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    Guide to Understanding Claim Settlement Ratio Formula

    Last Updated On 09-02-2021

    The purpose of life insurance is to secure your loved ones against financial hardships due to an unfortunate event. The insurer pledges to pay a definite sum to the person you name as the beneficiary, in case of any eventuality.

    The loss leading to a life claim is irreplaceable. But timely payouts as financial reimbursement for the loss act as a fallback during such unforeseen situations. However, if the insurance company fails to make good on its undertaking, the purpose is defeated.

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    Hence, you need to look into the insurer’s past performance when you buy a life insurance policy. Checking the insurer’s claim settlement ratio is a crucial component of such background research.

    What is meant by the claim settlement ratio?

    This number stands for the percentage of claims the insurance company honoured in a financial year. It is the ratio of the number of claims the insurer paid to the number of claims raised.

    The formula to calculate an insurance company’s claim settlement quotient is:

    Claim settlement ratio = (Number of claims settled/Number of claims received) x 100

    For example, suppose an insurance company reports a 95% claim settlement percentage. It implies that the insurer settled 95 out of every 100 life claims it received. The remaining 5% either did not comply with policy terms or were fake claims.

    Why should you inspect insurance companies’ claim settlement ratio?

    A higher claim ratio stands for the insurer’s robust underwriting practices and risk management competence. It reflects the company’s ability to process claims and spot false or invalid applications efficiently. It is also a sign of the insurance company’s commitment towards its policyholders.

    Thus, the higher the ratio, the more confident the insurer is about its capability to handle genuine claims. It is advisable to buy life insurance from an insurer consistently maintaining a high claim settlement percentage. It assures that the chances of prompt settlement of your family’s claim in their hours of need are higher.

    PNB MetLife claim settlement ratio

    You can determine different insurers’ claim history from the Annual Report section on the Insurance Regulatory and Development Authority’s (IRDAI) official website. The regulator uploads this report every year. As per the 2018-19 statement, the PNB MetLife claim ratio is 96.21% for the 2018-19 financial year.

    The report mentions that PNB MetLife Insurance received 4170 claims in total, out of which the company settled 4012 claims. This figure signifies a very low 3.76% claim repudiation by this insurer.

    An analysis of the company’s track record reveals that PNB MetLife has maintained a high 85%-plus settlement ratio over the years.

    Financial Year

    Claim Settlement Ratio

    2014-15

    92.86%

    2015-16

    85.36%

    2016-17

    87.14%

    2017-18

    91.12%

    2018-19

    96.21%

    2019-20 97.18%
    2020-21 98.17%
    2021-22 97.33%

    Source: IRDAI Annual Report

    This consistency in PNB MetLife claim ratio shows the insurer’s inclination to honour its obligation towards policyholders.

    What are the reasons for claim repudiation?

    The 3.76% repudiation means PNB MetLife determined that such claims do not meet their policy terms. How can you ensure that your claim does not figure in this fraction?

    Refusals in claim settlement often result from the policyholder misrepresenting facts or suppressing information. While filling the application form when you buy the policy, provide accurate data. Do not withhold details about health conditions and your family’s medical history to avoid life cover refusals or higher premiums. It can cost your loved ones the rejection of their claims when they need the financial cushion the most.

    Final word

    Apart from taking this precaution, you can use claim ratios as a fair benchmark to gauge the insurer’s credibility. The high PNB MetLife claim settlement ratio is a reliable indicator of this insurance company’s efficiency and dedication towards serving policyholders.

    Please read the sales brochure and the terms and conditions of the policy, as well as the life insurance claims process carefully before concluding the sale.

    Find out more about the types and benefits of life insurance plus health insurance plans at PNB MetLife. Secure the future of you and your loved ones with our life insurance for family protection.

    To know more about term plan, term insurance, long term savings & retirement plan visit PNB MetLife website.

     

    Disclaimer:

    The aforesaid article presents the view of an independent writer who is an expert on financial and insurance matters. PNB MetLife India Insurance Co. Ltd. doesn’t influence or support views of the writer of the article in any way. The article is informative in nature and PNB MetLife and/ or the writer of the article shall not be responsible for any direct/ indirect loss or liability or medical complications incurred by the reader for taking any decisions based on the contents and information given in article. Please consult your financial advisor/ insurance advisor/ health advisor before making any decision.

    PNB MetLife India Insurance Company Limited
    Registered office address: Unit No. 701, 702 & 703, 7th Floor, West Wing, Raheja Towers, 26/27 M G Road, Bangalore -560001, Karnataka
    IRDAI Registration number 117 | CIN U66010KA2001PLC028883
    For more details on risk factors, please read the sales brochure and the terms and conditions of the policy, carefully before concluding the sale.
    Goods and Services Tax (GST) shall be levied as per prevailing tax laws which are subject to change from time to time.
    The marks "PNB" and "MetLife" are registered trademarks of Punjab National Bank and Metropolitan Life Insurance Company, respectively. PNB MetLife India Insurance Company Limited is a licensed user of these marks.
    Call us Toll-free at 1-800-425-6969, Phone: 080-66006969, Website: www.pnbmetlife.com, Email: indiaservice@pnbmetlife.co.in or Write to us: 1st Floor, Techniplex -1, Techniplex Complex, Off Veer Savarkar Flyover, Goregaon (West), Mumbai – 400062, Maharashtra. Phone: +91-22-41790000, Fax: +91-22-41790203.

    AD-F/2020-21/618

    Beware of Spurious Phone Calls and Fictitious / Fraudulent Offers!
    IRDAI is not involved in activities like selling insurance policies, announcing bonus or investments of premium. Public receiving such phone calls are requested to lodge a police complaint.

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    Disclaimer

    Collapsed Expanded

    As your trusted life insurance partner, PNB MetLife is with you amidst the current COVID-19 outbreak. Our policies also cover COVID-19 Claims. In case of a Death Claim, kindly submit the signed Claim Intimation Letter mentioning the policy number, brief of the insured event and other claim documents on the email mentioned herewith. Please write-in to us at claimshelpdesk@pnbmetlife.com or indiaservice@pnbmetlife.co.in. You can also call us on 1800-425-6969 for death claims intimations and for any queries on Monday - Saturday between 10:00 am - 7:00 pm.

    PNB MetLife Insurance, amongst the trusted Life Insurance companies in India, aims to provide a wide range of Life Insurance products that suits the needs of an individual at every stage of his life. Life Insurance Plans range from Term Life Insurance PlansTerm PlanProtection PlansLong Term Savings Plans , Retirement Plans & Child Education Plan.

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