, 2015 at 12:12 PM
Hello Sir,
I want to take policy for me and my husband.We both are diabetic and below 30 yrs.
pls suggest we want to take health cover.We both diagnosed this disease bcoz of some financial
problems in family.can u pls suggest best for us.
Companies cover pre existing disease after 3 yrs thats no problem for us but they need to take
medical of us if we mentioned diabetes in this age medical they take ???
if any company covers after 36 mnths & 48 mnths we are ok with that but the claims we get
afterwards if any complications arise
As u know diabetes are not having complications in early ages if we hide and we need claim after 10
years then how company willa ble to diagnose etc..
but we want to be honest but good claim settlement.Pls suggest your approach in our case.
waiting your valuable feedback.
Reply
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June 18, 2015 at 12:23 PM
Meena-I suggest you to check with first through public sector companies. In private sector, my
recommendations are Apollo, Religare or MaxBupa. I personally have insurance with Religare.
Reply
Pal says
June 22, 2015 at 3:17 PM
Dear Basavaraj Tonagatti,
you must check the claim settlement ratio of religare, I am not commenting you, please
check it, it have lowest claim settlement ratio. also never recommend apollo munich to any
customer its a fraud company, Apollo Munich can increase premium any time according to
there policy wording in addition to age group. recently they have increased the premium to
40% and at your age of 50yrs the premium of customer will be rs 2.7lakhs for sum insured
of Rs 3Lakhs, Always ask your customer to buy health insurance from public sector
insurance companies like oriental, new india, united and national if you are really a good
financial planner.
Reply

June 22, 2015 at 3:20 PM
Pal-How efficient are these PUBLIC SECTOR biggies when it comes to responding to
emergencies? I know how they behave. Regarding Apollo, if the feature of plan
matching you and the claim is within purview of the insurance contract then even GOD
cant stop. Please note that, claim incurred ratio is not a single criteria to select a
product.
Reply
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SHAMBHBU says
June 23, 2015 at 4:08 PM
yOU CAN CAN TRY FOR CIGNA AND ROYAL SUNDARAM .IF THEY WILL REJECT THEN
LAST OPTION NATIONAL TELLERMADE
Reply
SHAMBHU JHA says

June 23, 2015 at 4:15 PM
mEENA U CAN TRY WITH CIGNA ,l&t ,rOYAL sUNDRAM,AND NATIONAL TELLER MADE
Reply
Gaurav Gupta says

June 12, 2015 at 2:33 PM
Hi,
Thanks for nice blog.
Want to confirm if executive of any company make a false commitment and make us to buy policy. Is
he doing the violation of IRDA rules and do we have any chance to challenge the company based on
this fact.
Notable thing is, every time conversation is on Recorded line but that is for company only. consumer
dont have any access to that.
Reply

June 12, 2015 at 7:06 PM
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Gaurav-If you have valid proof then you can go ahead and compalin. But the problem is, in most
cases you fail to produce the proof.
Reply
Jai says
June 3, 2015 at 11:18 AM
Dear basu. I have corporate medical insurance of. 5 lac from new india insurance and a family floater
policy from national insurance for 5 lac ( one member can use only 2.5 lac ) .i want to add topup to
these. I have shortlisted apollo Munich but then all policies will be from different cowill it be
problematic at time of claim if I need claim from two co. Will it be more useful to take topup from new
india co itself ..
In top up policy if claim is rejected by first company ( like new india, national ) then the company
which is supposed to pay the topup ( like Apollo munikh ) above certain sum will reject rest of sum of
topup or will always pay the topup irrespective of first company
Thanks
Reply

June 3, 2015 at 1:36 PM
Jai-For comfort and ease better to use the same insurer. However, it is not mandatory to hold
both under one insurance company. Because what if you change job and new company not
offering the insurance with New India? It is your comfort with a company that matters.
Regarding rejection, they may or they may not. Because it is purely a decision based on case to
case.
Reply
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Pal says
June 13, 2015 at 12:55 PM
Dear basu and jai,
never buy insurance from any private company specially from Appollo Munich, these companies
always hide required information from customer, Appollo Munich have increased the premium
recently upto 40% by taking permission from IRDA, and according financial planners for a sum
assured of Rs 3 lakhs at age of 60yrs the premium will be as below
according to company after every 3 yrs (may be every years according to policy terms) apollo
munich will increase premium to 40 % and let us make calculations for sum assured of 3 lakhs at
age of 33 yrs premium is 10000/- approx, if ur aspect-ed age is 80 years
total number of yrs for premium 80-33= 47 years
total number of times premium increases 47/3= 16 times
premium increases 1st time 40%> 10000@40%= 4000/- total premium of next 3 yrs=
4000+10000=14000/and 2nd time increase in premium 14000*40% =5600/- total premium of next 3 yrs=
5600+14000=19600/and soon upto 16 or 17 times in ur life
in addition to this regular premium increase according to age group 36 to 45=5000/46 to 50=7000/50 to 55=23000-/56 to 60=32000/61 t0 65=70000/Now gross premium paid by you at age of 36=4000+10000+5000=19000/after 3 year with 40% increase in premium to 39 5600+14000+7000=26600/and so on.
at age of 60 years ur gross premium will be= 2.7 lakh for a sum assured of Rs 3lakh and at age of
75yrs premium will be 6 lakhs for sum insured of rs 3 lakhs
this is how apollo munich optima restore plan lot the Indian people by a other country company
and also optima restore option will not act effectively at that age and no other company will give
u an option to by any other plan.. its premium increases exponentially after age of 45 years
Reply

