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Health insurance claim settlement ratio 2026
Go Digit has the highest health insurance claim settlement ratio in India at 99.0%, then Narayana Health Insurance at 98.5% and HDFC ERGO at 97.8%. Care Health settles 96.0%, Niva Bupa 93.3% and Star Health 89.3% (IRDAI data, three-year weighted average, latest as of March 2026). We count 93% or more as good.
Last checked against IRDAI's published data on
Written by Shadab SayeedReviewed by Kshitij JainUpdated nyvo insurance Services LLP, IRDAI Corporate Agent (Composite) CA1085Salaried advisors, no commission-based ranking
| Highest ratio | Go Digit, 99.0% |
|---|---|
| Care Health Insurance | 96.0%, ranked 7 of 31 |
| Niva Bupa | 93.3%, ranked 16 of 31 |
| Star Health | 89.3%, ranked 25 of 31 |
| Lowest ratio | Cholamandalam MS, 84.5% |
| Insurers at 93% or more | 18 of 31 |
| Complaints per 10,000 claims | 4.2 to 173.6, about 41 times apart |
| Source | IRDAI published data, weighted average of the last three financial years, latest available as of March 2026 |
Choosing between two of these for a new policy? A nyvo advisor can put their plans side by side for you, free. Talk to an advisor.
Health insurance or life insurance?
Both markets publish a claim settlement ratio and they are not comparable. Life insurers settle a death claim, which is a binary event with a fixed sum, so their ratios sit above 99% and barely separate anyone. Health insurers settle thousands of itemised hospital bills against policy terms, so their ratios sit lower and mean more.
Highest on this page: Go Digit at 99.0%. The full table of all 31 insurers, with complaint volume beside every ratio, is below.
Highest: HDFC Life at 99.6%, then Bandhan Life at 99.6% and Tata AIA at 99.5%. See every life insurer’s ratio.
What is a claim settlement ratio?
The claim settlement ratio (CSR) is the share of claims an insurer settled out of every claim it decided in a financial year: claims paid divided by claims paid plus claims rejected, counted by number rather than by rupees. A 96% ratio means 96 of every 100 claims closed were paid. The figures below are IRDAI's published data, as a three-year weighted average, latest available as of March 2026.
It is the number every insurer markets, and it is close to useless for choosing between them. Across the 31 health and general insurers below, settlement ratios span 14.5 percentage points and cluster near the top. Complaints per 10,000 claims span 4.2 to 173.6 – a spread of about 41 times – and measure something the settlement ratio cannot: how much friction customers met on the way to being paid.
Read the two together. Go Digit settles the highest share of claims at 99.0%, while Bajaj General draws the fewest complaints at 4.2 per 10,000. They are not the same insurer, and that is the point.
What this video covers (8 chapters)
- 0:00Claim settlement ratio: is 98% the full story?
- 0:25How the ratio is calculated (IRDAI public disclosures)
- 0:59NL-37: claims settled divided by claims received
- 1:30The catch: group and retail claims mixed
- 2:38NL-47: the ratio plan by plan
- 3:02ReAssure, Care Supreme, Optima Secure, Activ One, Elevate
- 4:10How to choose a health insurance plan
- 5:07Book a free call with a nyvo advisor
Why the settlement ratio cannot pick your insurer
Every health insurer we track, plotted on both measures. Settlement ratios sit inside 14.5 percentage points of each other. Complaint volumes run 41× from best to worst.
Each dot is one insurer. Hover a dot for the name. Green, amber and red use the same thresholds as every plan page on this site.
Claim settlement and complaint ratio, every health insurer
Sorted by settlement ratio, highest first. Complaint bars are scaled to the worst figure in the table.
