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Updated 2026-08-18

Methodology & editorial standards

One page for everything that decides what you read here: the filings we pull numbers from, the formula behind each ratio, the benchmark we hold insurers to, how we score and review products, how we fact-check, and exactly how we get paid. If a claim on this site cannot be traced back to something on this page, treat it as a bug and tell us.

The short version

  • Ratios come from IRDAI filings, never from an insurer's marketing page.
  • Every ratio is averaged over 3 financial years (FY 2022-23 through FY 2024-25) so one odd year cannot swing it.
  • Benchmarks are published up front, and we set them above the industry average rather than at it.
  • No company can pay for a score, a ranking, or a review slot. Not now, not for any amount.
  • Where a number goes stale annually, we tell you to check the primary source instead of trusting ours.

Sourcing

Where our data comes from

Indian insurers are required to publish a standard set of disclosure forms every quarter, and IRDAI publishes its own annual report on top of them. That combination is enough to answer most of the questions a buyer actually has, which is why we work from it directly instead of from secondary summaries.

The source hierarchy

When two sources disagree, the higher tier wins. This is not negotiable, including when the lower tier is more convenient.

  1. 1

    The regulator

    IRDAI annual reports, handbooks, circulars, and the mandated quarterly public disclosure forms every insurer files. This is the only tier we treat as authoritative for ratios.

  2. 2

    The filed product document

    Policy wordings, customer information sheets, prospectuses, and card MITC filings. This is what decides a claim, so it outranks any marketing page.

  3. 3

    The company's own disclosures

    Annual reports, investor presentations, and official hospital or merchant locators. Used for scale, ownership, and network facts the regulator does not publish.

  4. 4

    Everything else

    News coverage, aggregator sites, and customer reviews. Useful for spotting a pattern worth investigating. Never used as the sole basis for a number or a verdict.

Primary sources, linked directly

Go check our work. These are the same pages we use, and they are more current than any comparison site including this one.

IRDAI

IRDAI Annual Reports

Segment-level incurred claims ratios, premium totals, grievance counts, and industry aggregates. Our starting point for any industry-wide figure.

IRDAI

IRDAI General Insurance hub

Registered general and standalone health insurers, product filings, circulars, and the disclosure formats insurers must publish against.

IRDAI

IRDAI Health Insurance section

The regulator's own definitions for pre-existing disease, waiting periods, entry age, and lifelong renewability. Where our guides and an insurer's brochure disagree, this decides it.

IRDAI

Bima Bharosa grievance portal

The official route for a policyholder to file and track a complaint. We link it on every insurer page instead of a call-back form.

Council for Insurance Ombudsmen

Council for Insurance Ombudsmen

Ombudsman jurisdiction, award orders, and the escalation path once an insurer's own grievance cell has failed you.

Government of India

Income Tax Department

Section limits, slab rates, and filing deadlines used by our tax guides and calculators.

Why we average 3 years

A single financial year moves on things that have nothing to do with how an insurer treats you: one large claim batch, a systems migration, a change in how outstanding claims are booked. Averaging over FY 2022-23 through FY 2024-25 separates insurers that perform consistently from ones having a good year. Network hospital counts are the exception, since they are a snapshot rather than a flow.

The numbers

Every metric we track, and the formula behind it

Six metrics carry most of the weight in a health insurance decision. For each one: what it actually measures, how it is calculated, which filing it is read from, the band we treat as acceptable, and the way it gets misread. Two of the six are live on our insurer pages today. The rest are documented here first, because we would rather publish the method and admit the gap than publish numbers we have not verified line by line.

Claim Settlement RatioCSR

Higher is betterPublished per insurer

The share of claims an insurer actually paid out of all the claims it had available to settle in a year. It is the closest public proxy for whether an insurer pays up.

Formula

CSR = [Claims paid / (Opening claims + Claims reported − Claims closed without payment − Closing claims)] × 100

Opening claims:
Claims still outstanding at the start of the financial year.
Claims reported:
New claims intimated or booked during the year.
Claims closed without payment:
Claims withdrawn, repudiated, or otherwise closed with no payout.
Closing claims:
Claims still outstanding at the end of the year.

Our benchmark

95% or higher is strong. 90-95% is acceptable. Below 90% is a flag we call out in the review.

The health segment industry average sits in the low 90s, so a 90% bar would clear almost every insurer and tell you nothing. We set the strong band above the industry average instead of at it.

Where it comes from

Form NL-37 (Claims Data), health segment, from each insurer's quarterly public disclosures. We read the Q4 filing for a full-year view.

Open the source on irdai.gov.in

How it gets misread: A near-perfect CSR from a young insurer is a small-sample artefact, not a track record. We do not rank an insurer on CSR until it has three consecutive years of filings.

