When picking a good health insurer, there are 4 things you need to look for – you want a financially stable company that settles claims efficiently while offering good coverage at a reasonable price. There are several insurance companies that offer various policies. But how do you pick one that satisfies all the above conditions? Two popular options in the market are Tata AIG Health Insurance and Oriental Health Insurance. But which one is better?
Tata AIG is a private-sector insurer that has aggressively grown in the last few years. It is backed by the Tata group and offers a good range of health insurance plans for different needs, including individual policies, family floater insurance, and even senior citizen plans. It also has a good claim settlement record and a growing clientele, which seems good on the surface.
Oriental Insurance, on the other hand, is a decades-old public sector giant. As a government-backed entity, it enjoys a large customer base and a reputation for issuing policies to the underserved. While Oriental offers a variety of health insurance plans, does it offer good coverage for its policyholders? Let’s compare the two and find out now!
Pro tip: The health insurance market can be a labyrinth. Instead of spending hours navigating through the hundreds of policies out there, why not book a 30-minute call with our expert IRDAI-certified advisors? No spam or pressure to buy. Just honest insurance advice.
Tata AIG Health Insurance or Oriental Health Insurance: Which is Better?
- Claim Settlement Ratio (CSR) – Tata AIG vs Oriental Insurance
When choosing a health insurance provider, one of the most commonly heard metrics is Claim Settlement Ratio, which is given by –
(Total number of claims settled in a year / Total number of claims received in the year) * 100
Where,
The total number of claims for a year = Total Claims Handled During the Period = Claims Outstanding at the Beginning + Claims Reported During the Period - Claims Closed - Claims Outstanding at the End
We recommend you go with an insurance provider with a CSR of 90 or above. If you find an insurer with a CSR of above 100 or below 80, it’s best to avoid them because:
- If the CSR of an insurer is over 100% consistently, it suggests that the insurer settles more claims than they receive. This could either indicate inconsistency in their data or delay in claim settlement from the previous year.
- If the CSR is below 80%, it may indicate that the insurer is quite inefficient, has a high claim rejection rate, and you may have a poor experience overall. They suggest that the providers either delay claim settlement or have lost credibility due to their poor experience with claim settlement and its process.
| CSR across the years | Tata AIG % | Oriental % | Industry Average % |
|---|---|---|---|
| 2021 - 2022 | 90.85 | 99.86 | 85.85 |
| 2022 - 2023 | 88.65 | 93.05 | 91.1 |
| 2023 - 2024 | 107.71 | 94.21 | 92.3 |
| Average of 3 years | 95.74 | 95.71 | 89.76 |
Conclusion: This is a close call! With only a 0.03% score as a lead, Tata AIG Health Insurance takes the win over Oriental Insurance. It is certainly a plus point that both their CSRs are higher than the industry average AND below 100%. However, this is not the only metric you should look at.
- Incurred Claim Ratio (ICR) – Tata AIG vs Oriental Insurance
When you approach an insurer for a health insurance policy, you seek a long-term relationship with your provider. Thus, the insurer must hold good business stability and financial potential to stay sustainable and be capable of meeting claim settlements in the future.
But how do you ensure this?
Simple - check the Incurred Claim Ratio and ensure your chosen insurer has an ICR ranging from 55 to 80. This range reflects how the insurer has a balanced focus on its business stability and its client requirements of claim settlement.
| ICR across the years | Tata AIG % | Oriental % | Industry Average % |
|---|---|---|---|
| 2021 - 2022 | 86.53 | 139.86 | 90.51 |
| 2022 - 2023 | 78.33 | 130.09 | 79.94 |
| 2023 - 2024 | 77.94 | 101.96 | 81.32 |
| Average of 3 years | 80.93 | 123.97 | 83.92 |
Conclusion: While it’s true that its numbers are slightly higher than the ideal range of ICR, the numbers reflect that TATA AIG is trying to balance meeting its client requirements and earning profits, which is a good sign for policyholders.
On the other hand, Oriental Insurance’s numbers lie far beyond the ideal zone for ICR. This is a sign that they are paying out more in claims than they receive in premiums. This could be because they are settling the previous year’s claims the following year or because of inefficiency – both being red flags.
