Health Insurance Data Lab | Ditto

Q: 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 2022-25 industry average is 91.22%. 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 (98.66%) and Bajaj General (96.78%) have stayed well above this mark for three straight years.

Q: 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 2022-25 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.

Q: 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 93.13% average CSR but a more conservative 58.68% average ICR, which shows the two numbers can paint very different pictures of the same insurer.

Q: 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 16,900+ hospitals, and SBI General, with 16,600+. 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.

Q: 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 2022-25 industry average sits at 27.06 complaints per 10,000 claims, while insurers like Bajaj General average just 3.07 complaints per 10,000 claims, putting them well inside the safer zone.

Q: 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 2022-25 industry average is ₹3,969 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.

Q: 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.

Q: 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.

Q: 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, 2022-23 through 2024-25, 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.

Q: 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.

Raw data taken from IRDAI annual reports and insurer 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 figures up to FY 2024–25. Data compilation for FY 2025–26 is currently underway.

Data Sources

IRDAI Annual Reports

View source

Insurer Public Disclosures

View source

India’s Health Insurance Industry Insights

↓ Ditto: <20 (Gen) / <40 (SAHI)

CSR - Claim Settlement Ratio

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.

Ditto's Benchmark ↑ 90%+

Formula & Methodology

Formula

[Claims Paid / (Opening Claims + Claims Reported − Claims Closed − Closing Claims)] X 100

Variable Definitions

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 2022–23, 2023–24, and 2024–25.

Name of the Insurer	Average CSR (FY 2022-2025)	FY 2024 - 2025	FY 2023 - 2024	FY 2022 - 2023	FY 2021 - 2022	FY 2020 - 2021	FY 2019 - 2020
Acko	96.50%	95.75%	96.31%	97.45%	95.53%	94.41%	94.92%
Aditya Birla	95.81%	95.88%	95.61%	95.95%	93.72%	89.30%	78.89%
Bajaj General	96.78%	97.32%	96.16%	96.85%	90.75%	94.51%	97.29%
Care	93.13%	96.74%	92.61%	90.03%	87.03%	95.20%	92.28%
Cholamandalam	82.61%	83.28%	82.74%	81.81%	80.94%	82.95%	80.57%
Digit	98.66%	98.98%	98.83%	98.18%	93.02%	91.50%	99.15%
Generali Central (Formerly Future Generali)	91.78%	94.54%	92.15%	88.64%	88.89%	84.04%	89.55%
Galaxy Health	79.37%	79.37%	NA	NA	NA	NA	NA
HDFC ERGO	96.71%	97.45%	97.19%	95.49%	100.00%	97.00%	96.44%
ICICI Lombard	84.50%	83.65%	84.83%	85.02%	85.87%	85.69%	88.45%
IFFCO Tokio	91.19%	85.64%	93.20%	94.73%	96.00%	100.34%	100.00%
Liberty	91.05%	90.84%	91.62%	90.69%	88.34%	87.33%	84.71%
Magma HDI	89.38%	90.83%	88.04%	89.27%	89.13%	90.99%	95.19%
Manipal Cigna	90.80%	93.70%	88.54%	90.16%	89.81%	90.26%	86.57%
Niva Bupa (Formerly Max Bupa)	91.62%	92.39%	91.93%	90.53%	90.78%	90.68%	89.93%
Narayana Health	100.00%	100.00%	NA	NA	NA	NA	NA
National Insurance	94.61%	93.56%	94.68%	95.60%	90.14%	95.55%	96.73%
Navi	71.44%	80.39%	63.49%	70.45%	57.00%	94.76%	96.74%
New India Assurance	98.91%	98.38%	98.44%	99.90%	99.75%	100.00%	100.00%
Oriental Insurance	93.55%	93.38%	94.21%	93.05%	99.86%	99.89%	103.81%
Raheja QBE	89.59%	89.70%	88.43%	90.63%	74.46%	18.64%	24.53%
IndusInd General(Formerly Reliance General)	87.45%	86.38%	86.32%	89.65%	90.59%	94.25%	93.95%
Royal Sundaram	92.57%	89.23%	95.06%	93.42%	93.35%	92.55%	91.79%
SBI General	96.14%	96.13%	98.08%	94.20%	97.31%	93.31%	87.23%
Shriram	90.85%	94.26%	93.93%	84.35%	59.88%	72.30%	77.99%
Star Health	84.97%	88.34%	86.49%	80.07%	82.33%	83.64%	82.93%
Tata AIG	88.72%	86.63%	90.88%	88.65%	90.85%	87.70%	80.68%
United India	93.79%	95.92%	92.72%	92.72%	97.84%	96.34%	90.63%
Universal Sompo	94.20%	89.21%	93.39%	100.00%	76.12%	86.66%	95.70%
Zuno (Formerly Edelweiss General)	90.10%	86.43%	89.72%	94.16%	92.98%	92.59%	98.83%
Zurich Kotak	91.19%	92.05%	88.51%	93.02%	91.18%	78.65%	80.17%

