Health Insurance (Non-Life) Data Analysis Report

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Insurance Information Bureau of India

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Introduction The Insurance Information Bureau has been collecting transaction level data on Health Insurance policies, members and claims from all non life insurance and standalone health insurance companies in India. The Health data is collected in 3 formats. 1. Policy Data 2. Members Data 3. Claims Data The data received from Insurers for the year 2011-12 has been analyzed and the following analyses are generated for the information use of all the stake holders. Data Source IIB collects Health Insurance data through offline mode (i.e. CDs submission on half yearly basis) and online mode (i.e. uploading on to the IIB-website on monthly basis). The online mode commenced from financial year 2010-11. The data submitted through online mode are subjected to certain validation checks to prevent transaction data with some inconsistencies from entering the IIB data base. (Going forward, health insurance data submitted through online mode only will be utilized by IIB for analysis and generation of reports.) It was observed that a few insurers data submitted through online mode did not meet the minimum acceptance criteria, but their data submitted offline did. Nevertheless in order not to delay the generation of Health Insurance Report of 2011-12 any further, it has been decided to proceed with Offline submitted data of public sector insurers and Online submitted data of private sector insurers. Deficiency in the data considered for analysis: While arriving at analysis of attributes, the data records with discrepancies in values of respective attributes, have been excluded and a corresponding number of records with discrepancies is shown in the respective tables. Given the large size of data, despite these deficiencies, the trends / conclusions arrived at can be sufficiently representative of the whole population. Qualifier Under the section Detailed Analysis the data records with amount of claims paid less than `1/- and greater than `20,00,000/- have been excluded so as not to the get the analyses distorted due to the presence of outliers in claim paid data field. o Only 39% out of total claims data set have valid diagnosis codes (ICD-10) which account for 10 lac claim records and ` 2,141 crore claim paid amount. o 56% of the total number of claims do not have pin codes of the hospital. 44% of total claim records only have correctly filled-in Pin codes which account for 11.3 lac claim records and ` 2,551 crore claim paid amount. o 41% of the total claim records are shared among top 11 states. o The gender is specified for 78% of total claims records. o 24% of total number of claims paid have incorrect information about age and/or gender of the claimants. o The claim frequency among Females for diagnosis type PREGNANCY and PERINATAL PERIOD CONDITIONS is observed to have non-zero values for age greater than 55 and also for age less than 16 which could be due to incorrect information in age or date of birth or diagnosis codes of claimants. o 15% in number accounting for 22% in claim paid amount did not have hospital stay information. Insurance Information Bureau of India Page 1

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Executive Summary: Number of Policies issued in 2011-12 increased by 6% whereas number of insured members and number of claims paid in the year 2011-12 have reduced by 45% and 33% respectively when compared with those of 2010-11 which could be attributable to data omissions/errors in member and claim data sets. In the year 2011-12 the Health Premium has increased by 0.09%. However, Total Claim Paid Amount has declined by 21% when compared with that of 2010-11. Claim paid ratio has declined by 21%, from 99% in 2010-11 to 78% in 2011-12. 6% increase in number of policies and 0.09% increase in premium has resulted in decrease in 'Premium per policy' by 6%, whereas 33% reduction in number of claims has resulted in 'Claim Paid Amount per policy' being decreased by 26%. Reduction in number of members by 45% has resulted in increase in Premium per insured member by 80% and Claim Paid Amount per insured member has increased by 42%. The number of persons insured per policy has decreased to 4. Gender-wise Claims Summary, compared to previous year (Chart 9 - Appendix: HR-4): o Percentage -wise number of claims in respect of males increased from 54% to 59%. o Percentage -wise claim paid amount in respect of males increased from 56% to 64%. o Average claim paid amount of males increased from ` 22,402/- to ` 27,490/- (23% increase). o Average claim paid amount of females increased from ` 20,279/- to ` 22,343/-(10% increase). Age-wise Claims Summary (Chart 10.a, 10.b- Appendix: HR-5): o Age-band of '46-55' is highest claim making group both in number and claim paid amount with 27% share in number and 25% in amount followed by '26-35' (14%/11%) and 'Less than 1 year' (12%/23%). o Age-bands '6-15' through '46-55' witness a smooth increase in number of claims. Thereafter a steep decrease of number of claims is observed. There is a slight dip in number of claims in age-band 36-45. Thus number of claims for young children (starting from age 6 years) is low and increases with the increase in age up to the middle-age. o 82% in number and 78% in amount of claims are paid to aged up to 55. o 17% in number and 9% in amount of claims are paid to age up to 25. o Thus for youngsters below 25, the percentage of number of claims paid is high but that of claims paid amount is low. Most of the claims are paid to individuals aged below 55. o Abnormally high levels of claims both number-wise and amount-wise are paid to members with age-band 'Less than 1 year'. 12% in number of claims which accounted for 23% in amount are from age-band 'Less than 1 year'. This could be attributable to incorrect information in 'age' or 'date of birth' data fields of members where possibly 0 is filled in. o Average claim paid amount gradually increases from age-band '1-5' to that 'Above 70'. The lowest average claim paid amount is ` 12,417/- for age-band '1-5 years' and highest average claim paid amount is ` 40,684/- for age-band 'Above 70 years'. o Thus, on an average, the higher the age-band the higher the average amount of claim paid. Health Insurance Policies- Individual Cover (Chart 11.a, 11.b- Appendix: HR-5.1): o The ratio of number of claims paid to number of members insured is highest for age-band Less-than 1 year (49%), second highest for age-band 'Above 70' years (27%) and is lowest for age-band 6-15 years (3%). The ratio consistently increases throughout all the age-bands starting from 6-15. o The average amount of claim paid is highest for the age-band Above 70 (` 42,479) and lowest for age-band 1-5 years (` 11,155/-). It consistently increases throughout all the age-bands starting from 1-5. o Thus both ratio of number of claims paid to number of members insured and "average amount of claim paid" increase with the age. o The numbers of members insured are highest in age-bands 26-35 (35.8 lacs) and 36-45 (35.7 lacs) and lowest in age-band Less than 1 year (94,162). o 89% of members insured are aged 55 and below. o Average sum insured per member is highest for age-band 56-60 (` 2,06,454/-) and lowest for age-band Less-than 1 year (` 70,447/-). The average sum insured per member increases from age-band Less-than 1 year till 56-60 and thereafter decreases gradually in higher age-bands. o For age greater than 60 years the average claim paid amount keeps increasing and the average sum insured keeps falling (Chart 11a, 11b- Appendix: HR-5.1). o The sum insured utilization i.e., average claim paid per average sum insured (%) is highest for age-band Above 70' years (25%) and lowest for age-band 1-5 years (12%). It increases consistently from age-band 26-35 years. The sum insured utilization seems to be elevated for age-bands 6-15 (17%) and 16-25 (17%) in comparison to the Insurance Information Bureau of India Page 2

Health Insurance (Non-Life) Data Analysis Report 2011-2012 o neighbouring age-bands 1-5 (12%) and 26-35 (15%). Thus, the average sum insured of the age-bands 6-15 (` 91,151/-) and 16-25 (` 1,15,391/-) is lower than that of age-band 26-35 years (` 1,45,998/-) but proportion of average claims paid amount out of average sum insured is higher for age-bands 6-15 (17%) and 16-25 (17%) as compared to 26-35 (15%), indicating that age-bands 6-15 and 16-25 consume more proportion of their sum insured for hospitalization costs as compared to age-band 26-35 years (Chart 11b- Appendix: HR-5.1). Though, it is observed that age-band Less-than 1 year shows high levels of ratio of number of claims paid to number of members insured and "average claim paid per average sum insured" this apparent anomaly could be due to incorrect information in 'age' or 'date of birth' fields of members where possibly 0 is filled in. Age and Gender-wise Claims Summary (Chart 12- Appendix: HR-6): o Number of claims of males is more than that of females for all age-bands except for the age-bands '16-25' and '26-35' where they are less by 1% and 2% respectively. o Age-band Less-than 1 year shows high number of claims paid as well as an abnormal ratio between male and female. This anomaly could be due to incorrect information in age or date of birth of members where possibly 0 is filled in. o Irrespective of gender, the average amount of claim paid is highest for the age-band Above 70 and lowest for ageband 1-5 years. It consistently increases throughout all the age-bands starting from 1-5. o Average amount of claim paid per male claimant is more than that of female across all age bands. Types of Cover-wise Claims Summary (Chart 13- Appendix: HR-7): o Individual and Individual floaters account for 90 % of number of polices but only 44 % of amount of premiums. o With a meagre share of 3% in number of health insurance policies, group type of policy (Group + Group floater) commands 56% of the total health insurance industry premium. o The individual floater policies alone account for 22% of total number of policies and 22% of total policy premium within the range of (individual + individual floater) type policy covers. Whereas the group floater policies alone account for 84% of total number of policies and 81% of total policy premium within the range of (group + group floater) type policy covers. o Thus group-floaters are more prevalent than group policies and individual policies are more prevalent than individual-floater policies. Disease-wise Claims Summary (Chart 14- Appendix: HR-8): o The top six highest number of claims paid categories are from disease groups 'INFECTIOUS', 'CLINICAL FINDINGS', 'UROLOGY', 'DIGESTIVE', 'PREGNANCY' and 'INJURY', in that order which account for 64% in number and 53% in claim paid amount. o The average claim paid amount is highest for CIRCULATORY, MALFORMATIONS/DEFORMATIONS, ARTHROPATHIES, NEOPLASM and INJURY, in that order. State-wise Claims Summary basing on Hospital Pincode(Chart 15- Appendix: HR-9): o Like in previous years, Maharashtra leads the states with 22% share in total claims records (excluding claim records where Hospital Pincodes are not available). Gujarat (12%), Tamilnadu (10%) continue to be in top 5 positions for the 5th year in succession. o Top six States in terms of number of claims paid, 'MAHARASHTRA', 'GUJARAT', 'WEST BENGAL', 'TAMIL NADU', 'DELHI' and 'KARNATAKA' account for 72% in number and 76% in claim paid amount. o The States, having less than 10,000 claims records each are, 'ORISSA', 'ASSAM', 'GOA', 'BIHAR', 'TRIPURA', 'UTTARAKHAND', 'CHATTISGARH', 'CHANDIGARH' and 'PONDICHERRY'. o Considering only those with > 10,000 claim records, the top six states of Hospitalization for which average claim paid amount is high are 'DELHI', 'MAHARASHTRA', 'ANDHRA PRADESH', 'HARYANA', 'UTTAR PRADESH' and 'RAJASTHAN', in that order. o Further classifying States into Northern, Eastern, Central, Western, Sothern and Union Territories regions, following is observed: REGIONS IN INDIA PROPORTION OF NUMBER OF CLAIMS PAID PROPORTION OF AMOUNT OF CLAIMS PAID WEST INDIA 36% 39% SOUTH INDIA 28% 26% EAST INDIA 13% 10% NORTH INDIA 10% 11% UNION TERRITORIES 9% 13% CENTRAL INDIA 3% 2% Insurance Information Bureau of India Page 3

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Thus Western India contributes to highest number of claims and claim paid amount, followed by Southern India. Central India contributes least number of claims and claim paid amount. Union Territories (where major contributor is DELHI) contribute 'number of claim paid' at second lowest level but contribute 'amount of claims paid' at third highest level, compared to other regions of India. Claim Paid Band-wise Distribution of Claims (Chart 16- Appendix: HR-10): o 99% of 'total number of claims paid' are below the amount of `3 lakhs which account for 73% share in 'total amount of claims paid'. o Maximum number of claims paid falls in the claim paid band of `10001- `25000 (29%) followed by ` 25001 - ` 50000 (17%). o The claims with paid amounts less than ` 1,000 account for 13% share in 'total number of claims paid' statistic but contributes only 0.12% to ' total amount of claims paid' statistic. Thus the transaction level data has considerable number of claim records corresponding to negligible amount of claims paid. o The claim paid band 'Above ` 20,00,000' accounts only for 0.07% share in 'total number of claims paid' statistic but contributes 15% to 'total amount of claims paid' statistic. Thus the transaction level data has negligible number of claim records resulting in extreme values of claims paid amount. Age-Gender-Type of Policy wise Proportion of Claims (Chart 17- Appendix: HR-11): o The proportion of total number of claims paid from Individual policies is 59% and that from the group policies is 41%. o Out of the claimants holding individual policies, the males' proportion exceeds that of females by 19%. o Out of the claimants holding group policies the males' proportion exceeds that of females by 12%. o Claimants with Individual Policy: o Highest number of claimant members (both gender) belong to age-band '36-45' and lowest in the age-band 'Less-Than 1 year'. o Irrespective of gender, there is consistent increase in proportion of claims paid upto age-band '36-45' years and thereafter it decreases steadily. o Claims of females in the age-range 16-55 years outnumber those of males. o Claimants with Group Policy: o o o Male proportion in age 'Less than 1 year' is unusually high which could be due to incorrect information in 'age' or 'date of birth' data fields of members where possibly 0 is filled in. Therefore age 'Less than 1 year' is not considered for further analysis. The highest claiming members (both gender) belong to age-band '26-35'. The proportion of females claims in the age-range '16-60' is more than that of males. The female proportion in age-bands '16-25' and '26-35' is quite high compared to that of males which could be due to the Pregnancy cover being utilized by female members. Age and Disease-wise Claim frequency of MALES {No. of claims / No. of Members Insured} (Appendix: HR-12.1): o The claim frequency for Males with age 'Less than 1 year' is unusually high and is also greater than 100% which could be due to incorrect information in 'age' or 'date of birth' data fields of claimants where possibly 0 is filled in. Therefore age 'Less than 1 year' is not considered for further analysis. o Claims frequency increases consistently from age-band 26-35' (4%) till Above 70 Years (26%). Thus as the age of Male members increases the susceptibility to claim, out of hospitalization, also increases. o Overall, Males' claim frequency (i.e. number of claims out of total members insured) is 6.704%. o Considering only those claims where disease codes are available, the top six diseases with highest claim frequency for Males are INFECTIOUS (0.534%), CLINICAL FINDINGS (0.33%), DIGESTIVE (0.288%), INJURY (0.271%), UROLOGY(0.256%) and CIRCULATORY (0.222%). o Within each of the above six diseases, the following top three age-bands of MALES have highest claim frequency: TOP SIX DISEASES HIGHEST CLAIM SECOND HIGHEST CLAIM THIRD HIGHEST CLAIM FREQUENCY & AGE BAND FREQUENCY & AGE BAND FREQUENCY & AGE BAND INFECTIOUS 1-5 years (0.915%) 6-15 years (0.704%) 25-36 years (0.522%) CLINICAL FINDINGS Above 70 years (0.762%) 1-5 years (0.758%) 61-65 years (0.507%) DIGESTIVE 66-70 years (0.574%) Above 70 years (0.544%) 61-65 years (0.481%) INJURY Above 70 years (0.335%) 66-70 years (0.33%) 26-35 years (0.308%) UROLOGY 66-70 years (0.993%) Above 70 years (0.827%) 61-65 years (0.767%) CIRCULATORY 66-70 years (1.91%) Above 70 years (1.219%) 61-65 years (0.925%) Insurance Information Bureau of India Page 4

