Top 5 Health Insurance Companies in India - IRDAI Approved

The top 5 health insurance companies in India, approved by the Insurance Regulatory and Development Authority of India (IRDAI) in 2024, include HDFC ERGO Health Insurance, Acko Health Insurance, ICICI Lombard Health Insurance, Kotak Mahindra Health Insurance, and Bajaj Allianz Health Insurance. These companies are known for their comprehensive coverage, excellent customer service, and hassle-free claim settlement process.

Top 5 Health Insurance Companies in India 2024: Based on Claim Settlement Ratio (CSR)

Health insurance is crucial to protect against unexpected medical expenses. In the below table, we have mentioned the top 5 health insurance companies in India based on claim settlement ratio (CSR), network hospitals, solvency ratio, and incurred claim ratio.

Claim Settlement Ratio: The Claim Settlement Ratio refers to the proportion of claims that an insurance company has successfully resolved in a given financial year. It is typically considered favorable if it falls within the range of 95 to 99 percent.

Solvency Ratio: The solvency ratio is a measure of an insurer's capacity to pay off its long-term obligations by comparing its total liabilities to its available capital.

Incurred Claims Ratio: The Incurred Claim Ratio (ICR) is the percentage of the total premium collected by the insurer in one financial year that is paid out in claims.

Disclaimer: We at Okbima do not promote or endorse any particular insurance company or insurance product provided by insurers. 

1. HDFC ERGO Health Insurance

HDFC ERGO is a health insurance company in India, founded in 2002, and is a joint venture between HDFC Limited and ERGO International AG, a German company. With a claim settlement ratio (CSR) of 98.49%, 13000+ network hospitals, and a solvency ratio of 1.68.

Some Plans Offered By HDFC ERGO Health Insurance:

• Individual Health Insurance Plans: These plans are designed for individuals and provide coverage for hospitalization expenses, pre and post-hospitalization expenses, ambulance charges, and other medical costs. Some of the popular individual health insurance plans offered by HDFC ERGO include Optima Secure, Critical Illness Plans, and Corona Kavach Policy.

• Family Floater Health Insurance Plans: These plans cover the entire family under a single sum insured. This means that you can claim for the hospitalization expenses of any member of your family, up to the limit of the sum insured. Some of the popular family floater health insurance plans offered by HDFC ERGO include Health Suraksha and My Health Suraksha Gold.

Features:

• Wide Coverage: Covers hospitalization expenses, pre & post-hospitalization costs, day care treatments, ambulance services, and more.

• Sum Insured Options: Choose your desired coverage amount (sum insured) depending on your needs. Options typically range from Rs. 50 lakhs to Rs. 1 crores.

• No Room Rent Capping: In certain plans, you can choose any room type up to a standard private AC room without limitations on room rent.

• Cumulative Bonus: Earn an additional 5-10% of the sum insured on every claim-free year, which can increase your coverage amount over time.

• Lifelong Renewability: Renew your policy for as long as you want, even after making claims.

• Claim: If you have HDFC ERGO health insurance, you can have 100% of your coverage reinstated immediately following your initial claim.

• Free Health Check-up: You are eligible for a complimentary health examination within 60 days of renewing your policy.

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2. Acko Health Insurance

Acko Health Insurance is a general insurance company in India, founded in 2016, and is the parent company of ACKO General Insurance. With a claim settlement ratio (CSR) of 97.20%, 7100+ network hospitals, a solvency ratio of 1.84, and an incurred claims ratio of 103.75.

Some Plans Offered By Acko Health Insurance:

• Individual Health Insurance Plans: It is designed for a single person, providing coverage for hospitalization expenses, pre and post-hospitalization costs, ambulance charges, and other medical bills.

• ACKO Standard Health Insurance Plan: This plan offers various sum insured options, ranging from Rs. 10 lakhs to Rs. 1 crores. It covers hospitalization expenses, ambulance charges, AYUSH treatment, and more.

• ACKO Platinum Health Insurance Plan: This comprehensive plan provides an unlimited sum insured, covering hospitalization expenses, pre and post-hospitalization costs, ambulance charges, AYUSH treatment, and more.

• Family Health Insurance Plans: Cover your entire family under a single plan, including yourself, spouse, parents, parents-in-law, and dependent children.

• ACKO Standard Family Health Insurance Plan: This plan offers various sum insured options, providing coverage for hospitalization expenses, ambulance charges, AYUSH treatment, and more, for all covered family members.

