Niva Bupa Health Insurance Claims Settlement Ratio Analysis for 2024-25

Niva Bupa Health Insurance Co. Ltd. has released its claims data for the period 2024-25, showcasing significant activity in claims processing and resolution. 

Claims Processing Overview 

During the period 2024-25, Niva Bupa Health Insurance began with 15,127 outstanding claims. Throughout the year, the company received 10,24,782 new claims.  

Out of these, 9,42,543 claims were successfully paid, indicating a robust claims settlement process.  

The company also repudiated 75,892 claims, while 21,474 claims remained outstanding at the end of the period. 

Age Analysis of Number of Claims Paid (%)  

Claim Settlement Ratio as a Performance Indicator  

Claim settlement ratio reflects the percentage of claims settled by an insurer out of the total claims received in a given period.  

IRDAI data focuses on claims settled within 3 months, as timely settlement is a key indicator of operational efficiency in health and general insurance. 

Age Analysis of Claims Paid 

The age analysis of the claims paid by Niva Bupa Health Insurance reveals that 100% of the claims were settled within 3 months.  

This swift processing time reflects the company's efficiency in handling claims and ensuring timely settlements for its policyholders. 

Repudiated and Outstanding Claims 

In the 2024-25 period, Niva Bupa Health Insurance repudiated 75,892 claims, which accounts for approximately 7.4% of the total claims processed.  

The reasons for repudiation can vary, including policy exclusions or incomplete documentation. At the end of the period, 21,474 claims were still outstanding, awaiting further processing or resolution. 

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Conclusion 

The data from Niva Bupa Health Insurance for 2024-25 highlights the company's effective claims management, with a high percentage of claims being settled promptly. The age analysis indicates a focus on quick resolutions, benefiting policyholders through timely claim settlements. 

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