The Insurance Regulatory and Development Authority of India (IRDAI) has raised concerns over the claim settlement practices of Star Health and Allied Insurance, a prominent stand-alone health insurer. The regulator’s investigation uncovered significant issues in the company’s approach to settling claims.
IRDAI’s report delved into various claim-related metrics, including the number of claims rejected, accepted, deductions made, and queries raised by policyholders, among other aspects.
According to IRDAI’s insurance statistics handbook, Star Health reported an incurred claim ratio of 66.47% for the financial year 2023-2024. This figure indicates that for every Rs 100 collected in premiums, Star Health paid out approximately Rs 67 in claims during the year.
Additionally, Star Health recorded the lowest claim settlement ratio within three months among all stand-alone health insurers, standing at 82.31% for the year 2023-2024. During this period, the insurer settled only 2.74% of its claims between three to six months, while around 0.35% of claims were resolved within six months to one year. The company’s claim settlement ratio dropped significantly to 0.074% for claims settled between one and two years. Furthermore, only about 0.03% of its claims were settled after a period of more than two years.
Navigate below link for complete information: