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Check Insurer Claim Settlement Ratio With IRDAI Data Before You Buy

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.

At a glance: how to read each claim number

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.

How to actually look it up

  1. Go to the IRDAI website at https://irdai.gov.in and open the Reports and Statistics area. Download the latest Handbook on Indian Insurance Statistics. The 2024-25 edition was published in February 2026.
  2. Also download the latest IRDAI Annual Report from https://irdai.gov.in/annual-reports. It carries company wise claim figures for the year.
  3. For a life insurer, find the claims table and read its Claim Settlement Ratio, both by number of policies and by benefit amount. Note the figure for the last three or four years, not just one.
  4. For a health or general insurer, find the Incurred Claim Ratio table. Remember this is claim money over premium earned, so read it as a sustainability signal, not as a settlement rate.
  5. Open the insurer's own website and search for its public disclosures or policyholder handbook. Insurers must publish claim payment and rejection data there. Look for claims paid, claims repudiated and claims pending, counted by number.
  6. Write down all of it, the CSR or claims paid ratio, the ICR, and the rejection and pending counts, side by side for every insurer on your shortlist. Compare like with like: same year, same product type.

What the claim ratio does NOT tell you

A single ratio hides a lot. Before you decide, check the things a number cannot show.

  • How fast claims get paid. A high ratio can still hide long delays. Look separately for the claim turnaround time, or TAT, in the insurer's disclosures.
  • Why claims were rejected. A number never explains whether rejections were fair or harsh. Read the repudiation reasons and the fine print on waiting periods and exclusions.
  • How many customers complained. Check the grievance and complaint record. IRDAI runs the Bima Bharosa grievance portal at https://policyholder.gov.in, where insurers must resolve complaints within a set timeline.
  • Your own product. Company wide ratios mix every product together. Your specific plan can behave very differently from the average.
  • One good year. A single year can be a fluke. Always read three to four years, so a one off spike or dip does not mislead you.

A smarter pre-purchase checklist

  • Compare the right ratio for the right cover: CSR for life, ICR plus the claims paid count for health and general.
  • Read three to four years, not one. Look for steadiness, not a single high number.
  • Put the ICR next to the claims paid count. A high ICR with heavy rejections is a warning, not a comfort.
  • Check the complaint and grievance record on Bima Bharosa, and the claim turnaround time.
  • Read the exclusions, waiting periods and room rent limits. Most health claim fights start here, not in the ratio.
  • Prefer an insurer that is easy to reach and quick to respond over one with a slightly prettier number.
  • Keep proof. Save the disclosure page and note the date you checked, so you can compare again at renewal.

Frequently asked questions

What is a good claim settlement ratio for a life insurer?

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.

Is a high incurred claim ratio good or bad?

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.

Is the incurred claim ratio the same as the claim settlement ratio?

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.

Where does IRDAI publish claim data?

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.

Which number should I check for health insurance?

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.

Can a good ratio still mean my claim gets rejected?

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.

What if my genuine claim is rejected after I buy?

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.

Sources

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