Insurance Desk · Methodology v1.0 · last updated 2026-04-26
How we rate insurance.
Five segments — term life, health (individual + family floater), motor, travel — each with its own scoring rubric. Premium is the easy comparison; what actually decides outcomes is whether the policy pays when claimed. We weight IRDAI claim settlement ratio + claim-paid-on-time % heaviest.
· IRDAI-grounded· Claim experience first· Insurance Desk owns it
Per-segment rubrics
Five formulas. One scoring scale.
Term life insurance
Formula — Claim settlement ratio 35% · Premium for cover 25% · Coverage breadth 20% · Exclusions + waiting periods 10% · Service 10%
Pure protection product. Death benefit paid out → done. Score weights claim settlement ratio (CSR) heaviest because the entire product utility is contingent on the company paying when called. Premium per ₹1 cr cover is the comparison metric; lower wins, but only for insurers with strong CSR.
Factor
What we measure
Weight
Claim settlement ratio (CSR)
Latest IRDAI annual report: % of claims paid out by count + by amount. We weight 60/40 between 'count' and 'amount' to prioritise the typical retail experience over outlier-claim bias.
35%
Premium per ₹1cr cover (age-band normalised)
Age 25/35/45/55 bands separately — premium quotes vary 10×. Lower wins, but only when CSR is acceptable.
25%
Coverage breadth
Sum-assured caps, return-of-premium variants, accidental-death rider, terminal-illness payout, COVID-era exclusion absent (post-2023).
20%
Exclusions + waiting periods
Suicide clause (typically 12 months), pre-existing disease wait, specific-illness exclusions. Stricter exclusions hurt the score.
10%
Customer-claim experience
IRDAI grievance ratio, third-party complaint data, claim-paid-within-30-days %.
10%
Total
100%
Claim settlement ratio (CSR): Latest IRDAI annual report: % of claims paid out by count + by amount. We weight 60/40 between 'count' and 'amount' to prioritise the typical retail experience over outlier-claim bias.
Premium per ₹1cr cover (age-band normalised): Age 25/35/45/55 bands separately — premium quotes vary 10×. Lower wins, but only when CSR is acceptable.
Coverage breadth: Sum-assured caps, return-of-premium variants, accidental-death rider, terminal-illness payout, COVID-era exclusion absent (post-2023).
Exclusions + waiting periods: Suicide clause (typically 12 months), pre-existing disease wait, specific-illness exclusions. Stricter exclusions hurt the score.
Customer-claim experience: IRDAI grievance ratio, third-party complaint data, claim-paid-within-30-days %.
Health insurance — individual
Formula — Claim experience 30% · Coverage clarity (no sub-limits) 25% · Premium for cover 20% · Network hospitals 15% · Riders + value adds 10%
More complex than term: claim happens repeatedly across the policy lifetime. Coverage rules — room rent cap, ICU cap, sub-limits, PED waiting — silently determine real-world payout. Premium is meaningful but secondary to coverage clarity + cashless network depth.
Factor
What we measure
Weight
Claim settlement (CSR + paid-on-time)
IRDAI CSR + IRDAI claim-settled-within-30-days %. Health insurers vary 60-99% on the latter — huge real-world impact.
30%
Coverage clarity (sub-limits, room-rent, co-pay)
No room-rent capping = top score. Per-disease sub-limits, ICU cap, doctor-fee cap — penalise heavily because they erode payout when actually claimed.
25%
Premium per ₹10L cover (age + city normalised)
Premium varies by tier-1 vs tier-2 city, age band, individual vs floater. We score within band.
20%
Network hospitals (cashless coverage)
Cashless network size + tier-1 / tier-2 city density. Some insurers have huge networks but poor cashless TAT.
15%
Riders + value adds (no-claim bonus, restoration)
No-claim bonus accumulator (some go up to 100% NCB), automatic restoration after exhaustion, OPD coverage, maternity, AYUSH treatment.
