Picture this: You’re rushing a loved one to the hospital in the midst of an emergency. Then comes the paperwork, the bills, and the formalities. Your focus shifts from the health of your loved one to the unpaid bills. That’s where health insurance steps in, relieving you from the worry of payments and instead directing your attention to more pressing issues at hand. 

However, not all insurers are the same. Some dabble in everything, from motor and home to travel insurance, while others go all in on health. These specialists called Standalone Health Insurance Companies (SAHI), live and breathe healthcare, often offering more tailored plans, bigger benefits, and smoother claims.

In this article, we’ll break down what makes standalone insurers special, weigh the pros and cons, and walk you through the top 5 standalone health insurance providers in India — so you can choose the best safety net for you and your family. Let’s dive in!

Pro Tip: Still unsure which plan is right for you? Ditto can help! Get a free 30-minute consultation with expert advisors who provide honest, unbiased insurance advice—no spam, no hidden agendas. Just the right guidance to ensure you make an informed decision.

What are Standalone Health Insurance Companies?

Unlike general insurance providers, standalone health insurance providers only sell health, accident, and travel covers. Star Health and Allied Insurance became the first standalone health insurer in India in 2006. Since then, an array of other companies, like Care, Niva Bupa, and Aditya Birla, have followed suit. 

Standalone health insurance companies have grown significantly due to their specialized focus on healthcare and are regulated by the Insurance Regulatory and Development Authority of India.

Key Features of Standalone Health Insurance Providers

What sets standalone health insurers apart? It’s their laser-sharp focus on healthcare. As they specialize in health insurance alone, they can craft more comprehensive, flexible, and personalized policies. Let’s break down the key features that make them stand out:

Comprehensive health benefits: Standalone health insurers offer more extensive and inclusive coverage with higher sum insured options and unlimited restoration benefits. Their plans often include wellness programs, OPD coverage, and domiciliary treatments, with fewer sub-limits and co-payment clauses than general insurers, providing enhanced financial protection. 

Specialization in health insurance: These insurers focus solely on health policies, allowing them to offer more tailored, disease-specific plans and innovative features like maternity benefits, renewal bonuses, and wellness incentives.

Catering to different segments of society: Standalone health insurance companies design policies to meet the needs of various demographics, offering affordable plans for low-income individuals, family floater policies, senior citizen plans, and critical illness covers.

Pros of a Standalone Health Insurer

Why choose a standalone health insurer over a general one? It all comes down to specialization. Since these companies focus purely on health insurance, they can refine their offerings, streamline claims, and provide more flexible, tailored coverage. Let’s get into the advantages of a standalone health insurance provider:

Diverse portfolio of health insurance plans: Standalone health insurers offer a broad spectrum of health insurance products. Their product lineup includes individual and family floater plans, senior citizen health insurance, critical illness coverage, maternity and newborn policies, and super top-up plans for enhanced coverage. Unlike general insurers, who balance multiple verticals, standalone health insurers continuously innovate and expand their health insurance offerings. 

Superior claim assistance and hospital network: With a dedicated focus on healthcare, standalone insurers establish strong hospital tie-ups, ensuring an efficient cashless claims process. Their specialized claim management teams handle health insurance claims exclusively, leading to faster turnaround times and higher settlement efficiency. In addition, many standalone insurers offer personalized claim assistance and 24*7 customer support, making hospitalization and reimbursement processes significantly smoother for policyholders. 

More flexibility: Standalone health insurers provide highly customizable plans, allowing policyholders to tailor coverage with disease-specific riders, OPD coverage, no-room-rent capping, and international treatment options. They may have faster policy issuance cycles, minimal paperwork, and real-time risk assessment. At the same time, standalone insurers often have simplified medical screening procedures, reducing the need for extensive pre-policy health check-ups, particularly for young and healthy individuals.

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Cons of a Standalone Health Insurer

While standalone health insurers have a strong edge in specialization, their narrow focus comes with certain trade-offs. Here are some key drawbacks to consider before making your decision:

1. Higher Complaint Volume: A Victim of High Expectations?

Since standalone health insurers specialize in healthcare, customers expect flawless service, quick claim approvals, and seamless reimbursements. But reality often falls short.

    • More claim disputes: Policyholders report a higher number of complaints related to claim denials, partial settlements, or delays compared to general insurers.
    • Unfair comparison? General insurers handle everything from motor to travel insurance, diluting their complaint ratio. Standalone insurers, focused only on health, naturally see a higher complaint count—even when their approval rates are reasonable.

What this means for you: If you choose a standalone insurer, read customer reviews carefully and ensure you understand the fine print on claims to avoid frustration later.

2. Complicated Terms & Conditions: The Devil is in the Details

Standalone insurers may offer more benefits, but they also tend to have tighter rules. This can make the policy wording feel overwhelming, leading to unpleasant surprises when filing claims.

    • Hidden exclusions: Some plans don’t cover consumables, alternative treatments, or have sub-limits on room rent, which can limit coverage.
    • Waiting periods & loading charges: Pre-existing condition coverage often comes with waiting periods of 2-4 years, and some insurers hike premiums after claims (called "loading").
    • Technical jargon overload: Policy documents can be dense, leading to misinterpretations and potential claim rejections.

Pro Tip: Before buying, ask for a simplified explanation of your policy’s terms or consult an expert who can break it down for you.