Claim Settlement Ratio in the glossary

Network hospitals

Higher is betterPublished per insurer

How many hospitals will treat you cashless rather than making you pay and claim reimbursement later.

Formula

None. This figure is disclosed directly, so we read it rather than derive it.

Our benchmark

10,000 or more nationally.

It is a floor, not a ranking input, and it is the metric we most actively tell readers to ignore. A 24,000-hospital network that excludes the two hospitals near you is worse than an 9,000-hospital network that includes them.

Where it comes from

Each insurer's own hospital locator. IRDAI does not publish network counts, so this is the one metric where the company is the primary source.

How it gets misread: These counts are marketing figures, they move constantly, and empanelment is dropped as often as it is added. Always check the insurer's live locator for your own pin code before buying.

Rollout in progress

The four metrics below are part of our published method and our benchmarks for them are fixed, but we have not yet finished extracting them insurer by insurer from the filings. Until we have, our insurer pages tell you to check the primary source rather than showing you a number we cannot stand behind.

Incurred Claims RatioICR

A healthy range, not a high scoreDocumented, rollout in progress

How much of the premium an insurer collected went back out as claims. It reads as a pricing and sustainability signal rather than a service one.

Formula

ICR = (Net incurred claims / Net earned premium) × 100

Net incurred claims:
Claims paid plus the movement in outstanding claim reserves, net of reinsurance.
Net earned premium:
Premium earned for the period, net of reinsurance ceded.

Our benchmark

60% to 90%.

Persistently under 60% suggests the insurer is either priced well above its risk or is tight on approvals. Persistently over 90% suggests the book is not paying for itself, which usually resolves as a premium hike or stricter underwriting at renewal. Neither extreme is good news for a buyer.

Where it comes from

IRDAI annual report, health segment tables. The regulator publishes the ratio directly, so we do not recompute it.

Open the source on irdai.gov.in

How it gets misread: A high ICR is often marketed as generosity. It is not. It is a cost signal, and it is frequently the number that predicts next year's premium increase.

Complaints per 10,000 claims

Lower is betterDocumented, rollout in progress

How many formal grievances an insurer attracted for every 10,000 claims it registered. This is the service-quality metric, and it is the one buyers most often never see.

Formula

None. This figure is disclosed directly, so we read it rather than derive it.

Our benchmark

Under 20 for multi-line general insurers. Under 40 for standalone health insurers.

Standalone health insurers only handle health claims, which carry more pre-authorisations, hospital touchpoints, and medical-necessity disputes than motor or travel. Holding them to the same number as a diversified general insurer would penalise them for their product mix rather than their service.

Where it comes from

Form NL-45 (Grievance Disposal) in the insurer's quarterly public disclosures, which states complaints per 10,000 claims registered directly.

Open the source on irdai.gov.in

How it gets misread: Complaints per 10,000 policies and complaints per 10,000 claims are different numbers and insurers publish both. The per-claims figure is the one that reflects claim-stage friction.

Solvency Ratio

Higher is betterDocumented, rollout in progress

Whether the insurer holds enough capital above its liabilities to keep paying claims through a bad year.

Formula

Solvency ratio = Available solvency margin / Required solvency margin

Our benchmark

1.50 is the regulatory floor. We look for 1.80 or higher.

Everyone still licensed clears 1.50, so the floor is not a differentiator. A comfortable buffer above it matters more for a 30-year term policy than for a one-year motor policy.

Where it comes from

The solvency margin form in each insurer's quarterly public disclosures, numbered NL-25 in the current format.

Open the source on irdai.gov.in

How it gets misread: Solvency says nothing about whether an insurer settles claims fairly. A well-capitalised insurer can still be a difficult one to claim from.

Solvency Ratio in the glossary

Gross Written PremiumGWP

Higher is betterDocumented, rollout in progress

Annual business volume in the health segment. A scale signal: how much claims load, hospital negotiation, and servicing infrastructure the insurer is built to carry.

Formula

Gross direct premium for the total health segment, converted from lakhs to crore.

Our benchmark

₹2,000 crore or more in the health segment.

Below roughly that level an insurer is usually still building its hospital network and claims operation, which shows up as friction at claim time rather than in the brochure.

Where it comes from

Form NL-4 (Premium Schedule) in each insurer's quarterly public disclosures, total health segment.

Open the source on irdai.gov.in

How it gets misread: Scale is not quality. Some of the largest books on this list also carry the weakest complaint numbers, which is exactly why we never score on size alone.

Our data

What we publish today

The table below is our current health insurer dataset, drawn from the filings described above and averaged over 3 years. Rows marked "Not yet published" are insurers whose figure we have not finished verifying. We would rather show you the gap than fill it with an estimate.

