What is Care Health Insurance Claim Settlement Ratio for 2024-25?
According to IRDAI public disclosures for insurers, the claim settlement ratio (CSR) of Care Health insurance for FY 2024–25 is a solid 97%. However, the average CSR for Care Health Insurance from 2022-2025 shows 93.13%, ranking it lower than other top insurers, like HDFC ERGO.
Care Health Insurance Claim Settlement Ratio: Overview
An insurer’s reputation is built on numbers, and Care Health is no exception. As the second-largest standalone health insurer, Care Health offers a diverse portfolio of health insurance policies.
Given the significant market share, many people associate Care Health Insurance with a good claim settlement ratio. But is this truly the case? Let’s find out.
In this article, you will learn :
- What is claim settlement ratio?
- How to calculate the claim settlement ratio of Care Health insurance?
- Where can you find the claim settlement ratio for Care Health insurance?
- Care Health insurance’s past 3 years' claim settlement ratio
- Top health insurers in 2025 and their CSR
Friendly reminder: It’s easy to get lost comparing policies and premiums. Instead of spending hours on it, why not get personalised insurance advice from Ditto? We offer free consultations with zero spam! Just 30 minutes to clarify all your doubts. Book a call now!
What Is Claim Settlement Ratio?
Claim Settlement Ratio (CSR) is the percentage of claims paid by an insurance company out of the total claims received in a financial year.
But a high CSR (like >97%) isn’t the deciding point. It simply means the insurer honors most claims raised within that year. However, there’s no guarantee that all claims are approved.
In fact, health claims can be rejected for multiple reasons, starting with missing documents to specific policy exclusions. Find out more about the possible reasons why health claims can be rejected.
How to Calculate The Claim Settlement Ratio of Care Health Insurance?
One can calculate the claim settlement ratio of Care Health insurance in three simple steps.
Step 1: Note the total number of claims received by the insurer in a financial year.
Step 2: Note the total claims approved/settled in that year.
Step 3: Now, apply the formula: CSR = (Approved ÷ Received) × 100.
So, if 10,000 claims were reported and 9,674 were settled, the CSR would be 96.74%. To know more about CSR in detail, how it's calculated, and factors involved, check out our dedicated guide.
The illustration below shows how to interpret CSR and Ditto’s unique approach to CSR calculation.
Where Can I Find The Claim Settlement Ratio For Care Health Insurance?
IRDAI mandates insurers to publish their quarterly claims data publicly. This helps customers compare and evaluate actual claim settlement performance before purchasing a policy.
Here are your top sources to find the claim settlement ratio for care health insurance:
Care Health Insurance Claim Settlement Ratio Over 3 Years
To compare real-time performance, here are India’s top insurers with consistently high CSR across FY 2022-2025:
Top Health Insurers Based on Claim Settlement Ratio (FY 2022–25)
Source: IRDAI Public Disclosures consolidated in Ditto internal metrics (FY 2022–25).
To find out more about how Care Health compares against other insurers, read our exclusive guide on best health insurance plans in 2025.
Should You Buy Care Health Insurance : Ditto’s Take
Care Health Insurance pays about 97% of claims, which is definitely a plus point. But there are other compelling reasons that make it a good option.
Here’s how Care Health insurance scores on vital metrics across FY 2022–25:
- Care Health’s annual business volume: ₹6,775 Cr. (shows stability)
- Care Health’s Incurred Claim Ratio (ICR) [2021-24]: 58.86% (shows financial sustainability )
- Care Health’s complaints per 10,000 claims: 42 (suggests low friction)
- Care Health’s network hospital strength: 11,400+ (packs wide accessibility and convenience for policyholders)
Why Choose Ditto For Health Insurance?
At Ditto, we’ve helped 8,00,000+ customers match their unique needs to the right health insurance policy. That’s why customers like Pramey trust Ditto and recommend us to others.
✅No-Spam & No Salesmen
✅Rated 4.9/5 on Google Reviews by 12,000+ happy customers
✅Backed by Zerodha
✅100% Free Consultation
Conclusion
Care Health’s CSR of 93.13% across FY 2022-25 indicates decent performance, though not flawless. Nevertheless, its extensive cashless hospital network and health plans for all budgets make up for it.
Even though most of Care Health's plans address niche requirements, you must weigh the insurer’s pros and cons before making a final decision.
If you need help choosing the right policy, feel free to chat with us on WhatsApp or book a call at a convenient time. No spam. Just honest insurance advice.
FAQs
Are pre-existing diseases covered in Care Health Insurance?
Coverage for pre-existing diseases is only available after the completion of the waiting period. However, with Care Health, you have the option to customize and reduce the waiting period.
For example, by default, Care Supreme Plan has a waiting period of 3 years for PEDs and 2 years for specific illness. The PED waiting period can be brought down to 1 or 2 years for all diseases and to 30 days for certain diseases.
What is the difference between CSR and ICR?
Claim settlement ratio or CSR is a count-based metric denoting the share of reported claims that were settled. On the other hand, Incurred Claim Ratio or ICR is an amount-based metric (derived as claims paid ÷ premium).
To know more about how each metric affects buying decisions, read our exclusive guide on Claim Settlement Ratio (CSR) and Incurred Claim Ratio(ICR).
How fast are medical claims settled?
Cashless claims are usually faster than reimbursement. If you have all the right documents in order, insurers are expected to settle or reject within 30 days from the last document received. Any delay may attract a penalty.
Where can I verify Care Health’s CSR?
To verify Care Health’s Check, check IRDAI Public Disclosures and Care Health’s own public disclosures for the latest FY. from their official website.
Last updated on: