The claim settlement ratio (CSR) tells you what percentage of claims an insurance company paid out of the total claims it received in a financial year. IRDAI publishes this data annually for all registered insurers.
How IRDAI calculates CSR
CSR = (Claims settled in the year / Total claims received in the year) x 100.
If a life insurer received 10,000 death claims and paid 9,850 of them, the CSR is 98.5%. The remaining 150 were either rejected or pending at year end.
For life insurance, IRDAI tracks individual death claims (not group schemes) separately. For health insurance, it covers both cashless and reimbursement hospitalisation claims.
What counts as a good CSR
Above 99%: Excellent. Very few legitimate claims are rejected.
Above 95%: Good. Acceptable for most buyers.
Above 90%: Average. Verify claim process before buying.
Below 90%: Below average. Dig into why before committing.
For health insurance, the CSR range is typically 88-100%. The benchmark is lower because health claims involve more disputes about treatment necessity, room rent limits, and exclusions.
Why CSR alone is not enough
A high CSR is necessary but not sufficient. Two insurers with 98% CSR can behave very differently:
One might settle quickly via a digital process. The other might require 30+ days and multiple document submissions.
Also check: complaint ratio (complaints per 10,000 policies) published by IRDAI, network hospital count for health plans, and whether the insurer uses a TPA or settles in-house.
How to check current CSR data
IRDAI publishes CSR data in its Annual Report, usually released in August each year. The data covers the previous financial year (April to March).
The 2023-24 data, released in 2024, is the most recent available. Track all insurers on the CSR Tracker page, which is updated when each IRDAI report drops.