Does a higher number of complaints against a health insurer necessarily mean a poorer grievance experience for its customers? Not always, Grant Thornton Bharat suggests a new analysis of India's standalone health insurance sector, which finds that complaint numbers can look very different when measured against the size of an insurer's policy base.
The analysis of the top five standalone health insurers (SAHIs) for FY26 found that retail health grievance intensity varied sharply across the industry from 23.09 to 56.23 grievances per 10,000 policies, against an industry average of 27.52. The study uses grievances per 10,000 policies as a normalised measure to compare insurers with different-sized customer bases on a like-for-like basis.
The distinction is important. Larger insurers have more policyholders and can therefore be expected to receive a higher number of complaints in absolute terms. But the absolute number alone does not indicate how frequently grievances arise relative to the size of the portfolio.
The Grant Thornton analysis therefore looks specifically at retail health insurance, excluding group health, personal accident and travel segments. Publicly available grievance disclosures are reported on a combined basis across these categories, which can make it difficult to assess the grievance experience of retail health policyholders separately.
The analysis highlights Star Health, which had 84.65 lakh retail health policies covering 2.03 crore lives in FY26. Its retail portfolio accounted for 52.8 per cent of the policies in the five-insurer analysis. Despite its scale, Star Health recorded 25.87 grievances per 10,000 policies, below the industry average of 27.52.
The study also uses a Grievance Contribution Index (GCI), which compares an insurer's share of grievances with its share of policies. A score of one represents the industry benchmark. Star Health recorded a GCI of 0.94, indicating that its share of grievances was marginally lower than its share of policies.
“The analysis provides a more meaningful way to evaluate customer grievance experience by comparing retail health portfolios on a like-for-like basis. Star Health has continued to deliver customer outcomes in line with the industry despite operating the largest retail health portfolio, and continues to focus on improving the customer experience further,” said Deepak Ramineedi, Partner at WestBridge Capital.
The findings, however, do not suggest that a larger insurer will necessarily have fewer grievances. Instead, they show why absolute complaint numbers need to be viewed in the context of the number of policies. The insurer with the highest GCI in the analysis recorded a score of 2.04, meaning its share of grievances was more than twice its share of policies despite having the smallest policy base among the insurers compared.
The product-level data provides another perspective. At Star Health, the leading products accounted for 67.61 per cent of policies and 66.96 per cent of grievances. The relatively close figures suggest that grievances broadly followed policy concentration rather than being disproportionately concentrated in a small group of products.
Star Health Assure also illustrates the relationship between scale and grievance incidence. With 30.64 lakh policies, it was the largest product highlighted in the analysis, but recorded 19.47 grievances per 10,000 policies. The report says this indicates that large-scale products can maintain comparatively favourable grievance experience and that outcomes may be influenced by product design, servicing effectiveness and operational execution rather than scale alone.
The experience was not uniform across the insurers. In the most concentrated portfolio, leading products accounted for 83.59 per cent of policies and 93.87 per cent of grievances. In the most diversified portfolio, the corresponding figures were 48 per cent of policies and 54.03 per cent of grievances. The findings indicate that the concentration of grievances can vary significantly depending on the composition of an insurer's product portfolio.
For consumers, the findings suggest that the headline number of complaints may not be enough to assess an insurer's grievance experience. The report points to grievances per 10,000 policies as a more comparable measure across insurers of different sizes and also highlights the importance of examining individual products rather than relying only on an insurer-level figure.
There is, however, an important caveat. The analysis measures the incidence and concentration of grievances but does not assess their severity, type or root cause. It therefore does not establish that a lower grievance rate automatically translates into better claims outcomes or a superior customer experience across all parameters.
