Overview

Zuno General Insurance recorded an average health Claim Settlement Ratio (CSR) of 89.67% across FY 2024-26, below the industry average of 92.02%. This data is based on IRDAI’s annual reports and Zuno’s public disclosures. 

Breakdown of Zuno’s Claim Data

  • Recent CSR: Zuno’s CSR rose from 86.43% in FY 2024-25 to 92.86% in FY 2025-26.
  • Incurred Claims Ratio: Its average incurred claims ratio was 89.39% (FY 2023-25)
  • Other Metrics: The complaint volume is 21.45 per 10,000 claims, and its health business remains small at around ₹383 crore, both for average FY 2024-26.

Claim Processing and Support

Zuno routes retail health claims through Third-Party Administrators (TPAs) and offers cashless treatment at 10,000+ network hospitals. Review its policy terms, preferred hospitals, and claim process carefully before purchasing. 

To manage your health insurance policy or raise a claim, visit the Zuno Health Insurance Portal. 

A health insurer may offer comprehensive benefits, reasonable premiums, and a smooth digital buying experience. But these features mean little if the claims process becomes difficult when you actually need the policy. This is why an insurer’s claim settlement performance deserves a closer look before you shortlist its plans.

And if Zuno General Insurance is among the insurers you are considering, you may be wondering how dependable it is during a claim. Formerly known as Edelweiss General Insurance, Zuno is a digital-first insurer offering plans such as Silver, Gold, Platinum, and Zuno HealthPlus. 

The Zuno Health Insurance Claim Settlement Ratio (CSR) is one useful metric for evaluating its claims reliability, although it should not be considered in isolation.

This guide examines Zuno’s CSR, Incurred Claims Ratio (ICR), claims process, hospital network, customer support, and overall claims performance.

Not sure if Zuno Health Insurance is the right fit for you? Book a free call or chat on WhatsApp with Ditto’s advisors for clarity.   

Zuno Health Insurance Claim Settlement Ratio and Other Metrics (FY 2024-26)

A claim settlement ratio should not be evaluated in isolation, as it does not reveal how much the insurer pays, how often customers complain, or how smoothly claims are processed. So, we assess it alongside the incurred claims ratio, complaint volume, and claims experience for a more complete view of the insurer’s reliability.

Metrics (Average FY 2024-26)Zuno Health InsuranceIndustry Average
Claim Settlement Ratio (CSR)89.67%92.02%
Incurred Claims Ratio (Average FY 2023-25)89.39%81.88%
Complaint Volume (per 10,000 Claims)21.4529.35
Gross Written Premium- Total Health (in Crore)₹383₹4,504

Source: IRDAI annual reports, Zuno General Insurance's public disclosures and Ditto’s Health Insurance Data Lab. Complaint figures reflect Zuno's entire portfolio (health, motor, and travel) and are not limited to health insurance alone.

Ditto’s Insight: Zuno’s claim settlement ratio declined overall from 98.83% in FY 2019-20 to 86.43% in FY 2024-25, despite brief improvements in between. It then recovered to 92.86% in FY 2025-26, marking a notable turnaround.

However, such year-on-year inconsistencies are not an encouraging sign, particularly for a relatively smaller insurer with a limited claims track record compared to larger players. For customers, this volatility may create uncertainty around claim approvals and increase the possibility of additional documentation, disputes, or out-of-pocket expenses. 

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Zuno Claim Settlement Ratio vs. Incurred Claims Ratio: What's the Difference?

CSR and ICR both describe claim performance, but they measure different things, and mixing them up is one of the most common mistakes people make when researching an insurer. 

    • Claim Settlement Ratio: It's the number of claims settled divided by the number of claims received in a year. Zuno's average CSR of 89.67% means it settled approximately 9 out of every 10 claims filed.
    • Incurred Claims Ratio: It's the total claims paid out divided by the total premium collected. Zuno's ICR of 89.39% means that for every ₹100 it collected in health premiums, it paid out roughly ₹89 in claims.

At Ditto, we generally prefer an ICR between 55% and 85%, as it indicates a healthier balance between paying out claims and maintaining sustainable pricing over the long run. Zuno's ICR runs higher than this range and above the industry average, which isn't automatically a red flag, but combined with its small scale, it's a metric worth watching as the insurer's scale increases.

How to File a Zuno Health Insurance Claim?

Zuno offers both cashless and reimbursement claims, and retail claims are processed through Third-Party Administrators (TPAs) such as Medi Assist, rather than an in-house claims team.

For a Cashless Claim

  1. Get admitted to one of Zuno's network hospitals.
  2. Show your health card or policy number at the hospital's insurance desk, and the pre-authorization form gets sent to the TPA for approval.
  3. Once approved, get treated without paying the covered bill amount upfront.
  4. At discharge, pay only the non-covered expenses. The hospital will bill Zuno through the TPA for the eligible amount.

For a Reimbursement Claim 

You pay the hospital bill in full, then submit your claim form, original bills, discharge summary, and related medical documents to Zuno within 30 days of discharge. Reimbursement is usually done for non-network hospitals. 

Zuno Health Insurance Network Hospitals and Customer Care

Zuno gives you access to a network of 10,000+ hospitals across India for cashless treatment. That's a reasonable number, but it's still smaller than that of larger insurers like HDFC ERGO (16,000+), though it's equal to Ditto's recommended benchmark of 10,000+ network hospitals. 

Before buying or filing a claim, it's worth checking Zuno's hospital locator tool to confirm your preferred hospitals are covered.

Customer Care: Call Zuno’s toll-free number at 1800 12000 or paid landline at 022 423 12000. You can also email support@hizuno.com for policy-related assistance or claim queries.

