With the availability of numerous health insurance companies, selecting an appropriate and suitable health insurance plan has become quite a difficult task. Many times, you end up selecting an insurance plan that fails to meet your entire coverage requirements due to the lack of your awareness about health insurance. Thus, to make an informed selection while purchasing health insurance, one needs to have a thorough knowledge of various aspects.
The claim settlement ratio of the insurance company is one such aspect. In India, every health insurance company has a claim settlement ratio. Claim settlement is one of the important factors to be considered while selecting a health insurance company as it tells you about the claim settling ability of the insurance company. If the company is not able to settle claims in the given time period, then the whole purpose of purchasing insurance goes to vain.
In the article below, we will be discussing the HDFC ERGO Claim settlement ratio. Take a look below to explore the claim settlement ratio of HDFC ERGO health insurance and its claim settling process:
Claim Settlement Ratio or CSR, is the number of claims settled against the total number of filed claims during a financial year. Let's understand how CSR is determined:
For example, ABC health company has a total of 100 registered claims during a financial year, and it settled only 90 claims out of them, then the health claim settlement ratio of that health company will be 90% for that particular year.
Well, before buying any new product, we check its reliability and the brand's status. The same goes while buying a health insurance plan. By checking the claim settlement ratio of the company, one can get an insight into how the company is performing when it comes to claiming settlement.
Moreover, it will also give you an insight into the company's claim settlement ability. The higher the percentage, the better the company's ability to settle claims. Hence, this factor makes a company more trustworthy amongst its customers.
HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside in.
HDFC Health Insurance Claim Settlement Ratio 2021-22 | ||||||
Age Analysis of Number of Claims Paid (%) | < 3 months | 3 months to 6 months | 6 months to < 1 year | 1 year to < 3 year | 3 years to < 5 years | 5 years |
Claims Settled | 98.49 | 1.03 | 0.22 | 0.2 | 0.04 | 0.02 |
The Incurred Claim Ratio or ICR is the ratio of a health insurance company's net claims paid out to the total premium collected. For example, if an insurance company receives INR 10 crore in premium and pays out INR 8 crores in claims, the company's ICR would be 80%.
The greater the ICR, the better the insurance company's financial health. It means that the insurer is effectively resolving the majority of claims, which is something that every policyholder looks forward to while purchasing an insurance policy.
There is two ways to file a claim. Let's take a look at them one by one:
Cashless Claim Settlement Process
Reimbursement Claim Settlement Process
You can check the status of your claim through both online and offline mediums.
Procedure for Online
Procedure for Offline
You call the customer care executive at +91 120 6234 6234 to enquire about the status of your claim.
You can also visit the nearest branch of HDFC ergo general insurance company to know the status of your claim.
Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.