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Loss Ratio

Also called: claims ratio, medical loss ratio

The loss ratio is claims paid divided by premiums earned — the share of your premium that returns to policyholders as benefits. It's a direct measure of value: US health insurers are legally required to hit a medical loss ratio of 80–85% and rebate the difference. A very low loss ratio in a consumer product usually signals cover that rarely pays out, which is the profile of most extended warranties.

Formula

Loss ratio = Claims paid ÷ Premiums earned

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