June 13, 2015 at 1:30 PM
Pal-Premium will increase based on the age slab (irrespective of companies). Apollo may
have some different slab. But fixing the premium is entirely the company decision.
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Reply
SHAMBHU JHA says

June 23, 2015 at 4:22 PM
Dear BAsu What i would suggest you can try Super toup of L&T ,cigna or i.e. royal which is
unique in industry.
And one thing if your base company rejects any claim then also you can not claim from topup
also
Reply
sudhadar says
June 1, 2015 at 11:26 PM
sir
i want to purchase a health insurance policy for 5-6 lakhs. which company should i prefer public
sector or private sector. name some good companies and policies
Reply

June 2, 2015 at 10:28 AM
Sudhadar-To me all are good companies. Hence, first understand your requirement like apart
from sum insured what other features you are looking, premium budget and comfort with a
company.
Reply
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SHAMBHU JHA says

June 23, 2015 at 4:25 PM
You can go for ICICI Lombard health smart,max health companion,cigna plus,royal supreme
Reply
sakshi says
June 1, 2015 at 12:08 AM
Mr basu I would like To tell you that max bupa company has permanently excluded ulcerative colitis
and crohns disease.Im really shocked that max bupa has permanently excluded ulcers in large
intestine. I have read this thing in their policy wordings and they are saying that these are genetic
disease.but when I visited mayo clinic website there it is written ulcerative colitis often occurs to
those who do not have this disease in their families.max bupa is clearly violating the terms and
conditions of irda
Reply

June 1, 2015 at 10:48 AM
Sakshi-May I know which terms and conditions of IRDA is MaxBupa violating?
Reply
pradipta says
May 31, 2015 at 10:31 PM
Hi Basu,
I am a IT professional and have 3 lakh mediclaim policy from employer.I want to take another super
top up policy(family floter 2+2) 3 lakh deductible with more than 7 lakh sum insured.I know how
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topup and super topup policy works. I choosen United India(SUPER TOP UP MEDICARE POLICY)
and L&T (Medisure SuperTopUp policy). L&T offering little less premium than United India.Also
offering pre and post hospitalization.But pre and post hospitalization is not covered in United indias
case.Even in L&T case, 12 lakh sum insured possible with low premium.
But as per your chart, United india has better claim and revenue than L&T. Is govt company is better
than private? L&T has coomited to give better response at the time of claim settlement.But I doubt
about Gove case.
Could you please review these two policies and guide me which one is better. I am looking for only
super top up plan.
Thanks,
Pradipta
Reply

June 1, 2015 at 10:49 AM
Pradipa-When it comes to service, then private players always respond lately. Hence, if that is
your core concern, then I suggest to go for L&T.
Reply
pradipta says
June 30, 2015 at 11:21 PM
Dear Basu,
I want to share one incident with all the readers.
Recently I wanted to take super top hearth policy, so I approached many companies and
finally decided to take from L&T health insurance for 3 lakh deductible to 12 lakh sum
insured. They approached many times.
When I declared that my wife has preHypertension for last 1 year and no issue as of now,
they told to take medical test. After that when I agreed and asked them to schedule the
test, I did not get any answer from them, even they didnot replyed my mail. So they want
only healthy person to take insurance.
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So in this case what we can do.?So Im thinnking, i will not declare anything now, and declare
after 3/4 years of continuous renewal that i am suffering from that disease since last 1 year.
As there is no alternative.
Thanks,
Pradipta
Reply

July 1, 2015 at 10:27 AM
Pradipta-Is it right from you to hide only because they avoided the business of risky?
Let them not approach you, but you can approach and submit the proposal. If they
reject the proposal then let them provide valid reasons for that. If they are doing
wrong then why you too doing wrong by hiding the medical conditions? It may cost you
in different way. Please dont do.
Reply
ramreddy says
May 23, 2015 at 2:48 PM
hi,
i would like to take a health insurance policy for my family. myself, wife and my baby of 1 year old. i
would likr to inform that my baby was born with one kidney and he is fine . will i be able to add him in
the health insurance policy, will it be considered PED.kindly clarify
regards
Ramreddy
Reply
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May 23, 2015 at 8:57 PM
Ramreddy-This is unique case, I suggest you to discuss the same with insurance company.
Reply
SHAMBHU JHA says

June 23, 2015 at 4:27 PM
You can try with cigna and Royal
Reply
Aakash says
May 22, 2015 at 8:25 PM
A very good article. I was looking precisely for claim settlement ratio but incurred claim ratio is an
added bonus. Im personally looking to migrate from New India Insurance health policy.
Looking at this , i believe one should take into consideration is incurred claim ratio. It should ideally
be between 80-90%, anything more than that and there would be chances of premium being
increased in the future years.
Reply
Rajeev says
May 18, 2015 at 5:40 PM
Hello Sir,
I am at the age of 36 going to have family floater (2A + 2C )from Max.
I am having slightly hypothyroidism which is under controlled due to medicine and did not have any
issue because of it at present.
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I used to take tobacco 2 years back but quitted since 2012.