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Age and Disease-wise Claim frequency of FEMALES {No. of claims / No. of Members Insured} (Appendix: HR-12.2): o Claim frequency increases consistently from age-band '6-15 years' (4%) till Above 70 Years (22%) with a slight dip in claim frequency in the age-band '36-45 years'. Thus as the age of Female members increases the propensity to claim, out of hospitalization, also increases. o Overall, Females' claim frequency (i.e. number of claims out of total members insured) is 7.284% which is higher than that of Males. o In the age-bands '1-5 years' and '16 to 65 years' Females' claim frequency is more than that of Males. o The Claim frequency of Females exceeds that of Males for all diseases except INJURY, CIRCULATORY, ACCIDENT and MENTAL DISORDERS. o Considering only those claims where disease codes are available, the top six diseases with highest claim frequency for Females are PREGNANCY (0.726%), INFECTIOUS (0.685%), CLINICAL FINDINGS (0.437%), UROLOGY(0.404%), DIGESTIVE (0.354%) and EYE (0.241%). o Within each of the above six diseases, the following top three age-bands of FEMALES have highest claim frequency: TOP SIX DISEASES HIGHEST CLAIM FREQUENCY & AGE BAND SECOND HIGHEST CLAIM FREQUENCY & AGE BAND THIRD HIGHEST CLAIM FREQUENCY & AGE BAND PREGNANCY 26-35 years (1.946 %) 16-25 years (1.357 %) 36-45 years (0.166 %) INFECTIOUS Above 1-5 years (0.937%) 26-35 years (0.786%) 16-25 years (0.719%) CLINICAL 1-5 years (0.814%) Above 70 years (0.642%) 61-65 years (0.546%) FINDINGS UROLOGY 66-70 years (0.803 %) 61-65 years (0.777%) 56-60 years (0.586%) DIGESTIVE 66-70 years (0.475%) 61-65 years (0.46%) 26-35 years (0.418%) EYE 66-70 years (1.726%) 61-65 years (1.42%) Above 70 years (1.315%) Claim Paid Band (in `) and Disease-wise Proportion of Number of Claims Paid (in %) (Appendix: HR-13.1, 13.2): o Proportion of Number of Claims across Disease type and Claim Paid Band = No of Claims (for each type of disease in each Claim paid band) divided by Total Number of Claims (for all diseases). o Maximum number of claims paid are of amount below ` 75,000. o The claim-paid bands ' `10001 - `25000 '(28.56%), ' `25001 - ` 50000 '(16.90%), ' `5001 - `10000 ' (15.40%), ' `1001 - `5000 '(15.04%), ' `1 - `500 ' (9.59%)and ' `50001 - `75000' (4.54%) (containing highest proportion of claims paid, in that order) account for 90% of total number of claims paid. o Within each of the above six claim-paid bands, the following top three diseases account for highest proportion of claims: TOP SIX CLAIM-PAID BANDS `10001 - `25000 `25001 -` 50000 `5001 - `10000 `1001 - `5000 `1 - `500 ` 50001-`75000 HIGHEST CLAIM PROPORTION & DISEASE INFECTIOUS (1.77 %) PREGNANCY (1.29 %) INFECTIOUS (1.36 %) INFECTIOUS (1.06 %) INFECTIOUS (1.98%) INJURY (0.23%) SECOND HIGHEST CLAIM PROPORTION & DISEASE PREGNANCY (1.17 %) DIGESTIVE (0.67 %) CLINICAL FINDINGS (0.64 %) CLINICAL FINDINGS (1.06 %) CLINICAL FINDINGS (1.11%) DIGESTIVE (0.22%) THIRD HIGHEST CLAIM PROPORTION & DISEASE EYE (1.11 %) UROLOGY (0.59 %) DIGESTIVE (0.61 %) UROLOGY (0.58 %) UROLOGY (0.42%) UROLOGY (0.19%) Claim Paid Band (in `) and Disease-wise Proportion of Amount of Claims Paid (in %) (Appendix: HR-13.3, 13.4): o Proportion of Amount of Claims Paid (in %) across Disease type and Claim Paid Band = Amount of Claims Paid (for each type of disease in each Claim paid band) divided by Total Amount of Claims (for all diseases). o Maximum proportions of claim paid are from claim paid bands `100001 - `300000 (23.19%), `25001 - `50000 (21.36%), `10001 - `25000 (21.36%), `50001 - `75000 (9.89%) and `75001 - `100000 (7.46%), in that order. Thus 79% of total amount of claims paid belongs to range `10,000-`3,00,000. Insurance Information Bureau of India Page 5

Health Insurance (Non-Life) Data Analysis Report 2011-2012 o The top six highest proportions of amount of claims paid are from disease group CIRCULATORY, INJURY, DIGESTIVE, INFECTIOUS, PREGNANCY, UROLOGY, in that order. These diseases account for 62% of total amount of claims paid (where total claim paid amount is considered after ignoring the missing/incorrect diagnosis codes). Disease-wise and Days of Hospitalization-wise Proportion of Claims Paid (Appendix: HR-14.1, 14.2): o Lengths of stay 'Less than 1 day' and '3 days' had considerable chunks both in number and paid amounts of claims. o 23% in number accounting for 15% in claim paid amount were paid for hospital stay 'Less than 1' day. o 18% in number accounting for 16% in claim paid amount were paid for hospital stay '3 days'. o 54% in number accounting for 40% in claim paid amount were paid for hospital stay '0-3' days. o 67% in number accounting for 55% in claim paid amount were paid for hospital stay '0-10' days. o 18% in number accounting for 23% in claim paid amount were paid for hospital stay beyond 10 days. TPAs Vs Insurer's In-house Claims Settlements(Chart 4- Appendix: HR-15): o Distribution of number of claims between TPA and Insurers' In-house settlement is 46% and 54% respectively showing a possible tendency among insurers to have more control over claim settlement. Correspondingly the claim paid amount % between TPAs and In-house is 42% and 58% respectively. o Average claim paid by TPAs is less than that of In-house settlement by 17%. Product Type-wise Premium and Claim Summary (Chart 5, 6- Appendix: HR-16, HR-17): o Health insurance market is dominated by Hospitalization Indemnity Products which account for 86.8% of total Health Insurance Premium and 89.6% of total amount of Health Insurance claims paid. o Package policy premium accounts for 6.2% of total Health Insurance Premium and 8.1% of total amount of Health Insurance claims paid. o Hospital Cash Plan accounts for 3.7% of total Health Insurance Premium and 1.6% total amount of Health Insurance claims paid. Age- wise Claims Summary- Package Policy (Chart 7- Appendix: HR-20): o Age band '26-35' is the highest claim prone one with 27% in number and 29% in amount of claim paid under Package policy. Distant second positions are held by age band '36-45' in number and '46-55' in amount paid. o 67% in number and 65% in amount claimed by age range 16 to 55 years. After age 55 gradual decline in number and amount paid is visible. Metro City -wise Claims Summary (Chart 8- Appendix: HR-21): Among six metro cities Delhi, Mumbai, Kolkata, Chennai, Bangalore and Hyderabad, Delhi leads them in number of claims while Mumbai leads them in total amount of claims paid and average claim paid amount. Bangalore has the least average claim paid amount. Insurance Information Bureau of India Page 6

Numbers of Policies and Claims Number of Members Health Insurance (Non-Life) Data Analysis Report 2011-2012 MACRO INDICATORS Macro Indicators on (Non-Life) Health Insurance Data 2003-12 HR-1: Policies, Insured Members and Claims Year Number of Policies Number of Members Number of Claims 2003-2004* 22,65,451 83,61,629 3,60,088 2004-2005* 20,59,449 89,87,239 5,55,273 2005-2006* 38,28,495 1,63,45,575 10,16,785 2006-2007* 31,10,475 1,79,07,430 10,60,047 2007-2008* 37,90,838 2,41,21,625 14,36,998 2008-2009* 45,75,725 3,27,10,604 20,81,297 2009-2010** 68,84,687 5,48,93,453 32,63,597 2010-2011** 77,42,076 5,25,08,111 38,43,285 2011-2012*** 82,25,112 2,91,34,940 25,91,781 # NB: 1. * Policies serviced by TPAs only. 2. ** Figures of Policies serviced by TPAs and directly serviced by Insurers 3. *** Data submitted online by PVT insurers and offline by PSU insurers. 4. # - Inclusive of Claim Records where Claim Paid Amount >`20 lakh Chart 1, Table HR-1 Number of Policy, Insured Members and Claims by Years 9,000,000 60,000,000 8,000,000 7,000,000 50,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 40,000,000 30,000,000 20,000,000 10,000,000 0 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 Years Number of Claims Number of Members Number of Policies # - Inclusive of Claim Records where Claim Paid Amount >`20 lakh Inference: Number of Policies issued in 2011-12 have increased by 6% whereas number of insured members and number of claims paid in the year 2011-12 have reduced by 45% and 33% respectively when compared with those of 2010-11 which could be attributable to data omissions/errors in member and claim data sets. Insurance Information Bureau of India Page 7

Amount ( ` in Crs.) Claim Paid Ratio (in %) Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-2: Total Premium, Total Claim Paid and Claim Ratio Period Premium (` in Crs.) Claims paid (` in Crs.) Claims Paid Ratio (in %) 2003-2004* 944 785 83% 2004-2005* 987 948 96% 2005-2006* 1,947 1,777 91% 2006-2007* 2,820 2,198 78% 2007-2008* 2,758 2,904 105% 2008-2009* 3,976 4,087 103% 2009-2010** 7,803 7,456 96% 2010-2011** 10,932 10,797 99% 2011-2012*** 10,942 8,499 # 78% NB: 1. * Policies serviced by TPAs only. 2. ** Figures of Policies serviced by TPAs and directly serviced by Insurers 3. *** Data submitted online by PVT insurers and offline by PSU insurers. 4. # - Inclusive of Claim Records where Claim Paid Amount > `20 lakh 5. Claim Paid Ratio = Total Claim Paid Amount / Total Premium * 100 Chart 2, Table HR-2 12,000 11,000 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 - Total Premium, Claim Paid Amount and Claim Paid Ratio by Years 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 Years Premium Claims Paid Amount Claims Paid Ratio (in %) 120% 100% 80% 60% 40% 20% 0% # - Inclusive of Claim Records where Claim Paid Amount >`20 lakh Inference: In the year 2011-12 the Policy Premium has increased by 0.09%. However, Total Claim Paid Amount has declined by 21% when compared with that of 2010-11. Claim paid ratio has declined by 21%, from 99% in 2010-11 to 78% in 2011-12. Insurance Information Bureau of India Page 8

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-3: Average Premium, Average Claim Paid and Average Persons Insured - Per Policy and Per Member Year Premium per Policy (in `) Premium per Insured Member (in `) Number of Persons Insured Per Policy Claim Paid per Policy (in `) Claim paid per Insured Member (in `) 2003-2004* 4,166 1,129 4 3,465 939 2004-2005* 4,792 1,098 4 4,606 1,055 2005-2006* 4,892 1,146 4 4,642 1,040 2006-2007* 9,067 1,575 6 7,066 1,227 2007-2008* 7,275 1,143 6 7,661 1,204 2008-2009* 8,689 1,216 7 8,932 1,249 2009-2010** 11,333 1,421 8 10,910 1,368 2010-2011** 14,120 2,082 6 13,946 2,056 2011-2012*** 13,303 3,756 4 10,333 # 2,917 # NB: 1. * Policies serviced by TPAs only. 2. ** Figures of Policies serviced by TPAs and directly serviced by Insurers 3. *** Data submitted online by PVT insurers and offline by PSU insurers. 4. # - Inclusive of Claim Records where Claim Paid Amount > `20 lakh Chart 3, Table HR-3 Average Premium and Claim Paid Amount Per Member (in `) 4000 3500 3000 2500 2000 1500 1000 500 0 Average Premium and Claim Paid Amount by Years 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 Years 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Average Premium and Claim Paid Amount Per Policy (in `) Claim paid per Insured Member Premium per member Premium per Policy Claim Paid per Policy # - Inclusive of Claim Records where Claim Paid Amount >`20 lakh Inference: The values expressed in table HR-3 are derived from tables HR-1 and HR-2. When comparing the 2011-12 figures with that of 2010-11 the following are observed that: 6% increase in number of policies and 0.09% increase in premium has resulted in decrease in 'Premium per policy' by 6%, whereas 33% reduction in number of claims has resulted in 'Claim Paid Amount per policy' being decreased by 26%. Reduction in number of members by 45% has resulted in increase in Premium per insured member by 80% and Claim Paid Amount per insured member has increased by 42%. The number of persons insured per policy has decreased to 4. Insurance Information Bureau of India Page 9

