Founded in 2014, Manipal Cigna Health Insurance was previously known as CignaTTK Health Insurance Company Limited. This standalone health insurance provider is one of the few insurers that keeps up with its “no waiting periods” marketed statement. However, this is only true for their group health insurance policies. When it comes to retail health insurance plans, the policies are pretty limited and are a tad bit expensive compared to the others in its category.
On the other hand, if we are talking about the credibility of Manipal Cigna Health Insurance, numbers like Claim Settlement Ratio and Incurred Claim Ratio look reasonable. However, their overall complaint volume is a significant concern, considering it reflects their overall operational proficiency.
| Pros | Cons |
|---|---|
| Decent Claim Settlement Ratio | High Complaint Volume |
| Good Incurred Claim Ratio | Expensive health insurance plans |
Metrics of Manipal Cigna Health Insurance
As a joint venture between the Manipal Group and U.S.-based Cigna Corporation, Manipal Cigna has gained quite a reputation in the market thanks to its comprehensive group health insurance policies. However, regarding its individual and family health insurance plans, the insurer still has some issues to address in order to compete with the best in the industry.
But before we delve into the details of its health insurance plans, let’s focus on determining the insurer's credibility. To do this, we have taken a few metrics, averaged the data over the past 3 years (to determine consistency), and tallied them against the industry average.
Claim Settlement Ratio of Manipal Cigna Health Insurance
An insurer's Claim Settlement Ratio (CSR) is one of the primary metrics used to determine its credibility. It is given by the total number of claims settled by the insurer over a year divided by the total number of claims raised to the insurer over the year. This ratio is multiplied by 100, and you get the CSR of an insurer.
- An insurer with a CSR of below 80 is best avoided since it indicates that the company fails to settle claims for its policyholders.
- If the CSR is above 100, steer clear of the provider because this shows that the insurer has issues with the timely settlement of claims, and this delay is reflected in its 100+ CSR.
- The ideal CSR range is between 90 and 100. Any insurer with such numbers is a golden pick. (However, CSR can't be the only metric to consider when deciding upon a health insurance provider.)
| Years | Manipal Cigna Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 90.26 | 91.484 |
| 2021 - 2022 | 89.81 | 89.967 |
| 2022 - 2023 | 90.16 | 91.460 |
| Average (2020 - 2023) | 90.08 | 90.970 |
Insight: Manipal Cigna’s CSR crosses the 90+, but barely. Moreover, the numbers are yet to cross the industry average. So, while we consider Manipal Cigna’s CSR a decent number, we can’t place the insurer among the top providers in the current market (based on CSR).
Incurred Claim Ratio of Manipal Cigna Health Insurance
While the Claim Settlement Ratio (CSR) gives an overview of the number of claims settled by an insurer throughout a year, it's crucial to determine if the insurer is settling claims entirely or partially.
To analyse this, you need to look at an insurer’s Incurred Claim Ratio, which is given by -
(Total amount of claim settled / Total amount of claim filed for a single year) * 100
- If the ICR falls below 50, it suggests that the insurer may prioritise its business interests over ensuring complete claim settlements. This raises concerns for policyholders, who may face rejected claims or partial settlements.
- For health insurance providers, the ideal range for the ICR is between 50 and 70. Insurers within this range, possibly slightly higher, demonstrate a balanced approach, focusing on settling policyholder claims while maintaining business stability.
- If the ICR exceeds 100, insurers are paying out more claims than the premiums collected. While this may seem beneficial for policyholders initially, it could lead to financial challenges and sustainability issues for the insurer's brand in the long term, indicating potential concerns ahead.
| Years | Manipal Cigna Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 61.13 | 78.27 |
| 2021 - 2022 | 76.17 | 91.79 |
| 2022 - 2023 | 64.66 | 78.82 |
| Average (2020 - 2023) | 67.32 | 82.96 |
Insight: Manipal Cigna’s ICR falls within the recommended range of 50 to 70. This is a good sign for potential policyholders as chances are slim that their valid claims will be rejected by the provider.
Complaint Volume of Manipal Cigna Health Insurance
It's crucial to examine the complaint numbers of a health insurance provider to assess its credibility. Higher complaint numbers indicate poorer performance by the insurer. Since most complaints usually revolve around claim settlement issues, avoiding insurers with a high volume of complaints is advisable.
| Years | Manipal Cigna Health Insurance | Industry Average |
|---|---|---|
| 2020 - 2021 | 23 | 13.212 |
| 2021 - 2022 | 31 | 35.969 |
| 2022 - 2023 | 19.4 | 19.578 |
| Average (2020 - 2023) | 24.47 | 24.029 |
Insight: The complaint volume for Manipal Cigna is a significant hurdle for potential policyholders. Since complaints are generally rooted in claim settlement issues, the high numbers should be a major concern before you consider finalising your health insurance provider.
Top Health Insurance Plans Offered by Manipal Cigna Health Insurance
This is an economical and basic plan from the stable of Manipal Cigna. The policy covers most bases via no copayment requirement, no disease-wise sub-limits, 60 and 90 days of pre and post-hospitalisation coverage, restoration perks, daycare coverage, AYUSH coverage, and domiciliary coverage.
However, the policy has a few drawbacks.
Drawbacks: The policy offers a maximum coverage of ₹25 lakhs, which might not be optimum if you have certain specialised surgeries in mind. Moreover, there is a room rent restriction of ₹3000/day only. If your room rent is higher than this, you will be paying a pro-rata-based share of the entire hospital bill.
This is one of the decent health insurance policies from Manipal Cigna, considering its comprehensiveness and affordability. From international coverage for emergency treatments, no copayment (unless you turn 65, in which case you have a mandatory 20% copay), no disease-wise sub-limits, domiciliary and daycare coverage, and more. However, this plan has a couple of caveats that are difficult to ignore and might motivate you to look for other alternatives.
Drawbacks: The waiting period for policyholders with pre-existing conditions is 4 years, which is a bit extensive. Free health checkups are available only once every 3 years.
With a maximum coverage of up to ₹1 crore, this plan is comprehensive and barely lacks a feature. It offers international coverage, covers OPD benefits (up to ₹15,000/year), no room rent restrictions, no copayment, no disease-wise sub-limits, daycare coverage, restoration perks, domiciliary coverage, AYUSH coverage, and more.
Drawbacks: The plan is costly and can’t be a choice for only those with extraordinary financial stability.
Conclusion
Overall, Manipal Cigna is an okay-ish pick as a health insurance provider. We would have preferred the insurer to have a lower complaint volume, a higher CSR, and more affordable options in comprehensive health insurance plans. So, unless you hold brand loyalty, you might want to look at other health insurance providers in the country rather than this provider.