Quick Take: You must consider operational efficiencies, net promoter score, claim settlement rates, network hospitals, corporate track record, business scale, and product portfolio when comparing health insurance firms in India. You can then rank insurers according to the criteria you wish to give priority to after you have this data.
These are the top health insurance providers in India in 2025, in our opinion, based on our subjective evaluation.
Company | CLAIM SETTLEMENT RATIO(avg. of last 3 years) | Network Hospitals | Gross Written Premium (2023-24) | Track Record | Rating out of 10 |
---|---|---|---|---|---|
HDFC Ergo | 98% | 13,000+ | ₹5,942.58 Cr | 22 years | 9.2 |
Aditya Birla | 95% | 12,000+ | ₹3,447.15 Cr | 8 years | 6.7 |
Bajaj Allianz | 95% | 12,000+ | ₹6,522.38 Cr | 23 years | 6.7 |
Care | 90% | 11,400+ | ₹6,545.58 Cr | 12 years | 5 |
Niva Bupa (erstwhile Max Bupa) | 91% | 10,000+ | ₹5,494.43 Cr | 16 years | 3.3 |
In India, there are thirty health insurance providers. There are 24 general insurers and 6 independent health insurers.
Insurance firms that just offer health plans are known as standalone health insurance companies. The first organization in India to establish a stand-alone health insurance business was Star Health Insurance in 2012. Five other businesses have followed suit since then. Additionally, they jointly promote numerous insurance with a wide range of features and coverage.
businesses that experiment with health, auto, and other non-life insurance are known as general health insurance businesses. However, we will limit the analysis in this part to general health insurance providers that offer at least one policy.
When comparing health policies offered by independent health insurers and general insurance firms, there aren't many differences from the standpoint of the buyer. For example, just because a separate health insurer specializes in this area doesn't mean that they would provide a better experience. In our experience, general insurance firms have consistently outperformed independent health insurance providers. Thus, there are many problems with that analysis.
It should be mentioned, though, that a general insurance business might not offer as many goods as a standalone health insurer, which is likely to have a superior suite of products for a wider consumer base. Therefore, you would be better off using a stand-alone health insurance provider if you're trying to get a coverage for a very specific use case.
After taking care of the fundamentals, let's examine the following item.
Prior to making a final decision, you must rank several health insurance providers based on a number of objective criteria. How do these metrics appear? Let's begin with the fundamentals.
Consider a business that has only existed for a few strange months. Determining the insurer's potential is nearly impossible. Therefore, choosing a policy from their basket is probably a risk. On the other hand, you can create a thorough evaluation if your business already has a long history.
For example, a startup business with only a few years of experience may have outstanding claim settlement rates and provide exceptional customer support. However, as they grow their firm, it's feasible that these figures will change drastically. On the other hand, you may anticipate that an insurance firm that has been in operation for a long time would continue to publish comparable data. Additionally, you don't have to be concerned about possible problems that can arise as their company grows. Therefore, we advise you to constantly consider a company's history before choosing an insurer.
Here is a list of the top 5 insurance firms in India with the longest track records in case you are having problems accomplishing this yourself.
Company | Track Record |
---|---|
National Insurance | 118 years |
New India Assurance | 105 years |
United Insurance | 86 years |
Oriental Insurance | 77 years |
IFFCO Tokio | 24 years |
You will notice an odd pattern if you glance at the table above. Since the insurance industry in India was only privatized in 2000, all of these businesses are state-run. In other words, the majority of private businesses have fewer than 24 years of experience. Any business with ten years or more of experience, though, would be a wise choice. A business that has been in business for five years or more is respectable. Additionally, we typically advise customers to stay away from any business that has less than five years of experience.
Given their long history, you would expect state-run businesses are a better option based on the rating above. However, the reality is that state-owned businesses typically have a negative image in the sector. They process applications quite slowly. Reaching customer service executives in these big public companies is really difficult. Additionally, the claim settlement procedure is time-consuming. Therefore, one could contend that unless you consider additional criteria, such as operations efficiencies, the preceding table is worthless.
However, what does the term "operational proficiency" actually mean? Operational proficiency, thus, addresses the entire process, from completing the application to submitting the claim. You could say that an insurer is operationally sound if they provide a seamless experience from start to finish. On the other side, it's easy to assume that they won't score highly on operational efficiency if you observe client complaints, slow response times, and inadequate claim settlement procedures.
Additionally, private insurers typically outperform state-run insurance in this area.
However, even among private insurers, there are some who are more sensitive to their clients and others who are less concerned. Once again, it’s not easy to tell them apart. However, you may search the internet for some information. Online resources include data on social media acceptance, performance evaluations, and customer complaints. And in order to make a decision, you might need to combine them all. Conversely, you could seek our assistance in this situation by speaking with insurance professionals, such as our advisors at Ditto.