- Network Hospitals – Tata AIG vs Oriental Insurance
Cashless perks are only possible at network hospitals. Hence, when seeking a credible health insurance provider, you must look into the number of partner hospitals the insurer has tie-ups with. The better the network of medical facilities, the better an insurer is for you, considering you won’t have to spend out of your pocket initially to be reimbursed later.
Oriental Insurance has a network of over 4,000 hospitals, whereas TATA AIG has a network of over 11,000.
Conclusion: Clearly, TATA AIG has the edge over Oriental Insurance with a 6000+ hospital lead.
- Major Plans – Tata AIG vs Oriental Insurance
Now that we have an understanding of how the two players approach claims processing and their growing network of hospitals, let’s look at Tata AIG vs Oriental Insurance, in terms of the health insurance plans they offer.
| S. No. | TATA AIG |
|---|---|
| 1 | Medicare Plus Super Top UP |
| 2 | Medicare |
| 3 | Medicare Premier |
| 4 | Medicare Senior |
| 5 | Medicare Protect |
| 6 | Elder Care |
| 7 | Medicare LITE |
| 8 | Health SuperCharge |
| S. No. | Oriental Insurance |
|---|---|
| 1 | Happy Family Floater Policy Silver |
| 2 | Mediclaim Insurance Policy |
| 3 | Health of Privileged Elders |
| 4 | Happy Family Floater Policy Diamond |
| 5 | Super Health Top-up |
| 6 | Happy Family Floater Policy Gold |
| 7 | Happy Family Floater Policy Platinum |
- Average Annual Business Volume – Tata AIG vs Oriental Insurance
Over the past three financial years (2021-2024), Oriental Insurance has consistently generated a significantly higher annual business volume than Tata AIG. Oriental's average business volume for this period stands at ₹7,519 crore, nearly four times Tata AIG’s average of ₹2,025 crore.
However, while Oriental Insurance maintains a larger business size, its growth has been inconsistent. After peaking at ₹8,251 crore in 2022-23, its business volume slightly declined to ₹7,895 crore in 2023-24. We feel that this fluctuation raises concerns about its long-term growth and stability.
When compared to the industry average of ₹3,157 crore, Oriental Insurance operates at a much higher scale. Tata AIG, on the other hand, remains below the benchmark, but continues showing strong upward momentum. We feel that this is certainly a good sign for TATA AIG’s future.
| Annual Business Volume | Tata AIG (in Cr.) | Oriental (in Cr.) | Industry Average (in Cr.) |
|---|---|---|---|
| 2021 - 2022 | ₹1432 | ₹6412 | ₹2604 |
| 2022 - 2023 | ₹2072 | ₹8251 | ₹3180 |
| 2023 - 2024 | ₹2572 | ₹7895 | ₹3706 |
| Average of 3 years | ₹2025 | ₹7519 | ₹3157 |
Conclusion: While the business volume of Oriental Insurance is higher than Tata AIG, we feel that TATA AIG takes the cake because it has a consistently increasing cash flow.
Note: Both TATA AIG & Oriental are general insurance companies dealing with a variety of products, including health, marine, business, motor insurance, etc. The above comparison is of the health insurance business segment only.
Why Talk to Ditto for Your Health Insurance?
At Ditto, we’ve assisted over 3,00,000 customers with choosing the right insurance policy. Why customers like Piyush below love us:
✅No-Spam & No Salesmen
✅Rated 4.9/5 on Google Reviews by 5,000+ happy customers
✅Backed by Zerodha
✅100% Free Consultation
You can book a FREE consultation here. Slots are running out, so make sure you book a call now.
Tata AIG Health Insurance or Oriental Health Insurance: What Should You Choose?
When selecting a health insurance plan, prioritize the credibility of your insurer. Unfortunately, Oriental Health Insurance has shown little improvement in metrics over the past 3 years. Hence, we are a bit hesitant when recommending plans from this insurer.
On the other hand, TATA AIG has good plans, but they tend to be quite expensive. You can get similar or even better plans at lower premiums, making them less cost-effective. Hence, we recommend exploring alternative insurers for a better balance of pricing, benefits, and claim settlement experience.
Last updated on