Please suggest me should I disclose Under Active Thyroid and Tobacco consumption to insurer
before taking health insurance or this will automatically treated in PED?
Should I avoid to disclose?
Does premium will increase if tell them?
Kindly suggest me
Reply

May 18, 2015 at 5:45 PM
Rajeev-Better disclose it. However, I am not sure whether they increase the premium or not.
Reply
Rajeev says
May 18, 2015 at 6:20 PM
Thanks for getting back to me.
Just one clarification sir.If someone hide it and disease occur due to hidden fact but after 5
years, ( after PED waiting time) then also insurer can raise issue?
Reply

May 18, 2015 at 6:49 PM
Rajeev-In theory no, but in practical insurers look for reasons to reject the claim
Reply
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Sanchita Ganguly says

May 15, 2015 at 10:56 PM
I have medical insurance from New India Assurance. I have a coverage of 2 lakhs. I am 43years now,
and want to buy a super top up plan for myself. for 10 15 lakhs. Please advice which one I should go
for.Thank You.
Reply

May 16, 2015 at 11:43 AM
Sanchita-New India Assurance offers this plan. You can buy from them.
Reply
RamaKrishna says
May 15, 2015 at 1:01 PM
Hello Sir,
I am 32 , married and i have a kid. I already (since 2009 Mar) have a term policy of tata aia for 20L
and a ULIP of 18 lakhs. Also, i have a health insurance policy of 3L from Apollo Munich since 2012
Nov.
I am diagnosied with Asthama 2 years back. Now, i want to close the existing policies and take fresh
policies of term plan to 1 cr and health insurance to 10L. I want to disclose my health condition but i
am not sure if insurance companies are going to decline the policy. Please suggest. Thank you very
much for your suggestion !
Thanks,
Rama
Reply
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sakshi says
May 14, 2015 at 6:46 PM
Mr basu u r a promoter of religare health insurance company
Reply

May 14, 2015 at 6:51 PM
Sakshi-Not at all. Because if I promote or not, I will not receive any benefit from that.
Reply
Jai says
May 7, 2015 at 2:01 PM
Hi
In continuation with previous question If I add some other policy to national family floater and keep
both..if at any time my hospital bill cross limits of one policy.. Can I get rest of billing from other
company
How bills are divided if there r two policies and bill crosses limit of policies individually.
Thank you in anticipation
Appreciate urs help
Reply

May 8, 2015 at 8:50 AM
Jai-You can claim. Initially, you approach one company for the claim. Once they approve the
claim then take the photocopies of bills and settlement summary and submit it to another
insurer for approval of remaining cost. Otherwise, you can inform to the hospital about your
multiple insurance companies. Hospital will send the request for approval to all insurers and
accordingly it will be settled directly with the hospital.
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Reply
Jai says
May 7, 2015 at 1:40 PM
Hi
I have parihar mediclaim family policy from national insurance for myself 41 yr wife 35 yrs two
sons 8 and 5 yr for sum of 5 lac. I find it inadequate. I have this policy for 5 yrs. if I want to shift to
some private insurance co or some other govt insurance co ( who give more sum assured like oriental
for 10 lacs )will the benefits accrued after 3 yrs of policy will be granted to me in new policy or not.
If I take policy from national itself for all members individually ..will the same benefits be granted to
us.
How many companies offer 1 adult + 1 child type policies..will these better if I need higher insurance
cover
Thanx
Jai
Reply

May 8, 2015 at 8:53 AM
Jai-First check for moving to the different plan in National only. In that case your existing
benefits will get transferred to the new plan. Otherwise, you can use portability option to move
from National to the different insurer.
Reply
Sunny Jain says

May 5, 2015 at 7:03 PM
Hi,
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I was looking at Religare, TTK, Max and Apollo.. and all of them looks good to me Can you please
suggest me one..
Is there any advantage of public sector companies like national.
I have only one requirement.. Company which settle claims and the process is simple
Reply

May 6, 2015 at 10:14 AM
Sunny-Go with Apollo, Max or Religare (I am not aware about TTK). There is no advantage. But
in case of settlement they may be bit generous.
Reply
T janakiraman says
April 29, 2015 at 3:42 PM
We are having health insurance at new india assurance myselfage31 father64mother55for 3 lake each
with accumulated bons 30000 each now I feel new India peri mum is high I want to change company
for the fast 10 years with new India so tell me which one best in public sector pls mail me thank u
Reply