Features:

• Cashless hospitalization: Acko has a network of over 14,300 hospitals across India where you can avail cashless hospitalization. This means that the insurance company will settle your hospital bills directly with the hospital, saving you from the hassle of upfront payments.

• Transparent pricing: Acko prides itself on being transparent about its pricing. You can easily get quotes and compare plans online before you buy.

• Simple claim process: Acko offers a simple and hassle-free claim process. You can file claims online or through their mobile app.

• Sum Insured: They provide coverage of up to Rs 1 Crores in Sum Insured.

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3. ICICI Lombard Health Insurance

ICICI Lombard, established in 2000, is a general insurance provider in India. It is a collaboration between ICICI Bank and Fairfax Financial Holdings Limited. With a claim settlement ratio (CSR) of 97.07%, 6700+ network hospitals, a solvency ratio of 2.54, and an incurred claims ratio of 91.67.

Some Plans Offered By Acko Health Insurance:

• Individual Health Insurance Plans: These plans are designed for a single person and provide coverage for hospitalization expenses, pre and post-hospitalization expenses, ambulance charges, and other medical costs. Some of the popular individual health insurance plans offered by ICICI Lombard include Health AdvantEdge, Arogya Sanjeevani Policy, and Health Booster.

• Family Health Insurance Plans: These plans cover the entire family under a single sum insured, meaning you can claim for the hospitalization expenses of any member of your family, up to the limit of the sum insured. ICICI Lombard offers a floater benefit with most of their individual health insurance plans.

• Critical Illness Insurance: This plan provides a lump sum payout in case you are diagnosed with a critical illness such as cancer, heart attack, or stroke. ICICI Lombard offers critical illness cover as an add-on rider that can be attached to some of their individual and family health insurance plans.

Features:

• Cashless hospitalization: ICICI Lombard has a wide network of over 9,500 hospitals across India where you can avail cashless hospitalization. This means the insurance company will settle your hospital bills directly with the hospital, saving you from upfront payments.

• Sum insured options: You can choose your desired coverage amount (sum insured) depending on your needs. Options typically range from Rs. 1 lakhs to Rs. 5 crores.

• No room rent capping: In certain plans, you can choose any room type up to a standard private AC room without limitations on room rent.

• Cumulative bonus: Earn an additional 5-10% of the sum insured on every claim-free year, which can increase your coverage amount over time.

• Lifelong renewability: Renew your policy for as long as you want, even after making claims.

• 24/7 customer support: ICICI Lombard offers 24/7 customer support to assist you with any queries or claims-related issues.

• Insured Policyholders: So far, the company has provided insurance for over 32.7 million policyholders.

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4. Kotak Mahindra Health Insurance

Kotak Mahindra Health Insurance Company is a subsidiary of Kotak Mahindra Bank, one of India's leading financial institutions, founded in 2015. With a claim settlement ratio (CSR) of 96.90%, 7000+ network hospitals, a solvency ratio of 2.1, and an incurred claims ratio of 72.11.

Some Plans Offered By Kotak Mahindra Health Insurance:

• Individual Health Insurance Plans: These plans provide coverage for a single person, including hospitalization expenses, pre and post-hospitalization costs, ambulance charges, and other medical bills. Some popular individual health insurance plans from Kotak Mahindra include Kotak Secure Shield, Kotak Health Premier, Kotak Health Care, and Kotak Accident Care.

• Family Floater Health Insurance Plans: Family floater plans cover your entire family (spouse and dependent children) under a single sum insured. This means you can claim for hospitalization expenses of any family member, up to the limit of the sum insured. 

Features:

• Cashless hospitalization: Cashless hospitalization allows you to get treatment at a network hospital without having to pay any money upfront. The insurance company will pay the hospital directly for the bill.

• Reimbursement: If you get treatment at a non-network hospital, you can file a claim for reimbursement with the insurance company.

• Room rent: The insurance company will pay for your room rent up to a certain limit per day.

• Doctor's fees: The insurance company will pay for the doctor's fees up to a certain limit.

• Pre and post-hospitalization expenses: The insurance company will cover some of the expenses incurred before and after hospitalization.

• Daycare procedures: The insurance company will cover the cost of certain daycare procedures.

• Ambulance charges: The insurance company will cover the cost of ambulance services up to a certain limit.

