Abstract: This research analyses the financial sustainability of Star Health and Allied Insurance Co. Ltd., a top private standalone health insurer in India. With the healthcare sector becoming more complex as medical expenses rise, regulatory demands increase, and customers become more demanding, financial sustainability has emerged as a key driver of long-term success. This study employs a mixed-methods strategy of ratio analysis, trend analysis, and comparative financial performance between the years 2020 and 2024. Performance indicators such as the claims ratio, expense ratio, net profitability, solvency, and liquidity are examined to determine how Star Health developed and responded to internal and external forces. The results show significant enhancements in claims handling, operational effectiveness, and profitability despite liquidity and working capital challenges. The report points to the need for digitalization, investment prudence, and forward-looking risk management in ensuring business continuity. This study provides useful insights to stakeholders in the insurance industry, including policymakers, investors, and financial analysts who wish to know the dynamics of private health insurance in India

| DOI: 10.17148/IARJSET.2025.125144