April 29, 2015 at 5:39 PM
Janakiraman-I suggest to continue with same insurer.
Reply
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Sunendra says
April 27, 2015 at 12:29 PM
Hello,
I need health insurance coverage of my parents (father age 65 yrs & mother age 59 yrs). please
advise options of good and best health plans and scheme.
Regards,
Sunendra
Reply

April 27, 2015 at 6:37 PM
Surendra-I request to go through my earlier post Best Senior Citizen Health Insurance in
India-Product Comparison.
Reply
Sreenivasulu says
April 24, 2015 at 12:53 PM
Dear sir as per claim ratio and services and future of policy which is better please send reply from
these below companies Apollo, Cignattk, Marbury, Star health and Riligare
Reply
Sreenivasulu says
April 24, 2015 at 12:54 PM
Apollo, Cignattk, Maxbupa, Star health and Riligare
Reply
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April 24, 2015 at 5:11 PM
Sreenivasulu-I prefer Apollo, Star and Religare. I am not aware about Cigntattk.
Reply
Sreenivasulu says
April 25, 2015 at 6:56 AM
Dear sir, please send reply immediately I want term insurance policy which is better for claim
ratio and services and low cost premium my age 37 and I want term maximum how much is
there that requires and give priority 1to 6 Companies sequence give names and please send
reply THANQ Sreenivasulu
Reply

April 25, 2015 at 8:52 AM
Sreenivasulu-You can go with LIC, HDFC, LIC, SBI, Max, Bajaj enough?
Reply
Suresh says
April 10, 2015 at 5:21 PM
Hi
My father age is 72 Years old kindly advise for if any medical policy available either for his. or
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attached with my family flotter plans.

Regards
Suresh
Reply

April 10, 2015 at 6:02 PM
Suresh-You can opt National Insurance.
Reply
Kaushik says
April 6, 2015 at 3:31 PM
Hi,
Great article.
Can you also help me with my query: I need to buy health insurance for my father (age 69 years) and
mother (age 58). Which policy would you recommend for a SI of Rs 3 lacs each.
Thanks,
Kaushik
Reply

April 6, 2015 at 6:05 PM
Kaushik-You can check with Star and Apollo senior citizen plans. If you need lesser sum
insurance then go for National Insurance.
Reply
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Bappaditya Mondal says

April 7, 2015 at 6:20 PM
HI Basavaraj,
First of all thanks for sharing such useful article.
I have gone through your other comments based on people queries.
I am a bit confused here. As you said in your article higher the incurred claim ratio then it
is good for you. From the above table Apollo Munich is having 65.59% of ICR where as
Oriental is having 115.23 %. But for few people you suggested to go for Apollo Munich. Can
you please elaborate the reason behind it. And If I want to take a new health policy, which
one should I go for. I dont have any issue with a higher premium, but I need the best claim
settlement and service.
The second part is , My wife is a Cancer survivor. Four year back She got diagnosed with
breast Cancer. Its god grace that it was in very initial stage. We did the complete treatment
in Tata Memorial and now she completely cured. Last three years there is no re-occurrence
of cancer and she is not going under any medication. Is any Health policy available for her .
(I asked almost all insurance company, but everyone denied tough even I am fine with the
waiting period)
Waiting for your earliest response
Thanks
Bappaditya
Reply

April 7, 2015 at 7:47 PM
Bappaditya-I recommended Apollo based on the requirment and looking at the
features of plans. Do remember that, considering incurred claim ratio for plan selection
is one creteria but not the sole creteria. Hence dont look too much on this data. There
may be many reasons for hospitalization and there may be many reasons for
rejections, which not known to us. Hence if the plan suites to you and premium within a
budget then go ahead. Regarding your wifes insurance, check with public sector
insurers than private insurers. I am not sure who issues. Because it is purely a decision
of insurers.
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Reply
Mohan says
April 21, 2015 at 9:42 AM
Hi Basavaraj,
I want to a family floater health policy pls. suggest any best policy,how is HDFC
Ergo based on service and claim?
Reply

April 21, 2015 at 11:00 AM
Mohan-You can go ahead with HDFC. No issues.
Reply
Anil lohia says

April 25, 2015 at 7:42 PM
Dear ,
In Health Insurance Sector claim ratio means the profit and loss of the company.
the higher it is, the higher the loss.
it is just opposite of the Life Insurance Companies.
please buy a policy from the company which has lower claim ratio.
Regards
Anil Lohia
Reply
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April 26, 2015 at 1:13 PM
Anil-You mean to say the company the company which settles higher claims and
be under loss is not good? In that case all Public Sector companies are totally BAD
for you right?
Reply
Abhishek says
April 3, 2015 at 9:55 AM
Hi Basu,
Thanks for sharing such a valuable article.
Looking for a health insurance plan for my Father(63) and mother (57). I have selected floater
Religare Health insurance Pan due to some of its unique features like no sub limit on Room and ICU
charges, Auto recharge of the policy Sum Insured if exhausted,No Claim based loading ever & Get
Lifetime renewability,Get health check-ups for insured members every year.
I am concerened with its low Incurred Claim ratio as compared with PSU and some private
companies having TPA.Also have seen lot of negative reviews abouth Religare during claim
settlement.Whats your take on this?
Looking for Company having hassle free cashless treatment and smooth claim settlement when its
required.
Which is better option to buy a Policy ,to buy policy through company itself of through financial
website like PolicyBazar,etc.
Please guide me.
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Reply

