For the last few days, we have been scouring the depths of insurance companies’ policy wordings to discover what the best health insurance plan is in 2025. So, in this article, that’s exactly what I’m going to talk about.
But, before we get started, you need to keep in mind that there’s no one ‘correct’ answer that fits everyone. And in this article, we have addressed how to select the best policy for yourself based on some important criteria.
And if you feel unsure after reading this article, you can always feel free to book a call with Ditto’s IRDAI-certified insurance advisors for honest, spam-free insurance sales advice.
How to Choose the Best Health Insurance Plans in 2025?
There are two aspects to choosing the best health insurance plan – the first is selecting one of the top insurers in the industry, and the second is choosing one of the best policies they offer. Let’s explore both of them in detail now.
A. Choosing the Best Health Insurers in 2025
Here are some important metrics to look for when shortlisting insurers:
- Claim Settlement Ratio – The Claims Settlement Ratio (CSR) is pretty straightforward. It is the number of claims the insurer settled against the total number of claims received by the insurer for a particular period. A higher ratio suggests a better track record of claim settlements, providing more reliability.
- Incurred Claim Ratio — The Incurred Claims Ratio (ICR) is the total amount of settled claims against the total amount of premiums collected. A good range for ICR would be 50-80%. This is generally considered a healthy ratio, indicating the insurer’s ability to pay out claims while being financially sound.
- Complaint Volume — The complaint volume indicates the number of complaints the insurer has received for every 10,000 claims received. Naturally, a lower complaint volume suggests better customer service and a higher net promoter score.
- Number of Network Hospitals — Health insurance policies often have a network of hospitals, clinics, and doctors with whom they contract to provide services for their policyholders. The higher the number of facilities they tie up with, the higher the number of facilities you, as the policyholder, have for cashless treatment. A more extensive network ensures better accessibility and convenience for you during medical emergencies.
- Customer Base — The number of policyholders an insurer has can also indicate its popularity and trustworthiness. A larger customer base reflects more customer confidence in the insurer's services.
To make it easy, we’ve compiled a list of the top insurers so you don’t have to.
| Top Health Insurers | CSR (Avg of 2021-2024) | ICR (Avg of 2021-2024) | Complaint Volume (Per 10k claims, Avg of 2021-2024) | Number of Network hospitals |
|---|---|---|---|---|
| HDFC ERGO | 98% | 86% | 7 | 13k + |
| CARE | 90% | 59% | 36 | 11.4k + |
| NIVA BUPA | 91% | 58% | 43 | 10k + |
| Aditya Birla | 95% | 68% | 22 | 12k + |
| Bajaj Allianz | 94% | 83% | 3 | 12k + |
| ICICI Lombard | 85% | 83% | 9 | 13k+ |
| TATA AIG | 96% | 81% | 11 | 11k+ |
| Industry Average | 90% | 84% | 22 | N/A |
PS: It might also be prudent to review what hospitals in your neighbourhood or city are part of which insurers’ networks and rank accordingly. For instance, Royal Sundaram has a strong network in Chennai, and Manipal Cigna has a strong network in Mangalore.
Feel free to go through this article for a more comprehensive overview of the top insurers in India in 2025.
B. Choosing the Best Health Insurance Plans in 2025
Now that you know how to select an insurer, here are some essential features to look for when choosing the actual health insurance policy:
- No Co-Payment — Co-payment is the percentage of the claim amount that you, as the policyholder, must pay out of your pocket while the insurer covers the rest. Opting for a policy with no co-payment ensures you don't have to bear any portion of the medical expenses, making the coverage more comprehensive and reducing your financial burden during medical emergencies.
- No Room Rent Restrictions — Many health insurance policies impose a limit on the room rent they will cover during hospitalisation. This restriction can lead to significant out-of-pocket expenses if you choose a room with a higher rent than the limit specified in your policy. Selecting a policy with no room rent restrictions provides greater flexibility in choosing a hospital room without worrying about additional costs.
- No Disease-Wise Sub-Limits — Some health insurance plans have sub-limits for specific diseases, treatments, or procedures. A policy without disease-wise sub-limits ensures you have full coverage for all treatments.
- Substantial Restoration Perk — The restoration benefit restores the sum insured if it gets exhausted within a policy year due to claims. Policies with a substantial restoration perk provide additional financial security by reinstating the sum insured, allowing you to claim multiple times for unrelated illnesses within the same year. Ideally, restoration should be unlimited no of times, for any disease, without any cooling-off period, and on partial as well as complete exhaustion.
- Low Waiting Period — Health insurance policies often have waiting periods for specific ailments (up to 2 years) before you can make a claim related to those diseases. Insurers also impose a waiting period if you have certain pre-existing diseases (up to 3 years). In case you want to make a claim related to a specific illness or a pre-existing disease, you need to wait until each of their waiting periods is completed. A good health insurance policy has the least waiting period or has add-ons to reduce them.