• Tax benefits: You can avail of tax benefits under Section 80D of the Income Tax Act for the premiums paid towards your health insurance policy.

• Annual Premium Number: They have an annual premium revenue of 742 crores.

• Cumulative Bonus: By using Kotak Mahindra Health Insurance, policyholders can receive a 10% cumulative bonus for each year without making any claims.

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5. BAJAJ Allianz Health Insurance

Bajaj Allianz Health Insurance Company is a leading health insurance provider in India. It's a joint venture between Bajaj Finserv, an Indian financial services company, and Allianz SE, a German multinational financial services conglomerate, and founded in 2001. With a claim settlement ratio (CSR) of 96.59%, 8000+ network hospitals, a solvency ratio of 3.41, and an incurred claims ratio of 90.64.

Some Plans Offered By BAJAJ Allianz Health Insurance:

• Health-Guard: This is a comprehensive health insurance plan that offers coverage for hospitalization expenses, pre and post-hospitalization expenses, daycare treatments, and more.

• Silver Health: This plan is designed for senior citizens and provides coverage for medical expenses related to age-related illnesses, pre-existing conditions, and more.

• Critical Illness: This plan provides a lump sum benefit upon diagnosis of specified critical illnesses like cancer, heart attack, stroke, etc.

• Extra Care: This plan offers additional coverage for expenses not covered under regular health insurance plans, like maternity expenses, organ donor expenses, etc.

• Health Ensure: A family floater plan that provides coverage for the entire family under a single sum insured.

• Personal Guard: This plan offers personal accident coverage along with health insurance benefits.

Features:

• Wide Coverage: Covers hospitalization expenses, pre & post-hospitalization costs, day care treatments, ambulance services, and more.

• Sum Insured Options: Choose your desired coverage amount (sum insured) depending on your needs. Options typically range from Rs. 50 lakhs to Rs. 1 crores.

• No Room Rent Capping: In certain plans, you can choose any room type up to a standard private AC room without limitations on room rent.

• Cumulative Bonus: Earn an additional 5-10% of the sum insured on every claim-free year, which can increase your coverage amount over time.

• Lifelong Renewability: Renew your policy for as long as you want, even after making claims.

• Cashless Claims: Get your hospitalization bills paid directly by the insurance company at network hospitals. Bajaj Allianz has a wide network of over 18,400 hospitals across India.

• Annual Health Check-up: Policyholders who are 60 years and older are eligible for a complimentary annual health checkup to help detect any potential health issues early on.

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How to Choose the Best Health Insurance Companies In India?

With the numerous best health insurance companies in India, it can be overwhelming to choose the right one. Here are some factors to consider when choosing the best health insurance companies in India.

• Reputation: Look for health insurance companies that have a good reputation in the market. Check online reviews, ratings, and feedback from customers to understand their service quality.

• Network hospitals: Consider health insurance companies that have a wide network of hospitals and healthcare providers across India. This will ensure that you have access to quality healthcare services in case of an emergency.

• Claim settlement ratio: The claim settlement ratio is a crucial factor to consider when choosing a health insurance company. It indicates the percentage of claims settled by the insurer against the total number of claims received. A higher claim settlement ratio reflects the insurer's reliability in settling claims.

• Coverage and benefits: Compare the coverage and benefits offered by different health insurance companies. Look for policies that provide comprehensive coverage for hospitalization, ambulance services, pre and post-hospitalization expenses, and other medical expenses.

• Premiums and deductibles: Consider the premium rates and deductibles of health insurance policies offered by different companies. Choose a policy that offers an affordable premium with a reasonable deductible amount.

• Customer service: Opt for health insurance companies that provide excellent customer service. Check the insurer's customer support channels, response time, and availability to assist you in case of any queries or issues.

• Policy features and exclusions: Read the policy terms and conditions carefully to understand the coverage, features, and exclusions of the health insurance policy. Ensure that the policy covers your specific healthcare needs and requirements.

Read More:

How Many Types of Health Insurance Plans In India?

Health Insurance Claim Settlement Ratio 2024

Tax Benefits of Health Insurance Plans In India

Best Family Health Insurance Plans in India 2024

Conclusion

In conclusion, the top 5 health insurance companies in India offer extensive coverage and reliable services to their customers. These companies have established themselves as leaders in the field with their diverse range of policies and innovative offerings. If you want to buy the best health insurance plan from the best company, contact the okbima expert to make an informed decision.