Indian health insurance plans — IRDAI trust scorecards in plain English

Indian health insurance plans — decoded

Don't have a PDF yet? Start here. Every plan card shows the IRDAI Claim Settlement Ratio, Incurred Claim Ratio and complaints per 10,000 claims — plus the trap clauses (copay slabs, room rent caps, sub-limits, restoration mechanics) that decide whether you actually get paid.

No commission · No broker · No affiliate fees · Numbers cited verbatim from public IRDAI reports

HDFC ERGO

HDFC ERGO Critical Illness Platinum

Sum insured₹5L–₹1Cr

Copay: None published
Room rent: No cap
PED wait: 48 mo

HDFC ERGO · IRDAI FY 2024-25

CSR

97.37%

ICR

84.85%

Complaints/10k

Known traps

Fixed-benefit lumpsum — paid ONCE per listed illness. Policy terminates after payout on most variants.
30-day survival period — die within 30 days of diagnosis, claim is forfeited.

See full plan breakdown Get policy wording PDF from HDFC ERGO ↗

Last verified: 2026-06 · Source: third party aggregator

ICICI Lombard

ICICI Pru iProtect Smart CI Rider

Sum insured₹10L–₹1Cr

Copay: None published
Room rent: No cap
PED wait: 48 mo

ICICI Lombard · IRDAI FY 2024-25

CSR

85.82%

ICR

82.24%

Complaints/10k

Known traps

This is a RIDER on the iProtect Smart term plan, NOT a standalone CI policy.
Lumpsum paid once per illness, but the base term plan continues.

See full plan breakdown Get policy wording PDF from ICICI Lombard ↗

Last verified: 2026-06 · Source: third party aggregator

Niva Bupa

Niva Bupa Heartbeat

Sum insured₹2L–₹1Cr

Copay: None published
Room rent: Single private
PED wait: 24 mo

Niva Bupa · IRDAI FY 2024-25

CSR

92.39%

ICR

61.22%

Complaints/10k

Known traps

Heartbeat is positioned as 'critical-illness-equivalent indemnity' but is actually an indemnity plan with CI-style add-ons — read carefully.
PED waiting 24 months on most variants.

See full plan breakdown Get policy wording PDF from Niva Bupa ↗

Last verified: 2026-06 · Source: third party aggregator