April 3, 2015 at 11:39 AM
Abhishek-I have policy with Religare. Better to go directly to Insurance Companies. I dont
believe neither financial websites nor policybazaar.
Reply
NKP says
April 3, 2015 at 6:20 PM
Dear Abhishek
I had also almost finalised a religare policy for parents (aged 57 & 54) . All other features are
good compared to other companies. Only shortcoming is Religare doesnt cover the cost incurred
towards prosthesis. I dropped religare at that point of time. These days after 50 years, knee/hip
joint replacement are not uncommon. Cost of prosthesis is very high.
Take a decision based on family history.
Reply
NKP says
April 3, 2015 at 6:36 PM
Dear Abhishek
You please download the policy wording from Religare website and go through it word-byword. It make take some time but its worth doing.
Reply
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Raghavendra says
March 31, 2015 at 4:36 PM
Dear Basavaraj,
I am a 30 year old software engineer working in bangalore. I dont have any pre-existing illness.
Below are my existing policies:
Oriental Family Floater Silver Plan (Myself, Spouse and My Mother) : Sum assured of 6 Lakhs
HDFC CLick to Protect Plus Term Insurance (Myself) : Sum assured of 1 crore
I am thinking of going for a critical illness plan for myself and policy bazaar recommend me Religare
Assure and after reading the product brochure it sounds good.
Could you please suggest me can i rely upon Religare Assure or should i go for Max Bupa or Bharti
Axa?
What sum assured should i go for or how do i know how much sum assured i should go for?
Should i go for Individual/Family when it comes to critical illness?
And finally am i insured sufficiently with my existing insurance portfolio or do you recommend any
other extra add on to my insurance portfolio?
Many thanks for your assisstance in advance
Thanks and Best Regards,
Raghavendra P
Reply

March 31, 2015 at 5:56 PM
Raghavendra-If Religare plan features attractive to you then go ahead. How much you need and
whether the current life and health insurance are suffice or not depends on many things. So I
cant say in one word. Better you buy family floater critical illness cover.
Reply
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prasanna says
March 30, 2015 at 10:18 AM
Hello Basavaraj,
In 2014 article (http://www.basunivesh.com/2014/05/12/best-health-insurance-companies-inindia-based-on-irda-data/) you tabulated the health insurance based on Individual/Family/Group.
My question is what does the above table ICR specify for Individual/Family/Group?
Because i see Religare ICR is 67.8%, 70.23% & 108.61% respectively for Individual/Family/Group.
This variation is huge for HDFC ergo.
~Cheers
Prasanna
Reply
Basawaraj says
March 28, 2015 at 10:30 AM
Dear Mr.Basavaraj,
I , Am 37 Years Old , Looking For A New Medical Insurance For Me And My Family. Wife Is 33 Yrs
And Son 5 Yrs. Looking For A Cover Of Around 10 Lakh Rupees. I Have Zeroed In On Religare- Care
, Star- Optima , ICICI Complete , And Max Bupa Heart Beat( Its Expensive). Could U Please
Suggest Which One is Better. Many Thanks In Advance.
Basawaraj Tegnoor.
Reply

March 28, 2015 at 2:12 PM
Basawaraj-I prefers Religare and Apollo.
Reply
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shweta aggarwal says

March 23, 2015 at 2:20 PM
i have checked the claim settlement ratio and claim incurred ratio of new india assurance. both the
percentages are very good.
Reply
pradeep says
March 22, 2015 at 12:20 AM
Mr basu you will yourself know that religare never replies for customer queries .totally inefficient
staff
Reply

March 23, 2015 at 1:25 PM
Pradeep-But in my case it is not like that
Reply
pradeep says
March 22, 2015 at 12:16 AM
Mr basu u have purchased your health policy from religare .if u go for hospitalization they will never
pay u
Believe my words
I wish u get your claim when u are in most need of money
Reply
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March 23, 2015 at 1:26 PM
Pradeep-In my case no such bad experience.
Reply
vishal says
March 28, 2015 at 10:18 PM
brother you are very rite chor hai sale kutte. mera 73000 ka claim reject kr dia or no reply
Reply

March 29, 2015 at 8:46 AM
Vishal-Please use a proper language. I will not allow such harsh words.
Reply
Mahi says
March 19, 2015 at 1:31 AM
Hi Basu,
Very Interesting blog.
I have a 6 Lakhs cover from Reliance General Insurance and I liked their services so far.
In none of your blogs, I could read Reliance. Do you suggest to change from my existing insurer to
some other company.
Reply
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March 19, 2015 at 10:12 AM
Mahi-If you satisfied with their service then why to change?
Reply
Anirban says
March 14, 2015 at 6:16 PM
First of all thanks for such valuable information.
I am looking for a health insurance, Comparing with these three: Apollo Munich, Max Bupa and
Religare? Which One you recommend although i know you have Religare for yourself. But i am little
bit confuse about these threes claim settlement. My Age: 27, Wife:26. Lived in Gurgaon, Looking for
2lac Yearly Packages for two member. No pre existing diseases to both.
Regards
Anirban
Reply

