Care Health Insurance, formerly called Religare Health Insurance, is a well-established provider selling health, travel, and corporate plans. Since the year 2012, crores of people have come to rely on them. In this article, we'll see the good and the not-so-great aspects of Care and see if Care Health Insurance is a smart choice:

Care Company Overview

Care Health Insurance Limited is a Standalone Health Insurance (SAHI) provider founded in 2012 and rebranded from Religare to Care in 2020. Headquartered in Gurgaon, it operates under 

  • Religare Enterprises (around 64% stake), 
  • with Kedaara Capital (around 16% stake) and 
  • Care employees (around 10% stake) are the other major shareholders. 
  • The Burman family, although not a direct shareholder in Care but holding a 25.18% stake in Religare Enterprises, has been involved in governance disputes over the company. 

With a vast network of over 11,400+hospitals offering cashless treatment to those insured by Care and having sold over 7 crore policies, they are clearly one of the major contenders in the health insurance world, with a market share of over 6% and ₹4,890 crores in annual business volumes.

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Claim Settlement Ratio of Care Health Insurance

An insurance company's Claim Settlement Ratio (CSR) tells us the percentage of claims they settle out of all the claims they receive in a given policy year.  The ideal Claim Settlement Ratio for a health insurer is => 90%. The CSR of Care Health Insurance is 90% (average of last 3 years), equal to the industry average. This implies that Care settles 90 claims for every 100 claims they receive. While not a cause for concern, some other health insurers have a much higher CSR. 

Incurred Claim Ratio of Care Health Insurance

The Incurred Claim Ratio of an insurer tells us about the amount of money they pay out in claims for every Rs 100 they receive in premiums. The ideal range for ICR is 55%-80%, while the industry average for health insurers is 84%. Care Health Insurance's ICR is 59%, much lower than the industry average. While still in the ideal range, this may imply that Care is penny-pinching when it comes to settling claims by rejecting most claims or settling them partially. Conversely, it denotes that Care is profitable and financially stable enough to continue operations.

Complaint Volume of Care Health Insurance

The Complaint Volume of an insurer tells us about the number of claims registered against them for every 10,000 claims they receive. Naturally, the lower an insurer's Complaint Volume is, the better the claim settlement experience it provides. Care's Average Complaint Volume for the last three years is 36, significantly higher than the industry average of 23. Moreover, Care's Complaint Volume has steadily increased in the past five years- from 6 in 2019 to 39 in 2024. This might prove to be a point of concern for its policyholders and, on the flip side, a scope of improvement for the insurer. 

Care Health Insurance Plans Available

Care has the following health insurance plans:

  • Care Ultimate
  • Joy Today
  • Care Plus Complete
  • Enhance Super Top-up
  • Care Heart
  • Care Freedom Plan
  • Care Advantage
  • Care Plus Youth
  • Care Classic
  • Care Senior
  • Care Supreme- Senior Super
  • Care Supreme- Super Saver
  • Senior Health Advantage
  • Supreme Enhance Super Top-up
  • Care Supreme- Senior Premium
  • Care Supreme- Value for Money
  • Care Supreme
  • Care
  • Joy Tomorrow

Pros and Cons of Care Health Insurance

  1. Advantages of Care Health Insurance: 
  • Good CSR: Care's Claim Settlement Ratio stands at 90%, which is not only in the ideal range but also equal to the industry average. This high CSR reflects their reliability in settling most claims, making them a trustworthy choice for policyholders.
  • Long history of insurance data: As a standalone health insurer founded in 2012, Care has a long history of settlement data for customers to fall back on and make decisions accordingly. 
  • Vast network of cashless healthcare providers: Care has a network of more than 11,400 cashless providers that boost your chances of approaching a network hospital that would facilitate cashless settlement.
  • No loading charges: Care has one of the lowest premiums in the market as they generally do not apply loading charges to their premiums. 'Loading charges' are applied to an insured's premium when they have a pre-existing disease (PED), harmful lifestyle habits like smoking or drinking, or an unusual Body Mass Index(BMI). Care may be ideal for people who fall under any of those three categories.
  1. Disadvantages of Care Health Insurance
  • High Complaint Volume: Although not a deal-breaker, Care's high Complaint Volume does dampen the impact of their otherwise solid profile. However, their Complaint Volume has displayed a downward trend in the past year, going down from 40 in 2023 to 39 in 2024. 

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Conclusion

Care Health Insurance offers solid features like a high Claim Settlement Ratio, good Incurred Claim Ratio, low premiums, and a vast network of cashless healthcare providers. However, their Complaint Volume is something to watch out for. 

If you're still unsure which health insurance plan is right for you, consider contacting our expert advisors at Ditto for a free consultation. We'll help you find the right policy and guide you every step of the way until your claim is settled.