Manipal Cigna ProHealth Accumulate vs Acko Standard Health
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Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. ProHealth Accumulate is sold by Manipal Cigna and Standard Health is sold by Acko. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have massive differences in their core structure. ProHealth Accumulate is specifically designed for International. However, Standard Health is quite basic. It offers little protection and it's a generic policy that anybody could pick off the shelf. So in many ways, you're comparing apples and oranges here.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That's something you'll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let's start with ProHealth Accumulate. The product comes from Manipal Cigna's stable:
ManipalCigna Health Insurance Company is a collaborative partnership between Manipal Group and Cigna and together they have over 200 years of expertise in the healthcare business. And while the company has shown some potential recently, it still only corners a small part of the Indian market.
Also, they have a settlement ratio of 90% with more than 14,000+ network hospitals in tow.
Standard Health meanwhile comes from Acko's stable:
Acko, founded in 2016 and backed by Amazon is a tech-first insurance company that recently entered the health industry. And despite not having the most extensive track record, they have managed to market products that are truly affordable.
They also have a claim settlement ratio of 96% alongside 11,500+ network hospitals and they are brimming with potential.
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Manipal Cigna ProHealth Accumulate vs Acko Standard Health
Compare Insurances Insurance Parameters Recommended Not Recommended | Manipal Cigna ProHealth Accumulate | Acko Standard Health |
|---|---|---|
| Network hospitals | 14000 | 11500 |
| Claim settlement ratio (avg. of last 3 years) | 90% | 96% |
| Co-payment | 20% (if purchased after turning 65) | No |
| Room rent | Single Private room | Any Room |
| Disease sub-limit | No | No |
| Pre existing diseases waiting | 3 years | 3 years |
| Pre/Post hospitalization | 60/90 days | 60/120 days |
| No claim bonus | 5% per year (up to 200%) | 10% per year (up to 100%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (unlimited no. of times for different illness) | 100% restoration (unlimited no. of times for different illness) |
| Health check-up | Once every 3 years | Once every year |
| Maternity | ||
| Out Patient Department | Up to ₹20,000 (Annually) | |
| Day care |
Insurer Comparison
Manipal Cigna settles 90% of the claims it receives, while Acko settles 96%. Both clear the 90% mark Ditto looks for, so neither insurer is a concern on this metric. Do keep in mind that the claim settlement ratio counts claims, not the money paid out, so it is only one part of the picture.
What is the Claim Settlement Ratio (CSR)?
The Claim Settlement Ratio tells you what percentage of health insurance claims an insurer settled during a given year, out of the total claims it received. A CSR of 93% means the insurer paid out 93 claims for every 100 filed. Ditto uses a 3-year average to smooth out year-on-year fluctuations, and recommends insurers at 90% or above — anything below 85% is a red flag.
Incurred Claims Ratio
Manipal Cigna pays out ₹82 in claims for every ₹100 it collects as premium. Acko pays out ₹66. Both sit inside the 55%-85% band Ditto considers healthy — high enough to show claims are actually being paid, low enough to be sustainable.
What is the Incurred Claims Ratio (ICR)?
The Incurred Claims Ratio tells you how much of every rupee collected as premium was paid back to customers as claims. An ICR of 70% means the insurer paid out ₹70 in claims for every ₹100 of premium collected. Unlike CSR, a very high ICR is not necessarily good — it can point to an unsustainable payout rate and future premium hikes, while a very low ICR can indicate an insurer that is overly restrictive in settling claims. Ditto looks for an ICR between 55% and 85%.
For every 10,000 claims processed, Manipal Cigna received 18 complaints and Acko received 19. Fewer complaints usually mean smoother claim processing and better servicing, so Manipal Cigna has the edge on this metric. Ditto looks for under 20 complaints per 10,000 claims from general insurers, and under 40 from standalone health insurers, since their claims are more complex.
What is the complaint volume?
Complaint volume shows how many customers formally complained per 10,000 claims processed. Fewer complaints generally mean smoother claim processing and better customer support. General insurers and Standalone Health Insurers (SAHIs) are judged against different baselines because SAHIs handle only health claims, which are more complex — Ditto looks for below 20 complaints for general insurers and below 40 for standalone health insurers.
Manipal Cigna has 14,000 network hospitals and Acko has 11,500. Both are past the 10,000-hospital mark Ditto recommends. A bigger network makes it easier to find cashless treatment near you, but it counts for little if your preferred hospitals are not on the list — so check that before you decide.
What are network hospitals?
Network hospitals are the hospitals an insurer has tied up with, where it settles bills directly so you get cashless treatment instead of paying out of pocket and claiming reimbursement later. The larger the network, the easier it is to find cashless treatment near you. Ditto recommends a network of 10,000+ hospitals, but a large network matters little if your preferred hospitals are not on it — always check.
Track Record
Manipal Cigna has been operating since 2014 (12 years) and Acko since 2016 (10 years). Both have the 10+ years of history Ditto looks for, which means there is enough data to judge how they behave at scale rather than just early on.
Why does the insurer’s track record matter?
India’s insurance sector was privatised in 2000, so most private players have been operating for 20-25 years. A company with just 3-4 years of data gives you very little to judge it on — numbers can look excellent early on and deteriorate sharply as the insurer scales. Ditto considers 10+ years ideal, and under 5 years a reason to proceed with caution.
Feature Comparison
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, ProHealth Accumulate requires you to co-pay a part of the bill 20% if you purchase after turning 65 whereas Standard Health doesn’t impose a co-payment clause
If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, ProHealth Accumulate only lets you stay in a single private room but you can pick any room you want with Standard Health.
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, neither ProHealth Accumulate imposes disease-wise sub-limits nor does Standard Health
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, ProHealth Accumulate imposes a 3 year waiting period on pre-existing diseases and Standard Health will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, ProHealth Accumulate covers expenses incurred 60 days before hospitalization and expenses incurred 90 days post-hospitalization. Meanwhile, Standard Health covers expenses incurred 60 days before hospitalization and expenses incurred 120 after hospitalization, although there may be different sub-limits
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, ProHealth Accumulate offers a no-claim bonus of 5% whereas Standard Health offers a no-claim bonus of 10%. And the no-claim bonus may be capped at different levels too.
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, ProHealth Accumulate offers domiciliary cover. And Standard Health also coves domiciliary expenses.
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, ProHealth Accumulate covers Ayush procedures and Standard Health also extends coverage for Ayush treatments.
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, neither ProHealth Accumulate offers maternity cover nor does Standard Health.
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, ProHealth Accumulate offers OPD cover whereas Standard Health doesn’t offer OPD protection.
Final Conclusion
If you're specifically looking to buy a policy for International, ProHealth Accumulate makes a lot of sense. But considering Manipal Cigna has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Acko has to offer, if the policy is made available to you.
Other Manipal Cigna ProHealth Accumulate Comparisons
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