Care Health Insurance, previously known as Religare Health Insurance, is one of the industry's most popular standalone health insurers. Founded in 2012, the insurer has gained nationwide popularity over its flexible health insurance plans, affordable premiums, absence of loading charges, and comprehensive policies. While the insurer’s diverse health insurance portfolio surely has our confidence, its recent increase in complaint volume is a tad bit concerning.
| Pros | Cons |
|---|---|
| Good Claim Settlement Ratio | High complaint volume |
| Decent Incurred Claim Ratio | |
| Affordable health insurance plans | |
| No loading charges |
Metrics of Care Health Insurance
Care Health Insurance is a popular provider offering multiple plans catering to potential policyholders' customised financial and health requirements. The provider has a unique offering across all its health insurance plans - no loading charges. Usually, loading charges are applicable on policies based on the pre-existing medical history of policyholders and/or their BMI (Body Mass Index). Such additions increase the base premiums and take a toll on policyholders' wallets.
Now, since Care doesn’t demand loading charges, the premiums for its health insurance plans are one of the lowest in the industry. Subsequently, plans from this stable are especially beneficial for those with pre-existing medical conditions like Asthma, Blood Pressure, Diabetes, etc.
While Care, as a health insurance provider, definitely has a lot to offer to its policyholders, we need to determine its credibility, sustainability for the future, its claim settlement reputation, and top policies. Here’s a look at the metrics that help us understand the credibility of the insurer -
(P.S. Please note that we have taken an average of 3 years to get a more consistent understanding of the insurer’s overall performance.)
Claim Settlement Ratio of Care Health Insurance
One of the first metrics used to determine the credibility of a health insurance provider is the Claim Settlement Ratio or CSR. CSR is given by calculating the % drawn from the ratio of the total number of claims settled against the total number of claims filed to an insurer across a single year.
However, please remember that when calculating this ratio, the outstanding claims of the last year that have been settled this year are added. Also, the outstanding claims from this year are left out. Hence, if you encounter a health insurance provider with 100+ CSR, steer clear of the brand, which indicates delayed claim settlement. On the other hand, any insurer with a CSR of 90% or above is the ideal provider for you.
| Years | Care Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 95.2 | 91.484 |
| 2021 - 2022 | 87.3 | 89.967 |
| 2022 - 2023 | 90.03 | 91.460 | Average (2020 - 2023) | 90.75 | 90.970 |
Insight: Care’s CSR has remained a few points behind the industry average for 3 years. While the numbers are unsatisfactory, and we would have preferred to see Care with CSR which tends towards the higher end of 90s, its current claim Settlement ratio isn’t half-bad.
Incurred Claim Ratio of Care Health Insurance
Knowing and acknowledging its CSR isn’t enough when looking for a health insurance provider. The whole CSR will reveal the number of claims settled, but it doesn’t throw any light on the insurer's sustainability for the near future.
In that case, you need to take a look at the Incurred Claim Ratio (ICR) of an insurer, which is s given by -
(Total amount of claim settled / Total amount of premiums collected in a year) * 100
The ICR of an insurer reveals its financial stability and sustainability. Now, since health insurance plans are crafted as a long-term financial commitment and take on the responsibility of being a financial safety net during a health crisis, such a metric is crucial. Any insurer with an ICR between 50 and 70 (can go a bit higher) is perfect and shows that the provider lays equal priority to claim settlement and business stability. On the other hand, steer clear of insurers with ICR below 50 and above 100. These extremes indicate that either the insurer is heading for a financial crisis (above 100) or is too focused on stabilising its business (below 50) and might miss out on settling your claims.
| Years | Care Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 55.15 | 78.27 |
| 2021 - 2022 | 65.07 | 91.79 |
| 2022 - 2023 | 53.49 | 78.82 | Average (2020 - 2023) | 58.01 | 82.96 |
Insight: While Care’s ICR is in the ideal range of 50 and 70, the numbers being too close to the lower threshold is not a good sign for potential policyholders. This indicates that Care is a tad bit focused on keeping its business stable. We would rather have it closer to the industry average (80+) because this would indicate that Care prioritises client requirements of claim settlement.
Complaint Volume of Care Health Insurance
As a potential policyholder, your priority when choosing a health insurance provider is a brand that extends the hassle-free claim settlement process. To ensure this, you need to look at the data regarding the complaint volume of an insurer. The higher the complaint volume, the lower the chances of a credible provider (because complaints against a health insurer are almost always about a policyholder’s claim settlement experience).
| Years | HDFC Ergo Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 22.21 | 13.212 |
| 2021 - 2022 | 29.38 | 35.969 |
| 2022 - 2023 | 40 | 19.578 | Average (2020 - 2023) | 30.53 | 24.029 |
Insight: Care’s complaint volume has been increasing over the years, and this is a matter of grave concern because irrespective of how affordable a stable’s health insurance products are, if its overall operational efficiency is poor, that’s not a good indicator for its policyholders. While Care’s standalone status as a health insurance provider partially explains its high complaint numbers, multiple other standalone insurers have lower complaint volumes.