- Pre- and Post-Hospitalisation Coverage — Medical expenses are not limited to the period of hospitalisation. Pre-hospitalisation expenses (such as diagnostic tests and consultations) and post-hospitalisation expenses (such as follow-up visits and medications) can also slowly start adding up, especially for chronic illnesses such as cancer or heart disease. Choosing a policy that covers these expenses ensures you have a financial safety net for the entire course of treatment. Ideally, your policy should have a 60-day pre-hospitalization and 90-day post-hospitalization coverage.
- Daycare Treatment Coverage — Many medical procedures no longer require extended hospital stays and can be completed within a day. Policies that cover daycare treatments include these short-duration procedures, providing broader coverage for modern medical treatments that do not require overnight hospitalisation.
- Domiciliary Coverage — Domiciliary hospitalisation refers to situations where you are treated at home due to a lack of hospital beds or because you cannot be moved to the hospital. A policy with domiciliary coverage ensures that you are covered for such home-based treatments, offering more flexibility and comprehensive coverage.
- Good No-Claim Bonus — If you renew your policy for the next year, a no-claim bonus (NCB) is a reward insurers give for not making any claims during the previous policy year. This bonus usually increases your sum insured without increasing the premium. However, do note that there are two types of these bonuses: No-Claim Bonus and Renewal Bonus. The difference is that a renewal bonus will add to your coverage regardless of whether you make a claim or not. This is better than a no claim bonus.
What are the Best Health Insurance Plans in 2025?
1) HDFC ERGO Optima Secure: Optima Secure is one of HDFC ERGO's premier health insurance policies, offering comprehensive coverage. This plan now covers individuals up to 100 years of age, making it suitable for senior citizens, too. It provides 2X coverage right from day one, doubling your coverage without an increase in premiums. It also offers the choice of any hospital room without additional costs and covers pre- and post-hospitalization expenses for 60 and 180 days, respectively. HDFC ERGO does not impose co-payments, and this policy even covers consumables, which not many policies do.
Drawbacks: One of the few drawbacks is that HDFC ERGO policies are slightly more expensive than those of other insurers.
2) CARE Supreme: Care Supreme is known for being a highly affordable and comprehensive health insurance plan. This policy covers individuals up to the age of 99 and is suitable even for those with benign pre-existing conditions like BP or hypothyroidism. It features no co-payments, room rent restrictions, or disease-wise sub-limits. It covers daycare procedures, AYUSH treatments, and domiciliary treatments and includes air ambulance coverage up to ₹5 lakhs per year. The policy offers a restoration of the sum insured up to the base amount for any illness, and its NCB offers a 50% bonus up to 100%, with an add-on that can increase it up to 500% annually.
Drawbacks: Care, as an insurer, has a slightly higher complaint ratio, and this policy does not include annual health checkups, but these can be purchased as an add-on.
3) NIVA BUPA Aspire Titanium+: Niva Bupa Aspire is an innovative health insurance plan designed to cater to people who want maternity and family planning benefits. The plan includes unique features like the M-iracle maternity benefit, Booster+ (which allows unused sums insured to carry forward), and the Future Ready perk, which provides coverage for future spouses without extra waiting periods.
As an insurer, Niva Bupa has a vast network of over 10k hospitals and offers add-ons such as teleconsultations, coverage of pre-existing diseases, consumables, etc. It also has a unique feature where your premiums will not increase due to age until you make a claim.
Drawbacks: The CSR is slightly less than that of its competitors, and Niva Bupa also has a higher complaint volume of 43 for every 10k claims. But if you are looking for a plan with great features and are okay with the higher complaint volume, this policy is for you.
4) Aditya Birla Activ One Max: Aditya Birla Activ One Max offers extensive cashless coverage across India, including Preferred Provider Network (PPN) hospitals, which ensures affordable and transparent billing. Aditya Birla Activ One Max also has no room rent limits, unlimited restoration, a bonus of 100% per annum, and up to 500%, which is excellent. The plan focuses on wellness benefits and provides a smooth claims process, making it a good option for policyholders seeking quick cashless approvals. This plan also has wellness benefits that offer renewal discounts. Sometimes, up to 100%. As an insurer, Aditya Birla has an extensive network of over 12k hospitals offering cashless treatments and has a good claim settlement ratio and incurred claim ratio.
Drawbacks: Aditya Birla is a relatively new insurer. So, we are not sure what their long-term track record will look like.
5) ICICI Lombard Elevate: ICICI Lombard Elevate offers good value for money with a solid set of default features and a wide range of useful add-ons catering to various needs, including benefits like coverage for surrogacy, oocyte donor expenses, bariatric surgery, and wellness programs. While the base plan is fairly comprehensive and the optional covers add significant flexibility.
Drawbacks: While ICICI Lombard is a large and well-established insurer, its Claim Settlement Ratio (CSR) lags slightly behind some of its private sector peers. The CSR reflects the percentage of claims the insurer successfully settles, and a lower ratio could suggest potential delays or disputes during the claim process. For policyholders, this means they might face additional scrutiny or processing time when submitting claims. Although the insurer’s size and reputation are reassuring, it's worth keeping an eye on this metric, especially if hassle-free claim service is a top priority.
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Conclusion
Purchasing a good health insurance policy is essential to protecting yourself and your family from unexpected medical expenses and ensuring you receive superior healthcare without financial pressure.
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