Insurance Brokers Association Of India - Ibai
INSURANCE BROKERS ASSOCIATION OF INDIAGENERAL INSURANCE CLAIM INSIGHTSA POLICYHOLDERS HANDBOOK - 5th Edition1
CONTENTCONTENT2ABOUT THE HANDBOOK4ABOUT INSURANCE BROKERS4ABOUT INSURANCE BROKERS ASSOCIATION OF INDIA4METHODOLOGY5OVERALL INSURERS’ COMPARISON: SOLVENCY RATIO10OVERALL INSURERS’ COMPARISON: CLAIMS SETTLEMENT RATIO12OVERALL INSURERS’ COMPARISON: CLAIMS SETTLEMENT EFFICIENCY RATIO14OVERALL INSURERS’ COMPARISON: CLAIMS REPUDIATION RATIO16OVERALL INSURERS’ COMPARISON: CLAIMS CLOSED RATIO18OVERALL INSURERS’ COMPARISON: CLAIMS OUTSTANDING RATIO20OVERALL INSURERS’ COMPARISON: CLAIMS PENDENCY RATIO23FIRE: CLAIMS SETTLEMENT RATIO25FIRE: CLAIMS SETTLEMENT EFFICIENCY RATIO27FIRE: CLAIMS REPUDIATION RATIO29FIRE: CLAIMS CLOSED RATIO31FIRE: CLAIMS OUTSTANDING RATIO33FIRE: CLAIMS PENDENCY RATIO35MARINE CARGO: CLAIMS SETTLEMENT RATIO37MARINE CARGO: CLAIMS SETTLEMENT EFFICIENCY RATIO39MARINE CARGO: CLAIMS REPUDIATION RATIO41MARINE CARGO: CLAIMS CLOSED RATIO43MARINE CARGO: CLAIMS OUTSTANDING RATIO45MARINE CARGO: CLAIMS PENDENCY RATIO47MARINE HULL: CLAIMS SETTLEMENT RATIO49MARINE HULL: CLAIMS SETTLEMENT EFFICIENCY RATIO50MARINE HULL: CLAIMS REPUDIATION RATIO51MARINE HULL: CLAIMS CLOSED RATIO52MARINE HULL: CLAIMS OUTSTANDING RATIO532
CONTENTMARINE HULL: CLAIMS PENDENCY RATIO54MOTOR OD: CLAIMS SETTLEMENT RATIO55MOTOR OD: CLAIMS SETTLEMENT EFFICIENCY RATIO57MOTOR OD: CLAIMS REPUDIATION RATIO59MOTOR OD: CLAIMS CLOSED RATIO61MOTOR OD: CLAIMS OUTSTANDING RATIO63MOTOR OD: CLAIMS PENDENCY RATIO65MOTOR TP: CLAIMS SETTLEMENT RATIO67MOTOR TP: CLAIMS SETTLEMENT EFFICIENCY RATIO69MOTOR TP: CLAIMS REPUDIATION RATIO71MOTOR TP: CLAIMS CLOSED RATIO73MOTOR TP: CLAIMS OUTSTANDING RATIO75MOTOR TP: CLAIMS PENDENCY RATIO77HEALTH: CLAIMS SETTLEMENT RATIO79HEALTH: CLAIMS SETTLEMENT EFFICIENCY RATIO81HEALTH: CLAIMS REPUDIATION RATIO83HEALTH: CLAIMS CLOSED RATIO85HEALTH: CLAIMS OUTSTANDING RATIO87HEALTH: CLAIMS PENDENCY RATIO89MISCELLANEOUS: CLAIMS SETTLEMENT RATIO91MISCELLANEOUS: CLAIMS SETTLEMENT EFFICIENCY RATIO93MISCELLANEOUS: CLAIMS REPUDIATION RATIO95MISCELLANEOUS: CLAIMS CLOSED RATIO97MISCELLANEOUS: CLAIMS OUTSTANDING RATIO99MISCELLANEOUS: CLAIMS PENDENCY RATIO101SOURCES AND LIMITATIONS OF CONSIDERED DATA103WHY AVAIL OF AN INSURANCE BROKER?106GLOSSARY107DISCLAIMER1083
ABOUT THE HANDBOOKThis handbook is a part of the continued efforts of the Insurance Brokers Association of India (IBAI) toprovide additional data to help policyholders make an informed decision by analyzing general insurersfrom a claims perspective.ABOUT INSURANCE BROKERSInsurance Brokers are the only intermediaries who represent the policyholders and are regulated bythe IRDAI (Insurance Brokers) Regulations, 2018. Insurance brokers are the fastest growing amonginsurance distribution channels contributing to about INR 30,360 crores of gross direct premium inFY18-19 resulting in around 26% of the non-life insurance premium. As per the EY Vision 2025 reporton Insurance Brokers Driving Customer Centric Growth, it is expected that insurance broking willcontribute close to 40% of gross direct premium in non-life insurance in the progressive scenario. Asper the report, non-life insurance market in 2025 is expected to be at Rs. 4,00,000 Crs and brokers’market share is likely to be around Rs.1,60,000 Crs.ABOUT INSURANCE BROKERS ASSOCIATION OF INDIAInsurance Brokers Association of India (IBAI) is the only Insurance Regulatory and DevelopmentAuthority of India (IRDAI) recognized apex body of licensed Insurance Brokers. As per IRDAI(Insurance Brokers) Regulations, 2018 framed by the IRDAI, all licensed Brokers are required to bemembers of IBAI. As of 31st December, 2020, there are 485 insurance brokers in India, includingDirect Insurance Brokers, Composite Insurance Brokers and Re-insurance Brokers.4