 Go Digit | 99.0% | 19.9 |
|---|---|---|
 Narayana Health Insurance | 98.5% | 9.0 |
 HDFC ERGO | 97.8% | 8.3 |
 SBI General | 96.8% | 11.2 |
 Bajaj General | 96.6% | 4.2 |
 Aditya Birla Health Insurance | 96.5% | 18.2 |
 Care Health Insurance | 96.0% | 42.9 |
 Acko | 95.4% | 16.8 |
 New India Assurance | 95.0% | 5.9 |
 United India Insurance | 95.0% | 17.6 |
 Shriram General | 94.2% | 29.5 |
 National Insurance | 93.9% | 41.3 |
 ManipalCigna | 93.7% | 35.5 |
 Future Generali India | 93.7% | 12.1 |
_Limited.png&w=64&q=75){kind=small} Zurich Kotak General | 93.4% | 28.2 |
 Niva Bupa | 93.3% | 35.4 |
 Zuno General | 93.2% | 23.2 |
 The Oriental Insurance | 93.1% | NA |
 Universal Sompo | 90.3% | 5.1 |
 Galaxy Health Insurance | 90.0% | 25.9 |
 Liberty General | 90.0% | 15.0 |
 Magma General | 89.9% | 19.5 |
 Tata AIG | 89.5% | 11.6 |
 Raheja QBE General | 89.5% | 70.1 |
 Star Health | 89.3% | 53.9 |
 Royal Sundaram General | 89.0% | 24.3 |
 ICICI Lombard | 87.6% | 16.6 |
 IndusInd General | 87.3% | 4.4 |
 IFFCO Tokio | 85.8% | 46.8 |
 Navi General | 84.6% | 173.6 |
 Cholamandalam MS | 84.5% | 32.8 |
Both figures are a weighted average of the last three financial years, latest available as of March 2026, from IRDAI's published data. A general insurer's ratio blends motor and travel claims with health, which lifts it against a standalone health insurer. Oriental Insurance has no complaint figure in our source and shows NA rather than a zero.
A ratio ranks insurers, not plans. If you are choosing a policy, we rank the best health insurance plans for 2026 on claim record, cover and premium together.
Which health insurers have the highest claim settlement ratio?
On IRDAI's three-year data, the ten highest are Go Digit (99.0%), Narayana Health Insurance (98.5%), HDFC ERGO (97.8%), SBI General (96.8%), Bajaj General (96.6%), Aditya Birla Health Insurance (96.5%), Care Health Insurance (96.0%), Acko (95.4%), New India Assurance (95.0%) and United India Insurance (95.0%). All ten clear the 93% we count as good, and so do 8 more below them.
The order changes once you add complaints. Of those ten, only Narayana Health Insurance, HDFC ERGO, Bajaj General and New India Assurance draw fewer than 10 complaints per 10,000 claims. That is why we never pick an insurer on this column alone, and why the table above prints both.
What is Care Health Insurance's claim settlement ratio?
Care Health Insurance settles 96.0% of claims on IRDAI's three-year weighted average, latest as of March 2026, which ranks it 7 of 31 health insurers and above our 93% bar. It draws 42.9 complaints per 10,000 claims, ranked 26 of 30 on complaints, where first is fewest.
The figure is the insurer's, not a plan's, so Care Supreme and Care Ultimate carry the same 96.0%. Our Care Health claim settlement ratio page puts it beside its peers, and the Care Supreme review covers what the wording pays for.
What is Niva Bupa's claim settlement ratio?
Niva Bupa settles 93.3% of claims on the same IRDAI data, ranked 16 of 31, just over the 93% bar. It draws 35.4 complaints per 10,000 claims, fewer than Care Health's 42.9 and Star Health's 53.9. Star Health, at 89.3%, sits below the bar; the Star Health claim settlement ratio page explains what that does and does not mean for a claim.
Claim settlement ratio by insurer
A closer read on each of these insurers: its rank on both metrics, the insurers either side of it, and what the numbers do and do not tell you about a claim.
Full insurer reviews
Both ratios in context, every plan of theirs we have read from the policy wording, and how their claim process actually runs. All of them in one list: health insurance companies in India, A to Z.
Why a high ratio still does not mean your claim is safe
A settlement ratio is an average across every policy an insurer sells and every customer it has. It cannot know your waiting period, your room rent cap, your co-pay, or whether you declared the condition you already had.
It also groups a ₹8,000 day-care claim with a ₹20 lakh cancer claim and counts them the same. An insurer can decline the expensive, contested claims and still post a ratio in the high nineties, because the small ones dominate the count.
Before the ratio, check the clauses. We publish plain-English breakdowns of every plan we have read, and insurer-by-insurer claim guides covering how each one actually processes a claim.
The other ratio insurers quote
Claim settlement ratio counts how many claims an insurer paid. The incurred claim ratio measures something different: how much it paid out as a share of the premiums it collected. A high settlement ratio and a low incurred claim ratio can sit side by side, and the two answer different questions about the same company.
What the incurred claim ratio actually tells you →Looking for term insurance instead?