Health Insurance (Non-Life) Data Analysis Report 2011-2012 DETAILED ANALYSES [For detailed data, please refer to HR tables in the Appendices] TPA Vs. Insurers' In-house Claim Settlement Chart 4- Appendix: HR-15 Average Claim Paid Amount(in `) - 2011-12 TPA vs In-House Number of Claims Paid - 2011-12 TPA vs In-House Claim Paid Amount(in ` Cr) - 2011-12 TPA vs In-House 25,345 1,204,173, 46% 3,052.03, 42% 30,368 TPA Inhouse 1,385,844, 54% TPA Inhouse 4,208.46, 58% TPA Inhouse # - Excluding claim records where Claim Paid amount >`20 lakh Inference: Distribution of number of claims between TPA and Insurers' In-house settlement is 46% and 54% respectively showing a tendency among insurers to have more control over claim settlement. Correspondingly, the claim paid amount % between TPAs and In-house is 42% and 58% respectively Average claim paid by TPAs is less than that of In-house settlement by 17%. Product Type-wise Premium and Claims Summary Chart 5- Appendix: HR-16 Share in Amount of Claims Paid - 2011-12 Type of Product Share in Number of Claims - 2011-12 Type of Product 0.27% 0.30% 0.08% 8.15% 1.60% 0.00% 12.22% 1.93% 0.52% 0.23% 0.01% 0.00% 89.61% 85.10% Hospitalisation Indemnity Policy Package Policy Hospital Cash Plan Any Other Product Hybrid Policy Critical Illness Cover - Benefits Critical Illness Cover - Indemnity # - Excluding claim records where Claim Paid amount >`20 lakh Hospitalisation Indemnity Policy Hospital Cash Plan Hybrid Policy Critical Illness Cover - Indemnity Package Policy Any Other Product Critical Illness Cover - Benefits Insurance Information Bureau of India Page 10

Claim Paid Amount (` in crs.) Number of Claims Health Insurance (Non-Life) Data Analysis Report 2011-2012 Chart 6- Appendix: HR-17 Share in Amount of Premium- 2011-12 Type of Product 6.19% 3.56% 0.38% 2.80% 0.18% 0.00% 0.02% Share in Number of Policies - 2011-12 Type of Product 0.98% 1.31% 7.08% 2.68% 2.23% 0.01% 0.01% 86.87% 85.72% Hospitalisation Indemnity Policy Package Policy Hospital Cash Plan Any Other Product Hybrid Policy Critical Illness Cover - Benefits Critical Illness Cover - Indemnity Declaration Policy # - Excluding claim records where Claim Paid amount >`20 lakh Hospitalisation Indemnity Policy Hospital Cash Plan Hybrid Policy Critical Illness Cover - Indemnity Package Policy Any Other Product Critical Illness Cover - Benefits Declaration Policy Inference: Health insurance market is dominated by Hospitalization Indemnity Products which accounts for 86.9% of total Health Insurance Premium and 89.6% of total amount of Health Insurance claims paid. Package policy premium accounts for 6.2% of total Health Insurance Premium and 8.1% of total amount of Health Insurance claims paid. Hospital Cash Plan accounts for 3.7% of total Health Insurance Premium and 1.6% total amount of Health Insurance claims paid. Age-wise Claims Summary - Package Policy 180.00 160.00 140.00 120.00 100.00 80.00 60.00 40.00 20.00 - Chart 7- Appendix: HR-20 Age-band-wise Number of Claims and Amount of Claims Paid - 2011-12 Package Policy 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in years.) 100,000 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 - Total Claims Paid (` in crs.) Number of Claims # - Excluding claim records where Claim Paid amount >`20 lakh Inference: Age band '26-35' is the highest claim prone one with 27% in number and 29% in amount of claims paid under Package Policy. Distant second positions are held by age band '36-45' in number and '46-55' in amount paid. 67% in number and 65% in amount claimed by age range 16 to 55 years. After age 55, gradual decline in number and amount paid is visible. Insurance Information Bureau of India Page 11

Amount of Claims Paid (` in Crs.) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 Metro City-wise Claims Summary Amount of Claim Paid (in ` crs) 400 350 300 250 200 150 100 50 0 31,556 33,825 Chart 8- Appendix: HR-21 Metro City-wise Claims Summary 25,657 28,303 27,889 28,613 DELHI MUMBAI BANGALORE KOLKATA CHENNAI HYDERABAD Metro Cities Total Claims Paid Amount (in ` Crs) Number of Claims Paid Average Claim Paid Amount (in `) 120,000 100,000 80,000 60,000 40,000 20,000 0 Number of Claims Paid Average Claim Paid (`) # - Excluding claim records where Claim Paid amount >`20 lakh Inference: Among six metro cities Delhi, Mumbai, Kolkata, Channai, Bangalore and Hyderabad, Delhi leads them in number of claims, while Mumbai leads them in amount of claims paid and average claim paid amount. Bangalore has least average claim paid amount. Gender-wise Claims Summary Chart 9- Appendix: HR-4 Gender-wise Number and Amount of Claims Paid - 2011-12 3,500 3,000 2,500 2,000 1,500 1,000 500 - Male Female Gender Not Specified Gender Claims Paid Amount ( ` in Crs.) Number of Claims Paid 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 - # - Excluding claim records where Claim Paid amount >`20 lakh Inference: 22% of claim records do not have Gender information. Considering only those claim records where gender is specified the following is observed: For the year 2011-12, out of total number of claims paid, number of claims paid to males increased from 54% to 59%. Thus in the year 2011-12, claim experience(would incidence be more appropriate?)of Males has increased and that of Females has decreased by 5%. For the year 2011-12, out of total amount of claims paid, amount of claims paid to males increased from 56% to 64%. Thus in the year 2011-12, amount of claims paid to Males has increased and that to Females has decreased by 8%. Compared to previous year, the average claim paid amount to Males increased from ` 22,402/- to ` 27,490/- (23% increase) and that to Females increased from ` 20,279/- to ` 22,343/-(10% increase). The gap between the average claim paid amount of Males and Females has increased from ` 2,123/- (2010-11) to `5,147/- (2011-12). Insurance Information Bureau of India Page 12

Average Claim Paid Amount (in `) Number of Claims Paid Amount of Claims Paid (` in Crs.) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 Age-wise Claims Summary Chart 10.a- Appendix: HR-5 Age-wise Number and Total Amount of Claims Paid - 2011-12 2,000.00 1,800.00 1,600.00 1,400.00 1,200.00 1,000.00 800.00 600.00 400.00 200.00 - Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in Years) Total Claim Paid Amount (` in Crs.) Number of Claims Paid 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 - # - Excluding claim records where Claim Paid amount >`20 lakh Chart 10.b- Appendix: HR-5 60,000 50,000 40,000 30,000 20,000 10,000 Age-wise Number of Claims Paid and Average Claim Paid Amount -2011-12 51,361 40,684 35,261 35,546 31,920 26,678 23,176 21,102 17,637 12,417 12,505 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 - Less than 1 # - Excluding claim records where Claim Paid amount >`20 lakh 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in Years) Number of Claims Paid Average Claim Paid (in `) Average Claim Paid (`) Inference: Abnormally high levels of claims both number-wise and amount-wise are paid to members with age-band 'Less than 1 year'. 12% in number of claims which accounted for 23% in amount are from age-band 'Less than 1 year'. This could be attributable to incorrect information in 'age' or 'date of birth' data fields of members where possibly 0 is filled in. Age-band of '46-55' is highest claim prone group both in number and claim paid amount with 27% share in number and 25% in amount followed by '26-35' (14%/11%) and 'Less than 1 year' (12%/23%). Age-bands '6-15' through '46-55' witness a smooth increase in number of claims. Thereafter a steep decrease of number of claims is observed. There is a slight dip in number of claims in age-band 36-45. Thus number of claims for young children (starting from age 6 years) is low and increases with the increase in age upto the middle-aged individuals. 82% in number and 78% in amount of claims are paid to aged up to 55. 17% in number and 9% in amount of claims are paid to age up to 25. Thus for youngsters below 25, the percentage of number of claims paid is high but that of claims paid amount is low. Most of the claims are paid to individuals with age less than 55. Average claim paid amount gradually increases from age-band '1-5' to that 'Above 70'. The lowest average claim paid amount is ` 12,417/- for age-band '1-5 years' and highest average claim paid amount is ` 40,684/- for age-band 'Above 70 years'. Thus, on an average, the higher the age-band the higher the average amount of claim paid. - Insurance Information Bureau of India Page 13

Number of members insured (in tens) and Average Sum Insured (in `) Sum Insured Utilization (in %) Average Amount of Claims Paid (in `) Ratio of No. of Claim to No. of Members Health Insurance (Non-Life) Data Analysis Report 2011-2012 Health Insurance Policy - Individual Cover Chart 11.a- Appendix: HR-5.1 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 - Age-wise Average Claims Paid & Ratio of Number of Claims to Number of Members Insured Individual Policy - 2011-12 49% 13,024 6% 11,155 15,450 19,784 21,378 3% 4% 5% 25,464 6% 30,992 10% 34,822 35,862 13% 17% 37,414 21% 42,479 Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in Years) Average Amount of Claims Paid (in `) Ratio of Number of Claims to Number of Members Average Claim Paid (`) 27% 60% 50% 40% 30% 20% 10% 0% # - Excluding claim records where Claim Paid amount >`20 lakh Chart 11.b- Appendix: HR-5.1 400000 Age-wise Average Sum Insured per Member, Sum Insured Utilization Individual Policy - 2011-12 30% 350000 300000 250000 200000 18% 12% 17% 17% 15% 15% 17% 17% 18% 21% 25% 25% 20% 15% 150000 100000 50000 10% 5% 0 Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in Years) Number of Members Insured (in tens) Average Sum Insured per Member ( in ` ) Sum Insured Utilization (%) = Avg. Amount of Claims Paid / Avg. Sum Insured per Member # - Excluding claim records where Claim Paid amount >`20 lakh Sum Insured Utilization(%) 0% Inference: Considering the Health Insurance Policies issued to Individuals, following observations are made in respect of members insured, sum insured and claims paid: The ratio of number of claims paid to number of members insured is highest for age-band Less-than 1 year (49%), second highest for age-band 'Above 70' years (27%) and is lowest for age-band 6-15 years (3%). The ratio consistently increases throughout all the age-bands starting from 6-15. The average amount of claim paid ( i.e. total claim paid amount total number of claims paid) is highest for the age-band Above 70 (` 42,479 and lowest for age-band 1-5 years (` 11,155/-). It consistently increases throughout all the agebands starting from 1-5. Thus both ratio of number of claims paid to number of members insured and "average amount of claims paid" increase as we move up the age bands. Insurance Information Bureau of India Page 14

Health Insurance (Non-Life) Data Analysis Report 2011-2012 The numbers of members insured are highest in age-bands 26-35 (35.8 lacs) and 36-45 (35.7 lacs) and lowest in ageband Less than 1 year (94,162). 89% of members insured are aged 55 and below. Average sum insured per member is highest for age-band 56-60 (` 2,06,454/-) and lowest for age-band Less-than 1 year (` 70,447/-). The average sum insured per member increases from age-band Less-than 1 year till 56-60 and thereafter decreases gradually in higher age-bands. For age greater than 60 years the average claim paid amount keeps increasing and the average sum insured keeps falling. The sum insured utilization i.e., average claim paid per average sum insured is highest for age-band Above 70' years (25%) and lowest for age-band 1-5 years (12%). It increases consistently starting from age-band 26-35 years. Thus, for members with age greater than 25, as the age increases more proportion of sum insured is consumed for hospitalization costs. The sum insured utilization seems to be elevated for age-bands 6-15 (17%) and 16-25 (17%) in comparison to the neighbouring age-bands 1-5 (12%) and 26-35 (15%). Thus, the average sum insured of the age-bands 6-15 (` 91,151/-) and 16-25 (` 1,15,391/-) is lower than that of age-band 26-35 years (` 1,45,998/-) but proportion of average claims paid amount out of average sum insured is higher for age-bands 6-15 (17%) and 16-25 (17%) as compared to 26-35 (15%), indicating that age-bands 6-15 and 16-25 consume more proportion of their sum insured for hospitalization costs as compared to age-band 26-35 years. Though, it is observed that age-band Less-than 1 year shows high levels of ratio of number of claims paid to number of members insured and "average claim paid per average sum insured" this apprarent anomaly could be due to incorrect information in 'age' or 'date of birth' fields of members where possibly 0 is filled in. Insurance Information Bureau of India Page 15

Policy Premium ( ` in Crs.) Number of Policies Average Amount of Claims Paid (in `) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 Age and Gender-wise Claims Summary 45,000 Chart 12- Appendix: HR-6 Age and Gender-wise Number of Claims and Average Claim paid - 2011-12 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 - Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in years) Number of Claims Paid to Males Number of Claims Paid to Females Average Claims Paid to Males (in `) Average Claims Paid to Females (in `) # - Excluding claim records where Claim Paid amount >`20 lakh 200,000 180,000 160,000 140,000 120,000 100,000 80,000 60,000 40,000 20,000 - Inference: Number of claims paid to males is more than that of females for all age-bands except for the age-bands '16-25' and '26-35' where they are less by 1% and 2% respectively. It is observed that age-band Less-than 1 year shows high number of claims paid as well as an abnormal ratio between male and female. This anomaly could be due to incorrect information in age or date of birth of members where possibly 0 is filled in. Irrespective of gender, the average amount of claim paid is highest for the age-band Above 70 and lowest for age-band 1-5 years. It consistently increases throughout all the age-bands starting from 1-5. Average amount of claim paid per male claimant is more than that of female across all age bands. Type of Cover-wise Claims Summary 6,000 5,000 Chart 13- Appendix: HR-7 Type of Cover-wise Number of Policies and Policy Premium - 2011-12 4,000 3,000 2,000 1,000 - Individual Individual Floater Group Group Floater Declaration and Others Type of Cover Policy Premium (` in Crs.) Number of Policies # - Excluding claim records where Claim Paid amount >`20 lakh 7,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 - Inference: Individual and Individual floaters account for 90 % of number of polices but only 40 % of amount of premiums. With a meagre share of 3% of total health insurance policies issued, group type of policy (Group + Group floater) commands 56% of the total health insurance industry premium. The individual floater policies alone account for 22% of total number of policies and 22% of total policy premium within the range of individual + individual floater type policy covers. Whereas the group floater policies alone account for 84% of total number of policies and 81% of total policy premium within the range of group + group floater type policy covers. Thus group-floaters are more prevalent than group policies and individual policies are more prevalent than individualfloater policies. Insurance Information Bureau of India Page 16