10%
Total
100%
Claim settlement (CSR + paid-on-time): IRDAI CSR + IRDAI claim-settled-within-30-days %. Health insurers vary 60-99% on the latter — huge real-world impact.
Coverage clarity (sub-limits, room-rent, co-pay): No room-rent capping = top score. Per-disease sub-limits, ICU cap, doctor-fee cap — penalise heavily because they erode payout when actually claimed.
Premium per ₹10L cover (age + city normalised): Premium varies by tier-1 vs tier-2 city, age band, individual vs floater. We score within band.
Network hospitals (cashless coverage): Cashless network size + tier-1 / tier-2 city density. Some insurers have huge networks but poor cashless TAT.
Riders + value adds (no-claim bonus, restoration): No-claim bonus accumulator (some go up to 100% NCB), automatic restoration after exhaustion, OPD coverage, maternity, AYUSH treatment.
Health insurance — family floater
Formula — Claim experience 25% · Restoration + floater rules 25% · Coverage clarity 20% · Premium 20% · Network 10%
Insures multiple family members under one sum assured. Different physics: floater-cover-exhaustion risk + adult-child premium structure differ from individual policies. Restoration benefit becomes critical.
Factor
What we measure
Weight
Claim settlement (CSR + paid-on-time)
Same as individual — IRDAI data.
25%
Restoration of sum-insured
If full ₹10L is exhausted on Member A, does the policy restore for Member B? Some insurers offer 100% restoration once per year, others zero.
15%
Floater premium efficiency
Floater = single sum-insured shared. Cheaper than individual policies summed but exposes family to exhaustion risk. Score covers economics + breadth.
10%
Coverage clarity
Same as individual — no sub-limits, no room-rent cap, transparent co-pay.
20%
Premium for ₹10L floater (typical 4-member family)
Common scenario: 35yo father + 33yo mother + 2 kids. Premium normalised against this baseline.
20%
Network hospitals
Same as individual.
10%
Total
100%
Claim settlement (CSR + paid-on-time): Same as individual — IRDAI data.
Restoration of sum-insured: If full ₹10L is exhausted on Member A, does the policy restore for Member B? Some insurers offer 100% restoration once per year, others zero.
Floater premium efficiency: Floater = single sum-insured shared. Cheaper than individual policies summed but exposes family to exhaustion risk. Score covers economics + breadth.
Coverage clarity: Same as individual — no sub-limits, no room-rent cap, transparent co-pay.
Premium for ₹10L floater (typical 4-member family): Common scenario: 35yo father + 33yo mother + 2 kids. Premium normalised against this baseline.
Network hospitals: Same as individual.
Motor insurance
Formula — Claim experience 30% · OD premium efficiency 25% · Network garages 15% · Add-ons 15% · Renewal NCB protection 15%
Two parts: third-party (legally mandatory, regulated premium) and own-damage (own car damage + theft + natural disaster). OD market is competitive on premium; service quality during claim is the differentiator.
Factor
What we measure
Weight
Own-damage claim settlement experience
Time from claim to garage clearance, claim-rejection rate, total-loss-vs-repair decision fairness.
30%
OD premium for IDV (city + car-segment normalised)
Insured Declared Value (IDV) = depreciated car value. Premium per ₹1L IDV varies. Tier-1 cities + premium cars cost more.
25%
Network garage size + cashless coverage
Cashless network at OEM-authorised garages = most relevant for premium / under-warranty cars.
15%
Add-ons (zero-dep, engine protect, return-to-invoice)
Zero-depreciation cover + engine protect cover are now near-essential for post-2018 cars. Score availability + cost.
15%
NCB protection + renewal terms
No-Claim-Bonus protection rider + ease of porting NCB on insurer change. NCB is portable per IRDAI rules — but operationally insurers vary on cooperation.
15%
Total
100%
Own-damage claim settlement experience: Time from claim to garage clearance, claim-rejection rate, total-loss-vs-repair decision fairness.
OD premium for IDV (city + car-segment normalised): Insured Declared Value (IDV) = depreciated car value. Premium per ₹1L IDV varies. Tier-1 cities + premium cars cost more.
