- Claim Settlement Ratio
- What is CSR?
- What Is a good CSR?
- Types of Insurance Claims
- Why is Claim Settlement Ratio Important?
- Claim payout time
- Hassle Free Claim Settlement
- How to Process a Claim?
- HDFC Life Claim Settlement Process
- Annual Published CSR
- Documents required for claims
- CSR FAQ's
The Claim Settlement Ratio (CSR) indicates an insurance company's reliability by showing the percentage of claims it has paid out. A higher percent of CSR suggests the company is more dependable in paying claims. ...Read More
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Francis Rodrigues has a decade long experience in the insurance sector, and as SVP, E-Commerce and Digital Marketing, HDFC Life, manages the online sales channel, as well as digital and performance marketing. He has had hands-on experience in setting up sales channels and functional teams from scratch over a career spanning 2 decades.
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Vishal Subharwal heads the Strategy, Marketing, E-Commerce, Digital Business & Sustainability initiatives at HDFC Life. He is responsible for crafting and ensuring successful implementation of the overall organisation strategy.
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What is the Claim Settlement Ratio?
Claim settlement ratio (CSR) is defined as the percentage of claims an insurance company has fulfilled of the total received claims during a financial year. Hence, this ratio indicates the credibility of an insurer. It also assures you of settling your insurance claim on time. The higher an insurer’s claim settlement ratio, the more you can rely on it.
If a life insurance company has a very high claim settlement ratio, it is very likely to honour claims filed by the beneficiaries of a term plan. The number indicates the insurer's trustworthiness, credibility, reliability and quality of service.
The claim settlement ratios of life insurance companies are published on the official portal of IRDAI (Insurance Regulatory and Development Authorityof India) under the Annual Reports section.
How Is Claim Settlement Ratio Calculated?
Calculating the claim settlement ratio is straightforward. Here's a simple formula you can use:
Claim Settlement Ratio (CSR) = (Number of Claims Settled / Number of Claims Received) × 100
For example:
Imagine alife insurancecompany receives 1,000 insurance claims over the year and manages to pay out on 996 of them. To find out how well they’re doing, you can use this formula:
Claim Settlement Ratio = (Claims Settled ÷ Total Claims) × 100Here, it would be:
Claim Settlement Ratio = (996 ÷ 1,000) × 100 = 99.6%
So, the company successfully pays out on 99.6% of the claims it gets.
What Is a Good Claim Settlement Ratio?
For a provider of a term life insurance plan, a claim settlement ratio of 90% or above is considered good. This is so because 90 percent indicates that the insurance provider has successfully settled 90 out of 100 claims during the financial year.
The claim settlement ratiokeeps on changing each year, depending on the number of claims the insurer has successfully settled. An insurance company completing claims above 95 per cent, an insurance buyer can stay assured that the company is secured financially.HDFC Life has a claim settlement ratio of 99.50% for FY 2023-2024 with it, your nominees are assured of minimum hassles and fast claim processing.
However, before selecting an insurance policy, it is necessary to consider other factors including the turnaround time of claims, online review of the insurer, sum assured offered and premium amount.
Types of Insurance Claims
There are two types of claims under life insurance policy i.e., death claims and maturity claims.
Maturity Claims
Maturity claims can be received once your policy matures. This amount however can be fixed or market-linked, depending on the type of your policy. Several life insurance policies such as retirement plans, ULIPs, savings plans, and endowment plans offer attractive maturity benefits. At theend of your policy tenure, you can get a lump sumamount after submitting all necessary documents as required by the insurance company.
Death Claims
Death claims are paid out if the policyholder dies during the policy term. It is paid to the policyholder's nominee either as a regular income or a lump sum as chosen whenbuying the policy. However, the nominee must produce all necessary documents such as a doctor's certificate, proof of death, death certificate and more.
Death benefit claims ensurethat the policyholder’s family iscapable of sustaining themselves financially in your absence.
Why is Claim Settlement Ratio Important?
While purchasing a life insurance policy, there are several factors you must look into including the sum assured value, customer reviews and so on. However, it is crucial to consider the claim settlement ratio when you are researching for any life insurance provider.
Here are the most important benefits of choosing a life insurance provider with a high claim settlement ratio:
Assures Financial Security
In case of a policyholder's suddendeath, the amount his/her family receives from a life insurance policy provides them essential financial security. Often, when the breadwinner of a family passes away, the family members get overwhelmed with financial responsibilities. It can also be difficult for them to meet obligations like loan payments.
In such a situation, a policy from an insurer with a high claim ratioensures your family can support themselves financially.A high claim settlement ratio is one of the benefits of term insurance.
