When choosing an insurance policy, it is important to know how reliable the insurer is and how financially stable they are. Two important measures to look for this are the Claim Settlement Ratio (CSR) and the Incurred Claim Ratio (ICR).
Both ratios provide insights into an insurance company’s claim handling efficiency and financial prudence, but they measure different aspects of the insurer’s performance.
In this article, we will cover these ratios in detail. Let’s get started.
What is Claim Settlement Ratio?
The Claim Settlement Ratio (CSR) is a measure of an insurance company’s efficiency in settling claims. The rate shows how many claims an insurer has settled as compared to the total claims received over a specific period, usually a financial year.
Claim Settlement Ratio =(Number of Claims Settled / Number of Claims Received) x 100
A high CSR means that the insurer settles most claims filed by policyholders, suggesting reliability and customer-centric service.
A low CSR signals delays, disputes, or frequent claim rejections, which is a red flag.
Key points about CSR:
It focuses on the number of claims settled, not the amount paid.
It shows whether the insurer is willing and able to fulfil claims.
It is often used as a main indicator of how well claims are handled.
For example, if an insurer received 10,000 claims in a year and settled 9,500, the CSR would be 95%.
What is Incurred Claim Ratio?
The Incurred Claim Ratio (ICR), also known as the Loss Ratio, measures the proportion of claims paid and outstanding claims to the total premiums earned by the insurer during a period.
Incurred Claim Ratio = (Claims Paid +Outstanding Claim) / Premiums Earned x 100
ICR shows the insurer’s financial management and underwriting performance. A high ICR means the insurer pays out a large part of the premiums it collects as claims.
This may suggest generous claim payments, but also means lower profits.
A very low ICR might indicate stringent claim settlements or underpayment, potentially at the expense of policyholders.
Key points about ICR:
It considers the monetary value of claims, including paid and reserved amounts.
It reflects the insurer’s claim cost relative to premium income.
It is a critical indicator of the insurer’s financial health and sustainability.
For example, if an insurer collected ₹100 crore in premiums and paid ₹70 crore in claims (including outstanding claims), the ICR would be 70%.
The Critical Relationship Between Both Ratios
While CSR and ICR measure different dimensions, both are crucial in evaluating an insurer’s claim handling and financial soundness.
CSR assesses the frequency of claims settled relative to claims received, focusing on customer experience and claim approval rates.
ICR evaluates the severity and cost of claims relative to premiums, indicating underwriting effectiveness and pricing adequacy.
An insurer with a high CSR but very low ICR might settle many claims but pay out less than expected, possibly denying legitimate claims or settling for lower amounts. Conversely, a company with a high ICR but low CSR might pay large claims but reject many others, raising concerns about claim denial practices.
How to Use Both Ratios for Policy Selection
Now, let us see how you can use both of these ratios to make a policy decision.
1. The Category-Specific Considerations
Different insurance categories have varying benchmarks for CSR and ICR due to the nature of risks and claims:
Health Insurance: Typically expects a CSR above 90% and an ICR between 70-90%. High medical costs can push ICR higher, but insurers must maintain prompt claim settlements.
Life Insurance: CSRs are usually very high (above 95%) as claims are fewer but significant. ICRs vary widely based on product type and policy duration.
General Insurance (Motor, Property, Travel): CSRs can range from 80-95%, with ICRs between 60-80%, reflecting diverse claim types and frequencies.
Knowing these factors helps you set realistic expectations when comparing insurers in the same category.
2. The Company Size: Interpreting Ratios for Large vs Small Insurers
Large insurance companies usually have better systems for handling claims and are more financially stable. This results in higher customer satisfaction and steady financial performance.
For large insurers, consistent ratios over time indicate reliability. For smaller insurers, recent improvements or stable trends may be more relevant than absolute numbers.
3. The Policy Duration: Why These Ratios Matter Differently
For short-term policies like annual health or motor insurance, CSR and ICR provide immediate insights into claim handling and pricing.
For long-term policies, such as life insurance or multi-year health plans, it’s important to look at trends over several years. A single year’s ratio may not show how well the insurer is performing. You should consider averages from multiple years.
4. A Systematic Approach to Weighing These Metrics
When selecting an insurer, consider the following steps:
Check CSR and ICR for the relevant insurance category. Compare against industry benchmarks.
Look at trends over several years to see if the company is consistent.
Think about the size of the company and its reputation in the market, along with the ratios.
Review the claims process and customer feedback to get qualitative information.
Aim for a balance between CSR and ICR; a high CSR with a reasonable ICR is best.
Pay attention to policy features, premium rates, and exclusions to support your ratio analysis.
Overview of CSR and ICR of Indian Insurers
Conclusion
Both ratios show how well an insurance company handles claims and its overall financial health.
CSR shows how efficiently the insurer settles claims, while ICR measures how responsibly they handle claim costs compared to premiums. When you choose an insurance policy, don't focus on just one ratio.
It's important to consider both ratios and other factors like the insurer's size, the type of policy, and past claims. This approach helps you make better decisions.