Life insurers settle death claims, which work differently: the amount ratio matters as much as the count, and Section 45 of the Insurance Act stops an insurer questioning a claim on non-disclosure after three years.
Term insurance claim settlement ratio, all 25 life insurers →Rank them by complaints instead
Settlement ratios here sit within a few percentage points of each other. Complaints run from 4.2 to 173.6 per 10,000 claims, a spread of about 41 times, so that column separates insurers this one cannot.
Health insurance complaint ratio, every insurer ranked →Claim ratio questions, answered
What is a claim settlement ratio?
The claim settlement ratio is the share of claims an insurer settled out of every claim it decided in a financial year, counted by number of claims rather than by rupees. A 96% ratio means 96 of every 100 claims the insurer closed were paid. It is published by IRDAI and it describes the insurer as a whole, not any one policy.
What is a good claim settlement ratio for health insurance?
93% or more is the working bar, and 18 of the 31 health insurers on this page clear it, with 21 settling 90% or more. Across all 31 the ratio spans 14.5 points, while complaint volumes differ about 41 times, so the ratio separates insurers far less than complaints do.
Which health insurer has the highest claim settlement ratio in India?
Go Digit leads at 99.0% on the three-year IRDAI average we hold, ahead of Narayana Health Insurance at 98.5% and HDFC ERGO at 97.8%. Read those beside the complaint column, because a high settlement ratio and a heavy complaint load can and do sit on the same insurer.
Which is better on claims, Niva Bupa or Care Health?
Care Health settles more claims, Niva Bupa draws fewer complaints. Care's ratio is 96.0% against Niva Bupa's 93.3%, both above our 93% bar, while Care draws 42.9 complaints per 10,000 claims against Niva Bupa's 35.4 (IRDAI data, three-year average). Neither gap is large, so the plan wording, Care Supreme against ReAssure 3.0 say, decides more.
What is the claim settlement ratio of Care Supreme?
IRDAI publishes the claim settlement ratio for an insurer, not for one plan, so Care Supreme carries Care Health Insurance's figure: 96.0%, as a three-year weighted average latest as of March 2026, ranked 7 of 31 health insurers. What decides a Care Supreme claim is its wording: waiting periods, room rent and disclosure.
What is the complaints ratio, and why does it matter more?
It is the number of complaints an insurer drew per 10,000 claims. It matters more because it actually discriminates: across health insurers it runs from about 4 to about 174, a spread of roughly 41 times, against a settlement-ratio spread of a few points. It also measures something a settlement ratio cannot, which is how much friction customers met on the way to being paid.
Does a high claim settlement ratio mean my claim will be paid?
No. The ratio is an average across every policy the insurer sells and every customer it has. Your claim turns on your policy's own terms: the waiting period on a condition you already had, a room rent cap, a co-pay, whether restoration applies to the same illness, and whether you disclosed your history accurately when you bought. A 98% insurer will still decline a claim that falls inside a waiting period.
Why do general insurers show higher ratios than health-only insurers?
A general insurer settles motor and travel claims alongside health. Those are smaller, simpler and settle easily, so they lift the blended figure. A standalone health insurer's ratio is health claims only. Comparing the two directly flatters the general insurer.
Where does this data come from?
IRDAI's published disclosures, taken as a weighted average of the last three financial years so a single unusual year does not swing the figure, latest available as of March 2026. Oriental Insurance has no complaint figure in the source we hold, so it shows NA rather than a zero.
How often does the claim settlement ratio change?
Once a year, when IRDAI publishes. Because the figures on this page are a three-year weighted average, they move slowly and a single year rarely shifts an insurer's position much.
There is more to a policy than these two numbers
Both figures on this page describe the insurer, across every policy it sells and every customer it has. Neither describes the policy you are about to buy, and neither can tell you whether your claim will be paid.
What decides that sits in the wording: the waiting period on the condition you already have, whether there is a room rent cap that shrinks the bill proportionately, what the co-pay is at your age, whether restoration triggers for the same illness, and whether the hospital you would actually use is in the network. A high settlement ratio does not rescue a claim that falls foul of any of them.
Sources
- Claim settlement ratios and complaints per 10,000 claims: IRDAI published data, weighted average of the last three financial years, latest available as of March 2026, as held in nyvo's insurer registry and last checked 26 July 2026. IRDAI's annual reports: irdai.gov.in/annual-reports, read 24 October 2026.
- We hold the three-year average, not each year separately, so this page does not print a year-by-year table.