Claim Settlement Ratio in Health Insurance: What is a Good CSR? (2026)
Claim Settlement Ratio (CSR) in Health Insurance: Importance AI OVERVIEW Claim Settlement Ratio (CSR) shows the share of health insurance claims an insurer settled out of the claims it had to handle in a year. A higher CSR generally signals a greater likelihood that claims are paid. Many advisors look for a CSR consistently above […]
Cashless vs Reimbursement Claim: Which is Better? Costs, Timelines, and Examples
Cashless vs Reimbursement Claim Settlement: Which is Better? AI OVERVIEW Cashless and reimbursement are two ways the same health insurance claim gets paid. In cashless, the insurer pays a network hospital directly after pre-authorisation, so you pay only non-payables, co-pay, and excess; IRDAI requires decisions within 1 hour for pre-authorisation and 3 hours for discharge. […]
Does Health Insurance Cover Genetic Disorders in India? Rules, Court Cases and Tips
Does Health Insurance Cover Genetic Disorders in India? AI OVERVIEW Health insurance in India can cover genetic disorders, but how depends on timing and policy terms. In 2018, the Delhi High Court held that a broad “genetic disorders” exclusion was ambiguous and discriminatory, and IRDAI issued a circular in response; the Supreme Court later stayed […]
Room Rent Limit in Health Insurance: Proportionate Deduction Explained (2026)
What is Room Rent Limit in Health Insurance? AI OVERVIEW A room rent limit is the maximum your health insurance policy pays per day for your hospital room. It can be a fixed amount (for example ₹3,000 a day), a percentage of the sum insured (commonly 1% for a normal room and 2% for ICU), […]
What is the Co-payment Clause in Health Insurance?
What is Co-payment in Health Insurance? Meaning, Types, and Examples (2026) AI OVERVIEW Co-payment (co-pay) in health insurance is the fixed percentage of every admissible claim you pay, while the insurer pays the rest. IRDAI’s standard definition describes it as a cost-sharing requirement where the insured bears a specified percentage of the admissible claim amount, […]
