Kotak Health Insurance CSR Review 2025

Zurich Kotak Health Insurance made headlines last year after Zurich Insurance acquired a 70% stake in the company. The move promised a blend of global expertise and local know-how, an exciting prospect for policyholders.But while the rebrand sounds impressive on paper, we wanted to dig deeper. One of the best ways to judge an insurer is by its Claim Settlement Ratio (CSR), which shows how reliably claims are paid. 

For FY 2023-2024, Kotak’s CSR stood at 89%, with a three-year average of 91%. Not industry-leading, but not a deal-breaker either.

But how does it compare to top players like HDFC ERGO and Aditya Birla? That’s what we cover in this review, so let’s dive right in.

Top 10 Health Insurance Companies Based on CSR 2025

When comparing insurers, a CSR above 90% is considered a strong indicator. Here are the top performers based on the latest available data:

Rank	Health Insurance Company	CSR 2021–2022 (%)	CSR 2022–2023 (%)	CSR 2023–2024 (%)	Average CSR (%)
1	HDFC ERGO	100	95	97	98
2	SBI General	97	94	98	97
3	Aditya Birla	94	96	96	95
3	Bajaj Allianz	91	97	96	95
3	IFFCO Tokio	96	95	93	95
6	Niva Bupa	91	91	92	91
6	Zurich Kotak	91	93	89	91
8	Care Health	87	90	93	90
9	ICICI Lombard	86	85	85	85
10	Star Health	82	80	86	83

All figures are sourced from the insurer’s official public disclosure.

Ditto’s Insight: As the table indicates, Zurich Kotak Health Insurance sits comfortably above industry laggards but falls short of top-tier insurers such as HDFC ERGO or Aditya Birla. It’s in the "good but not great" territory.

If you want to understand how we calculated the claim settlement ratio, you can check out our article on the Claim Settlement Ratio of Health Insurance Companies here. 

These rankings show where Kotak stands on paper, but let’s dig deeper to understand how its CSR really compares to its peers.

Why Does the Claim Settlement Ratio Matter? A high CSR usually means a smoother claims process. However, CSR alone doesn’t tell the whole story, as some insurers might delay claims or settle small ones more quickly to pad their numbers. That’s why, at Ditto, we always look at the complete performance picture, not just the ratio.

Kotak Health Insurance CSR vs Other Health Insurer CSRs

In the competitive landscape of health insurance, every percentage point counts. While Kotak Health’s average CSR of 91% isn’t bad, it doesn’t scream “market leader” either.

What works in its favor:

• Consistency over the past 3 years
• Low complaint volume.

Ditto’s Verdict: The low complaint volume is a result of it being a general insurer. If we were to compare it with other general insurer complaints, such as HDFC, Bajaj, and ICICI, it would be relatively high. 

If CSR is your top priority, insurers like HDFC ERGO (98%), Aditya Birla (95%), and Bajaj Allianz (95%) may offer greater peace of mind.

Still, a CSR over 90% is workable, as long as Kotak checks other boxes, such as network hospitals, pricing, and customer experience.

Did You Know? Insurers that settle claims in-house tend to offer faster response times and better accountability. For instance, for retail / personal health insurance policies, Zurich Kotak uses both in-house claim settlement and TPAs. The majority of retail customers are handled via TPAs (e.g., Family Health Plan), and a small subset is managed in-house, as reflected in the disclosure.

Other Key Factors to Consider While Choosing a Health Insurer

Claim Settlement Ratio is just one piece of the puzzle. Choosing the right health insurance provider requires a more holistic view. Here are the other critical metrics to keep in mind:

1) Incurred Claim Ratio

It shows how much the insurer is paying out relative to its earnings. This is calculated as the total claims paid divided by the total premiums collected. How to judge? A very low ICR (<50%) may indicate high rejections or overpricing, while a very high ICR (>100%) may suggest financial instability.

Kotak has an ICR of 62% (average of 21-24), which falls in the relatively safer zone. 

2) Complaint Volume

Another essential factor to consider is that an insurer may approve claims but still deliver poor service. The complaint volume is calculated as complaints per 10,000 claims, and the lower this number is, the better it is for you.

Kotak scores well here, with fewer complaints (17 on average from 2021 to 2024) compared to some more prominent insurers.

3) Network Hospitals

A vast cashless hospital network ensures you can access treatment without paying upfront. Always check the number of hospitals in the insurer’s network and verify if your preferred hospitals are covered.

Kotak has a network of 16,900+ hospitals, which is excellent. 

Pro Tip: Even insurers with a high CSR can become inconvenient if their hospital network is limited.

So how does Kotak measure up when we take all these factors into account? Here’s our take based on what really matters.

Ditto’s Take on Kotak Health’s CSR

Kotak Health Insurance’s Claim Settlement Ratio (CSR) stands at 89% for FY 2023-24 and averages 91% over the last three years, placing it at 6th in our rankings. That’s not bad at all. While it doesn’t reach the gold standard of 95% or higher, like HDFC ERGO or Aditya Birla, it remains within the acceptable range, especially if the rest of the insurer’s performance holds up. 

And in Kotak’s case, other metrics do look decent.

Its Incurred Claim Ratio (ICR) is balanced. It’s not so high that it raises questions about sustainability, and not too low to suggest aggressive rejections. Notably, Kotak performs exceptionally well in terms of complaint volume, which is a key indicator of service quality. In fact, it surpasses many larger insurers in this regard.

That said, Kotak is still relatively new in the health insurance space. It entered the market in 2015 and is continuing to expand its portfolio. It doesn’t yet have the kind of depth or innovation seen in more seasoned players, such as HDFC ERGO, Niva Bupa, or Care Health.

So, should you pick Kotak?

If you’re already a Kotak Mahindra Bank customer, or if you value the backing of a strong financial group, Kotak could be a good fit, assuming the product features align with your needs.

Why Choose Ditto for Health Insurance

At Ditto, we’ve assisted over 7,00,000 customers with choosing the right insurance policy. Why customers like Varun below love us:

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Conclusion

Zurich Kotak Health Insurance’s 3-year average claim settlement ratio of 91% places it firmly in the “good but not great” category. It offers consistency, relatively low complaint volumes, and a robust hospital network. However, if your top priority is an impeccable claims track record, insurers like HDFC ERGO or Aditya Birla remain ahead.

If you want a balanced choice with solid service and global backing, Kotak is worth considering. But if peace of mind for claim approvals matters most, it’s wise to compare Kotak against higher-ranked insurers before deciding.

Need more help? Speak with a Ditto advisor to understand if Kotak’s plans, pricing, and claim experience truly fit your needs, or if another option might serve you better.

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