Processed data taken from IRDAI annual reports and insurers' public disclosures, processed to help you pick the right health insurer - without the sales pitch. All metrics except network hospitals use a 3-year average to smooth out year-on-year noise.
The current data reflects updated figures up to FY 2025–26.
The Claim Settlement Ratio represents the total number of claims successfully settled out of the total claims available for settlement during a given period. Higher is better.
Opening Claims - Claims outstanding at the start of the financial year.
Claims Reported - New claims intimated or booked during the period.
Claims Closed - Claims closed without payment (withdrawn, no-claim, etc.).
Closing Claims - Claims still outstanding at the end of the period.
Source
Calculated from Insurer Public Disclosures Form L37, Q4 filing (for full year). We use a 3-year average across FY 2023–24, 2024–25, and 2025–26.
Name of
the Insurer
Average CSR FY
2024-2026 (%)
FY 2025-2026 (%)
FY 2024-2025 (%)
FY 2023-2024 (%)
FY 2022-2023 (%)
FY 2021-2022 (%)
Acko
95.64
94.86
95.75
96.31
97.45
95.53
Aditya Birla
96.25
97.27
95.88
95.61
95.95
93.72
Bajaj General
95.63
93.40
97.32
96.16
96.85
90.75
Care
95.45
96.99
96.74
92.61
90.03
87.03
Chola MS
84.16
86.45
83.28
82.74
81.81
80.94
Digit
99.01
99.21
98.98
98.83
98.18
93.02
Galaxy Health
and Allied Insurance Co. Ltd.
84.78
90.18
79.37
NA
NA
NA
Generali
Central
93.50
93.80
94.54
92.15
88.64
88.89
HDFC ERGO
97.61
98.19
97.45
97.19
95.49
100.00
ICICI Lombard
86.81
91.96
83.65
84.83
85.02
85.87
IFFCO Tokio
87.29
83.02
85.64
93.20
94.73
96.00
IndusInd
General
86.46
86.68
86.38
86.32
89.65
90.59
Liberty
97.35
109.59
90.84
91.62
90.69
88.34
Magma General
89.50
89.64
90.83
88.04
89.27
89.13
Manipal Cigna
92.69
95.84
93.70
88.54
90.16
89.81
Narayana
Health Insurance Limited
101.62
103.24
100.00
NA
NA
NA
National
93.76
93.04
93.56
94.68
95.60
90.14
Navi
79.82
95.58
80.39
63.49
70.45
57.00
New India
98.00
97.18
98.38
98.44
99.90
99.75
Niva Bupa
92.92
94.44
92.39
91.93
90.53
90.78
Oriental
92.51
89.95
93.38
94.21
93.05
99.86
Raheja QBE
88.04
86.00
89.70
88.43
90.63
74.46
Royal Sundaram
91.15
89.16
89.23
95.06
93.42
93.35
SBI General
95.94
93.62
96.13
98.08
94.20
97.31
Shriram
(Mainly Personal Accident, Not health)
94.15
94.25
94.26
93.93
84.35
59.88
Star
88.63
91.05
88.34
86.49
80.07
82.33
Tata AIG
88.94
89.30
86.63
90.88
88.65
90.85
United
95.03
96.46
95.92
92.72
92.72
97.84
Universal
Sompo
88.91
84.12
89.21
93.39
100.00
76.12
ZUNO
(Edelweiss)
89.67
92.86
86.43
89.72
94.16
92.98
Zurich Kotak
91.30
93.33
92.05
88.51
93.02
91.18
Mean
92.02
Median
92.69
Please Note: Galaxy and Narayana Health are newly established insurers with limited operational data. Their high initial metrics (such as Narayana’s 101% CSR) reflect a very small volume of early claims. It would be premature to rank them above established players until they demonstrate consistent performance over a sustained, long-term period.
ICR - Incurred Claims Ratio
The Incurred Claims Ratio (ICR) measures the percentage of total collected premiums that an insurer pays out as claims. It serves as a vital indicator of an insurer's financial health and pricing sustainability.
Ditto's Ideal Range55%–85%
High ICR: A consistently high ratio suggests that the insurer might be struggling to maintain a sustainable balance between premium collection and claim payouts. This could eventually force them to hike premiums or tighten their underwriting rules.
