HDFC ERGO Claim Settlement Ratio 2025 (CSR & ICR) – IRDAI Latest Report
HDFC ERGO Health Insurance Claim Settlement Ratio & ICR (2025)
When choosing a health insurance plan, it’s important to check how reliable the insurer is in settling claims. Two key IRDAI metrics help you judge this:
- Claim Settlement Ratio (CSR) – % of claims settled.
- Incurred Claim Ratio (ICR) – ratio of claims paid vs. premiums collected.
In this guide, we cover the HDFC ERGO health insurance claim settlement ratio (CSR), its ICR, why they matter, and how HDFC ERGO compares with other insurers as per the latest IRDAI annual report.
📊 What is Claim Settlement Ratio (CSR)?
Claim Settlement Ratio (CSR) shows how many claims an insurer pays compared to total claims received.
- Higher CSR = more reliable in approving claims.
- A CSR above 95% is considered excellent.
👉 You can verify CSR data directly from the IRDAI Annual Report.
📉 What is Incurred Claim Ratio (ICR)?
Incurred Claim Ratio (ICR) is the ratio of total claims paid to total premiums collected.
- ICR between 50%–90% is considered healthy.
- Too high ICR → insurer may be making losses.
- Too low ICR → insurer may not be paying enough claims.
Both CSR and ICR should be checked before buying health insurance.
✅ HDFC ERGO Health Insurance CSR & ICR (2025)
As per the latest IRDAI report:
- Claim Settlement Ratio (CSR): ~98%*
- Incurred Claim Ratio (ICR): ~85%*
- Average Claim Settlement Time: 2–3 days (cashless claims)
- Network Hospitals: 13,000+ across India
- Types of Claims Settled: Cashless & Reimbursement
Note: Exact numbers vary slightly each year. For latest figures, check the official HDFC ERGO Claim Page.
💡 Why CSR & ICR Matter for HDFC ERGO?
- Reliability – CSR shows your claim is more likely to be approved.
- Financial Stability – ICR shows the insurer’s claim payout balance.
- Quick Settlement – HDFC ERGO processes cashless claims within 2–3 days.
- Transparency – IRDAI publishes CSR & ICR annually for all insurers.
🏥 HDFC ERGO Claim Process (Step-by-Step)
1. Cashless Claim
- Get admitted in a network hospital
- Show your HDFC ERGO health card
- Hospital contacts insurer for approval
- Insurer settles bills directly with hospital
2. Reimbursement Claim
- Get treated at any hospital
- Pay bills upfront
- Submit claim documents to HDFC ERGO
- Amount reimbursed in 7–10 working days
👉 Full details on HDFC ERGO’s Claim Process.
👉 Full details available on HDFC ERGO’s Claim Process.
📌 HDFC ERGO vs Other Health Insurers (2025)
| Insurer | CSR (2025) | ICR (2025) | Avg. Settlement Time |
|---|---|---|---|
| HDFC ERGO | ~98% | ~85% | 2–3 days |
| Star Health Insurance | ~96% | ~89% | 3–5 days |
| ICICI Lombard | ~95% | ~82% | 4–6 days |
| New India Assurance | ~93% | ~90% | 5–7 days |
🔁 HDFC ERGO CSR & ICR Trend (2022–2025)
| Year | CSR (%) | ICR (%) | Report Source |
|---|---|---|---|
| 2025 | 98% | 85% | IRDAI Annual Report 2025 |
| 2024 | 97.8% | 84% | IRDAI Annual Report 2024 |
| 2023 | 97.5% | 83% | IRDAI Annual Report 2023 |
🔎 FAQs on HDFC ERGO Health Insurance CSR & ICR
1. What is the HDFC ERGO claim settlement ratio in 2025?
As per IRDAI 2025 data, HDFC ERGO has a CSR of ~98%.
2. What is the HDFC ERGO incurred claim ratio in 2025?
The ICR is ~85%, indicating a good balance between claims paid and premiums collected.
3. What is the difference between CSR and ICR?
- CSR = % of claims settled.
- ICR = claims paid vs. premiums collected.
Both are important when evaluating insurer reliability.
4. How to check HDFC ERGO claim status?
You can check via the HDFC ERGO website or mobile app using your policy details.
5. Does high CSR guarantee my claim approval?
Not always. CSR is an average ratio; claim approval still depends on your policy terms and documentation.
📝 Final Thoughts
The HDFC ERGO Health Insurance CSR (~98%) and ICR (~85%) prove it is both reliable and financially stable.
👉 When buying health insurance, always compare CSR, ICR, hospital network, coverage, and premiums. This ensures you choose a policy that offers both security and peace of mind.