March 15, 2015 at 8:35 AM
Anirban-But look at current year data at IRDA Incurred Claim Ratio-How to choose the best
health Insurance? and then decide
Reply
Kss says
March 27, 2015 at 9:57 PM
dont go for apollo munich,it cheats customers
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Reply
Rahul says
March 3, 2015 at 5:36 PM
Dear Basavaraj,
Need a suggestion. I am 36yrs, planning to get a health insurance for myself for a cover of 5 Lakhs. I
am thinking to split the sum insured in half and go with 2 different company. One with Private player,
other with Govt firm. Reason being that govt players settlement/claim ratio is always higher than
private players, but at the same time private players have more better coverage for cashless
hospitalization. So basically putting money in 2 basket approach. Is this planning correct or better go
with one firm? In that case which one will be better govt or private.
Secondly Which private players you would suggest I have shortlisted ICICI Lombard But
premium too high; Religare dont know if its reliable + claim ratio very avg/low ; Apollo Munich
Claim Ratio again very very low.
Public player United Insurance ; Oriental.
Please help in the following matter.
Reply

March 3, 2015 at 7:28 PM
Rahul-I dont think it is wise to split. You can check with ICICI, HDFC, Bajaja, and the
companies you mentioned.
Reply
Rahul says
March 4, 2015 at 11:57 AM
So you are suggesting me to better go with a Private player. Any specific reason for that
(since this suggestion will really help me in purchasing, as I am about to buy a health
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insurance today).
Secondly Religare settlement ratio is on the lesser side and thats a stand alone firm, will it
adviseable to purchase it.
Reply

March 4, 2015 at 3:17 PM
Rahul-I have not specified any particular company. First you must understand your
requirement, premium budget, company existence and service part. Then go ahead
with buying. I prefer standalone companies mainly because of expecting claims settled
at earliest.
Reply
Rahul says
March 4, 2015 at 10:29 PM
So this is where my problem of selection is coming. Premium is fine with me, but
service is a major aspect, where I am not getting that comfort with Public firm,
but then their claim settlement ratio is probably the best.
Now for example In private player, Religare is giving a product which is value
for money; but their sustainability in the insurance business is a question mark.
Whereas ICICI is a stable company, but their product has lot of loop holes.
So what should I do, please help.
Reply

March 5, 2015 at 8:16 AM
Rahul-A hint to go ahead
I personally have my insurance with Religare.
Because of its features, affordability and service they provided.
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Reply
atul dhumal says

February 23, 2015 at 8:14 PM
Hello ,
I want to take General Insurance agency ,with whom i can go New India Assurance or Religare.
Regards,
Atul
9595452646
Reply

Atul-It is hard for me to suggest.
Reply
sunil says
i would like to know your views on the following with regard to health insurance.
1. for a family of 4 (2adults and2 children), instead of taking a single family floater policy, would it be
wiser to go for 2 floater policies each for 1A+1C. logic is the chances of adults getting ill is more with
age.
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2. your opinion about top up/super topup plans.

3. which of the 3 is bettera) single plan with large sum insured say 10 to 15lakh coverage or b) one
plan for 10L and a top up of another 5 to 10lakhs or c) one small plan, family floater of 2 to 3 lakhs to
cover small illness and a top up orseperate policy for a larger sum.
4. there are conflicting opinion regarding need of critical illness plan. your take on that.
i am presuming a small healthy middle aged family of 35 to 40 yrs with no history or predisposition to
any major illness for self or in family
Reply

Sunil- 1) What about the cost? 2) Its good option. 3) It depends on your requirement and
affordability. 4) Yesbecause it is complicated product. Also I suggest to you have if you have
any family history of such critical deceases.
Reply
Sumi says
Dear Sir,
I am 35 years of age and I want to go for the Happy Family Floater of Oriental Health Insurance. I
want to cover my mother, 60 years of age and my sister (31 years) and brother (25 years). We don
not have any preexisting illness but my father has cancer, detected on 2011 who cannot be covered
under the plan now. The IRDA chart provided by you gives a good policy claim percentage to Oriental
Insurance but is it hassle free? I have read certain online reviews which say that in Oriental the
insurer has to run from pillar to post during claim settlement and hence private companies like Star
and Religare are the better ones during settlement. Kindly provide me your suggestion regarding this
matter. Public sector companies have less premium which suits my budget as my fathers treatment
needs a good amount of money.
Reply
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Sumi-No need to worry about Oriental. But it concerns you then opt Star or Religare (both are
best and I personally have insurance with Religare).
Reply
Ramakrushna says
Dear Mr. Basavaraj,
I am Ram. .
My age is 26 Years. (Single)
Fathers age 63 Years. (existing disease blood pressure)
Mothers age 52 Years (Asthma but not been in any major treatment)
Currently I am having health insurance for self of 2Lakhs and family health insurance of cover 3
Lakhs for parents from one of the corporate plan from mediassist ,
From coming march i want to opt for one private company health insurance of cover 5 Lakhs or more
for me and my parents either individually for me or group wise.
Please suggest me on this.
BR,
Ram
Reply

