Most health insurance companies in India publish claim settlement ratios that look reassuring at first glance. Figures above 90% suggest that claims are handled smoothly and that policyholders have little to worry about.

But the picture changes once you understand how these claims are counted. A claim can be recorded as settled even when the payout is small or the process is long and frustrating. That gap between the number and the experience raises a simple question: do claim settlement ratios reflect the real story, or only the part that looks good?

The claim settlement ratio shows the percentage of claims an insurer marks as settled in a given year. If a company receives 10,000 claims and pays any amount of 9,500, the ratio becomes 95%.

The metric is easy to understand, which is why

See Full Page