Average Amount of Claims Paid (in `) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 Disease-wise Claims Summary Chart 14- Appendix: HR-8 Disease-wise Number of Claims and Average Claim Paid (in `) - 2011-12 50,000 45,000 47,065 41,382 200000 43,986 180000 40,000 35,000 30,000 25,000 20,000 29,580 22,236 22,483 19,841 16,377 17,944 34,567 27,716 22,338 20,244 17,144 21,098 23,063 18,569 160000 140000 120000 100000 80000 15,000 10,000 5,000 11,344 10,044 17,857 18,058 60000 40000 20000-0 Diseases Number of Claims Paid Average Claim Paid (in `) Average Amount of Claims Paid ( in `) # - Excluding claim records where Claim Paid amount >`20 lakh There are 22 macro groups of diagnosis codes according to ICD-10. The possibility of certain disease group not having sufficient amount of claims data cannot be ruled out. Hence care should be exercised while deriving conclusions from the trend revealed by that particular disease group. Inference: Only 39% out of total claims data set have valid diagnosis codes (ICD-10) which accounts for 10 lacs claim records and ` 2,141 crore claim paid amount. Still this data is credible enough to throw up reasonable trends. The top six highest number of claims paid categories are from disease groups 'INFECTIOUS', 'CLINICAL FINDINGS', 'UROLOGY', 'DIGESTIVE', 'PREGNANCY' and 'INJURY', in that order which account for 64% in number and 53% in claim paid amount. The average claim paid amount is highest for CIRCULATORY, MALFORMATIONS/DEFORMATIONS, ARTHROPATHIES, NEOPLASM and INJURY, in that order. Insurance Information Bureau of India Page 17

Average Amount of Claims Paid (in `) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 State of Hospitalization-wise Claims Summary Chart 15- Appendix: HR-9 State-wise Number of Claims and Average Amount of Claims Paid (in `) - 2011-12 35,000 31,556 26,701 30,000 24,897 25,000 22,383 22,510 26,804 22,115 19,611 24,643 23,472 20,000 19,254 20,259 20,068 15,000 17,785 10,993 14,401 14,431 10,000 12,390 300000 250000 22,676 200000 150000 17,307 100000 5,000-3,921 7,256 722 50000 0 # - Excluding claim records where Claim Paid amount >`20 lakh States Number of Claims Paid Average Claim Paid (in `) Average Amount of Claims Paid ( in `) Inference: 23 States have been classified basing on 44% of total claim records where PIN Code is filled-in. Claim records, where PIN Code is filled-in, account for 11.3 lac claim records and `2,551 cr. claim paid amount. 41% of the total claim records are shared among top 11 states. Like in previous years, Maharashtra leads the states with 22% share in total claims records (excluding claim records where Hospital Pin codes are not available). Gujarat (12%), Tamilnadu (10%) continue to be in top 5 positions for the 5th year in succession. Top six States in terms of number of claims paid, 'MAHARASHTRA', 'GUJARAT', 'WEST BENGAL', 'TAMIL NADU', 'DELHI' and 'KARNATAKA' (in that order) accounts for 72% in number and 76% in claim paid amount. The States, having less than 10,000 claims records each, are 'ORISSA', 'ASSAM', 'GOA', 'BIHAR', 'TRIPURA', 'UTTARAKHAND', 'CHATTISGARH', 'CHANDIGARH' and 'PONDICHERRY'. Considering only those States with more than 10,000 claims records, the top six states of Hospitalization for which average claim paid amount is high are 'DELHI', 'MAHARASHTRA', 'ANDHRA PRADESH', 'HARYANA', 'UTTAR PRADESH' and 'RAJASTHAN', in that order. Further classifying States into Northern, Eastern, Central, Western, Sothern and Union Territories regions, following is observed: REGIONS IN INDIA PROPORTION OF NUMBER OF CLAIMS PAID PROPORTION OF AMOUNT OF CLAIMS PAID WEST INDIA 36% 39% SOUTH INDIA 28% 26% EAST INDIA 13% 10% NORTH INDIA 10% 11% UNION TERRITORIES 9% 13% CENTRAL INDIA 3% 2% Thus Western India contributes to highest number of claims and claim paid amount, followed by Southern India. Central India contributes least number of claims and claim paid amount. Union Territories (where major contributor is DELHI) contribute 'number of claim paid' at second lowest level but contribute 'amount of claims paid' at third highest level, compared to other regions of India. Union Territories (where major contributor is DELHI) contribute to 9% of number of claims and 13% of claim paid amount. Insurance Information Bureau of India Page 18

Total Amount of Claims Paid (` in Crs.) Number of Claims Paid Health Insurance (Non-Life) Data Analysis Report 2011-2012 Claim Paid Band-wise Distribution of Claims Chart 16- Appendix: HR-10 1,800.00 1,600.00 1,400.00 1,200.00 1,000.00 800.00 600.00 400.00 200.00 - Claim Paid band-wise Distribution of Claims - 2011-12 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 - Claim Paid Band (in `) Total Amount of Claims Paid (` in Crs.) # - Excluding claim records where Claim Paid amount >`20 lakh Number of Claims Paid Inference: 99% of 'total number of claims paid' are below the amount of `3 lakhs which account for 73% share in 'total amount of claims paid'. Maximum number of claims paid falls in the claim paid band of `10,001-`25,000(29%) followed by `25,00 -`50,000(17%). The claims with paid amounts 'less than `1000' account for 13% share in 'total number of claims paid' statistic but contributes only 0.12% to ' total amount of claims paid' statistic. Thus the transaction level data has considerable number of claim records corresponding to negligible amount of claims paid. The claim paid bands 'Above `20,00,000' accounts only for 0.07% share in 'total number of claims paid' statistic but contributes 15% to 'total amount of claims paid' statistic. Thus the transaction level data has negligible number of claim records resulting in extreme values of claims paid amount. Insurance Information Bureau of India Page 19

Proportion of Claims Paid (%) Health Insurance (Non-Life) Data Analysis Report 2011-2012 Age, Gender and Type of Policy-wise Proportion of Claims Chart 17- Appendix: HR-11 35.00 Age, Gender and Type of Policy-wise Proportion of Claims - 2011-12 30.00 25.00 20.00 15.00 10.00 5.00 - # - Excluding claim records where Claim Paid amount >`20 lakh Inference: Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Age-Band (in Years) Proportion of Claims Paid to Males - Individual Policy Proportion of Claims Paid to Males - Group Policy Proportion of Claims Paid to Females - Individual Policy Proportion of Claims Paid to Females - Group Policy 24% of total number of claims paid have incorrect information about age and/or gender of the claimants. Following observations and percentages are derived from the claim records with correct information of age and gender and rest of the claim records are excluded for the analysis. The proportion of total number of claims paid from Individual policies is 59% and that from the group policies is 41%. Thus more number of claims are paid to members with individual type of cover. Out of the claimants holding individual policies the males' proportion exceeds that of females by 19%. Out of the claimants holding group policies the males' proportion exceeds that of females by 12%. Claimants with Individual Policy: o For both the Genders, the age distribution is similar i.e. highest number of claimants (both gender) belong to age-band '36-45' and lowest in the age-band 'Less-Than 1 year'. o Irrespective of Gender, there is consistent increase in proportion of claims paid upto age-band '36-45' years and thereafter it decreases steadily. o The claims paid to Females in the age-range '16 to 55' outnumber male claims. Claimants with Group Policy: o Male proportion in age 'Less than 1 year' is unusually high which could be due to incorrect information in 'age' or 'date of birth' data fields of members where possibly 0 is filled in. Therefore age 'Less than 1 year' is not considered for further analysis. o The highest claiming members (both gender) belong to age-band '26-35'. o The proportion of females claims in the age-range '16 to 60' is more than that of males. The Female proportion in age-bands '16-25' and '26-35' is quite high compared to that of Males which could be due to the Pregnancy cover utilized by Female members. Insurance Information Bureau of India Page 20

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Appendices HR-4: Gender-wise Number of Claims, Claim Paid and Average Claim Paid - 2011-12 Gender Number of Claims # Total Claims Paid # (` in Crs.) Average Claim Paid # (in `) Male 11,86,786 3,262.50 27,490 Female 8,30,804 1,856.26 22,343 Gender Not Specified 5,72,427 2,141.73 37,415 Total 25,90,017 7,260.49 28,033 NB: Error records are those for which either the field is not filled up or no coding was adopted by Insurers. HR-5: Age-Band wise Number of Claims, Claim Paid and Average Claim Paid -2011-12 Age-Band (in Years) Number of Claims # Total Claims Paid # (` in Crs.) Average Claim Paid # (in `) Less than 1 3,19,653 1,641.76 51,361 1-5 1,20,498 149.62 12,417 6-15 1,18,602 148.31 12,505 16-25 1,90,184 335.42 17,637 26-35 3,68,230 777.03 21,102 36-45 3,20,534 742.87 23,176 46-55 6,89,301 1,838.93 26,678 56-60 1,45,954 465.89 31,920 61-65 1,28,911 454.56 35,261 66-70 91,387 324.84 35,546 Above 70 91,294 371.42 40,684 Age Not Specified 5,469 9.84 17,984 Total 25,90,017 7,260.49 28,033 HR-5.1: Age-Band wise Number of Members, Amount of Sum Insured, Number of Claims and Amount of Claims Paid for INDIVIDUAL COVER - 2011-12 Age-Band (in Years) Number of Members Number of Claims # Sum Insured (in `) Total Claims Paid # (in `) Ratio of Number of Claims Paid to Number of Members Insured Average Amount of Claims Paid Average Sum Insured per Member ( in ` ) Sum Insured Utilization (%) = Avg. Amount of Claims Paid / Avg. Sum Insured per Member Less than 1 94,162 46,226 6,63,34,12,739 60,20,64,257 49% 13,024 70,447 18% 1-5 10,72,879 64,542 99,24,71,32,499 71,99,80,497 6% 11,155 92,505 12% 6-15 22,84,040 79,467 2,08,19,23,71,109 1,22,77,62,646 3% 15,450 91,151 17% 16-25 24,13,065 99,225 2,78,44,62,52,230 1,96,30,40,476 4% 19,784 115,391 17% 26-35 35,78,759 1,70,894 5,22,49,16,81,525 3,65,34,20,138 5% 21,378 145,998 15% 36-45 35,71,420 2,25,274 5,92,96,03,57,330 5,73,63,48,004 6% 25,464 166,029 15% 46-55 23,28,248 2,27,357 4,35,55,07,00,098 7,04,63,38,962 10% 30,992 187,072 17% 56-60 7,75,758 97,310 1,60,15,80,54,189 3,38,85,20,813 13% 34,822 206,454 17% 61-65 5,18,936 86,057 1,01,79,34,24,251 3,08,61,64,680 17% 35,862 196,158 18% 66-70 2,95,465 62,301 53,78,55,78,420 2,33,09,26,279 21% 37,414 182,037 21% Above 70 2,44,327 66,457 41,82,44,42,025 2,82,30,13,455 27% 42,479 171,182 25% Total 1,71,77,059 12,25,110 25,01,08,34,06,416 32,57,75,80,207 7% 26,592 145,606 18% Insurance Information Bureau of India Page 21

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-6: Gender and Age-Band wise Number of Claims - 2011-12 Age-Band (in Years) Number of Claims # Average Claim Paid # (in `) Male Female Total Male Female Total Less than 1 1,35,226 1,989 1,37,215 33,566 12,652 119,649 1-5 65,008 44,881 1,09,889 13,062 11,296 13,615 6-15 72,491 45,977 1,18,468 12,889 11,892 12,519 16-25 94,400 95,506 1,89,906 19,630 15,658 17,662 26-35 1,81,768 1,85,955 3,67,723 22,660 19,561 21,131 36-45 1,79,678 1,40,276 3,19,954 24,881 20,954 23,218 46-55 1,78,091 1,37,276 3,15,367 31,481 25,346 58,311 56-60 84,601 60,776 1,45,377 33,533 29,736 32,047 61-65 77,474 51,181 1,28,655 36,864 32,827 35,332 66-70 56,876 34,251 91,127 36,326 34,221 35,647 Above 70 59,377 31,588 90,965 41,154 39,767 40,831 Age and Gender Not Specified 5,75,371 37,340 Total 11,84,990 8,29,656 25,90,017 27,489 22,354 28,033 HR-7: Type of Cover, Number of Policies and Premium - 2011-12 Type of Policy Number of Policies Policy Premium (` in Crs.) Share in Total Policies ( in %) Share in Premium ( in %) Individual 58,06,907 3,449 70.60% 31.52% Individual Floater 15,92,326 977 19.36% 8.93% Group 34,844 1,147 0.42% 10.48% Group Floater 1,78,868 4,935 2.17% 45.10% Declaration and Others 6,12,167 433 7.44% 3.96% Total 82,25,112 10,942 100.00% 100.00% Insurance Information Bureau of India Page 22