3. Lower Incurred Claim Ratio (ICR): Stricter Underwriting, Tougher Approvals

Standalone insurers are more cautious about whom they insure and how they process claims. Unlike general insurers who absorb risks across different sectors, standalone health insurers closely evaluate every claim to maintain financial stability.

    • Higher rejection rates: If you have pre-existing conditions or a complex medical history, you might face tougher scrutiny during policy issuance.
    • Premium hikes for high-risk applicants: If you make frequent claims, you may see steeper premium increases compared to general insurers.
    • Conservative claims approach: Lower ICR means insurers may be more selective in approving claims to avoid financial strain.

What you can do: If you have pre-existing conditions or expect to make frequent claims, compare the approval track records of different insurers before committing.

Top 5 Standalone Health Insurers in India

Aditya Birla: Aditya Birla Health Insurance Co. Limited (ABHICL), a part of Aditya Birla Capital Ltd., is a joint venture between Aditya Birla Group and Momentum Metropolitan Holdings Limited of South Africa. It commenced operations in 2016 and has since expanded its presence across 5000+ cities with a strong digital network. Known for its innovative approach, ABHICL introduced chronic care management and incentivized wellness programs to encourage healthier lifestyles. 

With an average Claim Settlement Ratio (CSR) of 95% (2021-24), an Incurred Claims Ratio (ICR) of 68%, and a vast network of 12,000+ hospitals, it has grown significantly, recording an annual average business income of ₹2498 crores. However, it has an average complaint volume of 22 during this period, which is less than ideal. 

The company's product portfolio includes a diverse range of policies: 

Care: Care Health Insurance, formerly known as Religare Health Insurance, began its operations in 2012 and has since grown into one of India’s leading standalone health insurers. With a strong focus on customer-centricity, Care offers a diverse range of health plans, including critical illness, top-up covers, senior citizen policies, and specialized plans for pre-existing conditions like diabetes and heart diseases. 

It maintains an average Claim Settlement Ratio (CSR) of 90% (2021-24), an Incurred Claims Ratio (ICR) of 59%, and a vast network of 11,400+ hospitals. With an annual average business income of ₹4890 crores and an average complaint volume of 36, Care has built a strong reputation in the market. 

Its product portfolio includes:

Niva Bupa: Niva Bupa Health Insurance, formerly Max Bupa, was established in 2008 as a joint venture between Max India and Bupa, a UK-based healthcare giant. It began operations in 2010 and has since grown into a leading health insurer in India. However, Max India sold its stake in Max Bupa Health Insurance to a private equity firm called True North in 2019, and the company rebranded as Niva Bupa in 2021. The company offers a range of policies, including high-sum insured plans (up to ₹3 Cr), international coverage for critical illnesses like cancer and CABG, and benefits like unlimited sum restoration and day-one health checkups. 

Niva Bupa has an average Claim Settlement Ratio (CSR) of 91% (2021-24), an Incurred Claims Ratio (ICR) of 58%, and a network of over 10,000 hospitals. With an annual average business income of ₹4077 crores and a complaint volume of 43, it remains a strong player in the health insurance sector despite their complaint volume being on the higher side. 

Its product portfolio includes: 

Star: Star Health & Allied Insurance, founded in 2006 and headquartered in Chennai, is India’s first standalone health insurance company. With over 14,000 network hospitals and a  massive distribution of agents, it has played a key role in expanding health coverage across the country. It offers a wide range of products catering to individuals, families, senior citizens, and people with chronic conditions like cancer/cardiac ailments.

Star Health has an average Claim Settlement Ratio (CSR) of 83% (2021-24), an Incurred Claims Ratio (ICR) of 73%, and an annual average business income of ₹13,029 crores. The company handles an average complaint volume of 46, reinforcing its strong customer service. However, these metrics have a lot of room for improvement.

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Its product portfolio includes: 

Manipal Cigna: ManipalCigna Health Insurance is a joint venture between the Manipal Group and Cigna, a global health services provider with a legacy of over 225 years. Since its inception, ManipalCigna has been focused on offering innovative health insurance solutions, including maternity cover, unlimited restoration of the sum insured, and international emergency hospitalization. 

With a strong presence in the Indian market, the insurer has an average Claim Settlement Ratio (CSR) of 90% (2021-24), an Incurred Claims Ratio (ICR) of 68%, and an annual average business income of ₹1,317 crores. It has a network of 8,500+ hospitals and a low average complaint volume of 25, reflecting strong customer satisfaction.

ManipalCigna’s product portfolio includes: 

    • ProHealth Plus
    • Super Top-up
    • ProHealth Preferred
    • ProHealth Protect
    • ProHealth Premier
    • SecureHealth
    • ProHealth Select
    • ProHealth Prime Active
    • ProHealth Prime Senior Classic
    • ProHealth Prime Protect
    • ProHealth Prime Advantage
    • LifeTime Health Global
    • ProHealth Prime Senior Elite
    • LifeTime Health
    • ProHealth Accumulate
    • Sarvah

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Conclusion

Standalone health insurers, with their specialized focus, comprehensive coverage, and customer-centric approach, offer a strong advantage over general insurers. Whether it's high claim settlement efficiency, extensive hospital networks, or tailored health plans, companies like Care, Niva Bupa, Aditya Birla, Star, ManipalCigna, Galaxy Health and Allied Insurance Co. Ltd., and Narayana Health Insurance Ltd. stand out as leaders in the industry.

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