Percentage of claims made by clients of the organization that were rejected during the reporting period relative to the total claims submitted to the organization during the reporting period.
Claims Rejection Ratio (PI7902)
Calculation:
- Reporting Format Decimal
- Metric Type Metric
- Metric Level Product/Service, Organization
- IRIS Metric Citation IRIS, 2021. Producer Price Premium (PI1568). v5.2.
Footnote
Organizations should footnote all assumptions used.
Usage Guidance
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This metric is intended to capture the percentage of claims rejected by the organization during the reporting period. This metric is applicable to organizations in the insurance industry and can be used to examine the proportion of claims that were disqualified for benefit payment (rejected) for whatever reason. As an example, a 10% claims rejection ratio means that for every 100 claims reported, 90 result in a benefit payment while the other 10 are denied.
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For more detail on the ratio and for guidance on interpretation, see the Microinsurance Network's Social Performance Indicators for Microinsurance, p. 25 (https://www.social-protection.org/gimi/ShowRessource.action?id=5270/).
Impact Categories & Themes
SDG Goals & Targets
No Poverty
- SDG Target 1.5
- SDG Target 1.4
Gender Equality
- SDG Target 5.5
Decent Work and Economic Growth
- SDG Target 8.1
- SDG Target 8.2
- SDG Target 8.3
- SDG Target 8.10
Industry, Innovation and Infrastructure
- SDG Target 9.3
Reduced Inequality
- SDG Target 10.1
- SDG Target 10.2
- SDG Target 10.3
Sustainable Cities and Communities
- SDG Target 11.5
Metric History
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June 2022 - IRIS v5.3 Released (current version)
Immaterial change. Minor revision to usage guidance for clarity.
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January 2020 - IRIS v5.1 Released
No change.
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May 2019 - IRIS v5.0 Released
No change.
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March 2016 - IRIS v4.0 Released
Immaterial change. Minor revision to definition language for clarity.
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March 2014 - IRIS v3.0 Released
Immaterial change. Minor revision to definition language for clarity.
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November 2011 - IRIS v2.2 Released
New metric. Claims Rejection Ratio (PI7902) was developed via the IRIS Taxonomy Development Group.