Ramkrushna-Is there any specific reason for opting of private insurer?
Reply
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Uttam Sahu says

Dear Mr.Basavaraj
I am very much impressed on this financial planning blog.At present ,I dont have any health
insurance.I have decided that I would like to buy Apollo Munich family floater plan in online mode.To
resolve my query,one support staff called me and described the query.He also said that insurer do
not require to send any document regarding KYC,no photo whereas in offline mode Kyc would be
accepted.Would it be better to buy without Kyc and photograph and no signature in online mode?
Waiting for your valuable suggestion.
Reply

Uttam-Nothing wrong in this. At the time of claim you need to produce the ID Proof.
Reply
Neil G says
Hi Sir,
Pls advise on this Money Back plans from AXA Bharti AXA Aajeevan Sampatti Whether this is a
good product to buy benefit ot expense ratio ? pls advise looking forward to your suggestion on this.
Reply
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Vijay says
Hi Mr.Basavraj,
I am 35 yrs of age based at Chennai & would like to take a family floater policy for 10 lakhs ( wife
-28yrs of age & Son 07 yrs & daughter 03 yrs ).No pre existing deseases. Have short listed Apollo
Munich and ICICI lombard.But confused between these two due to the Incurred claim ratio data
available at IRDA. Request your valuable suggestion regarding these 02 policies.
Reply

February 4, 2015 at 11:13 AM
Vijay-In my view both are good. So you can go ahead any one of your choice.
Reply
Sudheer says
January 21, 2015 at 9:27 PM
Hi basu season greetings.
I would like to invest Rs. 20000/ in NFO from BIRLA SUN LIFE MANUFACTURING EQUITY
FUND. Bcoz I am thinking that it would be advantageous to invest now in such funds as campaigning
is going on MAKE IN INDIA during MODI term.
what ll u suggest. Is it wise to invest in such funds? Pl share your knowledge.
Reply
Sudheer says
January 23, 2015 at 12:37 PM
Hi basu pl I am waiting for ur reply.
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Reply

January 23, 2015 at 12:55 PM
Sudheer-Investing based on political gimmick? what if the next day BJP outs Modi from PC
chair? Be optimistic. But not over optimistic on political issues. Because anything can
happen when it comes to politics. Instead think of long term growth. Stay away from NFOs.
Instead choose the fund which is consistent performer. NFOs are meant for agents
lucrative business module but not investors.
Reply
Sudheer says
Thanks basu. U r right.
Reply
Sachin says
Hi Basavaraj ,
Thanks for sharing such a valuable information to all of us. thanks a lot.
Need your valuable advise to continue with same company or change it and sum assured needs to
increase or continue with same.
I am 30 years old, spouse and 2 kids. Income: 30-35 K/Month
1. Life insurance : LIC policy Jeevan saral , Period: 20 years, Sum assured 5 Lacks, Premium half
yearly 12.5 k .. pl. advise continue with same plan or buy any new plan from LIC only.suggest
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sum assured also.

2. Health Insurance: Iffco Tokio SKP (Family Health Policy), Persons covered : 4 ,
1 year (renewal lifetime) , Sum assured 3 Lacks , Premiun 5 K Yearly . pl. advise continue with
same plan and company or buy a new one from any other company (please suggest company name
and plan).
3. Term Insurance: Bharti AXA eProtect , 1 year (renewal lifetime) , Sum assured 50 Lacks , persons
covered , 1, Premiun 5 K Yearly . pl. advise continue with same plan and company or buy a new one
from any other company (please suggest company name and plan).
Father and Mother : Need separate health and life insurance plan for both.
Father age: 54 Years till 20th March 2015, Mother age: 52 Years.
1. Life insurance : LIC policy Jeevan saral and Money Back , Period 20 years , Sum assured 5 Lacks.
pl. advise if needs to buy any new plan from LIC only.suggest sum assured also.
2. Health Insurance: Iffco Tokio (Individual Health Policy) : Persons covered : 2,
1 year (renewal lifetime), Sum assured 2 Lacks , Premiun 5 K Yearly . pl. advise continue with same
plan and company or buy a new one from any other company (please suggest company name and
plan).
3. Term Insurance: NO term insurance. . pl. advise
Reply

Sachin-I cant plan your life planning by commenting.
Reply
Didagur says
January 21, 2015 at 8:33 AM
I am lucky to come across your blog three days ago while surfing.I am really impressed.
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1)I do not have any health insurence for me and family.Suggest me best one which covers
family,spouse & 2 kids.Suppose I do not claim anything for 5 years in a row how the premium will be
calculated.
2)I also do not have any term plan as I was not aware either its importance,heeded to advices of
friends and relatives who happen to be LIC agents and took many policies like plus,money back and
recently Jeevan anand for 10lac cover with yearly premium 80k.Is it possible to reduce this to 5
lac,close,surrender or post paid(wait for maturity without paying now).kindly advice.
Many thanks.
Reply

