Most buyers begin their search by looking at just one figure: the claim settlement ratio (CSR). It is easy to understand and compare, and is often seen as a reassuring figure. However, a high CSR indicates how the insurer has performed against its customer base; it says little about how a particular policy may suit your needs, or how your claim will go.
Some factors, which are often not considered, can help you choose your insurance. An Insurance App is a convenient way of comparing several key factors and can help you choose which insurer to go with.
What the Claim Settlement Ratio Does Not Tell You?
- The CSR can be viewed as a headline figure, and it does not show several nuances, which may determine if and how well your claim goes.
- The ratio is an average settlement figure, calculated for all the claims received by the insurer in a year. It does not reflect claims of a particular category that you may be considering; for example, a huge hospital bill or a high life cover.
- A CSR of 97%, for instance, leaves 3% of claims outstanding, and the reasons for the rejections are seldom discussed.
- The speed at which the claim is settled is important, and the insurer’s average claim settlement time should be taken into account.
What To Look At in the Policy Terms?
The terms of the policy dictate what, and to a large extent, you can claim. A high CSR cannot override policy restrictions. You should always read the fine print.
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What is Covered and What is Not:
The key section to read is the ‘inclusions and exclusions’ because many riders, such as pre-existing diseases, are either restricted or not covered entirely.
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Waiting Periods:
Several health insurance plans have waiting periods, particularly for pre-existing diseases, and the waiting period is a major determinant in choosing an insurance plan.
How To Examine the Service and Network of the Insurer
After settling on the policy terms, the next step is to take a look at the insurer’s services and coverage.
- For health cover, the network hospital list is of paramount importance. You can be forced to bear out-of-pocket expenses if your preferred hospitals do not make it to the list. Make sure that the hospitals that you regularly visit, or that you will visit in the future if you are hospitalised, are on the insurer’s panel.
- How smooth or complicated the claiming process is, and the documents that you may need to submit for a cashless or reimbursement claim, should be taken into account.
- Independent customer reviews and complaints data that a state regulator may publish are useful because they show you the experience of other customers. Pay attention to recurring complaints.
How To Compare Your Needs With the Plan
While an excellent policy on paper is important, it must be matched to your individual circumstances, particularly your age, dependants and liabilities.
- The sum insured should be a multiple of your medical inflation rate, your dependants and your financial liability. Make sure that the plan has adequate coverage. A plan that covers less than you think may be detrimental in times of need.
- The premium that you will pay should align with your budget because a plan that you cannot afford to renew will be of little use to you. Compare premiums across insurers, keeping in mind the annual increase that you can expect as you age or after making a claim.
- Various riders such as critical illness, personal accident and maternity cover can be added to make the plan comprehensive, but an Insurance App can help you look at the features that can be beneficial to you.
What Are Leverage Digital Tools?
Comparing multiple insurance policies on paper can be tedious, and managing them later can be an equally unfun task.
- An Insurance App can be handy: it collates various offers for health, motor, life and other insurances so that your research and your insurance records stay in one place.
- You can look at the features and coverage that different Insurance plans offer using a digital Insurance App without switching between multiple websites.
- Policy documents, their due dates for renewal and other important reminders are stored in one place, helping you keep track of your insurance policies.
- An Insurance App makes it easier to get in touch and ask questions at the most crucial of times. It provides you with the information that you need to make the most important decisions when buying insurance or making a claim.
Conclusion
The claim settlement ratio is a factor to consider, but should not be the deciding element in choosing your insurance. Other factors such as the policy terms, waiting periods and sub-limits, the insurer’s services and claim settlement process, and how the plan fits your needs are important to consider as well.
Bajaj Finance’s App helps you to choose your insurance by collating multiple options and managing your policies. By comparing insurance plans and reading the terms and conditions, you can make the best choice when buying a plan and managing it after the fact.