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-8: Disease-wise Number of Claims, Amount of Claims Paid and Average Claim Paid - 2011-12 Disease Name ICD Codes Number of Claims # Total Claims Paid # Average Claim Paid # INFECTIOUS A00-B99 1,82,136 206.61 11,344 CLINICAL FINDINGS R00-R99 1,10,748 111.23 10,044 UROLOGY N00-N99 97,418 193.29 19,841 DIGESTIVE K00-K93 95,884 213.20 22,236 PREGNANCY O00-O99 91,017 204.63 22,483 INJURY S00-T98 73,058 216.11 29,580 RESPIRATORY J00-J99 71,903 117.75 16,377 CIRCULATORY I00-I99 63,364 298.22 47,065 EYE H00-H59 63,313 113.61 17,944 NEOPLASM C00-D48 47,182 163.09 34,567 ARTHROPATHIES M00-M99 28,141 116.45 41,382 SKIN L00-L99 15,900 27.26 17,144 ENDOCRINE E00-E99 14,243 31.82 22,338 NERVOUS G00-G99 13,276 36.80 27,716 PERINATAL PERIOD CONDITIONS P00-P96 10,865 21.99 20,244 HEALTH SERVICES RELATED Z00-Z99 9,325 16.65 17,857 EAR H60-H95 8,852 18.68 21,098 BLOOD DISEASES D50-D89 4,929 11.37 23,063 ACCIDENT V00-Y99 4,500 8.36 18,569 MENTAL DISORDERS F00-F99 2,864 5.17 18,058 MALFORMATIONS/DEFORMATIONS Q00-Q99 2,003 8.81 43,986 CODES FOR SPECIAL PURPOSES U00-U99 7* 0.04* 53,417* Diseases Not Specified 15,79,089 5,119.36 32,420 Total 25,90,017 7,260.49 28,033 * - The number of claims is too low to draw meaningful inference (` in Crs.) (in `) Insurance Information Bureau of India Page 23

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-9: State-wise Number of Claims, Total Claim Paid Amount and Average Claim Paid - 2011-12 State Region Classification Number of Claims # Total Claim Paid Amount # (in ` cr) Average Claim Paid # (in `) MAHARASHTRA West India 2,54,536 682.25 26,804 GUJARAT West India 1,39,803 269.18 19,254 WEST BENGAL East India 1,15,615 226.73 19,611 TAMIL NADU South India 1,12,215 227.33 20,259 DELHI Union Territories 1,04,314 329.18 31,556 KARNATAKA South India 91,527 204.86 22,383 KERALA South India 60,874 75.42 12,390 ANDHRA PRADESH South India 53,744 143.50 26,701 UTTAR PRADESH North India 47,577 111.67 23,472 HARYANA North India 45,450 113.16 24,897 MADHYA PRADESH Central India 30,199 43.49 14,401 PUNJAB North India 21,776 43.70 20,068 RAJASTHAN West India 15,291 34.42 22,510 JHARKHAND East India 10,176 3.99 3,921 ORISSA East India 9,366 10.30 10,993 ASSAM East India 8,652 6.28 7,256 GOA West India 3,396 8.37 24,643 BIHAR East India 2,463 3.55 14,431 TRIPURA East India 2,171 0.16 722 UTTARAKHAND North India 2,159 3.84 17,785 CHATTISGARH Central India 2,077 4.59 22,115 CHANDIGARH Union Territories 1,390 3.15 22,676 PONDICHERRY Union Territories 1,027 1.78 17,307 States with <1000 Claims 1,512 0.02 177,359 Pin codes not Specified 14,52,707 4,707.01 32,402 Total 25,90,017 7,260.49 28,033 Insurance Information Bureau of India Page 24

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-10: Distribution of Claims by Claim Paid Band -2011-12 Claim Paid Band (in `) Number of Claims Share in Number of Claims Claim Paid Amount (` in Crs.) Share in Claim Paid Amount Less than 500 2,48,457 9.59% 4.53 0.05% 501-1000 75,102 2.90% 5.84 0.07% 1001-5000 3,89,578 15.03% 116.69 1.37% 5001-10000 3,98,741 15.38% 298.55 3.51% 10001-25000 7,39,643 28.54% 1,253.62 14.75% 25001-50000 4,37,678 16.89% 1,551.05 18.25% 50001-75000 1,17,657 4.54% 717.84 8.45% 75001-100000 61,557 2.38% 541.52 6.37% 100001-300000 1,02,134 3.94% 1,683.89 19.81% 300001-500000 13,227 0.51% 515.32 6.06% 500001-1000000 4,343 0.17% 304.66 3.58% 1000001-1500000 1,223 0.05% 148.65 1.75% 1500001-2000000 677 0.03% 118.31 1.39% Total below ` 2000000 25,90,017 99.93% 7,260.49 85.43% Above 2000000 1,764 0.07% 1,238.45 14.57% Total 25,91,781 100.00% 8,498.93 100.00% HR-11: Type of Policy-wise, Age Band and Gender-wise Number of Claims # - 2011-12 Type of Policy Gender Less than 1 Age - Band (in Years) 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Individual Female 1871 21,807 29,674 40,529 73,784 95,286 90,041 39,205 34,172 23,680 23,256 Group Male 3068 32,788 49,713 58,597 96,939 1,29,650 1,29,529 57,911 51,717 38,437 42,940 Male 96,019 32,114 22,656 35,648 84,578 49,691 48,132 26,571 25,711 18,415 16,406 Female 102 23,011 16,220 54,869 1,11,986 44,704 46,987 21,485 16,965 10,533 8310 Type of Cover, Age & Gender Not Provided Type of Cover, Age & Gender Not Specified 6,14,310 6,14,310 Total 6,91,289 4,73,305 4,55,941 3,55,172 Total 1,01,060 1,09,720 1,18,263 1,89,643 3,67,287 3,19,331 3,14,689 1,45,172 1,28,565 91,065 90,912 6,14,310 25,90,017 Insurance Information Bureau of India Page 25

Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-12.1: Disease-wise and Age Band-wise Frequency (%) of Claims Paid to Males- 2011-12 Disease Name Frequency of Claims Paid # (in %) by Disease and Age - Band (in Years) Total Frequency Disease wise ACCIDENT - 0.013 0.007 0.010 0.015 0.020 0.021 0.021 0.030 0.027 0.019 0.016 ARTHROPATHIES 0.001 0.032 0.033 0.043 0.079 0.095 0.097 0.123 0.157 0.203 0.222 0.078 BLOOD DISEASES - 0.024 0.009 0.006 0.008 0.011 0.016 0.021 0.037 0.046 0.049 0.013 CIRCULATORY 0.001 0.058 0.044 0.044 0.104 0.220 0.401 0.610 0.925 1.190 1.219 0.222 CLINICAL FINDINGS 0.009 0.758 0.307 0.252 0.330 0.221 0.268 0.377 0.507 0.631 0.762 0.330 CODES FOR SPECIAL PURPOSES - 0.0001-0.000 0.000 0.000 0.000 - - - - 0.000 DIGESTIVE 0.007 0.406 0.198 0.183 0.289 0.304 0.301 0.348 0.481 0.574 0.544 0.288 EAR - 0.022 0.016 0.018 0.028 0.028 0.024 0.025 0.034 0.040 0.029 0.024 ENDOCRINE 0.001 0.024 0.011 0.008 0.017 0.035 0.072 0.112 0.161 0.251 0.223 0.040 EYE - 0.056 0.044 0.030 0.041 0.078 0.253 0.626 1.212 1.676 1.543 0.180 HEALTH SERVICES RELATED 0.001 0.025 0.009 0.009 0.015 0.014 0.023 0.021 0.034 0.049 0.053 0.017 INFECTIOUS 0.041 0.915 0.704 0.519 0.522 0.509 0.421 0.359 0.398 0.450 0.388 0.534 INJURY 0.007 0.218 0.222 0.261 0.308 0.304 0.241 0.223 0.276 0.330 0.335 0.271 MALFORMATIONS/ DEFORMATIONS - 0.028 0.006 0.003 0.004 0.003 0.004 0.004 0.005 0.005 0.005 0.005 MENTAL DISORDERS - 0.009 0.025 0.010 0.014 0.004 0.004 0.005 0.007 0.007 0.011 0.010 NEOPLASM - 0.073 0.049 0.028 0.051 0.078 0.144 0.262 0.437 0.634 0.502 0.101 NERVOUS 0.001 0.063 0.039 0.020 0.028 0.031 0.039 0.059 0.099 0.132 0.181 0.039 RESPIRATORY 0.050 0.838 0.229 0.116 0.144 0.137 0.145 0.183 0.285 0.424 0.559 0.206 SKIN 0.005 0.047 0.031 0.038 0.047 0.053 0.059 0.071 0.100 0.099 0.102 0.050 UROLOGY 0.005 0.219 0.111 0.132 0.225 0.235 0.308 0.486 0.767 0.993 0.827 0.256 Diseases Not Specified 153.080 1.760 1.668 1.567 1.823 3.240 5.366 5.969 9.214 12.988 18.640 4.022 Total Frequency Age-Band wise 153.208 5.586 3.765 3.296 4.092 5.619 8.205 9.905 15.166 20.750 26.216 Total Frequency = 6.704 NB 1: International Statistical Classification of Diseases and Related Health Problems 10 th Revision (ICD-10) classified by World Health Organisation (WHO) used for grouping the diseases. The first level (3 digit) classification is considered for the above grouping. NB 2: Diseases Not Specified where ICD codes have not been provided as per ICD-10 Classification/ not filled in at all/ wrong codes. NB 3: Disease-wise & Age Band-wise frequency = {no. of claims for the disease and age-band Total no. of exposure in corresponding age-band}*100 Total frequency Age Band-wise= { no. of claims in age-band Total no. of exposure in corresponding age-band}*100 Total frequency Disease-wise= { no. of claims for the disease Total no. of exposure}*100 Total frequency = { Total no. of claims Total no. of exposure}*100 Inference: Following are the observations about the claim frequency of MALES across age-bands and diseases. The claim frequency for Males with age 'Less than 1 year' is unusually high and is also greater than 100% which could be due to incorrect information in 'age' or 'date of birth' data fields of claimants where possibly 0 is filled in. Therefore age 'Less than 1 year' is not considered for further analysis. Claims frequency increases consistently from age-band 26-35' (4.092%) till Above 70 Years (26.216%). Thus as the age of Male members increases the propensity to claim, out of hospitalization, also increases. Overall, Males' claim frequency (i.e. number of claims out of total members insured) is 6.704%. Insurance Information Bureau of India Page 26

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Considering only those claims where disease codes are available, the top six diseases with highest claim frequency for Males are INFECTIOUS (0.534%), CLINICAL FINDINGS (0.330%), DIGESTIVE (0.288%), INJURY (0.271%), UROLOGY(0.256%) and CIRCULATORY (0.222%). Within each of the above six diseases, the following top three age-bands of MALES have highest claim frequency: TOP SIX DISEASES HIGHEST CLAIM FREQUENCY & AGE BAND SECOND HIGHEST CLAIM FREQUENCY & AGE BAND THIRD HIGHEST CLAIM FREQUENCY & AGE BAND INFECTIOUS 1-5 years (0.915%) 6-15 years (0.704%) 25-36 years (0.522%) CLINICAL FINDINGS Above 70 years (0.762%) 1-5 years (0.758%) 61-65 years (0.507%) DIGESTIVE 66-70 years (0.574%) Above 70 years (0.544%) 61-65 years (0.481%) INJURY Above 70 years (0.335%) 66-70 years (0.33%) 26-35 years (0.308%) UROLOGY 66-70 years (0.993%) Above 70 years (0.827%) 61-65 years (0.767%) CIRCULATORY 66-70 years (1.91%) Above 70 years (1.219%) 61-65 years (0.925%) Insurance Information Bureau of India Page 27

Less than 1 1-5 6-15 16-25 26-35 36-45 46-55 56-60 61-65 66-70 Above 70 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-12.2: Disease-wise and Age Band-wise Frequency (%) of Claims Paid to Females - 2011-12 Disease Name Frequency of Claims Paid # (in %) by Disease and Age - Band (in Years) Total Frequency Disease wise ACCIDENT - 0.011 0.006 0.010 0.013 0.018 0.022 0.018 0.018 0.021 0.022 0.014 ARTHROPATHIES - 0.031 0.034 0.049 0.091 0.115 0.195 0.270 0.339 0.361 0.278 0.114 BLOOD DISEASES 0.002 0.020 0.015 0.017 0.020 0.023 0.025 0.029 0.031 0.041 0.048 0.022 CIRCULATORY - 0.053 0.047 0.063 0.097 0.156 0.322 0.478 0.657 0.819 0.917 0.180 CLINICAL FINDINGS 0.002 0.814 0.276 0.428 0.454 0.311 0.468 0.516 0.546 0.600 0.642 0.437 CODES FOR SPECIAL PURPOSES - - - - - - 0.0001 - - - - 0.0000 DIGESTIVE 0.005 0.371 0.188 0.293 0.418 0.357 0.390 0.440 0.460 0.475 0.389 0.354 EAR 0.002 0.019 0.017 0.028 0.046 0.042 0.049 0.049 0.043 0.031 0.024 0.037 ENDOCRINE - 0.023 0.015 0.021 0.037 0.053 0.100 0.134 0.192 0.210 0.175 0.056 EYE - 0.053 0.048 0.059 0.074 0.118 0.400 0.955 1.420 1.726 1.315 0.241 HEALTH SERVICES RELATED 0.002 0.024 0.010 0.064 0.087 0.024 0.032 0.037 0.043 0.052 0.089 0.046 INFECTIOUS 0.049 0.937 0.652 0.719 0.786 0.701 0.566 0.470 0.444 0.445 0.315 0.685 INJURY 0.009 0.197 0.124 0.141 0.184 0.197 0.237 0.292 0.320 0.392 0.434 0.196 MALFORMATIONS/DEF ORMATIONS - 0.026 0.006 0.006 0.009 0.007 0.009 0.005 0.008 0.005 0.006 0.009 MENTAL DISORDERS - 0.007 0.013 0.009 0.012 0.006 0.006 0.008 0.007 0.009 0.010 0.009 NEOPLASM - 0.072 0.050 0.067 0.150 0.308 0.460 0.548 0.597 0.584 0.453 0.233 NERVOUS 0.005 0.058 0.036 0.037 0.043 0.044 0.056 0.065 0.088 0.096 0.108 0.048 PERINATAL PERIOD CONDITIONS - 0.767 0.010 0.047 0.080 0.013 0.010 0.010 0.010 0.014 0.016 0.084 PREGNANCY - 0.155 0.074 1.357 1.946 0.166 0.088 0.097 0.098 0.130 0.089 0.726 RESPIRATORY 0.033 0.750 0.213 0.175 0.211 0.167 0.194 0.241 0.298 0.380 0.446 0.241 SKIN - 0.046 0.029 0.047 0.060 0.056 0.061 0.069 0.075 0.087 0.075 0.054 UROLOGY 0.004 0.155 0.103 0.268 0.439 0.506 0.560 0.586 0.777 0.803 0.538 0.404 Diseases Not Specified 3.493 1.619 1.404 1.701 1.769 3.206 4.515 6.095 8.842 11.898 15.712 3.094 Total Frequency Age-Band wise 3.606 6.208 3.372 5.608 7.027 6.595 8.766 11.411 15.313 19.180 22.101 NB 1: International Statistical Classification of Diseases and Related Health Problems 10 th Revision (ICD-10) classified by World Health Organisation (WHO) used for grouping the diseases. The first level (3 digit) classification is considered for the above grouping. NB 2: Diseases Not Specified where ICD codes have not been provided as per ICD-10 Classification/ not filled in at all/ wrong codes. NB 3: Disease-wise & Age Band-wise frequency = {no. of claims for the disease and age-band Total no. of exposure in corresponding age-band}*100 Total frequency Age Band-wise= { no. of claims in age-band Total no. of exposure in corresponding age-band}*100 Total frequency Disease-wise= { no. of claims for the disease Total no. of exposure}*100 Total frequency = { Total no. of claims Total no. of exposure}*100 Inference: Following are the observations about the claim frequency of FEMALES across age-bands and diseases. Claims frequency increases consistently from age-band '6-15 years' (4%) till Above 70 Years (22%) with a slight dip in claim frequency in the age-band '36-45 years'. Thus as the age of Female members increases the propensity to claim, out of hospitalization, also increases. Overall, Females' claim frequency (i.e. number of claims out of total members insured) is 7.284% which is higher than that of Males. In the age-bands '1-5 years' and '16 to 65 years' Females' claim frequency is more than that of Males. The Claim frequency of Females exceeds that of Males for all diseases except INJURY, CIRCULATORY, ACCIDENT and MENTAL DISORDERS. Total Frequency = 7.284 Insurance Information Bureau of India Page 28

