The Insurance Regulatory and Development Authority of India (Irdai) has mandated Schedule NL-47 disclosures that provide comprehensive product-wise information beyond standard brochures. According to reports from Mint, these disclosures reveal critical metrics including claim settlement rates, complaint data, renewal behavior, and incurred claims ratios for each health insurance product. Unlike other company-wide disclosures, NL-47 reports information product by product, allowing buyers to assess specific policies they are considering rather than aggregated company data. As reported by Mint, each insurer publishes over 200 pages of dense information annually, making it difficult for general readers to find the most relevant pages for health insurance buying decisions.
NL-47 reports the claim settlement rate for each product—the percentage of claims that are paid, with settlement rates varying significantly even across products from the same insurer. As reported by Mint, among one standalone health insurer's products, claim settlement rates ranged from about 92% to 97%. The incurred claims ratio (ICR)—claims paid as a proportion of premiums collected—ranges from 52% to 107% across individual products for the same insurer. Buyers should ideally choose plans that settle more than 90% of claims, with ratios above 100% potentially indicating future premium increases or greater scrutiny. Up to 10% of rejected claims may arise from legitimate reasons such as outpatient expenses being claimed under policies that do not cover them or claims relating to pre-existing diseases filed before waiting periods have expired.
NL-47 reports product-wise complaint data alongside company-wide grievance statistics and Insurance Ombudsman annual data. According to Mint, when comparing insurers, focus should be on complaint rates rather than absolute complaint numbers, as larger insurers naturally receive more complaints due to their larger customer base. Renewal rates range from about 87% to 95% across products for one leading insurer, with some products showing nearly 2 lakh policies remaining active for five to ten years and almost 30,000 policies over a decade old. The age-wise distribution provides further insight, with one widely sold product having roughly 4.5 lakh active policies, including nearly two lakh that had remained in force for five to ten years and almost 30,000 that were more than a decade old—a strong indication that customers continue renewing the policy over time.
While insurer disclosures have improved steadily, Mint reports that the Insurance Regulatory and Development Authority of India (Irdai) could enhance transparency by requiring insurers to include key NL-47 metrics directly in product prospectuses rather than searching through annual reports. The regulator should also publish NL-47 every six months instead of annually to make information more current. Additionally, the Insurance Ombudsman should restore publication of detailed individual awards to provide greater transparency in the dispute resolution system. Some important aspects of the buying experience remain outside the scope of public disclosures, including how long insurers take to issue policies, how frequently they decline proposals, or how often they load premiums because of medical conditions. To understand these aspects, buyers should speak with people who have purchased the specific policy and consult advisors who have experience with multiple insurers.