Network garage size + cashless coverage: Cashless network at OEM-authorised garages = most relevant for premium / under-warranty cars.
Add-ons (zero-dep, engine protect, return-to-invoice): Zero-depreciation cover + engine protect cover are now near-essential for post-2018 cars. Score availability + cost.
NCB protection + renewal terms: No-Claim-Bonus protection rider + ease of porting NCB on insurer change. NCB is portable per IRDAI rules — but operationally insurers vary on cooperation.
Travel insurance
Formula — Premium per day 30% · Medical coverage 25% · Trip cancellation + delay 20% · Claim experience 15% · Pre-existing disease coverage 10%
Short-tenure, single-use product. Claim experience matters but premium-per-day-of-cover dominates because tickets are price-sensitive. International travel insurance has additional medical-coverage requirement (Schengen min ₹30L).
Factor
What we measure
Weight
Premium per day per ₹1L cover
Travel insurance is highly price-sensitive. We normalise to per-day-per-cover for like-for-like.
30%
Medical evacuation + hospitalisation cover
₹30L+ for Schengen/USA, ₹15L+ for SE Asia. Higher cover wins. Direct billing in destination matters.
25%
Trip cancellation + delay
Reimbursement cap, qualifying conditions (e.g., natural-disaster-related delay vs simple airline delay).
20%
Claim experience for international
Time to reimburse, support of overseas hospital direct-billing, 24/7 claim helpline. Most differentiating factor for actual user pain.
15%
Pre-existing disease (PED) + senior coverage
Many travel policies exclude PED — bigger risk for seniors. Score insurers that cover declared PED.
10%
Total
100%
Premium per day per ₹1L cover: Travel insurance is highly price-sensitive. We normalise to per-day-per-cover for like-for-like.
Medical evacuation + hospitalisation cover: ₹30L+ for Schengen/USA, ₹15L+ for SE Asia. Higher cover wins. Direct billing in destination matters.
Trip cancellation + delay: Reimbursement cap, qualifying conditions (e.g., natural-disaster-related delay vs simple airline delay).
Claim experience for international: Time to reimburse, support of overseas hospital direct-billing, 24/7 claim helpline. Most differentiating factor for actual user pain.
Pre-existing disease (PED) + senior coverage: Many travel policies exclude PED — bigger risk for seniors. Score insurers that cover declared PED.
Standardised adjustments
Cross-segment modifiers.
- ·Recent IRDAI penalty / show-cause order on insurer −0.3 to −0.7 stars
- ·Claim-paid-on-time % below 80% −0.2 to −0.5 stars
- ·COVID-era exclusion still present in policy wording −0.2 to −0.4 stars
- ·Solvency margin > 200% of regulator floor (financial stability) +0.0 to +0.1 stars
- ·Customer NPS / persistency ratio above industry median +0.0 to +0.2 stars
- ·Recent IRDAI award / commendation +0.0 to +0.1 stars
Data sources
Where the values come from.
IRDAI annual report
Claim settlement ratio (CSR), claim-paid-on-time %, complaint volume, solvency margin per insurer. Released annually; we pull each year's edition.
Insurer policy schedules + brochures
Public premium tables, sub-limits, exclusions, riders. Audited monthly for changes.
IRDAI consumer-grievance system
Per-insurer grievance count + resolution time.
Third-party complaint registries
Aggregated complaints from MoneyControl, Mouthshut, BankBazaar customer-experience data.
In-house claim sampling
Editorial team tracks ~50 anonymised claims per insurer per year via partner network for actual claim-experience data.
Update cadence
When scores get refreshed.
- Monthly: Premium + rider audit per insurer. Network hospital count update.
- Annually: Full rubric refresh after IRDAI annual report (typically released in October-November).
- Event-triggered: IRDAI penalty / show-cause / merger event → re-score within 7 days.
Related methodologies
Other product types we rate.
Insurance methodology v1.0 · last updated 2026-04-26