Is Zuno Health Insurance Reliable? Pros and Cons

ProsCons
Lower Complaint Volume: Zuno recorded 21.45 complaints per 10,000 claims, lower than the industry average of 29.35. However, this figure covers its overall insurance portfolio.Below-Benchmark, Inconsistent CSR: Zuno’s 89.67% CSR trails Ditto’s 90% benchmark and the 92.02% industry average. Its volatility is concerning for a smaller insurer.
High Sum Insured Options: Zuno offers health plans with sum insured options extending up to ₹1 crore, making it suitable for customers seeking higher coverage.TPA-Managed Retail Claims: Retail health claims are processed through third-party administrators rather than by an in-house claims team, which may add another layer to claim coordination and can cause delays. 
Adequate Hospital Network: Zuno provides access to over 10,000 network hospitals, meeting Ditto’s recommended benchmark for cashless hospital access.Higher ICR: Its ICR of 89.39% is above Ditto’s preferred range of 55% to 85% and the industry average of 81.88%. This may raise questions about the long-term sustainability of pricing.
-Relatively Small Business Scale: Zuno’s health business, at around ₹383 crore, is significantly below the industry average of ₹4,504 crore, suggesting a smaller customer base.

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Pallavi below love us:

Zuno Health Insurance Claim Settlement Ratio
    • No-Spam & No Salesmen
    • Rated 4.9/5 on Google Reviews by 25,000+ happy customers
    • Backed by Zerodha
    • Dedicated Claims Support Team
    • 100% Free Consultation

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call or chat on WhatsApp with us now!

Ditto’s Take

Zuno’s recent improvement in claim settlement performance is encouraging, but it does not offset the insurer’s broader limitations. It remains a very small player, with a health insurance business of around ₹383 crore compared to the industry average of ₹4,504 crore. Its average CSR of 89.67% is also only moderate and continues to fall behind the industry average of 92.02%.

Scale and CSR aside, Zuno offers a relatively limited product portfolio, and its retail health claims are processed through TPAs rather than an in-house claims team. None of these factors is necessarily a deal-breaker on its own. However, taken together, they make Zuno less compelling when several larger insurers offer more established claims track records, broader product options, and direct claims servicing.

So, before choosing a Zuno policy, it would be worth comparing it with the best health insurance plans to see whether another insurer offers a stronger overall combination of coverage and claims support.

Frequently Asked Questions

What is Zuno Health Insurance's claim settlement ratio?

Zuno Health Insurance recorded an average claim settlement ratio of 89.67% across FY 2024-26, compared with the industry average of 92.02%. Its CSR improved from 86.43% in FY 2024-25 to 92.86% in FY 2025-26. The recovery is positive, but its fluctuating performance should be assessed alongside other claims and operational metrics.

Is Zuno Health Insurance reliable for claims compared to established insurers?

Zuno settles most claims and reports a lower complaint volume than the industry average. However, its average CSR remains below the industry average, its health insurance business is relatively small, and retail claims are routed through TPAs. These factors make its claims track record less established than that of several larger insurers with in-house servicing.

What is the difference between claim settlement ratio and incurred claims ratio?

The claim settlement ratio measures the number of claims an insurer settles relative to the number it receives. The incurred claims ratio measures the total amount of claims paid against the premium collected. CSR indicates claim approval frequency, while ICR helps assess payout levels and pricing sustainability. Both metrics should be reviewed together before choosing an insurer.

How do you file a cashless claim with Zuno Health Insurance?

For a cashless claim, visit a Zuno network hospital and provide your health card or policy details at the insurance desk. The hospital sends a pre-authorization request to Zuno’s TPA for approval. Once approved, the eligible expenses are settled directly, while you pay deductibles, non-medical items, and other uncovered costs at discharge.

Is Zuno Health Insurance the same company as Edelweiss Health Insurance?

Yes. Zuno General Insurance is the new name of Edelweiss General Insurance, following a rebrand in February 2023. Existing policies continue under the same insurer after the name change. Policyholders should nevertheless use Zuno’s current website, hospital locator, customer care details, and claim documents when accessing services or filing a health insurance claim.

How many network hospitals does Zuno Health Insurance have for cashless treatment?

Zuno provides access to more than 10,000 network hospitals across India for cashless treatment. This meets Ditto’s recommended benchmark, although some larger insurers offer broader networks. Since hospital empanelment can change, check Zuno Health Insurance hospital list via their website before purchasing a policy or planning treatment to confirm that your preferred nearby hospitals remain available.

What is Zuno Health Insurance's customer care number for claims?

The Zuno Health Insurance customer care number for policy servicing or claim-related assistance is its toll-free number, 1800 12000, or the paid landline, 022 423 12000. You can also email support@hizuno.com. Keep your policy number, patient details, hospital information, and claim reference ready so the customer support or TPA team can locate and address your request faster.

Does Zuno Health Insurance use a TPA for claims?

Yes. Zuno processes retail health insurance claims through Third-Party Administrators (TPAs) such as Medi Assist rather than entirely through an in-house claims team. The TPA coordinates pre-authorization, document review, and settlement communication. This arrangement is common, but it introduces another party into the process and may make responsibility and follow-ups less direct during a claim.

How do you renew a Zuno Health Insurance policy?

Zuno Health Insurance renewal can be done online through the insurer’s official website using your policy details and the available digital payment options. Complete the renewal before the due date to avoid a break in coverage. Timely renewal helps preserve waiting-period credits, accumulated bonuses, and continuity benefits for pre-existing disease coverage.

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