Is ACKO health insurance good? Complaints, claim record and who it suits
ACKO is a sound choice on the numbers. It settles 95.4% of health claims and draws 16.8 complaints per 10,000 claims, both in the better half of the health insurers we track (IRDAI published data, three-year average, as of March 2026). The catch is in the plan: ACKO Platinum has no restoration and no bonus.
Written by Shadab SayeedReviewed by Kshitij JainUpdated nyvo insurance Services LLP, IRDAI Corporate Agent (Composite) CA1085Salaried advisors, no commission-based ranking
This is independent information from nyvo insurance Services LLP, an IRDAI-registered corporate agent (licence CA1085). It is not ACKO's own website. The figures here are from IRDAI's published data and ACKO's own public disclosures.
ACKO at a glance
| Measure | ACKO | Source and context |
|---|---|---|
| Claim settlement ratio | 95.4% | 8th of 31 health insurers; we look for 93% or more. IRDAI published data, three-year average, as of March 2026 |
| Complaints per 10,000 claims | 16.8 | 12th of the 30 with a complaint figure, fewer is better. Same source, averaged 2022-25 |
| Complaints registered, 2025-26 | 1,092 | All of ACKO General's business, motor included (Form NL-45) |
| Of which about claims | 856 (78.4%) | Same form, all lines of business |
| Complaints against retail health plans | 155 | ACKO's Form NL-47 product table, 2025-26 |
| Complaints open on 31 March 2026 | 12 | 11 less than 15 days old |
| Plans we've read | 1 | From ACKO's own policy wordings |
ACKO settles 95.4% of its health insurance claims by number, which meets the 93% we look for in a health insurer. The year-by-year record, and how it compares with other insurers, is on our ACKO claim settlement ratio page.
Weighing ACKO against another insurer? A nyvo advisor will read both wordings with you and tell you plainly which one fits. The call is free.
Talk to an advisor →What do ACKO customers complain about?
Read ACKO's totals with one thing in mind: its grievance disclosure covers all of ACKO General Insurance's business, motor as well as health. For 2025-26 (Form NL-45, for the year to 31 March 2026) it lists 1,092 complaints, 856 of them, 78.4%, about claims, then 92 under "others" and 70 about policies.
The product table in the same disclosure (Form NL-47) narrows it to health. ACKO's retail health products drew 155 complaints in 2025-26: 143 against ACKO Personal Health Policy, 7 against Acko Health II and 5 against Arogya Sanjeevani. Its group health policy, sold to employers and other groups, drew 350. ACKO Platinum sits inside ACKO Health III, a product filed for 2026-27, so it isn't in that year's table yet.
ACKO closed the year with 12 complaints open, 11 of them less than 15 days old and one between 15 and 30 days. For the market, IRDAI's Annual Report 2024-25 says that of the grievances reported under general insurance business on its Bima Bharosa portal, the majority were related to claims (69 per cent).
| Complaint type | Complaints | Share |
|---|---|---|
| Claims | 856 | 78.4% |
| Others | 92 | 8.4% |
| Policy servicing | 70 | 6.4% |
| Premium | 24 | 2.2% |
| Refund | 16 | 1.5% |
| Coverage | 16 | 1.5% |
| Proposal | 14 | 1.3% |
| Product | 4 | 0.4% |
| Total | 1,092 | 100% |
Shares are our arithmetic on the counts ACKO discloses. Open on 31 March 2026: 12, 11 less than 15 days old and one between 15 and 30 days.
Who is ACKO good for, and who should look elsewhere?
With ACKO, the trade-off sits in the plan rather than the claim record. Platinum pays the room at actual cost and pays consumables, which removes two familiar reasons a claim gets cut. It has no restoration and no bonus, so the sum insured you buy is all you get in a year, and it doesn't grow.
ACKO can suit you if
- You want the room and the consumables paid in full. Platinum pays room rent and ICU at actual cost, with no cap, and pays consumables and other non-payable items.
- You don't want to wait for the basics. Platinum waives the 30-day initial wait and most specified-illness waits.
- You're buying a large sum insured. ACKO Health III runs from ₹3 lakh to ₹10 crore, plus an unlimited option.
- You're older and buying fresh. There's no maximum entry age.
Look elsewhere if
- You expect more than one big claim in a year. There's no restoration: once a year's claims use up the sum insured, cover for that person ends until renewal.
- You want cover that grows in claim-free years. Platinum's wording has no bonus.
- You're planning a family. Maternity is excluded, and no benefit listed in the ACKO Health III prospectus adds it back.
- You have a pre-existing condition and want a fixed wait. ACKO's underwriting sets the wait on your schedule, and can add an exclusion or a sub-limit for a condition you declare.
Which ACKO plans have we read?
One, each from ACKO's own policy wording and prospectus rather than its marketing. Each page says what the plan leaves out as plainly as what it covers.
- Platinum (ACKO Health III)
No room cap, consumables paid, most waits waived. No restoration, no bonus and no maternity.
Our full ACKO Platinum review, compared with Optima Secure Plus and Care Supreme →
ACKO questions, answered
Does ACKO's complaint data cover only health insurance?
No. ACKO General Insurance's NL-45 disclosure counts complaints across all its business, motor included: 1,092 in 2025-26. The health-only view is in its NL-47 product table, where its retail health products drew 155 complaints and its group health policy 350 in the same year.
Does ACKO health insurance have a restoration benefit?
No, not on Platinum. The Platinum wording has no restore section, so once a year's claims use up the sum insured, cover for that person ends until renewal. There's no bonus either. If you choose ACKO, size the sum insured for a bad year rather than an average one.
Does ACKO health insurance cover maternity?
No. Childbirth is excluded on ACKO Platinum, as are miscarriage other than after an accident and medical termination, with ectopic pregnancy the only exception. No benefit listed in the ACKO Health III prospectus adds maternity back, so a couple planning a family should look at a plan that covers it.
How do I complain about ACKO?
Start with ACKO's own grievance desk and get a complaint reference number. The insurer has to resolve a grievance within 14 days (IRDAI Master Circular on Protection of Policyholders' Interests, 5 September 2024). If it doesn't, or the reply doesn't settle it, register the complaint on IRDAI's Bima Bharosa portal or call 155255. After that, the Insurance Ombudsman is free, and its award binds the insurer.
Sources
- ACKO General Insurance, public disclosure for Q4 2025-26: Form NL-45 Grievance Disposal and Form NL-47 Profile and Performance of Health, PA and Travel Products for FY 2025-26 (acko.com/gi/public-disclosure), read 24 October 2026.
- IRDAI Annual Report 2024-25, section II.6 (Grievances), Tables II.15 to II.17 and paragraphs II.6.8 and II.6.9, read 24 October 2026.
- Claim settlement ratios and complaints per 10,000 claims: IRDAI published data as compiled in our claim settlement ratio table.
- Plan facts: the nyvo policy database pages linked above, each built from ACKO's own wording.
Weighing ACKO against another insurer? A nyvo advisor will read both wordings with you and tell you plainly which one fits. The call is free.
Talk to an advisor →