11 of 15 private health insurers paid less than 75% of amount claimed
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Nov 29, 2024 | Page No.: 13 | Position: Top Left | Source: George Mathew | Sq Cm: 288 | AVE: 149652 | PR Value: 748260
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11 of 15 private health insurers paid less than 75 of amount claimed IBAI data shows that New GEORGE MATHEW I ndia Assura nce leads with a claim MUMBAI NOVEMBER 28 HOW INSURERS SETTLED HEALTH paid ratio on the number of CLAIMS IN 2022-23 claims of 95 04 per cent followed AS MANY as 11 of the total 15 pri- by Aditya Birla Health at 9 4 52 per vate health insurers shelled out cent Iffco Toldo 91 70 per cent and less than 75 per cent of the INSURER Claims Claim Total No Bajaj Allianz at 9029 per cent for amount claimed by the insured settled amount of Claims 2023 Claims paid ratio on num- patients in 2022-23 PSU INSURERS ber of claims means the number This means if an insured pa- New India 95 04 98 74 90 56 011 of claims paid during the year tient made a claim oft one lakh as Oriental Insurance 87 97 9735 25 98 779 from the total number of claims hospital bill the insurer paid only available for processing IBAI says less than 275 000 while the bal- National Insurance 84 61 87 95 24 48 869 that claims repudiation ratio of 23 ance amount was paid by the pa- United India 84 28 73 03 45 24241 insurers- mostly private players - tient In the case of claims paid ra- was between 5 and 18 per cent for tio -- the amount paid during the PRIVATE SECTOR INSURERS the year 2023 According to the IR- year from the total amount of IFFCO Tokio 91 70 80 44 6 70 026 DAI Annual Report during 2022- claims available for processing -- Bajaj Allianz 90 29 86 23 9 56 559 23 general and health insurers set- New India Assurance leads with a tled 236 crore number of health payout of 98 74 per cent Oriental SBI General 88 86 88 30 5 98 707 insurance claims and paid 270 930 Insurance came a close second Go Digit 87 30 79 50 84 006 crore towards settlement of health with a payout of 97 35 per cent HDFC ERGO 86 90 71 35 9 06 914 insurance claims data released by the Insurance The average amount paid per Brokers Association of India IBM Future Generali 83 83 74 32 1 42 952 claim was 130 087 In terms of on Thursday shows ICICI Lombard 82 59 _ _ 63 98 9 39 388 number of claims settled 75 per The claim ratio for the year Tata AIG 75 56 74 65 2 46 126 cent of the claims were settled 2024 is yet to be compiled through TPAs and the balance 25 The actual amount shelled out Chola MS 69 53 68 18 1 31 546 percent of the claims were settled by HDFC Ergo was 71 35 per cent Reliance General 58 06 71 07 4 78 120 through in-house mechanism of the claimed amount and for In terms of mode of settle- ICICI Lombard it was at 63 98 per STANDALONE HEALTH INSURERS ment of claims 56 per cent of to- cent IBAI data says Meanwhile Aditya Birla Health 94 52 71 56 8 60 863 tal number of claims were settled only four insurance companies Niva Bupa 88 57 67 76 4 51 369 through cashless mode and an- have reported a claim paid ratio other 42 per cent through reim- on the number of claims of over Manipal Cigna 88 48 56 14 4 13 835 bursement mode Insurers have 90 per cent in the year 2023 out of Care Health 88 06 67 55 7 98 382 settled two percent of theirdaims 29 insurers involved in health in- Star Health 75 10 54 61 19 55 549 amount through both cashless surance business As many as ten and reimbursement mode IRDAI insurers mostly private insurers Claims settled against total claims said IRDAI is yet to come outwith showed a claim paid ratio below Claim over total amount claimed by policyholder Source IBAI data on the insurance claims for 80 per cent IBAI data shows the fiscal 2023-24