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Health Insurance Companies: Know the Best from the Rest

We often determine a company’s performance on the basis of its products’ durability, longevity, quality, style, and the after-sales services offered.

There is a reason why iPhones or iPads rule the smartphone market, why Savile Row suits are considered the best in the lot, and why Life Insurance Corporation of India (LIC) has the majority market share in the life insurance industry.

But what should you look at while picking the best health insurance company in the market?

As such, the parameters you apply to fix the best life insurer cannot be applied in case of zeroing in on a health insurance company. In the face of more than 100 plans available in the market, we highlight the factors you should definitely consider while sifting through:

  • Claim Settlement Ratio: The most important reason to buy a health insurance plan is to be assured that all, or most of the medical expenses incurred in case of a medical eventuality get paid by the plan. But what if the insurance company rejects our claim? An insurance company’s claim settlement ratio, or CSR, reflects the proportion of claims settled by it against the total claims raised. A higher ratio means that higher claims have been fulfilled by the company. This also increases the probability of your claims getting fulfilled, when the need arises.

  • Solvency Ratio: This is basically the proportion of assets to the proportion of liabilities. A higher ratio indicates that the insurance company has a higher proportion of asset holdings. This is great news for the customers, because in case of bulk claims, the company will have enough resources to pay off the claims of the customers.

  • Claim Settlement Procedures: At the time of getting a claim settled, it is very important that the insurance provider has simple procedures and options. The less are the claim formalities, the more time and effort is saved.

  • Turnaround Time for Claim Settlement: Settling medical claims can become a bit of a hassle if the insurance company takes a long time to pay off the bills. In such a scenario, the burden of meeting the hospital expenses can fall on your head. Needless to say, it can be a massive financial burden. So, it's best to choose insurers that have a faster claim settlement process, which might also include in-house claim settlement.

  • Network Hospitals: Every health insurance company has a list of tied-up hospitals called Preferred Provider Network or PPN, where the facility of cashless claim settlement is possible. It becomes imperative to check the list of network hospitals to locate ones you prefer in your vicinity. Ideally, a good insurer should have an exhaustive list of hospitals in their network.

  • Business Volume: Business volume means the total number of policies sold by an insurance company and the premium collected. A company with a higher business volume is the one who is trusted by individuals and has a larger market share. This can also be a parameter while judging a health insurer because higher volumes mean greater trustworthiness.

  • Variety of Plans: It is only human to want more. That’s why we are not satisfied with our purchase unless we have gauged all possible options. Even in case of health insurance, companies often have a considerable range of plans catering to specific needs.

  • Insurance Intermediaries: Agents and brokers are the intermediaries who bring the insurance plans to us. While an agent represents only one company, a broker has the privilege of dealing with multiple insurers. As such, whenever you are confused about the company to get insured with, ask your broker for a bias-free and informed advice. Remember, your broker should be licensed as per the IRDA norms. At the end of the day, we want our hard-earned money to be invested in the best possible avenue. In case of health insurance, where having our claims met is an important criterion, we don’t want our money in the wrong hands, i.e. the wrong insurance company. With the above parameters, now you can easily pick the best from the rest in the market, and buy a health plan that suits your requirement.