Low ICR: A consistently low ratio often implies that the insurer is focusing heavily on profitability and maintaining a highly conservative approach to approving claims.
Source: IRDAI Annual report (direct numbers are published for the year.)
Name of
the Insurer
Average ICR (FY
2023-2025) (%)
FY 2024-2025 (%)
FY 2023-2024 (%)
FY 2022-2023 (%)
FY 2021-2022 (%)
FY 2020-2021 (%)
Acko
66.20
57.82
56.91
83.88
103.75
84.64
Aditya Birla
68.16
71.50
68.31
64.68
69.56
49.99
Bajaj General
82.18
87.31
84.96
74.27
90.64
77.31
Care
58.68
64.53
57.69
53.82
65.07
55.15
Chola MS
69.20
73.04
66.67
67.88
117.08
77.35
Digit
83.17
83.78
93.87
71.87
48.94
63.80
Galaxy Health
and Allied Insurance Co. Ltd.
NA
NA
NA
NA
NA
NA
Generali
Central
86.36
95.29
84.62
79.18
88.44
90.04
HDFC ERGO
81.62
84.85
80.98
79.04
97.47
79.30
ICICI Lombard
79.47
82.24
78.85
77.33
91.67
78.00
IFFCO Tokio
100.79
83.74
107.46
111.18
130.65
99.49
IndusInd
General
87.69
87.34
89.42
86.31
98.76
93.96
Liberty
82.36
92.99
79.92
74.17
89.30
76.98
Magma General
81.70
85.54
87.46
72.10
66.42
62.70
Manipal Cigna
67.75
74.81
63.78
64.66
76.17
61.13
Narayana
Health Insurance Limited
NA
NA
NA
NA
NA
NA
National
96.41
96.05
90.83
102.35
125.53
101.09
Navi
73.52
101.89
59.40
59.28
28.56
26.78
New India
103.39
100.98
105.87
103.33
124.54
92.79
Niva Bupa
58.10
61.22
59.02
54.05
62.12
56.09
Oriental
111.54
102.58
101.96
130.09
139.86
112.51
Raheja QBE
116.69
105.12
106.27
138.67
109.54
97.22
Royal Sundaram
90.33
95.56
92.06
83.36
90.22
67.88
SBI General
81.32
82.19
87.86
73.92
81.92
60.72
Shriram
(Mainly Personal Accident, Not health)
57.85
74.55
47.47
51.53
37.07
4.84
Star
67.26
70.30
66.47
65.00
87.06
94.44
Tata AIG
77.50
76.24
77.94
78.33
86.53
67.27
United
98.77
97.51
109.23
89.57
120.21
106.04
Universal
Sompo
95.24
97.12
105.76
82.84
113.39
111.23
ZUNO
(Edelweiss)
89.39
90.12
88.45
89.59
112.32
111.57
Zurich Kotak
61.92
70.69
59.06
56.01
72.11
55.17
Mean
81.88
Median
81.70
Note: Galaxy and Narayana Health are new insurers with limited data.
Talk to an expert today and find the right insurance for you.
Annual Business Volumes (GWP)
Annual Business Volume, also known as Gross Written Premiums (GWP), is a direct reflection of an insurer's market scale, operational depth, and overall system capacity. In the insurance industry, size translates to reliability; a larger volume indicates a deeply established company capable of managing extensive networks and heavy claim loads. Higher is always better.
Ditto's Benchmark₹2,500 crore+
Source: Insurer public disclosures, Form NL-4-Premium Schedule. Figures utilize the Gross Direct Premium Numbers specifically for the Total Health Segment and have been converted from lakhs tocrores for clarity.
Name of
the Insurer
Average Gross Written Premium (FY 2024-2026) (₹)
FY 2025-2026 (₹)
FY 2024-2025 (₹)
FY 2023-2024 (₹)
FY 2022-2023 (₹)
FY 2021-2022 (₹)
Acko
1,025
1,248
930
898
736
407
Aditya Birla
4,920
6,238
4,822
3,701
1,348
1,021
Bajaj General
7,901
8,717
8,043
6,943
3,373
3,381
Care
8,405
10,031
8,318
6,864
5,142
3,991
Chola MS
1,128
1,125
1,156
1,104
893
691
Digit
1,666
1,767
1,626
1,606
933
676
Galaxy Health
and Allied Insurance Co. Ltd.
