Paying claims or pushing back? What Irdai data reveals about insurers

Irdai's latest data shows how much insurers paid out in health claims in FY25

When buying health insurance, consumers often compare premiums, benefits and hospital networks. What mostly gets ignored is whether the insurer actually pays claims reliably. One of the most useful indicators for judging this is the incurred claim ratio (ICR), published annually by the Insurance Regulatory and Development Authority of India (Irdai).

 

The latest Irdai annual report for 2024–25 provides company-wise ICR data for general and health insurers, offering valuable insight for policyholders heading into 2026.

 

What does the incurred claim ratio mean?

The incurred claim ratio represents the proportion of premium income that an insurer spends on settling claims in a financial year. For example, an ICR of 85 per cent means the insurer paid Rs 85 in claims for every Rs 100 collected as premium.

 

 

Insurance experts generally view an ICR between 70 and 90 per cent as comfortable. A very low ratio may indicate restrictive claim practices, while a consistently high ratio can signal stress on the insurer’s finances.

 

Industry-wide trends

According to Irdai, the non-life insurance industry’s overall ICR stood at 82.88 per cent in 2024–25, slightly higher than the previous year. Net incurred claims rose to about Rs 1.88 lakh crore, reflecting higher healthcare costs and increased utilisation.

 

Public sector insurers continued to report elevated ratios, while private and standalone health insurers showed more moderate levels.

 

Private sector general insurers: FY25 ICR (health segment)

According to Irdai data, the incurred claim ratios for major private general insurers in 2024–25 were:

 

·  Acko General Insurance: 57.82 per cent

 

·  Bajaj Allianz General Insurance: 87.31 per cent

 

·  Cholamandalam MS General Insurance: 73.04 per cent

 

·  Future Generali India Insurance: 95.29 per cent

 

·  Go Digit General Insurance: 83.78 per cent

 

·  HDFC Ergo General Insurance: 84.85 per cent

 

·  ICICI Lombard General Insurance: 82.24 per cent

 

·  IFFCO Tokio General Insurance: 83.74 per cent

 

·  Kshema General Insurance: 40.03 per cent

 

·  Liberty General Insurance: 92.99 per cent

 

·  Magma General Insurance: 85.54 per cent

 

·  Navi General Insurance: 101.89 per cent

 

·  Raheja QBE General Insurance: 105.12 per cent

 

·  Reliance General Insurance: 87.34 per cent

 

·  Royal Sundaram General Insurance: 95.56 per cent

 

·  SBI General Insurance: 82.19 per cent

 

·  Shriram General Insurance: 74.55 per cent

 

·  Tata AIG General Insurance: 76.24 per cent

 

·  Universal Sompo General Insurance: 97.12 per cent

 

·  Zuno General Insurance: 90.12 per cent

 

·  Zurich Kotak General Insurance: 70.69 per cent

 

Public sector general insurers

Public insurers reported significantly higher ratios in FY25:

 

·  National Insurance: 96.05 per cent

 

·  New India Assurance: 100.98 per cent

 

·  Oriental Insurance: 102.58 per cent

 

·  United India Insurance: 97.51 per cent

 

The combined ICR for public sector general insurers stood at 99.84 per cent, according to Irdai.

 

Standalone health insurers

Standalone health insurers recorded a combined ICR of 68.06 per cent in 2024–25:

 

·  Aditya Birla Health Insurance: 71.50 per cent

 

·  Care Health Insurance: 64.53 per cent

 

·  ManipalCigna Health Insurance: 74.81 per cent

 

·  Niva Bupa Health Insurance: 61.22 per cent

 

·  Star Health and Allied Insurance: 70.30 per cent

 

Note: Health includes personal accident

 

ICR should not be viewed in isolation. Consumers should look at multi-year trends, claim settlement timelines, exclusions and customer grievance records before choosing a policy. Still, Irdai’s company-wise ICR data offers a useful starting point to assess how insurers balance claim payouts with financial stability.