Claim settlement ratio percentage-of-claims-paid batata hai — lekin amount-settlement ratio aur complaint numbers ke saath padhna chahiye.
Bahut log is stage pe ya to galat jagah apply kar dete hain ya adhoore documents ke saath — dono se rejection aur score-damage hota hai. Sahi sequence neeche hai.
Claim Settlement Ratio (CSR) = saal mein settle kiye claims ÷ total claims. Useful hai lekin akela misleading — 3 numbers saath padho: (1) CSR (count-based), (2) Amount-settlement ratio — bade claims ka behaviour yahan dikhta hai; count mein 98% lekin amount mein 90% ka matlab bade claims mein friction. (3) Complaints data + settlement TIME. Aur context: nayi companies ka CSR unstable hota hai (chhota base), isliye 3-5 saal ka trend dekho, single year nahi.
Lekin sabse bada sach ye hai: CLAIM ka result aapke DISCLOSURE par jitna depend karta hai utna insurer ke ratio par nahi. Repudiations ki bhaari majority misrepresentation/non-disclosure se hoti hai — smoking, purani condition, doosri policies, occupation. Matlab: 99% CSR wale insurer ke saath jhooth wala proposal risky hai; 95% wale ke saath sach wala proposal safe. Apne control wali cheez (100% sach + nominee updated + family ko policy ki jaankari) ratio-shopping se zyada important hai.
| Factor | Premium par asar |
|---|---|
| Age | Sabse bada lever — jitni jaldi, utna sasta lifetime |
| Smoking status | Significantly zyada premium, chhupana = claim risk |
| Cover amount | Proportionate — lekin per-lakh cost girti hai |
| Policy term | Retirement age tak logical hai |
| Metric | Kya batata hai | Kahan dhyan do |
|---|---|---|
| CSR (count) | Kitne claims settle | 3-5 saal trend |
| Amount ratio | Bade claims ka sach | CSR se gap check |
| Avg settlement time | Process speed | Family ke liye matter karta |
| Complaints | Ground reality | Trend dekho |
| Aapka disclosure | Asli decider | 100% sach |
Maan lijiye (udaharan kalpanik hai): ek family ne 'best CSR' dekh kar policy li thi — lekin proposal agent ne bhara tha aur usne diabetes mention nahi kiya ('premium badh jayega'). Claim investigation mein pharmacy records mile — repudiation. Usi saal ussi insurer ne ek doosri family ka waisa hi claim 12 din mein settle kiya — kyunki proposal clean tha. Insurer same, ratio same — outcome disclosure ne decide kiya.
Sabse pehla step apni exact situation clear karna hai. Claim settlement ratio percentage-of-claims-paid batata hai . WhatsApp pe apna scenario batao — hum free mein sahi direction dete hain, bina kisi fee ke.
Nahi — customer se koi fee nahi. Hum facilitation platform hain; partner se referral remuneration paate hain jo aapki cost nahi badhata. Final terms partner ke discretion par hote hain.
Documents complete hone par zyada cases mein kuch working days ka process hota hai — exact timeline partner aur profile pe depend karti hai. Hum realistic timeline pehle hi bata dete hain.
Nahi — koi bhi genuine platform approval guarantee nahi kar sakta. Approval regulated partner ke assessment par hota hai. Jo guarantee ka dawa kare, wahan se door raho — ye fraud ka sabse bada signal hai.
3 cheezein: policy documents kahan hain, insurer ka claim process (intimation kaise hota hai), aur nominee ke KYC documents ready. Ek 'family folder' banao — policy + is page jaisi basic jaankari + contacts. Claim-time confusion aadha isi se khatam hota hai.
Section 45 ke baad policy ko misstatement ke basis par question karna significantly limited ho jaata hai — ye policyholder-protection hai. Lekin fraud ke angles aur process-requirements phir bhi exist karte hain. Iska use 'ab jhooth chalega' samajhna dangerous misreading hai — disclosure hi rasta hai.
Apna scenario WhatsApp pe bhejo — +91 98332 16954 — ya High Sum Assured Term Guide page pe aur jaankari lo. Zero fee, seedhi baat.
💬 Abhi Poochho — Free