METHODOLOGYThis study considers the following criteria to analyze the claims data of insurers, which are publishedon their respective websites as a part of IRDAI Regulations.The entire data used in this handbook is objective and based on public disclosures by each insurerthemselves on their websites as required under IRDAI’s public disclosure of data requirements. Ratioshave been calculated to compare the data with complete transparency. Thus, the ratio calculations areentirely objective and none of the factors involve personal opinions or biases. The outcomes are datadriven.Please note the denominator for the various ratios (except solvency ratio) is defined as below:Total Claims Available for Processing Total Claims Outstanding at the beginning of the Quarterended June 30th, 2019 Total Claims Reported during the year ended March 31st, 2020.Please note each of these ratios is in percentage terms, calculated according to the formulae defined below.1. Solvency RatioIt measures the extent to which assets cover expected future payments (i. e., claims). IRDAI requiresinsurers to maintain a solvency minimum of 1.5 at all times.2. Claims Settlement RatioThe number of claims settled during the year from the total claims available for processing.Higher the claims settlement ratio, better is an insurance company in terms of the measured ratioClaims Settlement Ratio Total number of claims settled for the year ending March 31st, 2020Total Claims available for processing for the year ending March 31st, 20203. Claims Settlement Efficiency RatioThe efficiency of an insurance company to settle the claims, i.e., the number of claims settled in3 months as compared to the total number of claims available for processing.Higher the claims settlement efficiency ratio, better is an insurance company in terms of the measured ratio5
METHODOLOGYClaims Settlement Efficiency Ratio Sum of Total number of claims settled within 3 months for quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 20204. Claims Repudiation RatioThe number of claims that were repudiated by the insurer out of the total number of claims availablefor processing.Lower the claims repudiation ratio, better is an insurance company in terms of the measured ratioClaims Repudiation Ratio Total number of claims repudiated during the year ending March 31st, 2020Total Claims available for processing for the year ending March 31st, 20205. Claims Closed RatioThe number of claims that were closed by the insurer out of the total number of claims available forprocessing.Lower the claims closed ratio, better is an insurance company in terms of the measured ratioClaims Closed Ratio Total number of claims closed during the year ending March 31st, 2020Total Claims available for processing for the year ending March 31st, 20206. Claims Outstanding RatioThe number of claims that were outstanding out of the total number of claims available for processing.Lower the claims outstanding ratio, better is an insurance company in terms of the measured ratioClaims Outstanding Ratio Total number of claims outstanding as on March 31st, 2020Total Claims available for processing for the year ending March 31st, 20206
METHODOLOGY7. Claims Pendency RatioThe number of claims that are pending for more than 1 year out of the total number of claimsavailable for processing.Lower the claims pendency ratio, better is an insurance company in terms of the measured ratioClaims Pendency Ratio Total number of claims outstanding for more than 1 year as on March 31st, 2020Total Claims available for processing for the year ending March 31st, 2020Insurers are evaluated and ranked on the above 7 criteria for individual lines of business, i.e., Fire,Marine Cargo, Marine Hull, Motor Own Damage, Motor Third Party, Health and Miscellaneous andfor all lines of business combined.Insurer Categories:Insurers are categorized into four different categories according to the Gross Premium Writtenby them in that line of business for the year ended 31st March 2020 based on segmentwise datashared by the General Insurance Council. For ratios based on all lines of business combined, thetotal premium written is considered.I. Public Sector General InsurersII. Large Private Sector General Insurers:The top 10 private sector general insurers on the basis of the gross premium written in that lineof business for line of businesswise ratios for the specified period.III. Other Private Sector Insurers: The remaining private sector insurers.IV. Standalone Health Insurers:The various claims ratios were considered for the Health and Miscellaneous line of businessonly for the following a. Max Bupa Health Insuranceb. Care Health Insurancec. Star Health and Allied Insuranced. Manipal Cigna Health Insurancee. Aditya Birla Health Insurance7