Depicts the Insurer’s Reliability
To rely on an insurance company, it is crucial to look into whetherit maintains a high claim settlement ratio. A high claim settlement ratio indicates the life insurance company is capable of providing the sumassured to the policyholder's nominee, after the policyholder’ssudden demise. Hence, if a life insurance company holds the highest claim ratiothroughout, the insured personcan easily rely on the company to look after his/her family.
Co-operation from the Insurer
An insurance company’s high claim settlement ratio shows its concern for its policyholders and how much it cooperates with claimants. At the same time, policyholders get peace of mind that the insurer will settle their loved one’s claims quickly without hassles.
Considering all of these benefits, make sure to go through the claim settlement ratio before you proceed to choose a provider for alife insurance plan.
How Long Does it Take to Get the Claim Payout?
The time taken to get the claim payout varies among the insurance companies and the type of insurance. As per the IRDAI, all claims should be settled within 30 days1fromthe date of receipt of all relevant documents. During this period, the insurance company scrutinises the application, assesses the damage/loss, raises queries for additional information or documentation, and decides upon the approvals and rejections thereof.
Why is HDFC Life Claim Settlement easy and Hassle-Free?
HDFC Life Insurance has an easy and hassle-free claim settlement process.It is noteworthy that the HDFC Life Claim Settlement Ratio set a remarkable benchmark of 99.50% for FY 2023-2024. The claim can be lodged in the branch of the company as well as online whereby the policyholders can conveniently lodge their claims and solve out the queries if any.
Apart from such hassle-free and faster claim settlement, HDFC Life also provides for 1-day claim settlement. Here, the policyholder can receive the claim settlement amount within 24 hours of lodging the claim and submission of documents. Following are the conditions subject to which the policyholders can receive claim settlement within 24 hours:
- The policy should have been purchased online
- The insurance claim should not require field investigation to be undertaken
- The cumulative claim amount should not exceed Rs, 2 crores2
- All the claim documents shall be submitted by 3 pm on a working day.
HDFC Life holds complete accountability and responsibility to settle the claim within 24 hours on working days. In case the claim does not get settled, then HDFC Life will pay interest at the rate of2% per annum above the bank ratefor each additional day that the claim gets delayed.
What is the Process for Processing a Claim?
HDFC Life provides three different modes for claim intimation. These are:
1.Onlinesubmission of claims
2. Whatsapp users can simply scan the QR code or directly message ‘Death Claim’ on +91 82918 90569 in order to begin the process.
3. You can physically visit the branch for claim intimation with the claim form. The claim form can be downloaded fromhttps://www.hdfclife.com/claims
The lodging and processing of the claim is a 3-step easy process with HDFC Life Insurance.
- Online Claim Lodging
- Offline Claim Lodging
Online Claim Lodging
Online Claim Lodging
Online claim lodging is convenient, especially for the tech savvy people. It relieves them from going through the hassle of physically visiting the HDFC Life along with physical documents. It offers faster, seamless, paperless, and convenience in lodging the claim. If you wish to lodge the claim online, then follow the below-mentioned steps:
Step-1: Verify the Policy Details
You need to verify your policy details before lodging the claim. Through this, you can provide the necessary information from your policy viz. claim information, information about the claimant, information about the life insured, contact information of the claimant, etc.
Step-2: Submit the Details of Life Assured
The next step is to submit the details of the life assured including ID proofs, medical certificates, discharge receipt, and medical expense documents.
Step-3: Submit the Details of the Nominees
The details of the nominee as required in the claim settlement process shall be submitted.
Offline Claim Lodging
Offline Claim Lodging
In case you find online claim lodging inconvenient and an offline route is more preferable to you, then you can physically visit any one of our branches. Just follow the below mentioned steps:
Step-1: Submit the Claim Form
You can download the claim form from the website or visit a branch to acquire the same. You must fill in the necessary details before submitting the form. In case you require assistance, you can contact a representative at your nearest branch.
Step-2: Collect all the Required Supporting Claim Documents
Once you fill up the form, submit all the necessary supporting claim documents to the branch representative. This includes identity proofs of the life assured, discharge certificates, medical vouchers, medical reports, and other necessary documents.
Step-3: Submit Claim Form and Supporting Documents
Once the above two steps are completed, you can submit the claim form and supporting documents to our branch. To locate the branch in your city, you can use the branch locator from our website. By entering the state and city, the locator will show you the branches located in your city along with the address and office timings.
Reasons Why Our Claims Settlement Process Is Unique?
