SBI General Health Insurance Claim Settlement Ratio 2026

With deposits of ₹53.8 trillion, the State Bank of India is the largest in the country by a margin. That scale is often seen as a proxy for public trust, and by extension, brand credibility.

This same legacy carries into SBI General Insurance (IRDAI Reg. No. 144). Incorporated in 2009 as a joint venture between SBI and Insurance Australia Group (which later exited), the insurer has since grown into a sizable player, underwriting over ₹3,300 crore in gross health premiums annually.

In this article, we’ll break down SBI General’s claim settlement ratio - what it means, how it has moved over the years, how it compares with competitors, and whether it could be a suitable choice for you.

How to Calculate the SBI General Health Insurance Claim Settlement Ratio?

Claim Settlement Ratio (CSR), while not the only metric, is one of the most important ways to assess an insurer’s performance. It is the percentage of the insurer's total claims settled in a year relative to the total number of claims available to pay.

CSR = (Number of claims settled / Number of claims available to settle with the insurer) X 100The total claims available to settle include claims carried forward from the previous year, new claims reported, claims closed without payment, and claims still pending at year-end. 

Note: The IRDAI doesn’t have any specific formula for calculating the Claim settlement ratio. Hence, these numbers can differ depending on the formula used by different platforms and insurers. We, at Ditto: 

• Use the formula mentioned above, as it better captures long delays in claim settlement by insurers.
• Recommend looking at the 3-year average CSR, since a single year’s data isn’t enough to judge an insurer’s long-term stability.
• Suggest reviewing the 3-year averages of other key metrics as well—such as Average complaints received per 10,000 claims, the Incurred Claims Ratio (ICR) and Gross Written Premium. This is important because CSR alone doesn’t differentiate between partially and fully settled claims, and therefore cannot give the full picture of an insurer’s performance.

Note: The complaint numbers shown above reflect all of SBI General’s products (health, motor, and others), as the insurer does not publish product-wise complaint data separately.

Why Choose Ditto for Health Insurance?

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• No-Spam & No Salesmen
• Rated 4.9/5 on Google Reviews by 15,000+ happy customers
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• Dedicated Claim Support Team
• 100% Free Consultation

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call now, slots fill up fast!

Ditto’s Take on SBI General

• High Claim Settlement: SBI General has consistently reported one of the highest claim settlement ratios in the industry, making it a strong contender on this metric.
• TPA Usage: While SBI General has an in-house claims team, it still relies heavily on TPAs. This can sometimes lead to delays or inefficiencies in the claims process.
• Higher Premiums: Their plans tend to be slightly more expensive than those of peers, especially when you compare benefits. That said, this gap is gradually narrowing with newer offerings like SBI Super Health Platinum Infinite.
• Read the Fine Print: Always go through the policy wording carefully so you’re clear about what’s covered, what’s excluded, and any limits that may apply.

Conclusion

SBI General has a strong brand pedigree, and its performance has consistently kept pace with that of some of the better-performing insurers in the market. That said, specific competitors may offer more well-rounded coverage at a similar premium. So, if you’re looking for the best fit, it’s always worth comparing the top health insurance options based on your individual needs.