OVERALL INSURERS’ COMPARISON: SOLVENCY RATIOSolvency Ratio as on March 31st, 2020 - It measures the extent to which assets cover expected futurepayments (i. e., claims). IRDAI requires insurers to maintain a solvency minimum of 1.5 at all times.The comparison of the below ratios is based on the findings of the previous editions of the IBAIGeneral Insurance Claim Insights Handbook based on data disclosed for the years ending March 31st,2018 and March 31st, 2019 respectively.PUBLIC SECTOR GENERAL INSURERSRank1234InsurerNew IndiaOriental InsuranceUnitedNationalSOLVENCY RATIO(As on March 31, 2020)(As on March 31, 2019)(As on March 31, .55LARGE PRIVATE SECTOR GENERAL INSURERSRank12345678910InsurerBajaj AllianzSBI GeneralICICI LombardHDFC ERGOTATA AIGRoyal SundaramIFFCO TokioCholamandalamRelianceFuture GeneraliSOLVENCY RATIO(As on March 31, 2020)(As on March 31, 2019)(As on March 31, 1.692.211.621.611.681.69SMALL PRIVATE SECTOR GENERAL INSURERSRank1234567InsurerAckoShriram GeneralNavi GeneralGo DigitRaheja QBEEdelweissUniversal SompoSOLVENCY RATIO(As on March 31, 2020)(As on March 31, 2019)(As on March 31, .832.402.24NA2.35NANA4.00 qNA2.308
SMALL PRIVATE SECTOR GENERAL INSURERSRank891011InsurerLiberty VideoconKotak Mahindra GeneralMagma HDIBharti AXASOLVENCY RATIO(As on March 31, 2020)(As on March 31, 2019)(As on March 31, .86STANDALONE HEALTH INSURERSRank12345InsurerManipal CignaStar HealthAditya Birla HealthMax BupaCare HealthSOLVENCY RATIO(As on March 31, 2020)(As on March 31, 2019)(As on March 31, .771.672.111.56Note: The IRDAI prescribed minimum solvency ratio is 1.5 to be maintained at all times. This ratio isbased on the net written premium and net written claims.9
OVERALL INSURERS’ COMPARISON: CLAIMS SETTLEMENT RATIOClaims Settlement Ratio for the year ended March 31, 2020 – The number of claims settled in thequarters 1, 2, 3 and 4 of the financial year ended March 31, 2020 from the total claims available forprocessing, i. e., the total number of claims outstanding at the beginning of the quarter 1 totalnumber of claims reported/booked during the quarters 1, 2, 3 and 4 of the financial year ended March31, 2020.The comparison of the below ratios is based on the findings of the previous editions of the IBAIGeneral Insurance Claim Insights Handbook based on data disclosed for the years ending March 31st,2018 and March 31st, 2019 respectively.Claims Settlement Ratio Sum of Total number of claims settled for quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 2020Higher the Claims Settlement Ratio, better is an insurance company in terms of the measured ratioPUBLIC SECTOR GENERAL INSURERSRANKINSURER1234Oriental InsuranceNew IndiaUnited IndiaNational InsuranceCLAIMS SETTLEMENT RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 8546,199,385LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERIFFCO TokioHDFC ERGORoyal SundaramBajaj AllianzTata AIGICICI LombardFuture GeneraliSBI GeneralRelianceCholamandalamNO. OF CLAIMS AVAILABLEFOR PROCESSINGCLAIMS SETTLEMENT RATIOFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 2,112,195350,30410
OTHER PRIVATE SECTOR GENERAL INSURERSRANK1234567891011INSUREREdelweissLiberty GeneralBharti AXANavi GeneralUniversal SompoKotak MahindraGeneralGo DigitMagma HDIAckoShriram GeneralRaheja QBENO. OF CLAIMS AVAILABLEFOR PROCESSINGCLAIMS SETTLEMENT RATIOFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, .79%32.03%-196,44186,371233,291306,9151,352HEALTH INSURERSRANKINSURER12345NO. OF CLAIMS AVAILABLEFOR PROCESSINGCLAIMS SETTLEMENT RATIOFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 2020Care HealthMax BupaManipal CignaStar HealthAditya Birla 4,232147,718225,8471,143,291178,584Overall Industry Ratio85.18%85.18%80.77%*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimal places.For the sake of simplicity, the data has been rounded off. This data is based on the number of claims and notclaim amount. Data on claims by amount is not available in the public domain in the Indian Market11
