Aditya Birla Health Claim Settlement Ratio

Quick Overview

The Aditya Birla Health Insurance claim settlement ratio (CSR) for FY 2024-25 stands at 95.88%. The insurer has maintained this strong performance consistently, with an average ratio of 95.81% over the period 2022–2025. This suggests that Aditya Birla Health Insurance processes and settles a large share of claims, making it a reasonably dependable choice among insurers in India.

Aditya Birla Health Insurance (ABHI), a leading Standalone Health Insurer (SAHI) in India, has quickly built a strong reputation with its innovative, wellness-focused products. But when buying health insurance, the key question is, how reliable is the company when it’s time to make a claim?

That’s where the claim settlement ratio comes in. It shows the percentage of claims an insurer settles in a year. It shows how likely your claim is to be approved and paid.

In this guide, we break down the Aditya Birla claim settlement ratio, how it’s calculated, where it stands, and whether it’s strong enough for you to place your trust in the insurer.

What is a Claim Settlement Ratio?

A claim settlement ratio represents the percentage of claims an insurer has successfully settled out of the total claims received in a financial year.

For instance, if Aditya Birla Health Insurance receives 100 claims and settles 91 of them, the CSR would be 91%. Higher CSR generally indicates greater reliability in honoring claims.

How To Interpret CSR:

97% and Above: Indicates a strong, efficient, and highly reliable insurer with a high claim settlement track record.
90%–97%: Most claims are settled, but you should review other metrics before deciding.
Below 90%: May signal higher chances of delays, rejections, or an inconsistent claims experience.

How to Calculate the Aditya Birla Claim Settlement Ratio?

Claim Settlement Ratio = (Total Claims Settled / Total Claims Eligible for Settlement) × 100

Where:

Total Claims Settled includes both fully paid and partially paid claims
Total Claims Eligible for Settlement = (Claims carried forward from the previous year) + (New claims reported during the year) − (Claims rejected/closed without payment + Claims still pending at the end of the year)

Note: The Insurance Regulatory and Development Authority of India (IRDAI) does not mandate a standardized formula for calculating CSR. As a result, figures may differ slightly depending on the methodology used by insurers or analysis platforms.

At Ditto, we look at the 3-year average CSR instead of a single year’s figure, as it offers a more consistent view of an insurer’s claim performance. It’s also important to assess other metrics alongside CSR, such as complaint volume, incurred claim ratio (ICR), gross written premium (GWP), and network hospitals. These help fill the gaps CSR misses, like the difference between partial and full settlements and how smoothly claims are handled.

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Aditya Birla Health Insurance: 3-Year Claim Settlement Ratio and Other Metrics

Metrics (FY 2022–25)	3-Year Average	Industry Average
Aditya Birla Claim Settlement Ratio (CSR)	95.81%	91.22%
Incurred Claim Ratio (ICR)	68.16%	81.88%
Average Complaints per 10,000 Claims	18.67	27.06
Annual Business / Gross Written Premium (GWP) (in Crore)	₹3,290	₹3,969
Network Hospital	12,000+	10,000+ (Recommended)

Note: All this data is sourced from IRDAI annual reports and the insurer’s public disclosures.

Key Insights:

The 3-year CSR of 95.81% is notably higher than the industry average of 91.22%. This indicates a high likelihood of claims settlement and suggests that the insurer is dependable when it comes to paying claims.
The complaint volume is notably lower than the industry average of 27.06. This is a positive sign that most customers experience a relatively smooth claim and service journey without needing to escalate issues.
The ICR of 68.16% is comfortably within the healthy range of 50–80%. This shows Aditya Birla Health Insurance maintains a balanced and sustainable claims payout.
The GWP of ₹3,290 crore is below the industry average but has grown sharply, showing steady growth and rising customer trust.
With over 12,000 network hospitals, Aditya Birla Health Insurance ensures wide, convenient, cashless access to quality healthcare facilities across India.

Where Can I Find the Claim Settlement Ratio of Aditya Birla Health Insurance?

You can check the Aditya Birla Health Insurance claim settlement ratio from the following sources:

IRDAI annual reports or handbook.
Aditya Birla Health Insurance’s financial report for 2024–25 is available on its official website.
Trusted insurance advisory platforms like Ditto.

Top 10 Health Insurance Providers by Claim Settlement Ratio in 2026

Aditya Birla Health Insurance claim settlement ratio

Key Insight: Aditya Birla Health Insurance ranks among the top ten insurers by claim settlement ratio. Its consistent performance over time, along with stable claims handling, makes it a dependable choice for policyholders.

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Conclusion

Aditya Birla Health Insurance has maintained a consistently strong claim settlement ratio. This reflects a reliable and stable claims process. Its low complaint volume and healthy ICR further support this.

For those prioritizing a dependable insurer with a strong claims track record and broad hospital access, Aditya Birla Health Insurance is a solid option. It is particularly suitable for individuals and families seeking stability and trust.

If you’d like to see how Aditya Birla compares with other leading insurers, check out our detailed guide on the best health insurance companies in India.

Frequently Asked Questions

Does a high CSR mean your claim will definitely be approved?

No. A high CSR simply indicates that a large number of claims are settled overall. Individual claims can still be rejected due to policy exclusions, waiting periods, non-disclosure, or other terms. Relying only on CSR can sometimes be misleading.

Can an insurer with a good CSR still offer a bad claims experience?

Yes. CSR only shows the percentage of claims settled, not how they’re handled. It doesn’t reflect factors such as delays, complex paperwork, partial payouts, poor communication, or disputes, which can make the overall experience frustrating.

Is in-house claim settlement faster than using third-party administrators (TPAs)?

Generally, yes. Aditya Birla's in-house claims team works directly with its systems and hospital network, which often results in quicker cashless approvals compared to TPA-handled processes. However, the actual speed may vary depending on the hospital, the nature of the treatment, and the accuracy of submitted documents.

Should I choose a policy based only on claim settlement ratio?

No. While CSR is important, you should also factor in other metrics such as incurred claim ratio (ICR), complaint volume, and network hospitals. Additionally, consider coverage benefits, exclusions, sub-limits, claim process, and customer support before making a decision.

Last updated on: 18 Apr, 2026