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Considering only those claims where disease codes are available, the top six diseases with highest claim frequency for Females are PREGNANCY (0.726%), INFECTIOUS (0.685%), CLINICAL FINDINGS (0.437%), UROLOGY(0.404%), DIGESTIVE (0.354%) and EYE (0.241%). The Females' claim frequency for diagnosis type PREGNANCY and PERINATAL PERIOD CONDITIONS is observed to have non-zero values for age greater than 55 and also for age less than 16. Thus it could be due to incorrect information in age or date of birth or diagnosis codes of claimants. Within each of the above six diseases, the following top three age-bands of FEMALES have highest claim frequency: TOP SIX HIGHEST CLAIM SECOND HIGHEST CLAIM THIRD HIGHEST CLAIM DISEASES FREQUENCY & AGE BAND FREQUENCY & AGE BAND FREQUENCY & AGE BAND PREGNANCY 26-35 years (1.946 %) 16-25 years (1.357 %) 36-45 years (0.166 %) INFECTIOUS Above 1-5 years (0.937%) 26-35 years (0.786%) 16-25 years (0.719%) CLINICAL FINDINGS 1-5 years (0.814%) Above 70 years (0.642%) 61-65 years (0.546%) UROLOGY 66-70 years (0.803 %) 61-65 years (0.777%) 56-60 years (0.586%) DIGESTIVE 66-70 years (0.475%) 61-65 years (0.46%) 26-35 years (0.418%) EYE 66-70 years (1.726%) 61-65 years (1.42%) Above 70 years (1.315%) Insurance Information Bureau of India Page 29

Less Than 500 501-1000 1001-5000 5001-10,000 10,001-25,000 25,001-50,000 50,001-75,000 75,001-1,00,000 1,00,001-3,00,000 3,00,001-5,00,000 5,00,001-10,00,000 10,00,001-15,00,000 15,00,001-20,00,000 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR- 13.1: Disease-wise and Claims Paid Band(` in Crs) -wise Distribution of Number of Claims Paid - 2011-12 Number of Claims Paid # (` in Crs.) by Disease and Claim Paid Band Total Disease Name ACCIDENT 702 160 1453 555 835 373 146 121 148 5 2 4500 ARTHROPATHIES 3908 587 3371 3679 6439 3651 1676 1473 2992 346 19 28141 BLOOD DISEASES 563 115 878 855 1313 662 217 138 167 18 3 4929 CIRCULATORY 7795 862 6007 7184 16305 10006 3507 2856 7912 826 89 11 4 63364 CLINICAL FINDINGS 28638 10491 27414 16603 18083 6454 1343 610 908 106 97 1 110748 CODES FOR SPECIAL PURPOSES 1 2 2 1 1 7 DIGESTIVE 10709 1645 14851 15771 25145 17393 5721 2292 2240 98 17 1 1 95884 EAR 1290 179 1179 1144 2426 1911 490 127 83 14 8 1 8852 ENDOCRINE 1916 402 2424 2410 3442 2112 711 327 459 36 3 1 14243 EYE 7770 665 6332 6118 28868 11939 1070 316 219 13 3 63313 HEALTH SERVICES 1652 947 2293 1256 1585 1170 84 61 269 6 2 9325 RELATED INFECTIOUS 51331 3111 27396 35351 45857 13930 2666 1120 1266 89 16 2 1 182136 INJURY 7617 1355 10007 10748 17029 13051 5979 3462 3641 141 24 3 1 73058 MALFORMATIONS/ DEFORMATIONS 313 29 176 223 401 350 147 108 239 17 2003 MENTAL DISORDERS 536 507 1038 278 285 113 21 18 27 11 23 5 2 2864 NEOPLASM 6187 706 4055 5145 12258 9467 3584 2277 3286 185 26 6 47182 NERVOUS 1418 381 1890 2083 3723 2026 661 404 610 68 11 1 13276 PERINATAL PERIOD CONDITIONS 689 154 2092 2830 3118 1095 345 198 314 20 6 3 1 10865 PREGNANCY 6632 807 7707 10162 30216 33424 1534 289 214 15 10 3 4 91017 RESPIRATORY 8335 1346 14237 15784 19649 8323 2213 895 1052 56 11 2 71903 SKIN 2108 405 2680 2868 4698 2171 501 230 224 13 2 15900 UROLOGY 10808 7156 14939 14508 25485 15404 4987 2126 1908 88 8 1 97418 Disease Not 87540 43092 237158 243184 472483 282651 80054 42108 73955 11056 3963 1185 660 1579089 Specified Total 248457 75102 389578 398741 739643 437678 117657 61557 102134 13227 4343 1223 677 2590017 NB 1: International Statistical Classification of Diseases and Related Health Problems 10 th Revision (ICD-10) classified by World Health Organisation (WHO) used for grouping the diseases. The first level (3 digit) classification is considered for the above grouping. NB 2: Diseases Not Specified where ICD codes have not been provided as per ICD-10 Classification/ not filled in at all/ wrong codes. Insurance Information Bureau of India Page 30

Less Than 500 501-1000 1001-5000 5001-10,000 10,001-25,000 25,001-50,000 50,001-75,000 75,001-1,00,000 1,00,001-3,00,000 3,00,001-5,00,000 5,00,001-10,00,000 10,00,001-15,00,000 15,00,001-20,00,000 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR- 13.2: Disease-wise and Claims Paid Band(` in Crs) -wise Proportion of Number of Claims Paid (in %) - 2011-12 Disease Name Proportion of Number of Claims Paid # (in %) by Disease and Claim Paid Band (in `) Total ACCIDENT 0.03 0.01 0.06 0.02 0.03 0.01 0.01 0.00 0.01 0.00 0.00 - - 0.17 ARTHROPATHIES 0.15 0.02 0.13 0.14 0.25 0.14 0.06 0.06 0.12 0.01 0.00 - - 1.09 BLOOD DISEASES 0.02 0.00 0.03 0.03 0.05 0.03 0.01 0.01 0.01 0.00 0.00 - - 0.19 CIRCULATORY 0.30 0.03 0.23 0.28 0.63 0.39 0.14 0.11 0.31 0.03 0.00 0.00 0.00 2.45 CLINICAL FINDINGS 1.11 0.41 1.06 0.64 0.70 0.25 0.05 0.02 0.04 0.00 0.00-0.00 4.28 CODES FOR SPECIAL - - 0.00 0.00-0.00-0.00 0.00 - - - - 0.00 PURPOSES DIGESTIVE 0.41 0.06 0.57 0.61 0.97 0.67 0.22 0.09 0.09 0.00 0.00 0.00 0.00 3.70 EAR 0.05 0.01 0.05 0.04 0.09 0.07 0.02 0.00 0.00 0.00 0.00 0.00-0.34 ENDOCRINE 0.07 0.02 0.09 0.09 0.13 0.08 0.03 0.01 0.02 0.00 0.00 0.00-0.55 EYE 0.30 0.03 0.24 0.24 1.11 0.46 0.04 0.01 0.01 0.00 0.00 - - 2.44 HEALTH SERVICES RELATED 0.06 0.04 0.09 0.05 0.06 0.05 0.00 0.00 0.01 0.00 0.00 - - 0.36 INFECTIOUS 1.98 0.12 1.06 1.36 1.77 0.54 0.10 0.04 0.05 0.00 0.00 0.00 0.00 7.03 INJURY 0.29 0.05 0.39 0.41 0.66 0.50 0.23 0.13 0.14 0.01 0.00 0.00 0.00 2.82 MALFORMATIONS/ 0.01 0.00 0.01 0.01 0.02 0.01 0.01 0.00 0.01 0.00 - - - 0.08 DEFORMATIONS MENTAL DISORDERS 0.02 0.02 0.04 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.11 NEOPLASM 0.24 0.03 0.16 0.20 0.47 0.37 0.14 0.09 0.13 0.01 0.00 0.00-1.82 NERVOUS 0.05 0.01 0.07 0.08 0.14 0.08 0.03 0.02 0.02 0.00 0.00-0.00 0.51 PERINATAL PERIOD CONDITIONS 0.03 0.01 0.08 0.11 0.12 0.04 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.42 PREGNANCY 0.26 0.03 0.30 0.39 1.17 1.29 0.06 0.01 0.01 0.00 0.00 0.00 0.00 3.51 RESPIRATORY 0.32 0.05 0.55 0.61 0.76 0.32 0.09 0.03 0.04 0.00 0.00 0.00-2.78 SKIN 0.08 0.02 0.10 0.11 0.18 0.08 0.02 0.01 0.01 0.00 0.00 - - 0.61 UROLOGY 0.42 0.28 0.58 0.56 0.98 0.59 0.19 0.08 0.07 0.00 0.00-0.00 3.76 Disease Not Specified 3.38 1.66 9.16 9.39 18.24 10.91 3.09 1.63 2.86 0.43 0.15 0.05 0.03 60.97 Total 9.59 2.90 15.04 15.40 28.56 16.90 4.54 2.38 3.94 0.51 0.17 0.05 0.03 100.00 Proportion of Number of Claims Paid across Disease type and Claim Paid Band = No. of Claims (for each type of disease in each Claim paid band) divided by Total Number of Claims (for all diseases). Inference: Following are the observations about the claim proportions: The claim-paid bands ' `10001 - `25000 ', ' `25001 -` 50000 ', ' `5001 - `10000 ', ' `1001 - `5000 ', ' `1 - `500 ' and ' ` 50001-`75000 ' (containing highest proportion of claims paid, in that order) account for 90% of total number of claims paid. Thus, maximum number of claims paid are of amount below ` 75,000. Insurance Information Bureau of India Page 31

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Within each of the above six claim-paid bands, the following top three diseases account for highest proportion of claims: TOP SIX CLAIM-PAID BANDS HIGHEST CLAIM PROPORTION & DISEASE SECOND HIGHEST CLAIM PROPORTION & DISEASE THIRD HIGHEST CLAIM PROPORTION & DISEASE `10001 - `25000 INFECTIOUS PREGNANCY EYE (1.77 %) (1.17 %) (1.11 %) `25001 -` 50000 PREGNANCY DIGESTIVE UROLOGY (1.29 %) (0.67 %) (0.59 %) `5001 - `10000 INFECTIOUS CLINICAL FINDINGS DIGESTIVE (1.36 %) (0.64 %) (0.61 %) `1001 - `5000 INFECTIOUS CLINICAL FINDINGS UROLOGY (1.06 %) (1.06 %) (0.58 %) `1 - `500 INFECTIOUS CLINICAL FINDINGS UROLOGY (1.98%) (1.11%) (0.42%) ` 50001-`75000 INJURY DIGESTIVE UROLOGY (0.23%) (0.22%) (0.19%) Within each of the top six diseases having maximum proportion number of claims paid, the following top three claim-paid bands account for highest proportion of claims: DISEASES INFECTIOUS CLINICAL FINDINGS UROLOGY DIGESTIVE PREGNANCY INJURY HIGHEST PROPORTION &CLAIM BAND Less Than `500 (1.98%) Less Than `500 (1.11%) `10001 - `25000 (0.98%) `10001 - `25000 (0.97%) `25001 - `50000 (1.29%) `10001 - `25000 (0.66%) SECOND HIGHEST PROPORTION THIRD HIGHEST PROPORTION &CLAIM BAND &CLAIM BAND `10001 - `25000 `5001 - `10000 (1.77%) (1.36%) `1001 - `5000 `10001 - `25000 (1.06%) (0.7%) `25001 - `50000 `1001 - `5000 (0.59%) (0.58%) `25001 - `50000 `5001 - `10000 (0.67%) (0.61%) `10001 - `25000 `5001 - `10000 (1.17%) (0.39%) `25001 - `50000 `5001 - `10000 (0.5%) (0.41%) Insurance Information Bureau of India Page 32