OVERALL INSURERS’ COMPARISON:CLAIMS SETTLEMENT EFFICIENCY RATIOClaims Settlement Efficiency Ratio for the year ended March 31, 2020 - The efficiency of an insurancecompany to settle the claims, i.e. the number of claims settled in 3 months as compared to thetotal number of claims available for processing, i. e., the total number of claims outstanding at thebeginning of the quarter 1 total number of claims reported/booked during the quarters 1, 2, 3 and 4of the financial year ended March 31, 2020.The comparison of the below ratios is based on the findings of the second and third editions of theIBAI General Insurance Claim Insights Handbook based on data disclosed for the years ending March31st, 2018 and March 31st, 2019 respectively.Claims Settlement Efficiency Ratio Sum of Total number of claims settled within 3 months for quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 2020Higher the Claims Settlement Efficiency Ratio, better is an insurance company in terms of the measuredratioPUBLIC SECTOR GENERAL INSURERSRANKINSURER1234Oriental InsuranceNew IndiaUnited IndiaNational InsuranceCLAIMS SETTLEMENT EFFICIENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 8546,199,385LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERBajaj AllianzRoyal SundaramHDFC ERGOTata AIGICICI LombardIFFCO TokioRelianceFuture GeneraliSBI GeneralCholamandalamCLAIMS SETTLEMENT EFFICIENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 40372,573350,30412
SMALL PRIVATE SECTOR GENERAL INSURERSRANK1INSUREREdelweissCLAIMS SETTLEMENT EFFICIENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 202083.57%68.44%-9,0222Navi General79.77%79.54%-12,9463Liberty General79.26%87.64%78.26%258,7844Universal Sompo77.92%80.58%75.79%196,5435Kotak MahindraGeneral76.58%76.71%73.91%51,4666Go Digit75.84%80.71%-196,4417Bharti AXA74.67%74.93%74.20%337,5698Magma 9110Shriram General58.15%49.61%23.48%306,91511Raheja QBE10.80%2.75%-1,352STANDALONE HEALTH INSURERSRANKINSURER12345CLAIMS SETTLEMENT EFFICIENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 2020Care HealthMax BupaManipal CignaStar HealthAditya Birla 4,232147,718225,8471,143,291178,584Overall Industry Ratio73.98%74.18%69.37%*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimal places.For the sake of simplicity, the data has been rounded off. This data is based on the number of claims and notclaim amount. Data on claims by amount is not available in the public domain in the Indian Market.13
OVERALL INSURERS’ COMPARISON:CLAIMS REPUDIATION RATIOClaims Repudiation Ratio for the year ended March 31, 2020 – The number of claims repudiated outof the total number of claims available for processing, i. e., the total number of claims outstandingat the beginning of the quarter 1 total number of claims reported/booked during the quarters 1, 2, 3and 4 of the financial year ended March 31, 2020.Claims Repudiation Ratio Sum of Total number of claims repudiated during quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 2020Lower the Claims Repudiation Ratio, better is an insurance company in terms of the measured ratioPUBLIC SECTOR GENERAL INSURERSRANKINSURER1234Oriental InsuranceNational InsuranceNew IndiaUnited IndiaCLAIMS REPUDIATION RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, 75,539,854LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERHDFC ERGOBajaj AllianzRoyal SundaramTata AIGSBI GeneralIFFCO TokioRelianceFuture GeneraliICICI LombardCholamandalamCLAIMS REPUDIATION RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, ,2772,112,195292,9402,090,422350,30414
