Before you buy a policy, check the insurer's claim record that IRDAI already publishes: for a life insurance company look at its Claim Settlement Ratio, and for a health or general insurer look at its claims paid record. But treat any single number as a starting point, never the full story, because two very different ratios often get mixed up.
The two numbers people quote most, the Claim Settlement Ratio and the Incurred Claim Ratio, measure completely different things. Read this at a glance table first, so you know what each one is really telling you.
| Metric | What it measures | What a good value looks like | Where to find it |
|---|---|---|---|
| Claim Settlement Ratio, or CSR, for life insurers | Out of every 100 death claims received in a year, how many the insurer actually settled | Steady high 90s, around 98 to 99 percent, held for several years running | IRDAI Annual Report and Handbook on Indian Insurance Statistics, plus the insurer's public disclosures |
| Incurred Claim Ratio, or ICR, for health and general insurers | The total claim money paid out as a share of net premium earned. ICR is NOT the share of claims settled | There is no single good number. A commonly cited sustainable band is roughly 50 to 80 percent. Near or above 100 percent means the insurer paid out more than it earned. Very low can mean stingy payouts or simply high premiums | IRDAI Annual Report and Handbook on Indian Insurance Statistics on https://irdai.gov.in |
| Health claims paid ratio, by count | Out of every 100 health claims decided in a year, how many were paid rather than rejected or left pending | The higher the better, but always read it next to the rejection and pending numbers | The insurer's policyholder handbook and public claims disclosures, plus IRDAI claims data |
In plain words, for a life cover the CSR answers the question that matters most: will my family's claim get paid. For health cover the ICR answers a business question, how much of the premium the insurer spends on claims, not whether your own claim will be honoured. That is why a health insurer can show a healthy looking ICR and still reject claims. An insurer can even post a 99 percent settlement ratio while keeping a low ICR, by settling many small claims and pushing back on big hospital bills.
For scale, the whole non life insurance industry paid an overall ICR of about 82.88 percent in 2024-25, up slightly on the year before, with net claims of about ₹1.88 lakh crore, according to the IRDAI Annual Report 2024-25 as reported by CAalley. That is an industry average, not a score for any one insurer, so use it only as background.
A single ratio hides a lot. Before you decide, check the things a number cannot show.
A life insurer CSR in the high 90s, around 98 to 99 percent, held steady for several years, is generally seen as strong. IRDAI publishes this figure every year in its Annual Report and in the Handbook on Indian Insurance Statistics.
Neither on its own. A high ICR means the insurer paid out a large share of its premium as claims, which looks customer friendly but can hurt its profits and push future premiums up. A very low ICR can mean tight, stingy claim payment or simply high premiums. ICR is not a settlement rate.
No. The claim settlement ratio counts how many claims were settled out of those received. The incurred claim ratio measures claim money paid as a share of premium earned. An insurer can show a 99 percent settlement ratio yet keep a low ICR by settling many small claims and pushing back on big hospital bills.
On https://irdai.gov.in, in the IRDAI Annual Report and the Handbook on Indian Insurance Statistics. Each insurer also publishes its claim payment and rejection numbers in its own public disclosures and policyholder handbook.
Check the claims paid ratio by count, that is how many claims were paid out of those decided, and read it beside the rejection and pending numbers. Use the ICR only as a background sustainability signal, not as proof that your claim will be paid.
Yes. Ratios are company wide averages. Your own claim depends on your policy exclusions, waiting periods, disclosures and paperwork. Always read the fine print, not just the headline number.
Raise it with the insurer's grievance officer first. If it is not resolved in the set time, escalate on the IRDAI Bima Bharosa portal at https://policyholder.gov.in, and then to the Insurance Ombudsman if needed.