Bajaj Allianz | HDFC ERGO Health | |
---|---|---|
Claims Settlement Ratio** | 94.55% | 89.50% |
Number of Lives Covered* | 2,46,85,000 | 51,16,000 |
Network Hospitals | 6,500 + | 10,000 + |
|
Health Guard | Health Infinity | Health Ensure | Health Care Supreme | Arogya Sanjeevani | Easy Health | Optima Restore | Arogya Sanjeevani |
---|---|---|---|---|---|---|---|
In-patient Treatment | |||||||
Covers hospitalisation expenses due to an disease/illness /injury | Covered | Covers hospitalisation expenses due to an disease/illness /injury | Covers hospitalisation expenses due to an disease/illness /injury | Covers hospitalisation expenses due to an disease/illness /injury | Covered up to sum insured | Covered | Covered |
Room Rent | |||||||
Silver plan: Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower Gold: No sublimits |
Room rent expenses as provided by the Hospital/ Nursing Home maximum up to the per day room rent limit opted. | 1% of sum insured per day max.Rs.5,000 per day | Actual | 2% of sum insured, maximum up to Rs.5,000 per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
ICU Charges | |||||||
Actual | If admitted in ICU, the Company will pay up to ICU actual expenses provided by Hospital. | 2% of sum insured per day maximum Rs.10,000 per day | Actual | 5% of sum insured, maximum up to Rs.10,000 per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day |
Pre-hospitalization | |||||||
Up to 60 days | Up to 60 days | Up to 30 days | Up to 60 days | Up to 30 days | Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital |
Post-hospitalization | |||||||
Up to 90 days | Up to 90 days | Up to 60 days | Up to 90 days | Up to 60 days | Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital |
Day Care Procedures | |||||||
All day care procedures are covered | The Company will pay the Insured medical expenses as listed | All day care procedures are covered | All day care procedures are covered | Covered | All day care treatments covered | All day care treatments covered | 142 day care expenses covered |
Domiciliary Treatment | |||||||
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Covered | Covered upto sum insured | Not Covered |
Emergency Ambulance | |||||||
Up to Rs.20,000 per policy year | Up to Rs.5,000 per hospitalization | Up to Rs.1,000 per hospitalisation | Up to sum insured | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation |
Dental Treatment | |||||||
Not Covered | Not Covered | Not Covered | Covered out patient expenses procedures – Root Canal Treatment, Extractions | Dental treatment, necessitated due to disease or an injury | Individual - Standard & Exclusive: Not Covered Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500 Family - Standard & Exclusive: Not Covered Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000 (waiting period: 3 years) |
Not Covered | Dental treatment, necessitated due to disease or injury |
Bariatric Surgery | |||||||
50% of Sum insured maximum up to Rs.5 lakhs(waiting period 3years) | Not Covered | Not Covered | Covered if medically indicated | Not Covered | Not Covered | Not Covered | Not Covered |
Ayush Benefit | |||||||
Covered | Not Covered | Covered up to 20% of Sum Insured | Covered | Covered | Standard: Up to Rs.20,000 Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000 |
Not Covered | Covered |
Maternity Benefits | |||||||
Silver plan: Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower Gold: No sublimits |
Not Covered | Not Covered | Up to Rs.25,000 to Rs.1 lakh ( waiting period: 2 years) |
Not Covered | Standard: Not Covered Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000 (Waiting Period: 4 Years) |
Not Covered | Not Covered |
New Born baby cover | |||||||
50% of Sum insured maximum up to Rs.5 lakhs | Not Covered | Not Covered | Covered if medically indicated | Not Covered | Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered |
Vaccination of the new born baby | |||||||
Covered | Not Covered | Not Covered | Covered | Not Covered | Not Covered | Not Covered | Not Covered |
Organ Donor Expenses | |||||||
Covered up to sum insured | Not Covered | Covered up to sum insured | Available up to Rs.500,000 | Not Covered | Covered | Covered up to sum insured | Not Covered |
Vaccination (In case of post bite treatment) | |||||||
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
Health Check-up | |||||||
Every 3 years, 1% of sum insured, maximum Rs.5,000, irrespective of claim | Every 3 years, up to maximum Rs.5,000 | Every 3 years, 1% of sum insured, maximum Rs.1,500, irrespective of claim | Annual | Not Covered | Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim |
Individual - 3 Lakhs: Not Covered 5 Lakhs: Up to Rs.1,500 10 Lakhs: Up to Rs.2,000 15 Lakhs: Up to Rs.4,000 20 to 50 Lakhs: Up to Rs.5,000 Family - 3 Lakhs: Not covered 5 Lakhs: Up to Rs.2,500 10 Lakhs: Up to Rs.5,000 15 Lakhs: Up to Rs.8,000 20 to 50 Lakhs : Up to Rs.10,000 |
Covered |
Hospital daily allowance | |||||||
Not Covered | Not Covered | Not Covered | Upto Rs.1,000 per day | Not Covered | Standard: Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800 Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800 20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
Not Covered |
Co-pay | |||||||
Co-pay options of NIL / 20% based on Zonewise treatment availed |
Co-pay co-payment of 15%, 20%, 25% applies on the declared amount exceeding 100 times the per day room rent |
Co-pay options of NIL / 20% based on Zonewise treatment availed | Co-pay options of NIL | 5% Co-pay applicable on all claims | NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims |
Pre-existing diseases coverage | |||||||
Covered after a waiting period of 3 years | Covered after a waiting period of 3 years | Covered after a waiting period of 2 years | Covered after a waiting period of 2 years | Covered after a waiting period of 4 years | Covered after a waiting period of 3 years | Covered after a waiting period of 3 years | Covered after a waiting period of 4 years |
Restore Benefit | |||||||
Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | NIL Restoration benefit | Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit |
General waiting period | |||||||
30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
Renewal Benefit / Cumulative Bonus | |||||||
10% of base sum insured per annum up to 10 years (if without any break no claim in the preceding year) | Insured member is eligible for 5% discount at each renewal provided he / she submits the mentioned medical test reports & if all the reports are falling within normal range. | 5% on base sum insured for every claim free year and up to 25% | 10% on base sum insured for every claim free year and up to 50% | 5% on base sum insured for every claim free year and up to 50% | 10% on base sum insured for every claim free year and up to 100% | 50% for every claim free year up to 100% of basic sum insured | 5% for every claim free year up to 50% of sum insured |
Emergency Air Ambulance | |||||||
Not Covered | Not Covered | Not Covered | Rs.50,000 to Rs.5 lakhs | Not Covered | Standard: Not Covered Exclusive & Platinum (3 to 10 lakhs): Not Covered Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation |
3 to 5 Lakhs: Not Covered 10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year |
Not Covered |
Available sum insured options | |||||||
Silver Plan: Rs.1.5 Lakhs, 2 Lakhs Gold Plan: Rs.3 to 50 Lakhs |
No Limit | Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.5 to 50 Lakhs | Rs.1 to 5 Lakhs | Individual - Standard Plan: Rs.1 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs Family - Standard Plan: Rs.2 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.1 to 5 Lakhs |
Policy can be purchased for | |||||||
1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year | 1 year | 1/2 years | 1/2 years | 1 year |
Eligibility criteria | |||||||
Adults from 18 to 65 years (dependents 3 months to less than 30 years) | Minimum Entry age for proposer/ spouse/ dependent parents - 18 years. Maximum Entry Age for proposer/ spouse/ dependent parents - 65 years. Minimum Entry age for dependent Children - 3 months. Maximum Entry Age for dependent Children - 25 years. |
Adults from 18 to 99 years (dependents 3 months to less than 30 years) | Adults from 18 to 99 years (dependents 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | Adults from 18 to 65 years (dependents 91 days to 17 years) |
Renewability | |||||||
Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
Daily Cash for Accompanying an Insured Child | |||||||
Up to Rs.500 per day maximum up to 10 days during each policy year | Not Covered | Not Covered | Not Covered | Not Covered | Standard: Not Covered Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000 Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000 |
Not Covered | Not Covered |
Claims loading | |||||||
No Loading | No Loading | Loading | Loading | No Loading | Loading | Loading | No Loading |
Portablity (At the time of renewal) |
|||||||
Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Tax Benefits Limit | |||||||
Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
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