A high claim settlement ratio means a high rate of settling the received claims. Thus, the insurance company appears trustworthy to the insured person. HDFC Life’s claim settlement process is unique as we ensure a hassle-free claim filing process and immediate fulfilment of requests. Here are some of its features:
Ease
HDFC's Claim Centreprovides all the necessary information. In your absence, your nominee can choose either to download the claim form from the website or visit the nearest branch office to file a claim.
Speed
You can claim for your eligible amount under ClaimSecure maintaining the following conditions:
a)You can avail 1-day claim settlement exclusively for all online purchased policies.
b)Cumulative claim amount applicable for all policies up to Rs. 2 crore.
c)There is no need for a field investigation for the claim.
d)Submit all the necessary documents at any nearest office from Monday to Friday before 3 PM. Any document submission after 3 PM will be considered on the next business day.
e)HDFC Life offers interest on your amount death claim amount if there is a delay beyond one working day.
Appointment of Dedicated Officers
On the very next day of claim submission, a dedicated Claims Relationship Officer (CRO) is appointed to provide any personalised services. Having a CRO is very helpful during the settlement of a death claim. The nominee gets assistance and can avail the benefits of insurance claims on time.
Trust
HDFC Life has a claim settlement ratio of 99.50% over the fiscal year 2023-2024.This is by far the highest number that HDFC Life Insurance has achieved to date when compared with previous years.
Support
The customer support services provide constant and speedy support to all queries and grievances of customers. They are ready to serve the customers anytime and anywhere they need.
Claim Settlement Ratio is Published Annually
HDFC Life has a claim settlement ratio of 99.50% over the fiscal year 2023-2024. During the fiscal year 2022-23, the claim settlement ratio of HDFC Life Insurance was 99.39%. This percentage is computed based on individual claims over total individual claims during the financial year. For further details, visit the annual report section for the fiscal year 2021-22.
Consistency in Claim Settlement Ratio is Crucial
IRDAI's Annual Report publishes claim settlement ratios for all life insurance companies. The claim settlement ratio calculation is done based on the totalvolume of settled claims. At HDFC Life, we have maintained a consistency in claim settlement ratio over the last five years. By now, our ratio is holding a prominent figure in the entire industry.
Here are our claim settlement ratiosfor the last 6 years:
Financial Year | Claim Settlement Ratio |
2018-19 | 99.03% |
2019-20 | 99.07% |
2020-21 | 98.01% |
2021-22 | 98.66% |
2022-23 | 99.39% |
2023-24 | 99.50% |
Documents Required for Claim Settlement
Claim settlement involves the submission of certain documents in order for the company to verify the details of the claim. Mandatory Documents required for claims:
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Death claim form (including NEFT)
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Death certificate issued by the government or local municipality authority
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Original policy document, (where applicable)
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Claimant’s PAN details
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Claimant’s ID proof
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Claimant’s address proof
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Personalized cancelled cheque or Bank passbook(Printed account number, name of the account holder and IFSC code)
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Based on the type of claim, additional documents required as mentioned below:
Type of Claim | Documents Required |
Natural Death Claim | The medical cause of death certificate Medical records and associated documents |
Unnatural Death Claim (Accidental Death / Suicide / Murder) | Post mortem report First Information Report Panchnama Police inquest report Annuity claim documents |
Natural Calamities / Disaster Claims | Death certificate issued by the government or local municipality authority Death claim form (including NEFT) Claimant’s PAN card Claimant’s address proof Original policy document Bank passbook or cancelled cheque |
Critical Illness Claim | Critical illness claim form Medical records (current & past) for instance, hospital records Diagnostic tests reports |
Key Considerations While Checking Life Insurance Claim Settlement Ratio
Insurance companies may reject your claim applications if they find inconsistencies in the details you have filed. Otherwise, they must compensate you if they do not have sufficient information to reject your claim.
Following are the key considerations you should consider while checking life insurance claim settlement ratio:
1
Filling Out the Nomination Form Correctly
It is crucial to fill out the nomination form with the correct details. In your absence, the nominee will ultimately claim for the insurance.
2
Providing Right Information
Make sure to include all updated information accurately. This might include your medical history, smoking and drinking habits, employment profile, history of insurance policies, lifestyle and more.
Providing accurate information on your medical history might increase your premium amount. However, it will ensure that the insurer cannot deny your claims.
3
Paying Unpaid Premiums
Before getting a claim settlement, make sure your unpaid premiums are paid on time. This will enable you to receive life insurance coverage for your entire family. However, in cases, if you miss out on any premium, you can opt for policy revival and grace period. This will activate your policy and you can continue with life insurance coverage.
Customer Testimonials
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very professional and considerate to the claimants with grief. the process was really clean n fast by any standards. very happy the way the claim was received n settled.