Less Than 500 501-1000 1001-5000 5001-10,000 10,001-25,000 25,001-50,000 50,001-75,000 75,001-1,00,000 1,00,001-3,00,000 3,00,001-5,00,000 5,00,001-10,00,000 10,00,001-15,00,000 15,00,001-20,00,000 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR- 13.3: Disease-wise and Claims Paid Band(` in Crs) -wise Distribution of Amount of Claims Paid - 2011-12 Disease Name Amount of Claims Paid # (` in Crs.) by Disease and Claim Paid Band Total ACCIDENT 0.01 0.01 0.37 0.41 1.40 1.36 0.89 1.07 2.50 0.18 0.14 - - 8.36 ARTHROPATHIES 0.06 0.04 1.01 2.77 10.65 13.10 10.39 13.23 51.18 12.91 1.11 - - 116.45 BLOOD DISEASES 0.01 0.01 0.26 0.64 2.12 2.32 1.32 1.19 2.62 0.69 0.19 - - 11.37 CIRCULATORY 0.11 0.07 1.81 5.45 27.28 35.48 21.49 25.68 142.25 30.88 5.70 1.26 0.77 298.22 CLINICAL FINDINGS 0.64 0.77 7.20 12.10 28.46 22.23 8.13 5.35 14.85 4.18 7.17-0.15 111.23 CODES FOR SPECIAL PURPOSES - - 0.00 0.00-0.01-0.01 0.02 - - - - 0.04 DIGESTIVE 0.15 0.13 4.56 11.74 41.75 61.62 34.64 19.93 33.49 3.71 1.22 0.11 0.15 213.20 EAR 0.02 0.01 0.35 0.85 4.14 6.72 2.91 1.09 1.29 0.61 0.55 0.14-18.68 ENDOCRINE 0.03 0.03 0.71 1.77 5.65 7.46 4.34 2.87 7.31 1.38 0.16 0.12-31.82 EYE 0.10 0.05 2.32 4.86 54.09 38.96 6.40 2.74 3.34 0.52 0.22 - - 113.61 HEALTH SERVICES RELATED 0.04 0.07 0.58 0.94 2.78 4.19 0.51 0.53 6.66 0.21 0.13 - - 16.65 INFECTIOUS 0.82 0.24 8.84 26.31 72.40 47.10 16.10 9.75 20.12 3.40 1.08 0.28 0.17 206.61 INJURY 0.11 0.11 3.07 8.01 28.30 47.29 36.78 30.42 54.56 5.33 1.60 0.37 0.17 216.11 MALFORMATIONS/D 0.00 0.00 0.05 EFORMATIONS 0.16 0.70 1.30 0.92 0.97 4.09 0.61 - - - 8.81 MENTAL DISORDERS 0.01 0.04 0.23 0.20 0.45 0.38 0.13 0.16 0.52 0.46 1.61 0.61 0.35 5.17 NEOPLASM 0.09 0.05 1.23 3.90 20.92 33.96 21.90 20.06 51.24 7.01 1.87 0.86-163.09 NERVOUS 0.02 0.03 0.54 1.57 6.18 7.12 4.03 3.57 10.03 2.65 0.84-0.20 36.80 PERINATAL PERIOD CONDITIONS 0.01 0.01 0.69 2.08 4.87 3.84 2.10 1.75 4.92 0.73 0.40 0.41 0.18 21.99 PREGNANCY 0.09 0.06 2.51 7.68 53.80 122.87 9.39 2.53 3.40 0.57 0.71 0.37 0.66 204.63 RESPIRATORY 0.12 0.11 4.44 11.65 31.49 28.86 13.46 7.82 16.60 2.22 0.77 0.22-117.75 SKIN 0.03 0.03 0.79 2.13 7.66 7.50 3.01 2.00 3.50 0.48 0.11 - - 27.26 UROLOGY 0.15 0.61 4.25 10.88 42.01 54.76 30.30 18.41 27.82 3.41 0.52-0.18 193.29 Disease Not Specified 1.91 3.33 70.87 182.44 806.51 1,002.62 488.73 370.39 1,221.59 433.18 278.57 143.90 115.32 5,119.36 Total 4.53 5.84 116.69 298.55 1253.62 1,551.05 717.84 541.52 1,683.89 515.32 304.66 148.65 118.31 7,260.49 Insurance Information Bureau of India Page 33

Less Than 500 501-1000 1001-5000 5001-10,000 10,001-25,000 25,001-50,000 50,001-75,000 75,001-1,00,000 1,00,001-3,00,000 3,00,001-5,00,000 5,00,001-10,00,000 10,00,001-15,00,000 15,00,001-20,00,000 Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR- 13.4: Disease-wise and Claims Paid Band(in `) -wise Proportion (in %) of Amount of Claims Paid - 2011-12 Disease Name Proportion (in %) of Amount of Claims Paid # by Diseases and Claim Paid Bands(in `) Total ACCIDENT 0.00 0.00 0.01 0.01 0.02 0.02 0.01 0.01 0.03 0.00 0.00 - - 0.12 ARTHROPATHIES 0.00 0.00 0.01 0.04 0.15 0.18 0.14 0.18 0.70 0.18 0.02 - - 1.60 BLOOD DISEASES 0.00 0.00 0.00 0.01 0.03 0.03 0.02 0.02 0.04 0.01 0.00 - - 0.16 CIRCULATORY 0.00 0.00 0.02 0.08 0.38 0.49 0.30 0.35 1.96 0.43 0.08 0.02 0.01 4.11 CLINICAL FINDINGS 0.01 0.01 0.10 0.17 0.39 0.31 0.11 0.07 0.20 0.06 0.10-0.00 1.53 CODES FOR SPECIAL PURPOSES - - 0.00 0.00-0.00-0.00 0.00 - - - - 0.00 DIGESTIVE 0.00 0.00 0.06 0.16 0.58 0.85 0.48 0.27 0.46 0.05 0.02 0.00 0.00 2.94 EAR 0.00 0.00 0.00 0.01 0.06 0.09 0.04 0.01 0.02 0.01 0.01 0.00-0.26 ENDOCRINE 0.00 0.00 0.01 0.02 0.08 0.10 0.06 0.04 0.10 0.02 0.00 0.00-0.44 EYE 0.00 0.00 0.03 0.07 0.75 0.54 0.09 0.04 0.05 0.01 0.00 - - 1.56 HEALTH SERVICES RELATED 0.00 0.00 0.01 0.01 0.04 0.06 0.01 0.01 0.09 0.00 0.00 - - 0.23 INFECTIOUS 0.01 0.00 0.12 0.36 1.00 0.65 0.22 0.13 0.28 0.05 0.01 0.00 0.00 2.85 INJURY 0.00 0.00 0.04 0.11 0.39 0.65 0.51 0.42 0.75 0.07 0.02 0.01 0.00 2.98 MALFORMATIONS/ DEFORMATIONS 0.00 0.00 0.00 0.00 0.01 0.02 0.01 0.01 0.06 0.01 - - - 0.12 MENTAL DISORDERS 0.00 0.00 0.00 0.00 0.01 0.01 0.00 0.00 0.01 0.01 0.02 0.01 0.00 0.07 NEOPLASM 0.00 0.00 0.02 0.05 0.29 0.47 0.30 0.28 0.71 0.10 0.03 0.01-2.25 NERVOUS 0.00 0.00 0.01 0.02 0.09 0.10 0.06 0.05 0.14 0.04 0.01-0.00 0.51 PERINATAL PERIOD CONDITIONS 0.00 0.00 0.01 0.03 0.07 0.05 0.03 0.02 0.07 0.01 0.01 0.01 0.00 0.30 PREGNANCY 0.00 0.00 0.03 0.11 0.74 1.69 0.13 0.03 0.05 0.01 0.01 0.01 0.01 2.82 RESPIRATORY 0.00 0.00 0.06 0.16 0.43 0.40 0.19 0.11 0.23 0.03 0.01 0.00-1.62 SKIN 0.00 0.00 0.01 0.03 0.11 0.10 0.04 0.03 0.05 0.01 0.00 - - 0.38 UROLOGY 0.00 0.01 0.06 0.15 0.58 0.75 0.42 0.25 0.38 0.05 0.01-0.00 2.66 Disease Not Specified 0.03 0.05 0.98 2.51 11.11 13.81 6.73 5.10 16.83 5.97 3.84 1.98 1.59 70.51 Total 0.06 0.08 1.61 4.11 17.27 21.36 9.89 7.46 23.19 7.10 4.20 2.05 1.63 100.00 Proportion of Amount of Claims Paid across Disease type and Claim Paid Band = Amount of Claims Paid (for each type of disease in each Claim paid band) divided by Total Amount of Claims (for all diseases). Inference: The total claims dataset having valid diagnosis codes (ICD-10) account for only 29.5% of total amount of claims paid. Following are the observations about the Proportion of Amount of Claims Paid calculated according to following formula: Maximum proportion of claim paid from claim paid bands `100001 - `300000 (23.19%), `25001 - `50000 (21.36%), `10001 - `25000 (21.36%), `50001 - `75000 (9.89%) and `75001 - `100000 (7.46%), in that order. Thus 79% of total amount of claims paid belong to range `10,000-`3,00,000. The top six highest proportion of amount of claims paid are from disease group CIRCULATORY, INJURY, DIGESTIVE, INFECTIOUS, PREGNANCY, UROLOGY, in that order. These diseases account for 62% of total amounts of claims paid (where total claim paid amount is considered after ignoring the missing/incorrect diagnosis codes). Insurance Information Bureau of India Page 34

Less than 1 1 days 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 to 15 days 16 to 20 days 21 to 25 days 26 to 30 days 31 to 35 days 36 to 40 days 41 to 50 days 51 to 60 days 61 to 70 days 71 to 80 days 81 to 90 days More than 90 days Length of ay Not specified Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-14.1: Disease-wise and Days of Hospitalization-wise Proportion (in %) of Number of Claims Paid Disease Name Number of Claims # for duration of Hospitalization Total ACCIDENT 1175 445 506 437 334 343 220 181 103 72 82 252 57 41 58 39 10 10 16 22 2 9 53 4467 ARTHROPATHIES 6008 2677 2853 3604 2460 2013 1537 1495 820 648 484 1334 387 186 153 170 68 48 45 145 25 144 820 28124 BLOOD DISEASES 946 548 661 735 468 402 252 194 113 86 51 166 38 27 28 28 11 12 12 25 4 15 107 4929 CIRCULATORY 12661 7326 8259 9556 5485 4084 2609 2136 1553 1370 941 2420 778 352 359 364 110 126 109 358 29 369 2002 63356 CLINICAL FIINGS 54843 9173 11557 10807 7425 4697 2745 1642 876 614 456 1055 417 248 378 436 134 179 195 494 92 248 2003 110714 CODES FOR SPECIAL 1 2 1 1 1 1 7 PURPOSES DIGEIVE 18210 11883 17928 16807 9375 5879 3464 2354 1596 1109 708 1655 456 217 352 429 87 102 147 524 32 395 2151 95860 EAR 1847 2528 1956 1001 450 264 120 80 55 34 33 46 13 8 55 78 3 4 19 71 3 31 153 8852 EOCRINE 3245 1065 1642 2027 1283 1101 654 510 309 287 208 506 178 78 120 101 43 49 53 90 17 59 616 14241 EYE 35698 16517 2601 3661 663 471 226 215 127 72 69 177 70 36 306 396 20 24 41 118 1 329 1472 63310 HEALTH SERVICES 4200 594 804 1161 634 397 241 213 128 87 58 129 53 56 74 61 18 23 24 33 7 65 265 9325 RELATED INFECTIOUS 59426 8602 22632 28585 20142 14508 8355 5044 2454 1564 1023 1773 431 170 324 726 146 66 220 1108 21 683 4113 182116 INJURY 12824 11882 11102 9812 6106 4442 2944 2223 1510 1106 986 2718 861 406 518 576 137 119 158 491 32 297 1595 72845 MALFORMATI/ DFORMATION 477 268 271 230 137 76 76 70 54 65 29 109 33 21 16 18 3 5 4 11 1 4 23 2001 MENTAL DISORDERS 1932 137 173 114 72 46 54 32 32 16 22 58 43 30 21 12 7 11 10 7 4 6 25 2864 NEOPLASM 15983 6760 4330 5035 2872 2192 1406 1194 798 622 506 1509 579 354 342 376 183 298 176 212 36 217 1198 47178 NERVOUS 2835 1503 1953 1858 1004 732 569 406 300 270 200 568 187 86 85 109 35 26 28 66 7 61 383 13271 PERINATAL PERIOD CONDITIONS 1083 786 1837 2234 1347 822 500 376 274 184 144 361 198 119 73 70 39 45 31 32 12 56 242 10865 PREGNANCY 11644 7528 11555 18147 13770 9375 5860 4277 2228 1279 721 973 253 114 165 257 57 29 68 145 11 484 2077 91017 RESPIRATORY 12563 6788 12150 12672 8427 5901 3304 2112 1166 835 561 1184 404 144 270 408 80 65 130 552 26 308 1844 71894 SKIN 3353 3081 2074 1987 1190 927 578 475 312 228 164 417 133 78 126 114 24 25 42 99 7 83 380 15897 UROLOGY 26925 13855 11526 13134 7689 4991 2992 2331 1359 1034 820 2260 728 857 1901 790 163 196 256 490 56 526 2526 97405 Disease Not 305980 50939 47243 321047 29090 28778 11869 10715 4676 3056 3578 9274 1491 1094 16162 28686 2761 2316 6616 30678 1832 44064 241612 1203557 Specified Length of ay Not Specified 375922 375922 Total 593858 164885 175614 464651 120425 92442 50575 38275 20843 14639 11844 28944 7789 4722 21886 34244 4139 3779 8400 35771 2257 48453 265660 375922 2590017# Percentage 22.93 6.37 6.78 17.94 4.65 3.57 1.95 1.48 0.80 0.57 0.46 1.12 0.30 0.18 0.85 1.32 0.16 0.15 0.32 1.38 0.09 1.87 10.26 14.51 100 Cumulative % 22.93 29.29 36.08 54.02 58.66 62.23 64.19 65.66 66.47 67.03 67.49 68.61 68.91 69.09 69.94 71.26 71.42 71.57 71.89 73.27 73.36 75.23 85.49 100 Insurance Information Bureau of India Page 35