NA
148
17
NA
NA
NA
Generali
Central
1,597
1,621
1,628
1,542
8,796
6,696
HDFC ERGO
6,597
7,152
6,100
6,538
5,716
4,941
ICICI Lombard
7,955
9,076
7,673
7,117
5,592
4,007
IFFCO Tokio
1,178
984
905
1,646
2,170
1,860
IndusInd
General
2,367
2,831
2,217
2,054
1,561
1,121
Liberty
399
487
375
336
336
275
Magma General
740
964
743
512
252
113
Manipal Cigna
1,624
2,213
1,691
967
986
652
Narayana
Health Insurance Limited
NA
2
2
NA
NA
NA
National
8,283
8,806
8,592
7,450
7,406
6,078
Navi
35
41
52
13
13
21
New India
20,459
22,434
19,928
19,014
17,530
15,999
Niva Bupa
6,985
8,586
6,762
5,608
4,073
2,810
Oriental
10,542
12,565
10,032
9,028
8,789
6,702
Raheja QBE
67
142
31
28
15
5
Royal Sundaram
813
1,054
775
610
476
426
SBI General
4,975
6,194
4,731
3,999
1,255
1,118
Shriram
(Mainly Personal Accident, Not health)
133
157
123
120
61
32
Star
16,859
18,606
16,716
15,254
12,952
11,463
Tata AIG
3,776
4,603
3,592
3,134
2,770
1,930
United
8,088
8,496
7,519
8,248
7,683
6,827
Universal
Sompo
1,013
1,355
1,089
595
489
548
ZUNO
(Edelweiss)
383
378
376
395
197
126
Zurich Kotak
717
712
748
690
483
276
Mean
4,504
Median
1,666
Note: Galaxy and Narayana Health are new insurers with limited data.
Complaints per 10,000 Claims
This metric serves as a key indicator of service quality and customer satisfaction, tracking the number of formal grievances filed for every 10,000 claims registered. Lower is always better. Because health insurance claims involve complex medical definitions, pre-authorizations, and multiple hospital touchpoints, they naturally experience higher friction than other insurance lines. To account for this operational reality, the Ditto Benchmark sets two distinct, rigorous standards depending on the insurer's core focus:
General Insurance Companies: Because their broad product portfolios (like motor or home insurance) help balance out overall claim volumes, we hold them to a tighter standard. The Ditto Benchmark requires general insurers to maintain fewer than 20 complaints per 10,000 claims.
Standalone Health Insurers (SAHIs): Since these companies deal exclusively with highly complex, multi-stage health claims, a slightly higher baseline is expected. The Ditto Benchmark requires SAHIs to keep customer grievances to fewer than 40 complaints per 10,000 claims.
Source: Directly taken from the insurers' public disclosures (Form NL-45), grievance disposal.
Name of the Insurer
Average Complaints Per 10,000 Claims (FY 2022 - 2025)
FY 2024 - 2025
FY 2023 - 2024
FY 2022 - 2023
FY 2021 - 2022
FY 2020 - 2021
FY 2019 - 2020
Acko
19.29
15.58
27.33
14.97
8.89
7.06
62.29
Aditya Birla
18.67
16
22
18
26
35
30
Bajaj General
3.07
3.42
2.87
2.91
2.27
1.72
1.14
Care
42
47
39
40
29.38
22.21
5.54
Cholamandalam
15.74
13.33
14.47
19.43
19.11
15.59
6.38
Digit
16.88
19.13
16.41
15.1
16.84
4.45
1.72
Generali Central (Formerly Future Generali)
11.02
10.71
10.78
11.57
12.17
15.28
17.25
Galaxy Health
NA
0
NA
NA
NA
NA
NA
HDFC ERGO
9.28
14.72
6.89
6.23
7.95
6.21
6.21
ICICI Lombard
10.67
13.98
10.53
7.5
8.86
7.19
5.64
IFFCO Tokio
22
40.9
12.81
12.28
11.67
8.81
5.22
Liberty
13.69
14.08
13
14
16
18
10
Magma HDI
13.33
17
12
11
11
8.4
5.75
Manipal Cigna
23.5
25.3
25.8
19.4
31
23
21
Niva Bupa (Formerly Max Bupa)
42.85
43.44
38.76
46.36
42.74
44.46
38.57
Narayana Health
NA
0
NA
NA
NA
NA
NA
National Insurance
30.13
28.69
38.88
22.81
24.12
1.76
19.9
Navi
239.36
285.14
333.72
99.23
56.88
15.36
21.33
New India Assurance
5.04
4.77
5.58
4.76
5.05
NA
NA
Oriental Insurance
7.33
11.4
7.6
3
NA
NA
NA
Raheja QBE