G S Ravi
July 01,2023
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excellent claim settlement service death claim of Term Insurance policy settlement & payment made 2-3 working days on submission of paper and claim process on with in 2 hours on submission of documents. Excellent service.
Sanjay Goyal
June 30,2023
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The claim process is exceptionally good, very quick and clear document process..
thanks a lotThanshika Vijay
June 29,2023
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team understood the requirements, worked on the insurance work, provided details and helped me fill forms and with minimal effort and time completed the task. Person with grief had to go through multiple things but team made it easy and approachable. appreciate the work.
Shakuntalarashmi Anilkumarchandel
June 28,2023
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very humble and respectful service provided by your team member...I am very satisfied and greatful for him.
Nandita Joutick
June 27,2023
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thank you so much for understanding our needs at this difficult time of ours. the team was very organised and requested all the details promptly. once we furnished the information the process was quick and hassle free.
Suganya R
June 26,2023
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Extremely grateful for your fast and timely settlement.My whole family is so grateful to you for the kind concern.
Neetu Agarwal
June 25,2023
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you did your work honestly.better understanding with customer.
Ruchi Gupta
June 24,2023
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the service was excellent.. very helpful in this painful situation. i really appreciate HDFC Life.
i have given reference to other my friends.Sheetal Wadkar
June 23,2023
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very fast claim settled in 24 hours.
Surinder Kaur Manik
June 22,2023
FAQs on Claim Settlement Ratio
1 What is the meaning of term insurance claim settlement ratio?
The claim settlement ratioof a term insurance company is the percentage of settled term insurance claims divided by the total claims received during a financial year.
2 What is the formula for the claims ratio?
You can represent the formula for the claim settlement ratio as:
Claim Settlement Ratio (CSR) = (Total number of settled claims / Total number of received claims) *100
3 How do you calculate the claim settlement ratio?
The claim settlement ratio is calculated by dividing the total settled claims by the total received claims volume.
4 Why is proper disclosure critical for a better claim settlement ratio?
Improper disclosure or non-disclosure means failing to reveal any fact that is creating an impact on the policy issuance decision in the proposal. Non-disclosure also leads to denial of the claim. Hence, it is recommended to provide proper disclosure to create a positive effect on the claim settlement ratio.
5 What is the timeframe for reporting a claim?
There is no particular timeframe for reporting a claim. However, reporting a claim as soon as possible helps in faster processing. For disability claims, you need to report within 120 days from the date of disability. Moreover, it is essential to report the claim within 60 days for any surgery or critical illness.
6 Who qualifies to receive the claim benefit?
The following individuals qualify to receive the claim benefits of a life insurance plan:
- Proposer, if you are not the life-assured
- Nominee, if you are the life-assured
- Individual to whom the policy is assigned at the time of purchase
- Life assured, if you are alive and enjoying all the benefit claims including any major illness, claims under disability and major surgery
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In a Nutshell
Claim settlement ratio is an important criterion that every policyholder should look into before buying their policy. Also, the prospective policyholders shall maintain transparency when it comes to an insurance policy because incorrect or false information could lead to rejection of the claim in the future. This defeats the very purpose of the insurance. Thus, going with an insurer who has a proven track record for faster and higher claim settlements can help policyholders meet their objectives. With an Insurance Claim Settlement Ratio that is one of the highest in the country, HDFC Life has been consistently protecting the policyholders whenever things went south.
HDFC Life
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Disclaimer
- 30 days for non-investigation cases and additional 90 days for investigated cases
- This is subject to claim assessment and if no further investigation is required.
#Provided we have received all the relevant and required documents and no further investigation is required. Claim settlement process would be completed within stipulated timelines once the claim request is approved
##Individual death claim settlement ratio by number of policies as per audited annual statistics for FY 2023-24.
^ Available under Life & Life Plus plan options
***Online Premium for Life Option for HDFC Life Click 2 Protect Super (UIN: 101N145V04), Male Life Assured, Non-Smoker, 20 years of age, Policy term of 25 years, Regular pay, Annual frequency, exclusive of taxes and levies as applicable. (Monthly Premium of 622/30=20.7).
**7% online discount available on 1st year premium only
~Tax benefits of ₹ 54,600 (₹ 46,800 u/s 80C & ₹ 7,800 u/s 80D) is calculated at highest tax slab rate of 30% on life insurance premium u/s 80C of ₹ 1,50,000 and health premium (Critical illness rider) u/s 80D of ₹ 25,000. Tax benefits are subject to conditions under section 80C, 80D, 10(10D) as per Income Tax Act, 1961. Please consult your tax advisor for more information.
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