Which is Best Health Insurance Company in India for 2016? Hard to list it. However, let us try to shortlist based on IRDA’s Annual Report for 2014-15.
Note-IRDA released the data for FY 2015-16. I published the same in my blow post. Refer this below post for latest data.
Before proceeding further, let us first understand the term called “Incurred Ratio”. It is the total amount of claims paid by insurance companies to total amount of premium collected during the same year. This ratio shows how generous is the company in settling the claim or whether the company is in profit or loss.
For example, let us say Company A settled the total claim amount of Rs.90 Cr in a year. In the same year, it collected Rs.100 Cr as a premium for that particular year. In this situation, the incurred ratio stands to be 90%.
Hope you got clarity now about incurred ratio. Let us move and look at the recent IRDA Annual Report for 2014-15.
Below is the Incurred ratio of public sector companies for a period of 2014-15.
You notice that, when it comes to claim settlement ratio, public sector companies are more generous. They are paying more claim amount than what they receive as premium for that particular year (except for New India).
I highlighted the companies with green whose claim is more than 100% and red whose ratio is less than 100%.
Let us look into the non-life private sector companies data.
You notice that you get all data ranges in public sector companies. Ranges differ from as high as at 117% to low at 52%. For a moment forget about the new entrants like Magma QBE and Liberty Videocon. Look at the existing players. This gives you an indication of how to select the “Best Health Insurance Company in India for 2016”.
Let us move towards the standalone health insurance companies data.
You notice that data ranges from 64% to 55% ONLY.
Why there is such a huge difference among Public Sector, Private Sector and Standalone companies incurred claim settlement ratio?
There may be a few reasons for it. We can’t assume what went wrong. But the company whose incurred claim ratio is high may not look at its profitability. If the claim amount is less than what they collected as a premium, then it indicates that they are into profit and eyeing at the profit.
One more reason is that, if the company paying more claim amount than what it collects as premium, then it may have pools of high-risk profile insured. Mean old age people who have a probability of hospitalization are more.
You notice that standalone insurance companies manage the best within a range of around 60%. They are into profit and we may consider them for our health insurance need. However, what about public sector companies? They may be under loss from the health insurance sector. However, they are compensating from other types of insurance. The same applies to private sector companies.
The above-incurred claim settlement ratio is one type of indication for you to choose Best Health Insurance Company in India.
How about complaints against health insurance companies?
IRDA not indicate whether the grievances are particular to health insurance or for all types of insurance. Especially for Private and Public Sector companies, the grievances are clubbed which ranges from Fire, Motor, Health or other types of insurance. However, for standalone companies, we have a perfect data of grievances raised by customers. Below are the data available with us.
Look at the % of resolved complaints and also the status of pending data. You have to identify how old are these pending grievances. Based on that you can assume how fast are your insurance companies when it comes to customer centric.
The above IRDA Annual Report for 2014-15 data will not give you a clear picture of which company is best in India. But definitely a hint in choosing a company.
Apart from these above indications, you have to look for some more specific data to arrive at your health insurance products. These points are listed below.
- Identify whether you need individual or family floater health insurance. Remember that in family floater insurance, the premium will be based on the oldest person in the family and also depends on the number of members. Individual plans cost more than family floaters.
- Identify the sum insured you are looking for. Today Rs.5, 00,000 may looks a great and comfortable health insurance. But the same may not be the case after a few years. Hence, chose a sum insured amount based on future need.
- Identify the company which covers existing diseases at early. Usually, all insurance companies have a waiting period 3-4 years for existing diseases. However, if your concern is to cover the existing diseases, then give first priority to this point. L&T Health Insurance product offers 2 years of waiting period, Apollo Munich offers 3 years of waiting and rest of companies offer 4 years of waiting period.
- Identify the company which offers the lifelong renewal option. Because your health insurance need is more during your old age.
- Check for room rent capping.
- Check for the co-payment clause. Higher the co-payment means lower the premium for you. Co-payment means how much you also have to pay in total bill. If the co-payment clause states 20% co-payment, then for all bills claimed, you have to 20% and the rest 80% will be payable by health insurance company.
- Check for exclusions. If you feel the exclusions listed may be uncomfortable to you, then skip that product.
- Check for hospital network availability in your city or town. The cashless hospital benefit is better than producing the bills and waiting for claim settlement.
- Read carefully the wordings of policy brochure. If you have doubts on any feature, then try to clarify it NOW itself.
- Avoid all common features, which companies try to highlight.
- Check for No Claim Bonus company offers.
- Finally, if you feel the sum insured you opting is not within your budget, then go for sum insured according to your affordability and opt for a super top up plans.
This checklist may not be big to include everything. But gives you an indication in selecting the Best Health Insurance Company in India for 2016.
Conclusion-Each individual is different and his/her needs also. No one can perfectly claim that the particular company is the BEST or its product. But we can help him or her in identifying the that BEST which suited to him or her. Hence, this post won’t give you the result you may looking for ready-made answers. But definitely will help you in short listing the product. Also, I am personally not associated with any particular company. For me, all companies are same. Hence, I am not naming any one company. But forcing you to choose the product based on your comfort with company, features you are looking for and budget.