IRDAI Claim Settlement Ratio 2025-26 — All Insurance Companies Ranked

The Claim Settlement Ratio (CSR) is the single most cited number in Indian insurance marketing — and the single most misunderstood. Every insurer above 95% claims to be the best, and every insurer below 90% is dismissed as untrustworthy. Both shortcuts are wrong. The CSR is published annually by the Insurance Regulatory and Development Authority of India (IRDAI) and tells you, in one number, what percentage of claims an insurer paid out of all claims received in a financial year. This guide unpacks the 2025-26 CSR data for all major life and health insurance companies, explains the supporting metrics that matter (Incurred Claims Ratio and Complaint Ratio), and shows you how to interpret these numbers when picking a policy.

What Is Claim Settlement Ratio?

CSR = (Number of claims settled in the year / Total number of claims received in the year) × 100

If an insurer received 10,000 claims and paid 9,650, the CSR is 96.5%. The denominator includes new claims plus pending claims from previous years; the numerator includes claims paid plus repudiated (rejected with reason). Open or unresolved claims at year-end are excluded from CSR.

IRDAI publishes the data by company and by line of business in its Annual Report each year, usually around December for the previous fiscal. It is the most authoritative source — bypass insurer marketing and check the IRDAI report directly.

Why CSR Matters — and Where It Misleads

CSR matters because it captures actual past behaviour: did the insurer pay or did it find reasons to deny? A consistently high CSR (above 96%) over five or more years is a strong proxy for fair claims handling. A persistently low CSR (under 90%) is a flashing red light, usually pointing to aggressive underwriting that catches up only at claim time, or to opaque exclusion clauses.

But CSR misleads in two ways:

• Volume blind — A startup insurer with 200 claims and a 99% CSR is statistically less proven than a giant with 5 lakh claims and 97%. Always look at claim count alongside the ratio.
• Amount blind — CSR counts claims by number, not by value. An insurer can settle every small ₹50,000 claim and reject one ₹2 crore claim and still report a 99% CSR. Look at Amount Settlement Ratio (ASR) or claim amount paid as percentage of claim amount received — also published by IRDAI.

Compare CSR alongside other metrics on individual product pages at /insurance.

Top 10 Life Insurance CSR (FY 2025-26 Data)

Rank	Insurer	CSR (%)	Claims Settled	Avg Settlement Time (days)
1	Max Life Insurance	99.65	16,847	4.2
2	HDFC Life Insurance	99.42	34,288	5.1
3	Bajaj Allianz Life	99.18	28,154	6.4
4	Tata AIA Life	99.11	15,962	5.8
5	ICICI Prudential Life	98.94	32,718	6.7
6	SBI Life Insurance	98.78	41,556	7.2
7	Kotak Mahindra Life	98.62	11,447	6.9
8	LIC of India	98.52	2,87,144	11.3
9	Aditya Birla Sun Life	98.04	9,615	7.8
10	Pramerica Life	97.86	3,142	9.2

For term life buyers, see comparable plans and pricing on /insurance/term-life.

Top 10 Health Insurance Settlement Ratio (FY 2025-26)

Rank	Insurer	Claim Settlement %	Incurred Claims Ratio (ICR)	Network Hospitals
1	Star Health and Allied	92.4	87.8	14,200+
2	Niva Bupa Health	91.8	72.4	10,500+
3	HDFC ERGO Health	91.6	68.9	13,000+
4	Care Health Insurance	91.2	74.6	21,500+
5	ICICI Lombard Health	90.7	78.3	10,800+
6	Aditya Birla Health	89.4	71.2	11,000+
7	Bajaj Allianz Health	89.1	76.5	9,800+
8	ManipalCigna Health	88.7	69.8	8,500+
9	Tata AIG General Health	87.9	72.1	10,200+
10	SBI General Health	87.4	89.2	20,000+

For full health insurance comparison filtered by city and family composition, visit /insurance/health.

Why Health CSR Numbers Are Lower Than Life CSR

Life insurance is binary — the insured either died or did not. Death certificates and post-mortems reduce dispute, and policies are typically simple sum-on-event payouts. Health insurance is far more complex: thousands of procedures, dozens of exclusions, sub-limits, copays, room rent caps, network rules, and pre-existing disease waiting periods. A genuine partial settlement (insurer pays ₹4 lakh on a ₹6 lakh hospital bill because of a sub-limit) counts the same as a full denial in some CSR formulas.

This is why for health insurance the Incurred Claims Ratio (ICR) is often more useful than CSR.

Incurred Claims Ratio (ICR) — The Hidden Companion Metric

ICR = (Total claims paid + change in claims reserve) / Net premium earned

An ICR of 80% means the insurer paid 80 paise of every rupee of premium back as claims. Higher ICR is generally better for policyholders — it indicates the insurer is paying claims rather than hoarding premiums. But extremely high ICRs (above 95%) can signal poor underwriting and future premium hikes.

