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Claim Settlement Ratio

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29 Jan, 2023 by  Chaitanya Inge

I have narrowed down on two health insurance companies: HDFC Ergo Optima Restore and Niva Bupa Reassure. I am confused which to choose amongst them. I will

My father suffers from Pre-Existing disease like Hypertension/BP.

The options I have are:

  1. HDFC Ergo Optima Restore for my mother. The premium is Rs.29,671 with the riders.
  2. HDFC Ergo Energy Silver for my father. The premium is Rs.37,419

If I go with Niva Bupa

  1. Niva Bupa Reassure for my parents. Its a floater policy. The premium is 41,725

HDFC vs Niva Bupa

-The difference is of claim settlement ratio. Niva Bupa has 91% whereas HDFC Ergo gives 97%

-The other difference is that Niva Bupa also covers consumables cost like gloves etc for my father which was not covered under HDFC Ergo Energy

-Niva Bupa is cheaper.

Health Insurance

1 Answer

30 Jan, 2023
harivansh agrawal

Hello  Chaitanya Inge,

Both Optima Restore and Reassure from Niva Bupa are the flagship products of their respective company both have their own pros and cons for example Reassure will cover only a mono-focal lens in a cataract and limit of 1 lac on most of the robotic surgery. similarly, Restore does not cover Nonallopathic treatment. so look for the product that suites your need do not look for the premium they will not remain constant today ReAssure is cheaper tomorrow Restore will we do not know

and for Claim settlement ratio Beshak Has written a fabulous article on why these matrices do not work in your favor so look into it

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