What is Star Health Insurance’s Claim Settlement Ratio?
Star’s average claim settlement ratio (CSR) over the past three years (2022–2025) stands at around 85%, notably below the industry average of 91.3%.
This suggests that while Star is a major player with diverse plans, its claim efficiency still lags behind that of its peers.
In simple terms, Star settles most of its claims, but its performance remains inconsistent year-on-year compared to peers like HDFC ERGO or Aditya Birla, who maintain CSRs above 90%.
Introduction
Star Health Insurance Company is a prominent player across the Indian health insurance sector, offering a diverse portfolio of health insurance policies. The insurer is India’s first standalone health insurance company and is currently the second-largest in terms of health insurance volumes.
Given the significant market share, many people associate the company with a good claim settlement ratio. But is this truly the case? Let’s find out.
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What is Claim Settlement Ratio?
A company’s claim settlement ratio (CSR) shows us the percentage of claims settled against the total claims it receives within a given financial year.
For example, if an insurance company receives 1,000 claims but settles only 950 claims, it has a CSR of 95% in a given year.
The ideal range of CSR for a good health insurance provider is above 90 and below 100. On the other hand, any insurer with a CSR above 100 indicates that the insurer has an issue with delayed claim settlement, while a provider with a CSR below 80 suggests that the insurer may be rejecting a significant number of claims.
Thus, as a policyholder, you should steer clear of an insurer with a CSR that is below 80 and above 100.
Star Health Insurance Settlement Ratio
Here are the last 3 years’ CSR of Star Health Insurance. All figures are sourced from IRDAI public disclosures & the insurer’s public disclosures.
How to Calculate the Claim Settlement Ratio of Star Health Insurance?
You may find that the official CSR figures published by insurers differ from ours, as they may use slightly different calculation methods.
At Ditto, we rely on a simple and transparent approach:
CSR = (Total claims settled ÷ Total claims they had to settle) × 100
Here, “total claims settled” includes claims carried over from the previous year plus newly filed claims, minus those closed without payment and those still pending at year-end.
We usually take a 3-year average of the CSR because claim performance can fluctuate year to year, and averaging smooths out one-off spikes or dips. This helps you see an insurer’s true, long-term claim consistency rather than a potentially misleading single-year snapshot.
Other Performance Metrics of Star Health Insurance
- Average Complaints: Star Health records a three-year average of 52.31 complaints per 10,000 claims, which is noticeably higher than many leading private insurers that typically stay below 20. This suggests that while Star is one of the biggest players in the market, there is clear room to improve customer experience, especially around claim servicing and post-sale support.
- Incurred Claim Ratio (ICR): With a three-year average ICR of 65.5%, Star Health sits comfortably within the ideal 50–80% range. This shows that the insurer is maintaining financial health while still paying a reasonable volume of claims.
- Annual Business / Gross Written Premium (GWP): Star’s business has grown from ₹12,952 crore in FY 2022–23 to ₹16,716 crore in FY 2024–25. An average GWP of ₹14,974 crore highlights its position as the country’s largest standalone health insurer and reflects strong customer trust and increasing market penetration.
- Network Hospitals: Star Health’s network strength is one of the widest in the industry. This extensive network significantly boosts accessibility to cashless treatment.
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Conclusion
Star Health’s CSR of around 85% indicates decent performance, though not flawless. Its claims process and network of hospitals are some things to look out for. While most of Star’s plans address niche requirements, you must weigh the insurer’s pros and cons before making a final decision.
FAQs
Are pre-existing diseases covered by Star Health Insurance?
Pre-existing diseases are usually subject to waiting periods as per the policy and add-ons you select. Depending on how severe your pre-existing condition is, Star Health may accept or decline your policy application as per its underwriting rules.
Which company is No. 1 based on claim settlement ratio?
Based solely on the claim settlement ratio, New India Assurance is the #1 company, with an average CSR of 98.91% over the last three years.
Is Star Health a good insurance company?
Based on CSR, Star Health Insurance has consistently performed below the industry average for the last three years. That said, Star offers niche plans that cater to an audience often neglected by other insurers. This has to be kept in mind before making a decision.
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