Cashless authorisation timelines
The Health Insurance Master Circular states a one-hour window for deciding cashless pre-authorisation requests and a three-hour window for final discharge authorisation.
Check current IRDAI circulars ↗ A CLEARER VIEW OF INSURANCE
See the numbers.
Understand the story.
Explore Indian health insurance through official public data. Compare states, understand claims trends, and see exactly what each number can—and cannot—tell you.
✓ Source-linked metrics
✓ No “best insurer” score
✓ Missing data stays missing
Explore insurer evidence
YOUR STATE SNAPSHOT
IRDAI · FY 2024–25
Where does the premium go?
In All India, the individual and family policy segment reported … in premium; insurers paid … in claims.
CLAIMS PAID PER ₹100 OF PREMIUM i
…
Same-year claims paid ÷ same-year premium. Not an approval chance, ICR, CSR or profit measure.
THE NUMBER DECODERA little context changes everything
A number can be true
and still mislead.
Before you compare insurers, tap a card. These are the traps that turn a real statistic into the wrong conclusion.
01 / PREMIUM & PAYOUT“₹70 paid per ₹100 premium means 70% of claims were approved.”Unpack this ↘
NOT THE SAME THING
This compares amounts paid and premium reported in the same financial year. Claims paid may relate to policies from earlier years. It is not an approval rate.
See your state snapshot ↗02 / INCURRED CLAIMS“A high health ICR proves an insurer serves customers better.”Unpack this ↘
ONE SIGNAL, NOT A SCORE
ICR compares incurred claims with earned premium for the specified business. It does not measure service quality, solvency or your personal approval chance.
Compare the separate signals ↗03 / COMPLAINTS“More complaints automatically means a worse insurer.”Unpack this ↘
CHECK THE DENOMINATOR
Complaint totals depend on business size, product mix and reporting definitions. If complaint scope and policy denominator differ, the resulting rate is only a rough indicator—not an exact health-complaint rate.
Inspect scope and limitations ↗04 / NETWORK PROVIDERS“More network providers means my hospital will be cashless.”Unpack this ↘
CHECK YOUR ACTUAL POLICY
A reported network-provider count does not guarantee cashless access at a particular hospital under a particular plan. Provider lists and policy terms need a separate check.
Read the network-data limitation ↗01 / STATE PICTUREState + year filters
How does your state compare?
Compare the same metric across states using the same reporting year.
₹0₹50₹100₹150+
02 / THE LONG VIEWAnnual series
The ten-year story
Claims paid per ₹100 of premium, same year. Trends show what happened, not why.
A value above ₹100 means reported claims paid during that year exceeded reported premium in that same year. It does not mean the insurer lost money.
03 / HOW CLAIMS WERE PAIDPublished from 2020–21
Cashless is only part of the picture
04 / INSURER EVIDENCENo composite score
Compare insurance company data
Compare separate signals from IRDAI. Some metrics cover health insurance; others cover an insurer’s entire business. We show when that distinction prevents a fair comparison.
No overall winner. ICR, solvency, complaints and claims status measure different things. A number is useful only when you understand its scope.
VS
What IRDAI does not publish for each company
Public data does not provide every detail consumers want. This site cannot reliably show each company’s rejection reasons, company-specific cashless share, company-specific settlement speed, or combined state-and-insurer claims results. Missing data is not estimated.
05 / POLICY FIT STUDIOOptional AI · Document-grounded
Compare the policy wording—not just the premium.
Upload two or more health-insurance quote PDFs, add the full policy wording if you have it, then compare the terms against what matters to your family. Every finding should point back to a document page.
No made-up approval percentages.
BimaBrief compares the evidence in the documents. It does not promise claim approval or declare an insurer universally reliable.
Unknown is a valid answer.
If a quote does not state exclusions, waiting periods or limits, the result must say so—not guess.
Read this before uploading. The PDFs are sent to the provider selected above; the provider's own handling rules apply. BimaBrief does not persist the uploads, but cannot promise the provider itself retains no request data. A quote alone is not the full contract. This tool compares the uploaded evidence, not an individual claim's approval chance or an insurer's overall reliability. Verify important terms with the insurer before buying.
06 / CLAIM JOURNEYIRDAI Table 66 · Industry-level
Where did the claims workload go?
Explore the yearly stock and movement of health insurance claims, then inspect how long paid, repudiated and outstanding claims sit in the reported duration buckets.
Annual movement
These are events recorded during the year, not one group of claims followed end-to-end.
How long did claims take—or remain outstanding?
Choose a type below. The source uses different start dates for different aging measures.
07 / OFFICIAL RULES & UPDATESSources checked 29 Oct 2026
Rules change. Check the original.