54.88
134.11
16.37
14.15
12.81
3.16
12.81
IndusInd General (Formerly Reliance General)
4.31
5.04
2.99
4.9
6.62
6.17
2.67
Royal Sundaram
16.91
17.59
13.47
19.68
15.75
8.87
6.49
SBI General
20.51
14.66
23.28
23.59
12.3
3.86
16.9
Shriram
27.52
26.71
32.68
23.16
14.85
15.98
10.34
Star Health
52.31
52.3
55.79
48.85
33.65
4.62
10.73
Tata AIG
10.65
9.75
12.11
10.08
10.22
8.15
6.15
United India
12.75
19.6
9.32
9.32
4.84
6.84
15.61
Universal Sompo
5.75
6.52
4.45
6.29
52.58
35.04
32.11
Zuno (Formerly Edelweiss General)
15.37
28.61
10.81
6.68
14.72
NA
NA
Zurich Kotak
19.8
24.25
21.05
14.11
15.38
9.05
8.99
Note: Galaxy and Narayana Health are new insurers with limited data.
Network Hospitals
A large hospital network ensures that you can access quality medical care without paying out of pocket during emergencies. This metric tracks the total number of healthcare providers where an insurer offers seamless, cashless treatment. Higher is always better.
While a massive nationwide footprint is important, it is even more critical to verify your local coverage. Always check if your preferred neighborhood hospitals, workplace medical centers, or trusted family healthcare facilities are included in the insurer’s active list so that your specific geographic needs are fully met.
Source: Compiled directly from the respective insurers' official websites.
Note: These figures are updated periodically. Readers are highly encouraged to utilize each insurer's specific, real-time network hospital locator tool for the latest local listings.
Ditto's Benchmark10,000+
Name of
the Insurer
Network
Hospitals
Acko
11500+
Aditya Birla
16500+
Bajaj General
12600+
Care
11400+
Chola MS
13500+
Digit
9000+
Galaxy Health
and Allied Insurance Co. Ltd.
9400+
Generali
Central
10000+
HDFC ERGO
16000+
ICICI Lombard
11000+
IFFCO Tokio
8000+
IndusInd
General
10000+
Liberty
6000+
Magma General
11500+
Manipal Cigna
14000+
Narayana
Health Insurance Limited
20+
National
5300+
Navi
12000+
New India
2000+
Niva Bupa
10000+
Oriental
12000+
Raheja QBE
5000+
Royal Sundaram
12500+
SBI General
18000+
Shriram
(Mainly Personal Accident, Not health)
NA
Star
14000+
Tata AIG
12000+
United
4000+
Universal
Sompo
15000+
ZUNO
(Edelweiss)
10000+
Zurich Kotak
24500+
Note: Galaxy and Narayana Health are new insurers with limited data.
Corrections & Feedback
To maintain absolute data integrity across all articles, guides, and comparisons on our platform, please report any metric errors or outdated information directly to our Editorial Team at editorial@joinditto.in.
Required Data for Submissions:
Source URL: The exact webpage link containing the data point.
Identified Discrepancy: The specific metric, figure, or sentence requiring adjustment.
Verifiable Evidence: Official regulatory documentation, updated statutory returns, or credible reference data to validate the change.
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Frequently Asked Questions
What is a good claim settlement ratio for health insurance?
A CSR of 90% or higher is the benchmark to look for. At Ditto, we calculate this from IRDAI Form L37 disclosures and average it over three years rather than relying on a single year. The 2024-26 industry average is 92.02%. The formula adds claims outstanding at the start of the year and claims reported during the year, then subtracts claims closed without payment and claims still outstanding at the end. Insurers like Digit (99.01%) and Bajaj General (95.63%) have stayed well above this mark for three straight years.
