Reliance General Health Insurance Claim Settlement Ratio

Q: How do I file a cashless health insurance claim with Reliance General?

To file a cashless claim, get admitted to a Reliance General network hospital, present your health card and photo ID, and submit the cashless request form with required documents. The hospital coordinates with RCare Health/TPA for pre-authorization. For planned treatments, authorization details should be shared at least two days in advance. In emergencies, the hospital sends the authorization request immediately.

Q: How do I file a reimbursement claim?

Inform RCare Health/TPA at the earliest, pay the hospital expenses upfront, and collect all original bills and medical documents. Submit these along with the completed claim form. This process applies to both planned and emergency hospitalizations, and eligible expenses are reimbursed as per policy terms.

Q: How long does claim processing take?

Cashless claim pre-authorization is usually approved within one hour, and final discharge authorization is provided within three hours of receiving the request. Reimbursement claims are generally processed within 15 days after RCare Health/TPA receives all required documents.

Quick Overview

Reliance General Health Insurance recorded a claim settlement ratio (CSR) of 86.38% for FY 2024–25. Its three-year average CSR comes in at 87.45% (2022–25), which sits below the industry benchmark and indicates relatively weaker claim-handling consistency over recent years.

Reliance General Insurance is a long-standing general insurer in India that offers health, motor, travel, and commercial insurance products. With over two decades in the market, it remains a familiar name for many policyholders.

When evaluating a health insurer, one key question often arises: Is Reliance General reliable when it comes to settling claims?

This is where the Claim Settlement Ratio (CSR) becomes important. It reflects the proportion of claims an insurer has settled in a given year, offering a useful indicator of its reliability during a medical emergency.

In this article, we take a closer look at Reliance General Health Insurance CSR trends and assess what they reveal about its claims reliability.

Reliance General Health Insurance Claim Settlement Ratio

Financial Year	Reliance General Health Insurance CSR	Industry Average (in %)
FY 2022–23	89.65%	91.2%
FY 2023–24	86.32%	91.18%
FY 2024-25	86.38%	91.5%
Average CSR(2022-25)	87.45%	91.22%

Note: The above figures are based on the insurer’s public disclosures (Form NL 37).

Insights: Reliance General Health Insurance CSR shows a downward trend over these three years, consistently staying below the industry average. With a 3-year average of 87.45%, the insurer’s claim performance indicates room for improvement in efficiency and consistency.

To examine an insurer’s performance more accurately, we focus on a three-year average CSR instead of a year. This helps balance out temporary fluctuations and gives a clear picture of the insurer’s long-term claim reliability.

How to Calculate Reliance General Health Insurance Claim Settlement Ratio?

The claim settlement ratio published by insurers may differ from the figures we report. This happens because insurers often use their own internal formulas or classification methods.

At Ditto, we follow a transparent and uniform calculation:

CSR = (Claims Settled ÷ Total Claims Requiring a Decision) × 100

The total number of claims requiring a decision is calculated by adding the unsettled claims from the previous year to the new claims filed, and then subtracting the claims that were closed without payment and those still pending.

There are several other indicators that help you understand how Reliance General Insurance actually performs. Here’s an overview:

Reliance General Health Insurance: Key Performance Metrics

Metrics	FY 2022-23	FY 2023-24	FY 2024-25	Average (FY 2022–25)
Average Complaints per 10,000 claims	4.90	2.99	5.04	4.31
Incurred Claim Ratio (ICR) (%)	86.31	89.42	NA	91.50 (3-year avg for 2021–24)
Annual Business / GWP (₹ crore)	1,561	2,054	2,217	1,944

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Key Insights

Average Complaints

Reliance General’s complaint count fluctuates across the three years, with an average of 4.31 complaints per 10,000 claims. Despite some variation, the performance indicates strong customer experience and claim service quality.

Incurred Claim Ratio (ICR)

With a three-year average ICR of 91.50% (2021–24), Reliance General operates above the commonly preferred 50–80% range. A high ICR implies a large share of premiums going toward claims, which may strain finances.

Annual Business / Gross Written Premium (GWP)

Reliance General shows a steady but modest GWP, rising from ₹1,561 crore in FY 2022–23 to ₹2,217 crore in FY 2024–25. This reflects slow but consistent expansion.

Network Hospitals

Reliance General offers access to over 10,000 network hospitals and provides a wide cashless treatment network across the country.

Let’s compare Reliance General Health Insurance with other insurers based on their average CSR over the past three financial years.

As seen in the infographic, Reliance General does not feature among the top 10 insurers by claim settlement ratio. This suggests there is room for improvement in its claims-handling efficiency.

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Reliance General Health Insurance Claim Settlement Ratio

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Ditto’s Take

The Reliance Health CSR falls within a moderate range but is relatively lower than many other insurers in the market. On the positive side, it offers a reasonably wide hospital network, comparatively lower complaint volumes, and competitively priced plans similar to peers like Care and Niva Bupa.

For a better understanding of how to choose the right plan, reach out to our expert advisors for unbiased guidance tailored to your needs.

Note: Reliance General is not a Ditto partner, and all information in this article is drawn from publicly available sources, including the company’s website, disclosures, and annual reports. To learn more about how we evaluate insurers, check out Ditto’s Cut.

Frequently Asked Questions

How do I file a cashless health insurance claim with Reliance General?

Get admitted to a network hospital, present your health card, submit a cashless request form along with required documents, and photo ID. The hospital coordinates with RCare Health/TPA for pre-authorization. For planned treatments, provide authorization details at least two days in advance. In emergency situations, the hospital will send authorization immediately.

How do I file a reimbursement claim?

Notify RCare Health/TPA as soon as possible, pay the hospital bills in full, collect all original documents, and submit them along with the completed claim form. This applies to both emergency and planned hospitalizations. RCare Health/TPA will process your claim and reimburse the eligible expenses according to the policy terms.

How long does claim processing take?

For cashless claims, pre-authorization is generally approved within one hour, and final discharge authorization is granted within three hours of receiving the request. For reimbursement claims, RCare Health/TPA typically processes and adjudicates claims within 15 days of receiving the required documents.

Last updated on: 20 Dec, 2025