January 21, 2015 at 12:49 PM
Didagur-You can buy the health insurance from any of the public sector or in private sectors, I
prefer star, apollo of maxbupa. First understand how much insurance you need. Check the
premium affordability and features. Then go ahead. Regarding term insurance, you can go with
LIC (online), HDFC, ICICI, SBI or MaxLife. I dont think you can reduce the sum assured. But
still suggest you to contact LIC branch and discuss the same with them (avoid agents for this).
Reply
Didagur says
Grateful to you Basavaraj,Many many thanks for the advice.
Reply
Didagur says
Dear Basu,
But can you tell me wheather I can surrender or stop paying premiums of Jeevan
Anand and wait for the policy to mature. I have paid 4 years with 80k/annum
premium.This is huge on me and that too with low returns.Or will you advice me to
continue?
Kindly reply ,your advice and guidance appreciated.
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Thanks again.
Reply

January 27, 2015 at 11:45 AM
Didagur-First visit LIC office. Check for both surrender and paid up value. Share
with me then we discuss.
Reply
Didagur says
Thank you Basavaraj.
Sure I will visit LIC office,I am on official assignment for few months abroad.(
I could visit many sites including yours,the best one, to know about finacial
management during my free time)I am grateful to you for guiding me.So
many eye-openers for me after going through your blog.Love to meet up
with you once.
Many Thanks again.
Reply

Didagur-Pleasure
Reply
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sevan says
January 14, 2015 at 11:45 AM
Sir,
In such scenario is it not better to take an health insurance from a company which does not have
claim based loading?
Reply

Sevan-It is hypothetical also to say that loss making companies load the premium. It is just an
assumption or one way of filling their loss.
Reply
Atul Shirodkar says

January 14, 2015 at 10:19 AM
Hi, I am looking for a mediclaim policy for my senior citizen parents. The yave a pre history of diabets
and BP. I have gone through many policies for now bu confused now. Can you help me guide on which
policy can be benificial?
Reply

Atul-You go through my earlier post Best Senior Citizen Health Insurance in India-Product
Comparison
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Reply
Dev says
The link to policyadvisor is and affiliate link which is not explicitly mentioned. While using affiliate link
is okay but in the interest of transparency such details should be mentioned.
Reply

Dev-I understand your concern. But I am not promoting myself that one must use their facility.
If you found interesting and customer friendly then why cant use it?
Reply
Nagaraja says
Dear Basu hope all is well. Now I am doing Mutual Funds i full fledge. NOw my AUM crossed 5 Lakhs.
Just in 5 months. All from your guidance. NJ welath providing good service and technology. thank
you.
I am still in confusion about Health Insurance. Let us say I am doing X company Health Insurance.
which CIR is 67.21%. Is that worth doing business with that company.
Thank you.
Nagaraj.
Reply
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Nagaraja-Nothing wrong. Let your client be disclosed all facts and if claims are genuine then why
to worry?
Reply
sandeep says
January 12, 2015 at 11:38 PM
Good to know. Thanks for the information.
So, the public sector companies are in loss..:)
Does it also mean that they can recover the loss by rejecting some of the cases?
Thanks
Sandeep
Reply

Sandeep-They not recover the loss by rejecting claims, but every possibility that of loading your
premium next time.
Reply
satyendra kumar singh says

i want know about policy.
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Reply

Satyendra-Policy of what???
Reply
sashikumar says
Do u have any data Claim settlement ratios ?
For a layman the incurred claim ratios doesnt make any sense ??
Reply

January 12, 2015 at 10:07 AM
Sashikumar-For General Insurance companies, usually the data will be Incurred Claim Ratio
rather than claim settlement ratio. I stated the difference between two. Claim Settlement ratio
will be for Life Insurance companies. This is how the data is compiled and presented by IRDA.
Reply

March 23, 2015 at 2:02 PM
hello
i am 30 years old and was looking for a health plan for my family.. my husband and 2 kids.
out of various options i have short listed two companies religare and new india assurance.
can you suggest me which would be a better option. which company would be more efficient
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in settling my claims?
Reply

March 23, 2015 at 2:08 PM
Shweta-Frankly to say, both are good. But first understand who fulfills your plan
features or premium budget. Then go ahead.
Reply

March 23, 2015 at 2:39 PM
obviously religare is providing better features but , but my concern is about
faith in case if any emergency arises who will full fill my needs better religare or
new india assurance.. can you list out few dis advantages of new india assurance
which i m not able to find out
Reply
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IRDA Incurred Claim Ratio-How to choose

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Malhari salunkhe says

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

anindya ghosh says

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

Basavaraj Tonagatti says

Basavaraj Tonagatti says

IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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IRDA Incurred Claim Ratio-How to choose the best health Insurance?

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