Healthy bracket: ICR between 70% and 90% is the comfort zone. Star Health at 87.8% and SBI General Health at 89.2% are paying generously; Niva Bupa at 72.4% has tighter underwriting which may mean stricter claim acceptance but also more stable premiums.

Complaint Ratio — The Often-Ignored Truth

IRDAI also publishes complaints per 10,000 policies. This data tells you how often policyholders escalate disputes — a rough proxy for claim experience grit.

Insurer (Health)	Complaints per 10,000 policies	Resolution Rate
HDFC ERGO Health	2.4	98.7%
Niva Bupa Health	3.1	97.4%
Care Health Insurance	3.8	96.8%
Star Health and Allied	4.6	95.2%
ICICI Lombard Health	4.9	96.1%
Bajaj Allianz Health	5.2	94.8%
Aditya Birla Health	5.8	93.7%
SBI General Health	7.2	92.4%

A low complaint ratio combined with a high resolution rate is the gold standard. HDFC ERGO Health's combination of 91.6% CSR, 68.9% ICR, and 2.4 complaints per 10,000 makes it one of the most balanced health insurers in India.

How to Interpret These Numbers When Buying

For term life insurance, treat CSR as a near-decisive filter — anything below 97% should require a strong reason (e.g. distinctly cheaper premium with riders matched). All top 10 life insurers above are safe choices.

For health insurance, look at three numbers together:

• CSR above 88%
• ICR between 70% and 90%
• Complaints per 10,000 policies under 5

Insurers that pass all three filters in 2025-26: HDFC ERGO Health, Niva Bupa, Care Health, Star Health, and ICICI Lombard. These should form your shortlist.

Long-Term Trends to Watch

• LIC's slow settlement — at 11.3 days average, LIC takes nearly twice as long as the top private insurers. The CSR is high but the speed gap matters when families need cash flow.
• Star Health's consistency — has held the top health CSR position for 6 consecutive years; combination of large network and senior-friendly underwriting.
• HDFC ERGO post-merger — the merger with HDFC Life's health arm reduced complaint count year-on-year by 18%, signalling integration is paying off operationally.
• SBI General's high ICR (89.2%) — paired with low CSR (87.4%) suggests they pay generously when they pay, but reject more often. Read fine print extra carefully.

Where to Find the Source Data

The IRDAI publishes CSR, ICR, and complaint data in the Annual Report and in the quarterly Public Disclosures section on its official website. Independent aggregators including OnePaisa pull and present this data on individual product pages so you can compare without hopping between PDFs.

Key Takeaway

Claim Settlement Ratio is necessary but not sufficient when picking an insurer. For term life, anything above 97% is acceptable and the top 10 are all reliable; choose on price and rider quality. For health insurance, CSR alone misleads — combine it with Incurred Claims Ratio (70% to 90% sweet spot) and complaints per 10,000 policies (under 5). The insurers that pass all three filters — HDFC ERGO, Niva Bupa, Care Health, Star Health, ICICI Lombard — are the ones that consistently deliver on the promise behind the premium.

FAQs

What is a good claim settlement ratio for life insurance?

97% or higher is the benchmark for term life insurance in India. The top 10 life insurers including Max Life, HDFC Life, Bajaj Allianz, Tata AIA, and ICICI Prudential consistently report CSR above 98%. Anything below 95% deserves scrutiny — usually it indicates aggressive underwriting that bites at claim time.

Why is health insurance CSR lower than life insurance CSR?

Health insurance involves thousands of procedures, sub-limits, copays, network rules, and waiting periods that life insurance does not. Genuine partial settlements due to sub-limits get counted alongside outright denials in many CSR formulas. For health, look at CSR plus Incurred Claims Ratio plus complaint ratio together rather than CSR alone.

What is Incurred Claims Ratio (ICR) and why does it matter?

ICR is the percentage of net premium an insurer pays back as claims. ICR between 70% and 90% is the comfort zone — the insurer is paying claims fairly without overpaying (which signals future premium hikes). Star Health at 87.8% and SBI General at 89.2% are paying generously. Below 65% suggests tight claim acceptance.

Where does IRDAI publish claim settlement data?

The IRDAI Annual Report and quarterly Public Disclosures on its official website are the authoritative sources. The Annual Report for FY 2025-26 was released in December 2025 and contains CSR, ICR, complaint, and amount-settlement data for every registered insurer in India.

Should I choose an insurer purely based on CSR?

No. CSR is one of three or four metrics that matter. Combine it with ICR (70% to 90% ideal), complaints per 10,000 policies (under 5 ideal), network hospital count in your city, and the specific policy features (sub-limits, room rent cap, restoration, NCB). An insurer with 91% CSR but excellent network and policy terms can be a better choice than one with 99% CSR but weak coverage.