SMALL PRIVATE SECTOR GENERAL INSURERSRANKINSURERCLAIMS REPUDIATION RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, 202012345678910Raheja QBEEdelweissNavi GeneralShriram GeneralBharti AXAMagma HDIUniversal SompoAckoLiberty GeneralGo 3,291258,784196,44111Kotak MahindraGeneral9.56%51,466CLAIMS REPUDIATION RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, ONE HEALTH INSURERSRANKINSURER12345Care HealthMax BupaManipal CignaStar HealthAditya Birla Health7.66%10.00%13.29%16.11%19.86%Overall Industry Ratio4.09%*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimal places.For the sake of simplicity, the data has been rounded off. This data is based on the number of claims and notclaim amount. Data on claims by amount is not available in the public domain in the Indian Market.15
OVERALL INSURERS’ COMPARISON:CLAIMS CLOSED RATIOClaims Repudiation Ratio for the year ended March 31, 2020 – The number of claims closed by theinsurer out of the total number of claims available for processing, i. e., the total number of claimsoutstanding at the beginning of the quarter 1 total number of claims reported/booked during thequarters 1, 2, 3 and 4 of the financial year ended March 31, 2020.There is no comparison for the below ratio since claims closed were included in the calculation of therepudiation ratio for the years ending March 31, 2018 and 2019.Claims Closed Ratio Sum of Total number of claims closed during quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 2020Lower the Claims Closed Ratio, better is an insurance company in terms of the measured ratioPUBLIC SECTOR GENERAL INSURERSRANK12INSUREROriental InsuranceNew IndiaNational InsuranceUnited IndiaCLAIMS CLOSED RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, 55,539,854LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERRelianceRoyal SundaramIFFCO TokioHDFC ERGOCholamandalamICICI LombardFuture GeneraliBajaj AllianzTata AIGSBI GeneralCLAIMS CLOSED RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, 0,422292,9406,059,9401,271,513372,57316
SMALL PRIVATE SECTOR GENERAL INSURERSRANKINSURERCLAIMS CLOSED RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, 20201234EdelweissRaheja QBEGo DigitLiberty 845Kotak MahindraGeneral6.88%51,46667891011Universal SompoBharti AXAMagma HDIShriram GeneralNavi 43337,56986,371306,91512,946233,291CLAIMS CLOSED RATIONO. OF CLAIMS AVAILABLE FOR PROCESSINGFor the year ended March 31, 2020For the year ended March 31, ONE HEALTH INSURERSRANKINSURER12345Cigna TTKMax BupaCare HealthStar HealthAditya Birla Health0.00%0.00%0.00%0.00%2.34%Overall Industry Ratio2.12%*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimal places.For the sake of simplicity, the data has been rounded off. This data is based on the number of claims and notclaim amount. Data on claims by amount is not available in the public domain in the Indian Market.17
OVERALL INSURERS’ COMPARISON:CLAIMS OUTSTANDING RATIOClaims Outstanding Ratio for the year ended March 31, 2020 – The number of claims that wereoutstanding out of the total number of claims available for processing, i. e., the total number of claimsoutstanding at the beginning of the quarter 1 total number of claims reported/booked during thequarters 1, 2, 3 and 4 of the financial year ended March 31, 2020.The comparison of the below ratios is based on the findings of the second and third editions of theIBAI General Insurance Claim Insights Handbook based on data disclosed for the years ending March31st, 2018 and March 31st, 2019 respectively.Claims Outstanding Ratio Sum of Total number of claims outstanding for the quarter ending March 31st, 2020Total Claims available for processing for the year ending March 31st, 2020Lower the Claims Outstanding Ratio, better is an insurance company in terms of the measured ratioPUBLIC SECTOR GENERAL INSURERSRANKINSURER1234New IndiaOriental InsuranceUnited IndiaNational InsuranceCLAIMS OUTSTANDING RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 9,385LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERBajaj AllianzTata AIGHDFC ERGORoyal SundaramSBI GeneralIFFCO TokioICICI LombardFuture GeneraliRelianceCholamandalamCLAIMS OUTSTANDING RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 372,5731,170,2772,090,422292,9402,112,195350,30418
