Which is the Best Health Insurance Company in India – 2023?

When I analyzed the last published Annual Report of IRDA to find the Best Health Insurance company in India, I found that New India Insurance company had the highest approval rate of 92.25% for Health Insurance-related claims in 2021-22. However, if we look at their Network Hospitals list, it is only around 3000.

On the other hand, SBI General Insurance approved 85% of the total claims, and their Partner Hospitals list consists of 20,000+ hospitals.

Imagine you have a health insurance policy, and one day you encounter a health problem. What would you do first? You would immediately rush to the nearest hospital. But if you reach the hospital and find out that your policy does not cover that nursing home or hospital, you will obviously become worried.

It is evident that you will not have enough time to visit your Health Insurance provider’s website and check if your nearby hospital is covered under their network. That’s why it is crucial to check the room limit when taking a policy.

Health Insurance Comparison

Let’s now compare 34 different health insurance companies on 6 different parameters and find which is best on what parameter.

The insurance companies are divided into three categories –

1. Private Sector Health Insurers
2. Public Sector Health Insurers
3. Stand alone Health Insurers

These 6 parameters are:

1. Claims Approval Ratio
2. Claims Rejection Ratio
3. Claim Settlement Ratio
4. Claims Paid in <3 Months
5. Number of Network Hospitals
6. Incurred Claims Ratio

Claims Approval and Speedy Disposal

First, in this column, you can see which health insurance company has approved the highest number of claims, and you can also see how many claims they have paid within 3 months. The higher the value, indicated by green, the more claims that company has approved and settled quickly.

Claims Rejection Ratio

Next, you can see the total number of claims that have been rejected. Again, a green value indicates a lower claim rejection ratio, while red indicates that you should try to avoid those health insurance companies if possible.

Number of Network Hospitals

Below you can see the number of network hospitals for each health insurance company. As you can see the number of network hospitals varies considerable. The higher the number of network hospital, the more are the chances for cashless claims.

Incurred Claims Ratio

The Incurred Claims Ratio indicates the percentage of the total premium received by the company that has been utilized for settling claims. It helps determine the financial health and performance of the company.

Before Buying a Health Insurance

Now let’s talk about my friend Rajan. Rajan has a health insurance policy. One day, he experienced some kidney-related complications and had to be admitted to the ICU overnight. The recovery process took a bit longer, and he had to spend two weeks in the hospital. The total bill from the hospital amounted to ₹4,25,000.

Fortunately, Rajan had a Family Floater policy with a coverage of ₹5 lakhs, so he didn’t have to pay anything from his pocket. However, now he starts thinking about what would happen if his wife or children also face health issues in the future.

In such a case, his policy may not fully cover the medical expenses for his wife or children because most of the coverage amount has been utilized during his illness. This is where the importance of understanding restoration benefits becomes necessary.

Some insurance policies provide unlimited restoration benefits for any illness, while others have limits. For example, restoration benefits may not be available to the same person or for the same illness, as in Rajan’s case of kidney-related problems.

Our recommendation is always to choose a policy with restoration benefits, especially if you have a Floater policy or an Individual policy. However, it is important to carefully read the policy’s terms and conditions to understand how the restoration benefit works each time and to obtain important coverage information.

Special Savings Tip

When we take Car Insurance, the car companies offer a No Claim Bonus if we do not make any claims, which reduces our premium for the next year.

Similarly, some Health Insurance companies also provide a No Claim Benefit. If you do not make any claims, the company increases your base sum insured without any extra charge for the next year. The No Claim Benefit may vary depending on the company’s plan. Isn’t it a fantastic offer?

For example, let’s say you started with a policy of 5 lakhs, and you didn’t make any claims in the first year. When you renew your policy the next year, you will have to pay the same premium amount as last year, but your base sum insured/coverage will increase from 5 lakhs to 7.5 lakhs, which is 50% of the base sum insured. (e.g., Star Comprehensive)

With the same premium, you are getting extra coverage, which means additional savings for you.

Keeping these important factors in mind, you can purchase an appropriate policy according to your requirements on the PolicyX.com website, where you can view all these parameters on a single screen. Don’t forget to save this blog and be sure to share it in your family members’ WhatsApp group.

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