Mediclaim Ratings Criteria – mint
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Business News/    Mediclaim Rating Criteria

Mediclaim Rating Criteria

Here are the individual parameters on the basis of which we have rated health plans for the age groups of 30, 45, 60 and 75 years. ... read more
Here are the individual parameters on the basis of which we have rated health insurance plans for the age groups of 30, 45, 60 and 75 years. According to their importance, each parameter has been assigned a weightage on the basis of which points are given; a final score is then calculated. The final ranking in percentage terms is based on the sum of the scores. Keep in mind that we have a separate ratings matrix for the higher age group of 75 years old. ... read less

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Non-seniors (30, 45, 60 years)
Senior citizens (75 years)
  • Price
  • 25%
  • Premium
  • Points25%
  • Weighted Scale 
  • Top quartile
  • 1
  • 25%
  • 2nd quartile
  • 0.75
  • 19%
  • 3rd quartile
  • 0.50
  • 13%
  • 4th quartile
  • 0
  • 0%
  • Product features
  • 40%
  • Pre-existing exclusion
  • Points12.5%
  • Weighted Scale 
  • 1 year
  • 1
  • 12.5%
  • 2 years
  • 0.66
  • 8.3%
  • 3 years
  • 0.33
  • 4.1%
  • Over 3 years
  • 0
  • 0%
  • Sub-limits on room
  • 15%
  • No
  • 1
  • 15%
  • Yes
  • 0
  • 0%
  • No-claim bonus
  • 5%
  • Maximum NCB of 100% or more
  • 1
  • 5%
  • Maximum NCB of 50-100%
  • 0.5
  • 3%
  • Less than 50%
  • 0
  • 0%
  • Wellness
  • 5%
  • Yes
  • 1
  • 5%
  • No
  • 0
  • 0%
  • Restore
  • 2.50%
  • Yes
  • 1
  • 3%
  • No
  • 0
  • 0%
  • Claims
  • 35%
  • Claims settled
  • Points25%
  • Weighted Scale 
  • 95% and higher
  • 1
  • 25%
  • 85-95%
  • 0.5
  • 13%
  • Less than 85%
  • 0
  • 0%
  • Claim complaints per 10,000 claims registered
  • 5%
  • Less than 30
  • 1
  • 5%
  • 30 to 60
  • 0.5
  • 3%
  • Over 60
  • 0
  • 0%
  • Claims ageing (settled within a month)
  • 5%
  • 98% and higher
  • 1
  • 5%
  • 96-98%
  • 0.75
  • 4%
  • 94-96%
  • 0.5
  • 3%
  • Less than 94%
  • 0
  • 0%
  • Total
  • 100%
  • Price
  • 20%
  • Premium
  • Points20%
  • Weighted Scale 
  • Top quartile
  • 1
  • 20%
  • 2nd quartile
  • 0.75
  • 15%
  • 3rd quartile
  • 0.5
  • 10%
  • 4th quartile
  • 0
  • 0%
  • Product features
  • 45%
  • Pre-existing exclusion
  • Points15.00%
  • Weighted Scale 
  • 1 year
  • 1
  • 15%
  • 2 years
  • 0.66
  • 10%
  • 3 years
  • 0.33
  • 5%
  • Over 3 years
  • 0
  • 0%
  • Sub-limits on room
  • 15.00%
  • No
  • 1
  • 15%
  • Yes
  • 0
  • 0%
  • Co-pay
  • 5%
  • No
  • 1
  • 5%
  • Yes
  • 0
  • 0%
  • Disease-wise capping
  • 5%
  • No
  • 1
  • 5%
  • Yes
  • 0
  • 0%
  • Wellness
  • 5%
  • Yes
  • 1
  • 5%
  • No
  • 0
  • 0%
  • Claims
  • 35%
  • Claims settled
  • Points25%
  • Weighted Scale 
  • 95% and higher
  • 1
  • 25%
  • 85-95%
  • 0.5
  • 13%
  • Less than 85%
  • 0
  • 0%
  • Claim complaints per 10,000 claims registered
  • 5%
  • Less than 30
  • 1
  • 5%
  • 30 to 60
  • 0.5
  • 3%
  • Over 60
  • 0
  • 0%
  • Claims ageing (settled within a month)
  • 5%
  • 98% and higher
  • 1
  • 5%
  • 96-98%
  • 0.75
  • 4%
  • 94-96%
  • 0.5
  • 3%
  • less than 94%
  • 0
  • 0%
  • Total
  • 100%
  • Overall score
  • Rating
≥65%
A
64% to 45%
B
44% to 0
C
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