SMALL PRIVATE SECTOR GENERAL INSURERSRANK1234567891011INSURERCLAIMS OUTSTANDING RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 20205.15%5.27%10.75%4.35%-233,291196,441AckoGo DigitKotak MahindraGeneralNavi rty GeneralUniversal SompoBharti AXAMagma 543337,56986,3719,022Shriram GeneralRaheja STANDALONE HEALTH INSURERSRANKINSURER12345NO. OF CLAIMS AVAILABLEFOR PROCESSINGCLAIMS OUTSTANDING RATIOFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 2020Max BupaCare HealthManipal CignaAditya Birla HealthStar ,847178,5841,143,291Overall Industry Ratio8.78%8.27%13.70%*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimal places.For the sake of simplicity, the data has been rounded off. This data is based on the number of claims and notclaim amount. Data on claims by amount is not available in the public domain in the Indian Market.19
OVERALL INSURERS’ COMPARISON:CLAIMS PENDENCY RATIOClaims Pendency Ratio for the year ended March 31, 2020 – The number of claims that werepending for more than 1 year in the last quarter of the financial year ended March 31, 2020 out of thetotal number of claims available for processing, i. e., the total number of claims outstanding at thebeginning of the quarter 1 total number of claims reported/booked during the quarters 1, 2, 3 and 4of the financial year ended March 31, 2020.The comparison of the below ratios is based on the findings of the second and third editions of theIBAI General Insurance Claim Insights Handbook based on data disclosed for the years ending March31st, 2018 and March 31st, 2019 respectively.Claims Pendency Ratio Sum of Total number of claims outstanding for more than 1 year for the quarter endingMarch 31st, 2020Total Claims available for processing for the year ending March 31st, 2020Lower the Claims Pendency Ratio, better is an insurance company in terms of measured ratioPUBLIC SECTOR GENERAL INSURERSRANKINSURER1234Oriental InsuranceNew IndiaUnited IndiaNational InsuranceCLAIMS PENDENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, LARGE PRIVATE SECTOR GENERAL INSURERSRANK12345678910INSURERBajaj AllianzSBI GeneralTata AIGHDFC ERGOICICI LombardRelianceRoyal SundaramIFFCO TokioFuture GeneraliCholamandalamNO. OF CLAIMS AVAILABLEFOR PROCESSINGCLAIMS PENDENCY RATIOFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, ,112,195637,4271,170,277292,940350,30420
SMALL PRIVATE SECTOR GENERAL INSURERSRANK123456789INSURERNavi GeneralEdelweissAckoGo DigitKotak MahindraGeneralLiberty GeneralBharti AXAUniversal SompoMagma HDIShriram GeneralRaheja QBECLAIMS PENDENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 196,54386,371306,9151,352STANDALONE HEALTH INSURERSRANK123CLAIMS PENDENCY RATIONO. OF CLAIMS AVAILABLEFOR PROCESSINGFor the year endedMarch 31, 2020For the year endedMarch 31, 2019For the year endedMarch 31, 2018For the year endedMarch 31, 2020Aditya Birla HealthMax BupaCare HealthManipal 0.00%0.00%0.00%178,584147,7181,074,232225,847Star EROverall Industry Ratio*Please note that the above ranks have been derived on the basis of ratios calculated upto two decimalplaces. For the sake of simplicity, the data has been rounded off. This data is based on the number of claimsand not claim amount. Data on claims by amount is not available in the public domain in the Indian Market.21
FIRE: CLAIMS SETTLEMENT RATIOClaims Settlement Ratio for the year ended March 31, 2020 – The number of claims settled in thequarters 1, 2, 3 and 4 of the financial year ended March 31, 2020 from the total claims available forprocessing, i. e., the total number of claims outstanding at the beginning of the quarter 1 totalnumber of claims reported/booked during the quarters 1, 2, 3 and 4 of the financial year endedMarch 31, 2020.Claims Settlement Ratio Sum of Total number of claims settled for quarters 1, 2, 3 and 4Total Claims available for processing for the year ending March 31st, 2020Higher the Claims Settlement Ratio, better is an insuranc
a. Max Bupa Health Insurance b. Care Health Insurance c. Star Health and Allied Insurance d. Manipal Cigna Health Insurance e. Aditya Birla Health Insurance I. Public Sector General Insurers II. Large Private Sector General Insurers: IV. Standalone Health Insurers: III. Other Private Sector Insurers: The remaining private sector insurers .
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