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Acko Health Insurance - Unlimited cover with no waiting period!

So here is the whole story:

1) mother in law had an issue with vision in one eye

2) doctor recommended to get an injection in lv Prasad bhubaneswar

3) we checked with acko and the treatment was covered

4) we raised cashless Authorization claim on 21st sept. As the procedure was scheduled on 23rd sept.

5) we followed up with acko regarding the approval and till 23rd morning we were told that it will be approved within 1 hour. Believing then my mother in law went to hospital. Since I was worried, I raised it on Twitter.

6) while my mother in law is in hospital, acko calls and says that they need to verify something and they send an agent to check my mother in law credentials and reports.

7) their agent visits my mother in law and sees the reports etc

8) after another hour, an acko doctor calls and says that they cannot provide cashless facility citing some insurance clause and says that we can only go for reimbursement for the same. She says that there is not enough information for providing cashless claim. And getting the information will take 10-15 days as such they cannot provide cashless.

9) all this while my mother in law is in the hospital. Again we get another call from acko customer support and they repeat the same. I am pissed and I yell at them that I will be raising this with irdai. They say fine go ahead. I raise a ticket with irdai.

10) finally my mother in law undergoes the treatment after 6 hours of reaching hospital and we will file for reimbursement

11) I have to deal with snide comments by my wife and brother in law that I got acko insurance for my mother in law based on what I read in techofino
why did your brother in law not get insurance for her mother?
 
its foolishness to save some money on term insurance or health insurance. Go for firms with track record and best claim settlement
Still trying to find anything better than star for health insurance which will actually give insurance for insulin dependent PPL. Acko, tata both rejected it.
 
They are in growth phase with intense pressure from investors to show increase in customer base. So attractive low premiums and heavy advertising during world cup etc to gain maximum customers.

Most likely premiums will increase to regular reasonable levels in subsequent years or at least within the next 2-3 years.

Remember how jio started out offering freebies and now prices are comparable across all service providers? Expect same or similar outcome over the next few years with acko and other insurance providers.
 
Their Incurred Claims Ratio (ICR) is sometimes very low less than 23% in 2 out of last 4 years. In one year it is > 100%. In 1 year left, it is about 84%, as far as I remember which is okay. I have only talked about the last 4 years data.

ICR simply means tells how much amount they give back as insurance claim payment after considering the total premium collection.

ICR less than 60% is bad. Here, note that I have mentioned 23%, which is one of the worst.

ICR more than 100% means that company is paying more insurance claims than the total premium collected, as it means the model is not sustainable.

What I want to say is that they are not a stable company yet, and their ICR fluctuates a lot.

At the same time, their CSR(Claim Settlement Ratio) is on the higher side according to their website.

What I am worried about is that - high CSR + low ICR implies that company is passing most of the claims, but only partial amount (Ex: 2 Lakhs paid out of 5 Lakhs claim).

Overall policy looks great. But, their numbers not so much.

Edit: I included the screenshot with the data. This is from official IRDAI (Insurance regulator) report published each year.
 

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They are in growth phase with intense pressure from investors to show increase in customer base. So attractive low premiums and heavy advertising during world cup etc to gain maximum customers.

Most likely premiums will increase to regular reasonable levels in subsequent years or at least within the next 2-3 years.

Remember how jio started out offering freebies and now prices are comparable across all service providers? Expect same or similar outcome over the next few years with acko and other insurance providers.
final game is a ipo
 
I believe any increase in premium needs to be approved by IRDAI, so you should be safe on that front. I had been debating switching over from my reliable HDFC ERGO policy, but still on the fence. Hoping for some answers.
False, After a period in 3 years file and use Insurance company may decide its own premium based on their experience with the product.
 
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