Is the Bima Sugam Claim Score different from the Claim Settlement Ratio?

Yes. While CSR only counts the number of claims paid, the Bima Sugam score also considers speed and the actual amount settled.

Where can I find my Bima Sugam reliability rating?

You can find these ratings on the official Bima Sugam marketplace portal or through your Electronic Insurance Account (eIA) dashboard.

Does a high score mean my claim will never be rejected?

No. A high score means the insurer is generally reliable, but they can still reject claims if you provide incorrect medical information.

Can I switch my insurer if their score drops?

Yes. You can use the porting feature on Bima Sugam to move to a more reliable insurer during your policy renewal period.

Are zero-commission policies on Bima Sugam safe to buy?

Absolutely. These are official products from reputed insurers. The lower price is simply because agent commissions have been removed from the premium.

Is GST still applicable on my parents' health insurance?

No. The government has exempted individual health insurance for senior citizens from the 18% GST, making it much more affordable now.

Bima Sugam Claim Scores: Read New Govt Reliability Ratings

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Bima Sugam Claim Scores: How to read the new government reliability ratings

Stop falling for high claim settlement percentages that hide the truth about slow payouts and rejected bills.

4 min read

OneAssure Team

March 30, 2026

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

The 99% trap and why you need a better metric

Imagine your father is in the hospital for a knee replacement. The surgery goes well. You feel relieved because you bought a policy with a 99% Claim Settlement Ratio (CSR). Then the bill comes. The insurer rejects ₹40,000 because of a room rent cap you didn't understand. Or they take six hours to approve the discharge while you wait in the lobby. That 99% suddenly feels like a lie. This happens because CSR only tells you if a claim was paid, not how much was paid or how fast it happened. A company could settle 99 small travel insurance claims of ₹2,000 and reject one massive heart surgery claim of ₹10 lakh. Their CSR still looks great. This is why the new Bima Sugam Claim Score is a game changer for young Indians. It is the government's way of giving you a real reliability rating. It looks at speed, amount settled, and overall service quality.

What exactly is the Bima Sugam Claim Score?

Bima Sugam is the new digital marketplace backed by the IRDAI. Think of it as the UPI for insurance. Every insurer will be listed here. Along with their products, you will see a Claim Score. This is not just a marketing number from the company. It is an official rating based on hard data from the Public Insurance Registry. It tracks how often an insurer rejects valid claims. It looks at whether they pay the full amount or just a fraction. For a 28 year old professional, this is the most honest way to check an insurer's performance before paying a single rupee in premium. You no longer have to rely on biased agent advice or confusing brochures.

How to use these ratings for your parents

Buying health insurance for parents is stressful. Premiums are high. Medical history is complicated. If you choose an insurer with a low Bima Sugam score, you are essentially buying a headache. A high score reveals that an insurer is fast with cashless hospital bills. In cities like Mumbai or Bangalore, a single private room can cost ₹8,000 per day. If your insurer has a room rent limit of ₹5,000, you pay the difference out of pocket. Insurers with high reliability scores usually have clearer terms and fewer hidden deductions. Since the government recently removed the 18% GST on senior citizen health insurance, your parents' coverage is now more affordable. Use those savings to pick a plan with a top-tier Bima Sugam rating rather than just the cheapest one.

The power of the Electronic Insurance Account (eIA)

Everything on Bima Sugam works through your Electronic Insurance Account or eIA. This is a mandatory digital folder for all your policies. It makes tracking claims incredibly simple. You do not need to hunt for physical papers or old emails when an emergency strikes. Your eIA will show you the real-time status of your claim. It also displays the insurer's current reliability score. If you see their score dropping over two years, it is a clear signal to port your policy. While platforms like OneAssure help you compare specific features, the Bima Sugam score adds a layer of government-verified trust to your final choice.

Choosing term insurance based on data, not price

Many young earners pick the cheapest term insurance they find online. This is a mistake. Term insurance is a 30 to 40 year commitment. You want a company that will be reliable decades from now. A low Bima Sugam score is a major red flag. It suggests the company might be aggressive in rejecting claims or has poor financial health. Now that GST is 0% on individual term insurance, the price gap between top-rated and low-rated insurers has narrowed. There is no reason to risk your family's future for a few hundred rupees. Always check the official marketplace ratings to compare insurers without any bias from brokers.

When should you switch your insurer?

If your current insurer has a low Bima Sugam score, it is time to move. Low scores usually mean a history of rejecting valid claims or making the paperwork a nightmare. Bima Sugam makes the porting process much smoother. You can see which companies are actually providing zero-commission policies. These policies are often cheaper because the distribution cost is removed. However, never switch for the price alone. Use the reliability data to find an insurer that actually pays up when things go wrong. Reliability is the only thing that matters in the long run.