Claim Settlement Ratios of Life Insurance Companies in India

Presently, 24 companies sell life insurance plans in India. Of all these 24 providers, the only provider under public sector is the LIC of India. The rest of the 23 companies are either private or JVs between national or international insurance/finance companies and private or public sector banks/financial institutions.

The access to life insurance sector was given to the private life insurers in the year 2000. Also, most of the private insurers have partnered with the international insurance players to bring up their insurance venture.

An important parameter to judge the middle insurance company is by its Claim Settlement Ratio.

What is Claim Settlement Ratio?

A Claim Settlement Ratio (CSR) is the ratio of the total number of claims that an insurance provider settles to the total number of claims it receives in a year. CSR for life insurance providers is issued by the Insurance Regulatory and Development Authority (IRDA) of India, every year.

The formula to calculate the Claim Settlement Ratio is as follows:

Claim Settlement Ration = Total number of claims approved and paid by the insurer/Total number of claims received by the insurance company*100

For example, if the number of death claims received by the insurance provider is 1000, out of which it settles 980, the Claim Settlement Ration of that provider would be 98%.

Claim Settlement Ratio = (980÷1000) x 100 = 98%

The higher the CSR of the insurer, the better it is for its customers.

Claim Settlement Ratio of Life Insurance Providers for 2016-17:

Insurer

Death Claims Received

Death Claims Paid

Claims Rejected/Repudiated

Claims Written Back

Claim Pending

Claim Settlement Ratio (CSR in %age)

LIC

769,386

756,399

7,432

2,352

3,203

98.31

Max Life

9,821

9,606

212

0

3

97.81

HDFC Standard Life

12,725

12,421

244

0

59

97.62

Aegon Life

588

571

17

0

0

97.11

SBI Life

17,610

17,027

451

0

132

96.69

ICICI Prudential

10,901

10,539

305

21

36

96.68

Exide Life

2,973

2,866

107

0

0

96.40

Tata AIA

2,707

2,599

108

0

0

96.01

Canara HSBC Oriental

653

620

32

0

1

94.95

Birla Sunlife

6,048

5,727

240

33

48

94.69

Reliance Nippon

11,079

10,473

529

42

35

94.53

Edelweiss Tokio

164

153

11

0

0

93.29

Bharti AXA

878

811

33

0

34

92.37

Bajaj Allianz

16,239

14,887

932

357

63

91.67

Kotak Mahindra

2,831

2,583

99

130

19

91.24

DHFL Pramerica

471

428

36

1

6

90.87

IDBI Federal

1,065

962

96

0

7

90.33

Sahara Life

725

654

45

0

26

90.21

Future Generali India

1,366

1,233

126

0

17

89.53

PNB Metlife India

3,879

3,380

357

34

108

87.14

Star Union Daichi

1,473

1,238

200

16

19

84.05

India First

1,741

1,439

273

0

29

82.65

Shriram Life

2,926

1,859

774

0

293

63.53

 

The claim settlement ratio for the sector, on the whole, stands at 97.74% for 2016-17. There has been a growth from the CSR of 97.43% for 2015-16. The claim rejection ratio decreased to 1.45% when compared to 1.73% in 2015-16.

The report by IRDA also implies that the CSR of LIC was 98.31% at March-end in 2017. This was 98.33% on March 31, 2016. The claim rejection ratio for LIC has gone down marginally and is at 0.97% currently. This ratio was 0.98% at end of the fiscal year 2015-16.

For all the private insurance companies in India, the Claim Settlement Ratio has noticed a definitive growth of 2.24%. The ratio for the fiscal year 2016-17 is 93.72%, while in the previous financial year it was 91.48%. The claim repudiation ratio also came down to 4.85% for 2016-17 from 6.67% for the fiscal year 2015-16.