health insurance review
Care Health
“Why waste time say lot word, when few word do trick?”
Strong product options and a 96.9% claim settlement ratio in FY 2024-25, but complaints per claim run well above our benchmark.
- Overall score 8.1/10
- Top fit: families, individuals
- Compare plan-level pages before purchase.
Quick Facts
Founded
2012
Headquarters
Gurugram, India
Ownership
Religare Enterprises (Burman family promoters), with Kedaara Capital and Union Bank as shareholders
Official Website
careinsurance.com ↗Score breakdown
Claim settlement statistics
Figures for Care Health come straight from IRDAI publications and the insurer's own statutory filings, and each one links to its source. Where we could not verify a figure we say so instead of printing a number. Read our rating methodology for how these feed our scores.
Claim settlement ratio
96.85%
FY 2024-25, by number of health claims · Strong (95%+)
Incurred claims ratio
65.1%
FY 2024-25, all health business (healthy band 60-90%)
Complaints per 10,000 claims
69.2
FY 2024-25, whole company (benchmark under 40)
Solvency ratio
1.68
31 Mar 2025 · above the 1.50 regulatory floor
| Year | Claims reported | Settlement ratio | Repudiation rate | Source |
|---|---|---|---|---|
| FY 2022-23 | 7,82,784 | 90.49% | 9.51% | IRDAI Handbook 2024-25, Table 53 |
| FY 2023-24 | 10,71,814 | 92.81% | 7.19% | IRDAI Handbook 2024-25, Table 53 |
| FY 2024-25 | 14,86,706 | 96.85% | 3.15% | IRDAI Handbook 2024-25, Table 53 |
- Care Health is a standalone health insurer, so IRDAI's company-wide claim table (Handbook Table 53) is effectively its health book, including personal accident and travel.
- Settlement ratio = claims paid ÷ (claims outstanding at the start + reported − closed without payment − outstanding at the end). We band it at 95% and 90%.
- Our Claim Settlement score of 8.2/10 is provisional: the methodology needs three consecutive years of verified data and a published score mapping, and both are still being completed. Read the methodology.
- Sources: ICR from IRDAI Handbook 2024-25 Table 62, complaints from Table 56; solvency from IRDAI Annual Report 2024-25, Statement 12.
Industry benchmark
In FY 2024-25, general and health insurers together paid 87.5% of all health claims they handled by number, repudiated 7.92% and had 4.58% outstanding at year end. By amount, only 71.14% of the money claimed was paid; 13.98% was disallowed under policy terms (deductions such as room-rent limits and non-payable items). Source: IRDAI Annual Report 2024-25, Table I.29. These shares use all claims handled as the base, so they run slightly lower than the settlement ratio we compute for each insurer.
Three numbers that get confused
Claim settlement ratio
Claims settled as a share of claims registered. Count-based, so many small settled claims can flatter it.
Settled within 3 months
A speed measure, not a payout measure. Often quoted because it looks higher.
Incurred claim ratio
Claim amount paid against premium collected. A different thing entirely, and frequently mislabelled as settlement ratio.
We take ratios from IRDAI publications and insurer statutory filings, never from insurer marketing, and show each year separately rather than blending them. See our metric definitions and benchmarks for the formula behind each figure, or go straight to the primary sources: IRDAI annual reports and insurer public disclosures.
All plans
Care Classic
8/10Strong family plan with robust restoration benefits.
Rs 13k-26k
Care Supreme
Not scoredA well-built base plan: no room-rent cap, no mandatory co-pay, unlimited recharge and a claim-proof cumulative bonus. Avoid the Smart Select discount unless your preferred hospitals are on its list.
Quote-based (age, city and cover)
Network cashless hospitals
11,400+ Cashless Hospitals
At a network hospital, Care Health settles approved bills directly, so you pay only deductibles and non-covered items. Network size matters less than whether the hospitals you would actually use are on the list, so check your own city before buying.
How a Care Health claim works
Which route you use depends entirely on where you get treated. At a Care Health network hospital you can usually go cashless. Anywhere else, you pay first and claim it back.
Cashless
Network hospital- 1
Show your policy at the insurance desk
Carry your health card or policy number plus a photo ID. A soft copy is normally accepted.
- 2
Hospital raises pre-authorisation
The hospital sends the estimate and diagnosis to the insurer on your behalf.
- 3
Insurer approves an amount
Approval can be full, partial, or come back with queries. A rejected pre-auth does not stop treatment; you switch to reimbursement.
- 4
Settlement at discharge
The insurer pays the hospital directly. You settle the deductible, co-pay, and any non-payable items.
Reimbursement
Any hospital- 1
Tell the insurer early
Intimate the claim even though you are paying yourself. Late intimation is a common reason for disputes.
- 2
Pay and collect originals
You will need the discharge summary, itemised bills, payment receipts, prescriptions, and diagnostic reports.
- 3
File within the claim window
Submit the signed claim form with all documents. Keep photocopies of everything you hand over.
- 4
Insurer assesses and pays
The approved amount is credited to your bank account after deductions under your policy terms.
Intimation windows
Planned admission
~48 hours before
Gives the insurer time to pre-authorise.
Emergency admission
Within 24 hours
Some insurers allow up to 48 hours.
Reimbursement filing
15 to 30 days after discharge
Counted from the discharge date.
These are typical industry windows, not Care Health's guarantee. Exact deadlines are set in your policy wording and vary by plan, so confirm yours before you need them. For the full walkthrough, read our health insurance claim process guide. IRDAI's own deadlines for insurers, including the one-hour cashless decision, are in cashless vs reimbursement claims, and the usual reasons a claim is cut or refused are in why health insurance claims get rejected.
Renewing your Care Health policy
Renewal is the one moment each year when you can actually restructure your cover. Most people just pay the premium and lose that window. Renew before the due date, because a lapse can reset your waiting periods and your accumulated bonus.
Only possible at renewal
Increase your sum insured
You generally cannot raise cover mid-year. If your city or family situation changed, do it now.
Add or remove members
A spouse, newborn, or parent is normally added at renewal, subject to underwriting.
Port to another insurer
Apply to the new insurer between 60 and 30 days before renewal. Your waiting-period and no-claim bonus credits move with you.
Check before you pay
Your no-claim bonus was applied if you did not claim
The premium change is explained by age band, not a silent downgrade
Room-rent, co-pay, and sub-limit terms have not been revised
Waiting periods you have already served are preserved
Thinking of switching instead? Read how to port your health insurance before you let this policy lapse.
Renew on Care Health's official site ↗Check these terms in any Care Health plan
The insurer name tells you little about what a claim will pay. These four policy terms decide it, and each guide shows how to read them in the plan wording.
Pros and cons
Pros
- Good restoration benefits
- No claim bonus up to 150%
Cons
- 69.2 complaints per 10,000 claims in FY 2024-25, above our benchmark of 40 for standalone health insurers
- Co-payment clause on senior citizen plans
Compare Care Health head-to-head
Who this is for
Our verdict on Care Health
tldr.money editorial score: 8.1/10
Strong product options and a 96.9% claim settlement ratio in FY 2024-25, but complaints per claim run well above our benchmark.
This is our own editorial assessment, not a customer rating. We do not publish testimonials and we are not paid for placement. See how we score insurers for the inputs and their limits.
FAQ
Should I shortlist Care Health?
It can be, but shortlist it with at least two competitors and compare plan-level exclusions before buying.
Which Care Health plan is top pick?
Use the plan cards above to review score, verdict, and segment fit before finalizing.
Other insurers to compare
The insurers scored closest to Care Health, plus others of the same type.
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