Top Health Insurance Plans Offered by Care Health Insurance
Care Health Insurance has an exhaustive list of health insurance products. These plans are affordable, primarily comprehensive, and without unreasonable restrictions. Neither of these plans charges any loading fees. Here is a look at some of the most popular plans from the stable of Care
Care Supreme is the latest launch from the stable and is an extraordinary pick. The policy’s features are an unbelievable buy at the premiums Care is offering. The policy is possibly one of the cheapest buys in the market. It extends features like - no copayment, no room rent restrictions, no disease-wise sub-limits, daycare and domiciliary coverage, AYUSH coverage, unlimited restoration perk, and more.
While this shows the basic coverage extended by the policy, if you are looking for unique offerings, you will have to choose from its long list of health insurance add–ons:
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Instant Cover: In case you have been diagnosed with Hypertension, Diabetes, Hyperlipidemia and Asthma, usually you have a waiting period of 4 years under the Care Supreme policy. However, if you opt for the Instant Cover add-on, your waiting period gets reduced to 30 days only.
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Cumulative Bonus Super: Under this add-on, upon each policy renewal, you receive a Bonus of 100% of the sum insured up to a maximum of 500%. If you are 45 or younger or between the ages of 76 and 99, this add-on is added by default to your plan.
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Wellness Benefit: This rider offers you a basic discount based on the step goal set by your insurer. In the case of Care Supreme, the insurer expects you to complete 10k steps in a pre-set number of days, following which they will offer you a discount on your premium during renewal as an incentive for taking the initiative to stay healthy.
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Annual Health Check-Up: Under this plan, you can get a free annual check-up at a partner hospital of the insurer. However, please note that the insurer has a list of medical tests covered under this perk, and the feature can only be availed in network healthcare facilities.
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OPD coverage: While the built-in features of Care Supreme take care of hospitalisation expenses, this add-on covers your outpatient charges. This included physician fees, diagnostic charges, pharmacy bills, and more. However, the add-on has a cap on the frequency of visits to general physicians and specialists and a sub-limit on the fees per visit.
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Claim Shield: Non-payable items or consumables (equipment required across procedures/surgeries/treatments) like bandages, syringes, gloves, etc., hold a significant share of the hospital invoice and are generally not covered by an insurer. However, with this add-on, such non-payable items are funded by the health insurance plan.
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Reduction in Pre-Existing Disease Waiting Period: The usual pre-existing disease waiting period for Care Supreme is 48 months or 4 years. This is extensive and might pose a solid hurdle for potential policyholders. Hence, with an add-on like PED Reduction, you can cut down your waiting period from 48 months to 36 months, 24 months, or 12 months.
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Apart from this, there is also the Air Ambulance Cover add-on to customise your policy further.
Drawbacks: The in-built waiting period for policyholders with pre-existing medical conditions is 48 months. The next drawback of this policy is its extensive list of add-ons, which is confusing and yet essential to tap into the policy's full potential.
One of the most basic policies from the Stable of Care is the Care Health Insurance Plan. The policy extends exhaustive coverage of ₹5 lakhs to ₹75 lakhs. It comes with a list of diverse add-ons - Care Shield, Unlimited Automatic Recharge, No-Claim Bonus Super, Reduction in Pre-Existing Disease Waiting Period, Air Ambulance Coverage, OPD Coverage, Everyday Care, and Co-Pay Waiver.
Drawbacks: The policy has certain room rent restrictions unless your sum insured exceeds ₹50 lakhs, a copayment of 20%, nominal pre and post-hospitalisation coverage of 30 and 60 days, multiple sub-limits on its coverage, and more.
Care Freedom is not a comprehensive policy but offers unique coverage options for policyholders with pre-existing medical conditions. It's also one of the only few options in the market if you seek coverage as a Cancer patient in remission. While other health insurance plans reject such policyholders' applications outright, Care Freedom extends coverage by putting a permanent exclusion on the ailment and other underwriting terms and conditions.
Drawbacks: The plan comes with copayment, disease-wise sub-limits, room rent restrictions, no No-Claim Bonus, no AYUSHH treatment coverage, and more such restrictions. Additionally, despite being a niche product crafted for policyholders with pre-existing medical conditions, it has a 2 years waiting period for the coverage of such ailments.
Conclusion
Care offers one of the most affordable health insurance products on the market. If you are looking for an affordable policy with multiple customisation points via add-ons, Care is a great pick. However, we recommend you also factor in the insurer’s rising complaint volume before finalising a health insurance plan from this stable.