What is a good incurred claim ratio for health insurance?
ICR shows how much of the premium an insurer collects is actually paid out as claims. At Ditto, we consider 55% to 85% the healthy range, with the broader 2023-25 industry average at 81.88%. A ratio below 50% may indicate that an insurer is rejecting claims too aggressively to protect margins. A ratio consistently above 100%, such as Oriental Insurance's 111.54% average, indicates financial strain that often leads to future premium hikes or stricter underwriting for new policies.
What is the difference between claim settlement ratio and incurred claim ratio?
CSR counts how many claims an insurer settles out of the total it had to process in a year. ICR measures how much of the premium collected gets paid out as claims. CSR disclosures come from Form L37, while ICR is published in the IRDAI annual report. Care Health is a good example of why both matter. It carries a strong 95.45% average CSR but a more conservative 58.68% average ICR, which shows the two numbers can paint very different pictures of the same insurer.
How many network hospitals should a good health insurance company have?
At Ditto, we look for insurers with 10,000 or more network hospitals to ensure broad access to cashless treatment. Several insurers clear this bar comfortably, including Zurich Kotak, with 24,500+ hospitals, and SBI General, with 18,000+. That said, a large national number does not guarantee strong coverage in your area. Before buying a policy, always check the insurer's hospital locator to confirm that your nearby clinics, your workplace medical center, or your family's preferred hospital are actually part of the cashless network.
What counts as a good complaints per 10000 claims ratio for health insurance?
The right benchmark depends on the type of insurer. At Ditto, we expect general insurers that also sell motor and travel policies to remain under 20 complaints per 10,000 claims. Standalone health insurers get a slightly higher allowance for those under 40, since their claims involve more complex hospital documentation and pre-authorizations. The 2024-26 industry average sits at 29.35 complaints per 10,000 claims, while insurers like Bajaj General average just 3.85 complaints per 10,000 claims, putting them well inside the safer zone.
What is gross written premium and why does it matter when choosing insurance?
Gross Written Premium (GWP), or annual business volume, reflects the total value of policies an insurer sells in a year and signals its market scale and operational depth. At Ditto, we prioritize insurers with an annual GWP of ₹2,500 crores or more, since the 2024-26 industry average is ₹4,504 crores. A larger GWP usually means the insurer can support a wider hospital network and absorb heavy claim loads more reliably than a smaller, newer player still building scale.
How is the claim settlement ratio calculated?
CSR is calculated as total claims settled divided by total claims available to settle, multiplied by 100. Total claims available to settle equals claims outstanding at the start of the year, plus claims reported during the year, minus claims closed without payment, minus claims still outstanding at the end. At Ditto, we pull this directly from each insurer's Form L37 disclosure for the fourth quarter and average it across three financial years to smooth out any one-off spikes or dips.
Is a 100% claim settlement ratio always a good sign?
Not necessarily. A 100% CSR can look impressive, but newer insurers with very few recorded claims can post numbers like this simply because their claim volume is still tiny. Narayana Health, for instance, showed a 100% CSR for 2024-25, which is its first year of available data. At Ditto, we recommend waiting at least three consecutive years of disclosures before ranking a new insurer above established players, since a sustained track record matters far more than a single strong early year.
Why does Ditto use a 3-year average instead of just the latest year's data?
A single year's number can be misleading, since claim volumes and one-off events can swing it sharply in either direction. At Ditto, we average CSR, ICR, GWP, and complaint data across the last three financial years, 2023-24 through 2025-26, to get a steadier read on how an insurer actually performs. This approach helps separate insurers with genuinely consistent service from those riding a single good year that does not reflect their longer-term reliability.
Where does Ditto get its health insurance data from?
At Ditto, our health insurance metrics come directly from IRDAI annual reports and each insurer's public disclosures, including Form L37 for claim settlement ratio, Form NL-4 for gross written premium, and Form NL-45 for grievance and complaint data. Network hospital counts are sourced from insurers' websites, as IRDAI does not publish them separately. We rely only on regulatory and insurer-published data, not third-party estimates, and we welcome corrections from our editorial team, backed by verifiable source documents.
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