Insurers covered

22

CSR published

0

Median CSR

-

In our strong band

0

Median and mean are computed across the 0 insurers where we publish a ratio, so they describe our dataset rather than the whole Indian market. IRDAI's own annual report is the authority on industry-wide figures.

Health insurer claim settlement ratios and cashless network sizes published by tldr.money
InsurerClaim settlement ratioNetwork hospitalsOur claim score
ACKONot yet published11,500+8.0 / 10
Aditya BirlaNot yet published16,500+8.1 / 10
Bajaj GeneralNot yet published12,600+8.1 / 10
Care HealthNot yet published11,400+8.2 / 10
DigitNot yet published9,000+8.5 / 10
HDFC ErgoNot yet published16,000+8.6 / 10
ICICI LombardNot yet published11,000+8.1 / 10
IFFCO TokioNot yet published8,000+7.3 / 10
IndusInd GeneralNot yet published10,000+6.8 / 10
Manipal CignaNot yet published14,000+7.4 / 10
National InsuranceNot yet published5,300+7.8 / 10
NaviNot yet published12,000+6.3 / 10
New India AssuranceNot yet published2,000+8.3 / 10
Niva BupaNot yet published10,000+8.4 / 10
Oriental InsuranceNot yet published12,000+7.5 / 10
Royal SundaramNot yet published12,500+7.4 / 10
SBI GeneralNot yet published18,000+8.0 / 10
Star HealthNot yet published14,000+7.8 / 10
Tata AIGNot yet published12,000+7.2 / 10
United IndiaNot yet published4,000+7.7 / 10
Universal SompoNot yet published15,000+7.0 / 10
ZunoNot yet published10,000+7.1 / 10

Swipe horizontally on mobile. Ratios are 3-year averages from Form NL-37 filings; network counts come from each insurer's own locator and move often.

Scoring

How we score an insurer or a card

Every brand carries a score out of 10. It is a shortlisting signal, not a recommendation to buy. The same insurer can sell one excellent plan and one poor one, so the score gets you to a shortlist and the plan wording decides the rest.

Claim settlement

A consistent, multi-year record of paying claims without a fight.

Inputs

  • Form NL-37 claim settlement ratio
  • Grievance volumes at claim stage
  • Repudiation patterns in ombudsman awards

Value

What the cover actually delivers for the premium once the sub-limits are read.

Inputs

  • Premium bands for standard buyer profiles
  • Room-rent, co-pay, and disease-wise caps
  • Consumables and restoration terms

Customer service

Being reachable and useful when something has gone wrong.

Inputs

  • Complaints per 10,000 claims
  • Grievance resolution timelines
  • Reviewed patterns in customer feedback

Digital experience

Buying, servicing, and claiming without a phone call.

Inputs

  • Cashless pre-authorisation flow
  • Self-service policy changes
  • App and portal claim tracking

Flexibility

Adapting to real buyers instead of one narrow profile.

Inputs

  • Plan and rider variety
  • Sum insured and tenure options
  • Portability and continuity terms

How the five become one number

Each dimension is scored out of 10 from the inputs listed above. The overall score is anchored to those five and then reviewed by an editor against the current plan wording, so it can sit slightly away from the straight average of the five where the wording justifies it. We publish the five dimension scores on every brand page precisely so you can see the composition rather than take the headline number on trust.

Scores are refreshed quarterly and immediately on a material change: a new flagship plan, a regulatory action, a restructured fee table, or a shift in claim data.

Reviews

How we build a review, a comparison, and a best-of list

Reviews start with the filed document

For insurance that means the policy wording, the customer information sheet, exclusions, waiting periods, room-rent and disease-wise limits, co-payments, and restoration rules. For cards it means the fee table, reward rates, earning caps, exclusion categories, and redemption terms. We test the marketing claim against the fine print, and where the two disagree the fine print is what we publish.

Best-of lists are built from scores, then explained

We shortlist by score, then say who each pick suits and, just as importantly, who it does not. A pick with no stated downside is a pick we have not finished researching. Commission rates play no part in ordering.

Comparisons call a winner

A head-to-head comparison puts two brands against the same dimensions and names a winner per dimension where the data supports one. Where it does not support one, we say that instead of manufacturing a difference. The goal is a decision, not a draw.

Plain language, stated drawbacks

Jargon gets defined in our glossary or dropped. Drawbacks go in the body, not a footnote. Where a figure changes annually, such as a tax limit or a claim ratio, we explain the mechanism and point you at the primary source rather than hardcoding a number that will quietly go stale.

Accuracy

Fact-checking and corrections

Before publishing

Every guide, review, and calculator output is checked against primary sources before it goes live: the filed policy document, the issuer's own disclosure, or the regulator's published data. A claim we cannot trace to one of those does not get published.