A dated, plain-language guide to important health-insurance provisions, plus direct links to IRDAI's official pages. This is not a substitute for the current circular or your policy wording.
LATEST HANDBOOK LISTING OBSERVED
Handbook on Indian Insurance Statistics · FY 2024–25
At our review on 29 October 2026, IRDAI's Handbook listing showed the 2024–25 edition, with the listing marked updated 3 February 2026. Check the official page for any newer release.
Pre-existing disease waiting period
The 2024 health-insurance circular sets a maximum waiting period of 36 months for pre-existing diseases. The waiting period for a specific plan may be shorter; check its policy wording and any later amendment.
Find official health product documents ↗Moratorium is not a claim guarantee
After 60 continuous months, contesting a policy or claim on non-disclosure or misrepresentation grounds is restricted, except in cases of established fraud. Policy exclusions, limits, co-payments and other applicable terms do not simply disappear; enhanced cover may be treated separately.
Verify the applicable circular ↗A previous claim is not, by itself, the whole answer
The 2024 circular includes a protection against denying renewal solely because claims were made in previous policy years. Always verify the complete applicable rule, permitted exceptions and the policy's actual terms.
Review official notices and circulars ↗No blanket upper-age bar
The 2024 health-insurance circular provides for health products across age groups, without a blanket upper age limit for entry. This does not mean every product has identical benefits or that every proposal is automatically accepted; verify the specific product and current rules.
Check current product wording ↗
01Circulars & regulatory updatesCheck for later amendments↗
02Health insurance productsSearch policy terms and UINs↗
03IRDAI annual reportsSector performance and grievances↗
04Bima BharosaRegister or track a grievance↗
Can BimaBrief sync directly with IRDAI?
BimaBrief links to official IRDAI pages and runs a monthly check for a newer statistical Handbook, opening a review issue when it detects one. We have not verified a stable public IRDAI API or RSS feed for all circular amendments, so regulations are not auto-synced into this page. This card summarises a dated circular; open the official source to check whether it has been amended. IRDAI—not BimaBrief—is the authoritative source.
08 / SOURCES & METHODOpen and inspectable
About the data
Every result should answer three things: where it came from, how it was calculated, and what it cannot prove.
Why I built BimaBrief
I started BimaBrief because official insurance statistics can be difficult to explore and easy to misread. I wanted a practical public tool that links each result to its source, explains the calculation and says clearly when the available data cannot answer a question. The aim is to make the evidence easier to understand—not to attack or endorse any company.
— Harshil Desai, Project Lead
Where the numbers come from
Figures come from the IRDAI Handbook on Indian Insurance Statistics 2024–25, including Table 67 (state-wise health insurance business), Table 72 (state-wise claim settlement), Tables 53, 56 and 58 (insurer claims, grievances and policies), Table 62 (health incurred claims ratio), Table 49 (solvency), Table 80 (network providers) and Table 66 (industry claims development and aging). Health business in these tables excludes personal accident and travel unless noted otherwise. The Handbook is published annually.
What “claims paid per ₹100 of premium” means
It compares the amount of claims paid in a financial year with the premium reported in the same year. Some claims paid may relate to policies bought earlier. It is not the official Incurred Claims Ratio, not the Claim Settlement Ratio, not a measure of profit and not the probability that an individual claim will be paid.
Trends show what happened, not why. The data alone does not establish the cause of a change.
Own policy, employer or group, and government schemes
Own policy means an individual or family policy. Employer or group means cover provided through a group, such as employees. Government schemes are government-backed programmes. These categories have different funding and coverage structures and should not be treated as interchangeable.
What “Not available” means
“Not available” means the source did not provide a usable value or a fair calculation cannot be made. It does not mean zero. Source-reported zeroes and missing values are preserved separately.
Why some comparisons are limited or blocked
Metrics are compared only when their definitions, time period, units, denominators and insurance scope are compatible. A whole-company metric is not automatically health-only. The network-provider table is a 2024–25 snapshot, not a ten-year series.
How data discrepancies are handled
Automated checks validate headers, units, totals and key relationships. If IRDAI’s own table does not reconcile under a documented check, the values are preserved and the discrepancy is flagged rather than silently corrected. Every build runs tests; passing tests confirms only the checks defined, not that every possible error has been eliminated.
BimaBrief is an independent educational project. It is not affiliated with, endorsed by, or acting on behalf of IRDAI or any insurer. Company names appear only to identify entities in cited source tables; no allegation of wrongdoing is made. This is not financial or legal advice and is not a recommendation to buy any company’s insurance. If you identify a source or calculation error, report it with a public source reference.