Please Note: Galaxy and Narayana Health are newly established insurers with limited operational data. Their high initial metrics (such as Narayana’s 100% 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 Range 55%–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 2022 - 2025)	FY 2024 - 2025	FY 2023 - 2024	FY 2022 - 2023	FY 2021 - 2022	FY 2020 - 2021	FY 2019 - 2020
Acko	66.20%	57.82%	56.91%	83.88%	103.75%	85%	21%
Aditya Birla	68.16%	71.50%	68.31%	64.68%	69.56%	50%	49%
Bajaj General	82.18%	87.31%	84.96%	74.27%	90.64%	77%	82%
Care	58.68%	64.53%	57.69%	53.82%	65.07%	55%	59%
Cholamandalam	69.20%	73.04%	66.67%	67.88%	117.08%	77%	41%
Digit	83.17%	83.78%	93.87%	71.87%	48.94%	64%	52%
Generali Central (Formerly Future Generali)	86.36%	95.29%	84.62%	79.18%	88.44%	90%	83%
Galaxy Health	NA	NA	NA	NA	NA	NA	NA
HDFC ERGO	81.62%	84.85%	80.98%	79.04%	97.47%	79%	69%
ICICI Lombard	79.47%	82.24%	78.85%	77.33%	91.67%	78%	70%
IFFCO Tokio	100.79%	83.74%	107.46%	111.18%	130.65%	99%	96%
Liberty	82.36%	92.99%	79.92%	74.17%	89.30%	77%	88%
Magma HDI	81.70%	85.54%	87.46%	72.10%	66.42%	63%	73%
Manipal Cigna	67.75%	74.81%	63.78%	64.66%	76.17%	61%	62%
Niva Bupa (Formerly Max Bupa)	58.10%	61.22%	59.02%	54.05%	62.12%	56%	54%
Narayana Health	NA	NA	NA	NA	NA	NA	NA
National Insurance	96.41%	96.05%	90.83%	102.35%	125.53%	101%	103%
Navi	73.52%	101.89%	59.40%	59.28%	28.56%	27%	35%
New India Assurance	103.39%	100.98%	105.87%	103.33%	124.54%	93%	101%
Oriental Insurance	111.54%	102.58%	101.96%	130.09%	139.86%	113%	105%
Raheja QBE	116.69%	105.12%	106.27%	138.67%	109.54%	97%	85%
IndusInd General(Formerly Reliance General)	87.69%	87.34%	89.42%	86.31%	98.76%	94%	62%
Royal Sundaram	90.33%	95.56%	92.06%	83.36%	90.22%	68%	64%
SBI General	81.32%	82.19%	87.86%	73.92%	81.92%	61%	51%
Shriram	57.85%	74.55%	47.47%	51.53%	37.07%	5%	97%
Star Health	67.26%	70.30%	66.47%	65.00%	87.06%	94%	66%
Tata AIG	77.50%	76.24%	77.94%	78.33%	86.53%	67%	67%
United India	98.77%	97.51%	109.23%	89.57%	120.21%	106%	104%
Universal Sompo	95.24%	97.12%	105.76%	82.84%	113.39%	111%	79%
Zuno (Formerly Edelweiss General)	89.39%	90.12%	88.45%	89.59%	112.32%	112%	113%
Zurich Kotak	61.92%	70.69%	59.06%	56.01%	72.11%	55%	49%

Note: Galaxy and Narayana Health are new insurers with limited data.

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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 to crores for clarity.

Name of the Insurer	Average Gross Written Premium (FY 2022 - 2025) (in crore)	FY 2024 - 25 (in crore)	FY 2023 - 24 (in crore)	FY 2022 - 23 (in crore)	FY 2021 - 22 (in crore)
Acko	₹855	₹930	₹898	₹736	₹407
Aditya Birla	₹3,290	₹4,822	₹3,701	₹1,348	₹1,021
Bajaj General	₹6,119	₹8,043	₹6,943	₹3,373	₹3,381
Care	₹6,775	₹8,318	₹6,864	₹5,142	₹3,991
Cholamandalam	₹1,051	₹1,156	₹1,104	₹893	₹691
Digit	₹1,388	₹1,626	₹1,606	₹933	₹676
Generali Central (Formerly Future Generali)	₹3,989	₹1,628	₹1,542	₹8,796	₹6,696
Galaxy Health	NA	₹16.94	NA	NA	NA
HDFC ERGO	₹6,118	₹6,100	₹6,538	₹5,716	₹4,941
ICICI Lombard	₹6,794	₹7,673	₹7,117	₹5,592	₹4,007
IFFCO Tokio	₹1,573	₹905	₹1,646	₹2,170	₹1,860
Liberty	₹349	₹375	₹336	₹336	₹275
Magma HDI	₹502	₹743	₹512	₹252	₹113
Manipal Cigna	₹1,215	₹1,691	₹967	₹986	₹652
Niva Bupa (Formerly Max Bupa)	₹5,481	₹6,762	₹5,608	₹4,073	₹2,810
Narayana Health	NA	₹2.37	NA	NA	NA
National Insurance	₹7,816	₹8,592	₹7,450	₹7,406	₹6,078
Navi	₹26	₹52	₹13	₹13	₹21
New India Assurance	₹18,824	₹19,928	₹19,014	₹17,530	₹15,999
Oriental Insurance	₹9,283	₹10,032	₹9,028	₹8,789	₹6,702
Raheja QBE	₹24	₹31	₹28	₹15	₹5
IndusInd General (Formerly Reliance General)	₹1,944	₹2,217	₹2,054	₹1,561	₹1,121
Royal Sundaram	₹620	₹775	₹610	₹476	₹426
SBI General	₹3,329	₹4,731	₹3,999	₹1,255	₹1,118
Shriram	₹101	₹123	₹120	₹61	₹32
Star Health	₹14,974	₹16,716	₹15,254	₹12,952	₹11,463
Tata AIG	₹3,165	₹3,592	₹3,134	₹2,770	₹1,930
United India	₹7,817	₹7,519	₹8,248	₹7,683	₹6,827
Universal Sompo	₹725	₹1,089	₹595	₹489	₹548
Zuno (Formerly Edelweiss General)	₹323	₹376	₹395	₹197	₹126
Zurich Kotak	₹640	₹748	₹690	₹483	₹276