Le ss than 1 day 1 day 2 days 3 days 4 days 5 days 6 days 7 days 8 days 9 days 10 days 11 to 15 days 16 to 20 days 21 to 25 days 26 to 30 days 31 to 35 days 36 to 40 days 41 to 50 days 51 to 60 days 61 to 70 days 71 to 80 days 81 to 90 days More than 90 days Length of day Not specified Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-14.2: Disease-wise and Days of Hospitalization-wise Proportion (in %) of Amount of Claims Paid (in ` cr) Disease Name Amount of Claims Paid # (in `) for duration of Hospitalization Total ACCIDENT 0.55 0.54 0.83 0.91 0.62 0.73 0.49 0.62 0.29 0.28 0.29 1.01 0.36 0.21 0.08 0.10 0.06 0.03 0.06 0.10 0.01 0.02 0.15 8.34 ARTHROPATHIES 6.89 6.71 7.08 15.17 10.50 10.79 10.03 11.94 6.36 5.20 3.90 9.74 2.77 1.36 0.78 0.56 0.36 0.28 0.16 0.52 0.09 0.72 4.55 116.43 BLOOD DISEASES 0.87 0.75 0.90 1.60 1.03 1.06 0.75 0.55 0.47 0.30 0.31 1.14 0.40 0.22 0.30 0.12 0.06 0.07 0.11 0.05 0.02 0.04 0.26 11.37 CIRCULATORY 23.62 19.74 34.68 53.03 27.87 20.59 14.00 12.91 12.61 11.89 8.69 23.20 8.50 3.70 2.95 1.90 0.84 1.03 0.70 1.56 0.27 2.39 11.55 298.21 CLINICAL FIINGS 25.85 10.13 12.93 15.13 11.64 8.58 5.65 4.00 2.39 1.90 1.48 3.89 1.42 0.61 1.07 0.53 0.31 0.21 0.19 0.54 0.07 0.29 2.36 111.19 CODES FOR SPECIAL - - 0.00-0.00 0.00 - - - 0.01 - - 0.00 - - - - 0.02 - - - - - 0.04 PURPOSES DIGEIVE 15.08 20.87 34.59 41.26 23.35 16.16 10.55 8.64 6.15 5.10 3.49 9.46 3.57 1.72 1.78 1.11 0.31 0.36 0.42 1.26 0.15 1.03 6.77 213.19 EAR 1.17 5.74 4.96 2.29 1.04 0.81 0.41 0.21 0.28 0.11 0.19 0.25 0.03 0.04 0.23 0.17 0.00 0.01 0.12 0.17 0.00 0.07 0.37 18.68 EOCRINE 2.54 1.63 2.79 4.91 3.05 2.92 1.93 1.77 1.02 1.26 0.93 2.53 1.16 0.53 0.79 0.26 0.11 0.13 0.07 0.14 0.03 0.16 1.16 31.81 EYE 58.53 30.53 4.15 7.88 1.61 1.13 0.67 0.66 0.46 0.27 0.25 0.64 0.33 0.11 0.88 0.78 0.07 0.06 0.06 0.27 0.00 0.81 3.47 113.61 HEALTH SERVICES 7.32 0.69 0.99 2.18 1.26 0.74 0.48 0.44 0.33 0.27 0.14 0.40 0.16 0.04 0.12 0.11 0.02 0.06 0.08 0.05 0.00 0.14 0.62 16.65 RELATED INFECTIOUS 13.48 7.85 21.99 36.03 30.40 25.93 17.52 12.00 7.01 5.04 3.65 8.49 3.21 1.36 1.18 1.18 0.70 0.41 0.29 1.11 0.06 1.12 6.58 206.58 INJURY 15.49 19.28 25.42 31.64 21.88 16.95 12.89 10.02 7.53 5.83 5.28 16.19 6.51 3.53 2.80 2.31 1.27 1.44 0.74 1.35 0.21 1.14 6.29 215.99 MALFORMATION/ DEFORMATION 0.54 0.65 1.13 0.96 0.52 0.35 0.37 0.53 0.49 0.55 0.29 1.12 0.34 0.35 0.12 0.21 0.07 0.06 0.01 0.03 0.00 0.04 0.08 8.81 MENTAL DISORDERS 3.69 0.11 0.24 0.17 0.14 0.10 0.10 0.06 0.08 0.03 0.09 0.13 0.07 0.04 0.03 0.00 0.01 0.02 0.01 0.01 0.01 0.00 0.03 5.17 NEOPLASM 28.42 18.00 13.51 19.65 11.91 9.33 6.86 6.27 4.72 4.27 3.49 11.75 5.02 2.70 2.42 1.84 1.63 2.50 1.39 0.78 0.25 0.92 5.40 163.04 NERVOUS 3.51 2.43 3.29 4.83 2.67 2.38 2.06 1.66 1.40 1.33 1.01 3.77 1.72 1.03 0.38 0.54 0.35 0.12 0.17 0.21 0.13 0.36 1.44 36.79 PERINATAL PERIOD CONDITIONS 0.75 0.61 1.66 2.82 1.68 1.35 1.01 0.94 0.79 0.65 0.55 1.94 1.31 1.02 0.80 0.56 0.38 0.67 0.53 0.29 0.22 0.11 1.36 21.99 PREGNANCY 9.84 9.60 22.18 46.41 38.25 26.40 15.67 10.91 5.61 3.29 1.80 2.96 0.78 0.35 1.92 0.64 0.20 0.14 0.17 0.33 0.10 1.24 5.83 204.63 RESPIRATORY 7.89 11.39 15.81 18.98 12.56 9.80 7.13 5.60 3.84 3.31 2.33 6.24 3.52 1.10 1.30 0.95 0.43 0.29 0.18 0.68 0.13 0.59 3.69 117.74 SKIN 2.09 4.21 3.27 4.00 2.22 1.87 1.29 1.34 0.93 0.71 0.58 1.60 0.70 0.38 0.31 0.21 0.16 0.12 0.06 0.17 0.00 0.22 0.81 27.26 UROLOGY 17.71 25.41 24.02 31.21 19.07 14.04 9.52 7.16 5.11 4.22 3.40 8.58 3.29 2.44 4.61 1.97 0.53 0.71 0.78 1.09 0.20 1.42 6.77 193.27 Disease Not Specified 871.63101.36 101.02 800.45 80.13 91.72 43.00 49.94 22.54 16.41 24.95 187.74 11.32 7.02 36.74 64.77 13.95 40.49 15.96 76.7737.84 94.85 750.83 3,541.41 Length of ay Not Specified 1578.28 1578.28 Total 1117.46 298.23 337.44 1141.51 303.42 263.73 162.39 148.16 90.41 72.23 67.09 302.79 56.46 29.86 61.59 80.81 21.81 49.22 22.27 87.48 39.78 107.70 820.38 1578.28 7260.49# Percentage 15.39 4.11 4.65 15.72 4.18 3.63 2.24 2.04 1.25 0.99 0.92 4.17 0.78 0.41 0.85 1.11 0.30 0.68 0.31 1.20 0.55 1.48 11.30 21.74 100 15.39 19.50 24.15 39.87 44.05 47.68 49.92 51.96 53.20 54.20 55.12 59.29 60.07 60.48 61.33 62.44 62.74 63.42 63.73 64.93 65.48 66.96 78.26 100 Cumulative % Inference: o 15% in number accounting for 22% in claim paid amount did not have hospital stay info. o Lengths of stay 'Less than 1 day' and '3 days' had considerable chunks both in number and paid amounts of claims. o 23% in number accounting for 15% in claim paid amount were paid for hospital stay 'Less than 1' day. o 18% in number accounting for 16% in claim paid amount were paid for hospital stay '3 days'. o 54% in number accounting for 40% in claim paid amount were paid for hospital stay '0-3' days. o 67% in number accounting for 55% in claim paid amount were paid for hospital stay '0-10' days. o 18% in number accounting for 23% in claim paid amount were paid for hospital stay beyond 10 days. Insurance Information Bureau of India Page 36

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-15: Claims Settlement - TPAs Vs Insurer's In-house - 2011-12 Claims Settled by No of Claims # Claim Paid # (` in crs.) Average Claim Paid # (in `) TPA 12,04,173 3,052.03 25,345 In-house 13,85,844 4,208.46 30,368 Total 25,90,017 7,260.49 28,033 HR-16: Product Type-wise Policy and Claim Summary - 2011-12 Product Type Number of Policies Number of Claims # Policy Premium (` in crs.) Claim Paid Amount # (` in crs.) Hospitalisation- Indemnity Policy 70,50,389 22,03,982 9,505.83 6,506.33 Hospital Cash Plan 5,81,997 49,866 389.07 116.44 Critical Illness Cover - Indemnity 439 7 0.18 0.03 Critical Illness Cover - Benefits 80,198 251 20.00 5.55 Declaration Policy 690-1.70 Package Policy 1,07,344 3,16,470 677.32 591.43 Hybrid Policy 1,83,392 5,892 306.81 21.44 Any Other Product 2,20,663 13,549 41.31 19.27 Total 82,25,112 25,90,017 10,942.21 7,260.49 HR-17 : Product Type-wise Averages and Shares of Policy and Claim - 2011-12 Product Type Average Policy Claims # Average Premium (in `) Average Claim Paid # (in `) Share in Numbers (in %) Share in Premium (in %) Share in Numbers (in %) Share in Claim Paid (in %) Hospitalization Indemnity Policy 13,483 29,521 85.72% 86.87% 85.10% 89.61% Hospital Cash Plan 6,685 23,350 7.08% 3.56% 1.93% 1.60% Critical Illness Cover - Indemnity 4,112 44,369 0.01% 0.00% 0.00% 0.00% Critical Illness Cover - Benefits 2,493 2,21,255 0.98% 0.18% 0.01% 0.08% Declaration Policy 24,603-0.01% 0.02% - - Package Policy 63,098 18,688 1.31% 6.19% 12.22% 8.15% Hybrid Policy 16,730 36,388 2.23% 2.80% 0.23% 0.30% Any Other Product 1,872 14,221 2.68% 0.38% 0.52% 0.27% Total 13,303 28,033 100.00% 100.00% 100.00% 100.00% Insurance Information Bureau of India Page 37

Health Insurance (Non-Life) Data Analysis Report 2011-2012 HR-18 : Critical Illness Cover: Policy and Claim Summary -2011-12 Product Type Number Number Total Policy Total Claim Number of of of Premium Paid # Claims Per Policies Claims # (` in crs.) (` in crs.) Policy # Critical Illness Cover - Indemnity Critical Illness Cover - Benefits Premium Per Policy (in `) Amount of Claims Per Policy # (in `) Average Claim Claim Paid # Paid (in `) Ratio # (in %) 439 7 0.18 0.03 0.0159 4,112 627.44 44,369 17.20 80,198 251 20.00 5.55 0.0031 2,493 664.64 2,21,255 27.77 Total 80,637 258 20.18 5.58 0.0032 2,502 664.42 2,16,456 27.68 Inference: Under Critical Illness portfolio, Benefit policies are more popular than Indemnity ones. Claim ratio of Critical Illness Cover - Indemnity is 17.20% and that of Critical Illness Cover - Benefits is 27.68%. HR-19: Package Policy: Policy and Claim Summary -2011-12 Product Type Number of Policies Number of Claims # Package Policies Total Policy Total Claim Number Premium Amount of Average Claim Paid Premium Paid # of Claims Per Policy Claims Per Claim Ratio # (` in crs.) (` in crs.) Per Policy # (in `) Policy # Paid # (in %) (in `) (in `) 1,07,344 3,16,470 677.32 591.43 2.95 63,098 55,097 18,688 87.32% HR-20: Age-band-wise Number of Claims and Amount of Claims Paid for Package Policy - 2011-12 Number of Claims # Total Claims Paid # Age-Band (in Years) (` in crs.) Average Claim Paid # (in `) 1-5 26,780 25.42 9,494 6-15 19,772 14.85 7,513 16-25 41,778 56.50 13,523 26-35 86,509 170.06 19,658 36-45 42,122 70.32 16,694 46-55 40,867 86.04 21,054 56-60 21,216 55.98 26,384 61-65 17,402 50.30 28,904 66-70 10,616 32.69 30,791 Above 70 9,398 29.25 31,129 Age-Not Provided 10 0.01 10,551 Total 316,470 591.42 18,688 HR-21: Metro City - wise Number of Claims and Amount of Claims Paid - 2011-12 Metro City Number of Claims # Total Claims Paid # (` in crs.) Average Claim Paid # (in `) DELHI 104,314 329.18 31,556.48 MUMBAI 100,710 340.65 33,825.15 BANGALORE 63,586 163.14 25,656.57 KOLKATA 47,897 135.56 28,303.00 CHENNAI 39,689 110.69 27,888.60 HYDERABAD 38,084 108.97 28,612.81 Total 3,94,280 1,188 30,136 Insurance Information Bureau of India Page 38

Health Insurance (Non-Life) Data Analysis Report 2011-2012 Caveats: 1. Tabulations & Charts in the report are generated from the data supplied by Non-Life Insurers for the period 2011-12 through online( non-psus) as well as offline mode(psus) of data submission. 2. Aggregate data collated from the transaction level data supplied by non-life Insurers. 3. Classifications of Diseases have been done based on ICD-10 Codes to the extent provided by the non-life Insurers. 4. Data with erroneous codes like non-icd-10 and incorrect Pin codes have not been included for respective analysis. 5. The Tables are indicative and contextual. 6. Findings reflected here are only illustrative and not conclusive. 7. The information contained in the tables cannot be the subject matter for any litigation affecting IRDA/IIB/Insurance Companies/ Insurance Intermediaries. 9. The data a findings are excepted for errors and omissions. Insurance Information Bureau of India Page 39