Time-sensitive figures

Tax deduction limits, filing deadlines, premium bands, and claim ratios all move. Where a number can go stale within a year, we describe how it works and link the official source instead of freezing a value into the page. Where we do publish a figure, it carries the period it belongs to.

When we get it wrong

We fix confirmed errors promptly and note material corrections on the page rather than editing quietly. We also re-audit pages on a scheduled cadence, because the more common failure is not a wrong fact at publication, it is a right fact that aged.

Found an error? Send it over

To make it actionable, include:

  • The page URL the figure appears on.
  • The specific claim you think is wrong, quoted.
  • A source we can check it against, ideally a regulatory filing or an official document rather than another comparison site.

Use the contact form or email hello@tldr.money. Corrections that change a score or a verdict get logged in our changelog.

Independence

How we make money, and what it cannot buy

We earn a referral fee when a reader buys through some of our partner links. That is the whole business model: no banner ads, no sponsored rankings, no paid review slots, no advertorials dressed as guides.

What money cannot buy

  • A higher score, or any change to one.
  • A position in a ranking or best-of list.
  • Removal of a stated drawback or a critical verdict.
  • A preview of a score or review before publication.
  • Inclusion in a comparison the product does not belong in.

What we commit to

  • Affiliate links are disclosed on the page they appear on.
  • We only link to IRDAI or RBI regulated entities.
  • Brands we earn nothing from still get reviewed and can still win.
  • Editorial decisions are made without reference to commercial terms.
  • We say a product is bad when it is bad, partner or not.

What we are not

tldr.money is a publisher, not an insurance broker, agent, or adviser. We do not sell policies, we are not registered to give individualised financial, tax, or legal advice, and nothing here is a personal recommendation. For a licensed adviser or a complaint against an insurer, go to IRDAI Bima Bharosa or the official channels we list here.

People

Who writes and edits this

Every review carries a named writer and a named editor, both linked to a profile page. The writer builds the analysis from the filings and the product document. The editor independently checks the sourcing, challenges the verdict, and owns the final call on whether it publishes. Nobody reviews their own work through to publication.

Writers hold no positions or incentives tied to the products they cover, and commercial conversations are handled outside the editorial team. Read the about page for who we are and why we started this.

FAQ

What claim settlement ratio should I look for in health insurance?

We treat 95% or higher as strong, 90% to 95% as acceptable, and anything below 90% as a flag worth explaining in the review. The health segment industry average sits in the low 90s, so a 90% cut-off would clear almost every insurer and tell you very little. We read the ratio from Form NL-37 of each insurer's public disclosures and average it over three financial years.

Why do you average three years instead of using the latest figure?

A single financial year can swing sharply on one large claim batch, a system migration, or a change in how an insurer books outstanding claims. Averaging across three years separates insurers that perform consistently from ones riding a single good year. Network hospital counts are the exception, since they are a point-in-time figure rather than a flow.

Is a 100% claim settlement ratio a good sign?

Usually it means the insurer is new and has settled very few claims, so the percentage is a small-sample artefact rather than a track record. We do not rank an insurer on its claim settlement ratio until it has filed three consecutive years of disclosures.

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

Claim settlement ratio counts how many claims got paid out of the claims available to settle, and comes from Form NL-37 of the insurer's public disclosures. Incurred claims ratio measures how much of the premium collected went out as claims, and IRDAI publishes it directly in the annual report. The first is a service signal, the second is a pricing signal, and the same insurer can look very different on each.

Where does tldr.money get its insurer data from?

From IRDAI annual reports and the quarterly public disclosure forms every insurer is required to file: Form NL-37 for claims data, Form NL-4 for premium volumes, and Form NL-45 for grievance and complaint counts. Network hospital counts come from each insurer's own locator because IRDAI does not publish them. We do not use third-party estimates as the basis for a published number.

Do companies pay you to rank higher?

No. We earn referral fees on some partner links, and those relationships have no input into scores, rankings, or verdicts. There are no sponsored placements, no paid review slots, and no arrangement under which a company can see or influence a score before publication.

How many network hospitals does a good health insurer need?

We use 10,000 nationally as a floor, but treat the national number as close to meaningless on its own. A 24,000-hospital network that excludes the two hospitals nearest you is worse than a 9,000-hospital network that includes them. Check the insurer's live locator for your own pin code before you buy.

How do I report an error on one of your pages?

Send us the page URL, the specific figure or sentence you think is wrong, and a source we can verify it against, ideally a regulatory filing or an official document. We fix confirmed errors and note material corrections on the page. Use the contact form or email hello@tldr.money.

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