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 Benchmark 10,000+

Name of the Insurer	Network hospitals
Acko	10000+
Aditya Birla	12000+
Bajaj General	12000+
Care	11400+
Cholamandalam	12000+
Digit	16400+
Generali Central (Formerly Future Generali)	8000+
Galaxy Health	NA
HDFC ERGO	13000+
ICICI Lombard	10200+
IFFCO Tokio	7900+
Liberty	5000+
Magma HDI	7300+
Manipal Cigna	8500+
Niva Bupa (Formerly Max Bupa)	10000+
Narayana Health	NA
National Insurance	3200+
Navi	12000+
New India Assurance	3700+
Oriental Insurance	4000+
Raheja QBE	5000+
IndusInd General (Formerly Reliance General)	10000+
Royal Sundaram	10000+
SBI General	16600+
Shriram	NA
Star Health	14000+
Tata AIG	11000+
United India	4000+
Universal Sompo	5000+
Zuno (Formerly Edelweiss General)	6200+
Zurich Kotak	16900+

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 2022-25 industry average is 91.22%. 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 (98.66%) and Bajaj General (96.78%) 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 2022-25 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 93.13% 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 16,900+ hospitals, and SBI General, with 16,600+. 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 2022-25 industry average sits at 27.06 complaints per 10,000 claims, while insurers like Bajaj General average just 3.07 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 2022-25 industry average is ₹3,969 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, 2022-23 through 2024-25, 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.

Customer Reviews

4.9

20915 reviews

Ditto is doing really great. Absolutely spam free- that's the best part. They don't talk to you like they are forced to sell the product. It's more like, helping us buy better. Advisor Nuha was very patient and answered all my questions with clarity. Thanks for the service

INDHUMATHI M

Loved the service! Maheta Nidhi Hitesh was incredibly helpful and knowledgeable. She guided me through the whole process and made everything super easy to understand. I really appreciated how patient she was with all my questions—there was no pressure at all, just clear and honest advice. Honestly, I'm very happy with my experience at Ditto so far. Highly recommend!

Ragul Kumar

I had a great experience with Ditto while exploring health insurance options. The process was smooth and everything was explained clearly. A special thanks to Swaroop SK for patiently answering all my questions and guiding me through the policy details without any pressure. The transparency and support made it much easier to understand and choose the right plan. Really appreciate the assistance!

Pulkit Singh

Had a great experience with Ditto Insurance. Ishita Sudrania was extremely helpful in guiding me through choosing the right term plan. There was no spamming or sales pressure, and all my questions were patiently answered. She also assisted me thoroughly with the entire application process. Highly recommend!

Samil Shah

I had a great experience with Ditto while filing my health insurance claim. Their team guided me clearly through the entire process, helped with the required documents, and promptly answered all my queries. Their support made the claim process much smoother and less stressful. Highly appreciate their assistance.

Raghappriya Marimuthusamy

Last updated on: 19 Jun, 2026

Health Insurance Data Lab: 5-Year IRDAI and Insurer Data

Data Sources

India’s Health Insurance Industry Insights

CSR - Claim Settlement Ratio

ICR - Incurred Claims Ratio

Annual Business Volumes (GWP)

Complaints per 10,000 Claims

Network Hospitals

Corrections & Feedback

Why Choose Ditto for Health Insurance?

Frequently Asked Questions

What is a good claim settlement ratio for health insurance?

What is a good incurred claim ratio for health insurance?

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

How many network hospitals should a good health insurance company have?

What counts as a good complaints per 10000 claims ratio for health insurance?

What is gross written premium and why does it matter when choosing insurance?

How is the claim settlement ratio calculated?

Is a 100% claim settlement ratio always a good sign?

Why does Ditto use a 3-year average instead of just the latest year's data?

Where does Ditto get its health insurance data from?

Customer Reviews