If you want to purchase policies for a certain use case, the product portfolio is important. Some businesses, for example, provide items for a variety of use cases. They include premium plans that cover everything, from maternity costs to dental difficulties, comprehensive plans with a wide range of essential features, and reasonably priced plans with the bare minimum of features. Some even include policies for specific use cases, such as elderly people, cancer patients, people with diabetes, and those with severe medical conditions.
Therefore, we will feature businesses with a wide range of products here.
Company | Affordable Option | Comprehensive Options | Premium Options | Diabetic Specific policy | Cancer Specific policy | Heart Specific policy | Senior Citizen Options |
---|---|---|---|---|---|---|---|
HDFC Ergo | None | Optima Secure, Optima Super Secure, Optima Restore | Optima Secure Global, Optima Secure Global Plus, Health Wallet | Energy Silver, Energy Gold | None | None | Optime Secure |
Care | Care Advantage | Care Supreme, Care Plus | None | None | Care Freedom | Care Heart | Care Supreme |
Aditya Birla | Activ One NXT | Activ One MAX, Activ Fit | Activ One MAX+, Activ One VIP, Activ One VIP+ | Activ One MAX, Activ One NXT | None | None | Activ One MAX, Activ One NXT |
Niva Bupa | ReAssure 2.0 | ReAssure 2.0, Aspire | Health Premia, Heartbeat | None | None | None | Senior First, Health Companion |
Bajaj Allianz | Health Guard Silver, Health Ensure Family | Health Guard Gold, Platinum | Health Care Supreme | None | None | None | Silver Health |
A few hospitals collaborate with insurance providers in an effort to provide clients with a fully cashless claim settlement experience. In other words, you could theoretically file a claim without having to pay anything out of pocket if you ever went to a network hospital. However, you would be responsible for paying the bills and waiting for reimbursement if you were admitted to a hospital that is not part of the network. which, once more, can be a laborious procedure. It is obvious that you can save a significant amount of time and money by getting admitted to a network hospital.
But not every business collaborates with every hospital in the world. More than 10,000 hospitals have cooperated with certain businesses. Less than a few thousand hospitals are listed on the platforms of even others.
Any insurer with a hospital network that includes more than 8,000 hospitals is, in our opinion, a good choice. Anything from 5,000 to 8,000 is acceptable. And under 5,000 is strictly prohibited.
Having said that, the top 10 insurers with the biggest hospital networks are listed below.
Company | Network Hospitals |
---|---|
Digit | 16,400+ |
Care | 11,400+ |
Star Health | 14,000+ |
Navi | 12,000+ |
HDFC Ergo | 13,000+ |
Aditya Birla | 12,000+ |
Acko | 10,000+ |
Niva Bupa (erstwhile Max Bupa) | 10,000+ |
TATA AIG | 11,000+ |
Royal Sundaram | 10,000+ |
The percentage of claims that an insurer settles during a given time period is shown by the claim settlement ratio. In other words, if the insurance business has a claim settlement ratio of 90, it means that 90 out of every 100 claims it books during the year are settled.
Claims settled / (Claims booked + Claims outstanding at the beginning — Claims outstanding at the end) is the formula used to determine the amount.
A claim settlement ratio of 90% or higher is excellent, in our opinion. An 80–90% claim settlement ratio is considered respectable. Additionally, anything below 80% is unacceptable.
This is a list of businesses having the greatest average claim settlement ratios for FY2021–2024.
Company | CLAIM SETTLEMENT RATIO (avg. of last 3 years) |
---|---|
New India Assurance | 99% |
HDFC Ergo | 98% |
SBI | 97% |
Digit | 97% |
Oriental Insurance | 96% |
TATA AIG | 96% |
Acko | 96% |
Iffco Tokio | 95% |
Aditya Birla | 95% |
Universal Sompo | 95% |
Bajaj Allianz | 95% |
United India | 94% |
Royal Sundaram | 94% |
National Insurance | 93% |
Zuno (erstwhile Edelweiss) | 92% |
Niva Bupa (erstwhile Max Bupa) | 91% |
Manipal Cigna | 90% |
Care | 90% |
Reliance | 89% |
ICICI Lombard | 85% |
Bharti Axa | 85% |
Star Health | 83% |
Navi | 64% |
There are thirty health insurance firms in India. Six of these are independent health insurance firms, while the remaining 24 are general insurance carriers.
You can, indeed.
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But it's important to know the why, the how, and the when before choosing the portable choice! This comprehensive post will serve as your ideal manual!
A health insurance provider's greater CSR reflects the company's track record and capacity to resolve claims. When selecting your healthcare insurance partner, this is also one of the most important factors.
Based on their CSR, the top 5 health insurance companies are shown here:
Company | CLAIM SETTLEMENT RATIO(avg of last 3 years) |
---|---|
New India Assurance | 99% |
HDFC Ergo | 98% |
Digit | 97% |
SBI | 97% |
Acko | 96% |