Health Guard
Gold
Platinum
Silver
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Health Ensure
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Health Care Supreme
Ultimo
Vital
Smart
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Arogya Sanjeevani
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Healthline
Value
Freedom
Enrich
Privilege
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Flexi Health
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Arogya Sanjeevani
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In-patient Treatment | ||||||
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 | Covers hospitalisation expenses due to an disease/illness/injury | Covered | 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 |
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 | Single occupancy AC room is allowed for all Sum Insured except for Rs.1 Lakh / 2 Lakhs. For Rs.1 Lakh / 2 Lakhs Sum Insured the maximum room rent allowed is Rs.1,500 and Rs 3,000 per day respectively |
NIL Room Rent restrictions | Covered |
ICU Charges | ||||||
Actual | 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 | Not Covered | Not Covered |
Pre-hospitalization | ||||||
Up to 70 days | Up to 30 days | Up to 70 days | Up to 30 days | Value Healthline: 30 days before the date of admission to the hospital Freedom, Enrich, Privilege Healthline: 60 days before the date of admission to the hospital |
30 days | 30 days |
Post-hospitalization | ||||||
Up to 90 days | Up to 60 days | Up to 90 days | Up to 60 days | Value Healthline: 60 days before the date of admission to the hospital Freedom, Enrich, Privilege Healthline: 90 days before the date of admission to the hospital |
60 days | 60 days |
Day Care Procedures | ||||||
All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | Covered | Covered | Covered | All day care procedures covered |
Domiciliary Treatment | ||||||
Not Covered | Not Covered | Not Covered | Not Covered | Covered (Maximum 7 days) | Covered | Covered |
Emergency Ambulance | ||||||
Up to Rs.20,000 per policy year | Up to Rs.1,000 per hospitalisation | Up to sum insured | Up to Rs.2,000 per hospitalisation | Value Healthline: Rs.1,000 per hospitalisation; Freedom & Enrich Healthline: Rs.2,000 per hospitalisation Privilege Healthline: Rs.5,000 per hospitalisation |
Up to 1% of SI subject to a maximum of `2,000/- per hospitalisation | Maximum of Rs. 2000 per hospitalisation |
Dental Treatment | ||||||
Not Covered | Not Covered | Covered out patient expenses procedures – Root Canal Treatment, Extractions | Dental treatment, necessitated due to disease or an injury | Value,Freedom & Enrich Healthline: Not Covered Privilege Healthline: Rs.10,000 every 2 Years (Additional benefit) |
Not Covered | Covered |
Bariatric Surgery | ||||||
50% of Sum insured maximum up to Rs.5 lakhs (waiting period 3years) |
Not Covered | Covered if medically indicated | Not Covered | Not Covered | Not Covered | Not Covered |
Ayush Benefit | ||||||
Covered | Covered up to 20% of Sum Insured | Covered | Covered | Covered | Covered | Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy |
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 | Up to Rs.25,000 to Rs.1 lakh ( waiting period: 2 years) |
Not Covered | Value,Freedom & Enrich Healthline: Not Covered Privilege Healthline: Up to Rs.1 Lakh Per delivery (Upto 2 deliveries, after 3 consecutive renewals) |
Not Covered | Covered |
New Born baby cover | ||||||
50% of Sum insured maximum up to Rs.5 lakhs | Not Covered | Covered if medically indicated | Not Covered | Value,Freedom & Enrich Healthline: Not Covered Privilege Healthline: Covered upto Sum Insured of Mother / Floater Sum Insured |
Coverage from day one subject to mother being covered under the policy for 12 months continuously from policy commencement date | Not Covered |
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 | Value & Freedom Healthline: Not Covered Enrich Healthline : Rs 500 per day for 7 days Privilege Healthline: Not Covered (Additional benefit) |
Not Covered | Not Covered |
Organ Donor Expenses | ||||||
Covered up to sum insured | Covered up to sum insured | Available up to Rs.500,000 | Not Covered | Covered | Covered | Not Covered |
Vaccination (In case of post bite treatment) | ||||||
Not covered | Not covered | Not covered | Not covered | Not Covered | Covered | Not Covered |
Health Check-up | ||||||
Every 3 years, 1% of sum insured, maximum Rs.5,000, irrespective of claim | Every 3 years, 1% of sum insured, maximum Rs.1,500, irrespective of claim | Annual | Not Covered | Value Healthline: Not Covered Freedom Healthline: Once after 3 claim free years Enrich & Privilege Healthline: Once after 2 claim free years |
health check-up - once in every 2 claim-free years | No pre-policy health check-up before 50 years of age |
Hospital daily allowance | ||||||
Not Covered | Not Covered | Up to Rs.1,000 per day | Not Covered | Value & Freedom Healthline: Not Covered Enrich & Privilege Healthline: Rs.10,000(Minimum 10 days Hospitalization) (Additional benefit) |
Daily benefit of `500/- per day towards accompanying person expenses, up to a maximum of 10 days per policy period | Not Covered |
Co-pay | ||||||
Co-pay options of NIL / 20% based on Zonewise treatment availed |
Co-pay options of NIL / 20% based on Zonewise treatment availed | Co-pay options of NIL | 5% Co-pay applicable on all claims | Value Healthline: 10% on all claims Freedom, Enrich, Privilege Healthline: Not Covered (for age above 55years) |
No co-pay | Co-pay fixed at 5% for all ages/sum insureds in this policy |
Pre-existing diseases coverage | ||||||
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 | Pre-existing diseases covered after 4 years of continuous coverage | Pre-existing diseases covered after 3 years of continuous coverage | Benefits not available for any pre-existing condition(s) until 48 consecutive months of continuous coverage |
Restore Benefit | ||||||
Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | Not Covered | Covered | Not Covered |
General waiting period | ||||||
30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days (not applicable on renewal and for accidents) |
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) | 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% | Value Healthline: 5% of sum insured every claim free year subject to maximum of 25% of sum Insured Freedom Healthline: 5% of sum insured every claim free year subject to maximum of 50% of sum Insured Enrich Healthline: 50% of sum insured every claim free year subject to maximum of 100% of sum Insured Privilege Healthline: 5% of sum insured every claim free year subject to maximum of 50% of sum Insured |
10% for every claim-free year up to 50% of sum insured | Increase in the Sum Insured by 5% in respect of each claim free year subject to a maximum of 50% of SI |
Emergency Air Ambulance | ||||||
Not Covered | Not Covered | Rs.50,000 to Rs.5 lakhs | Not Covered | Not Covered | Not Covered | Not Covered |
Available sum insured options | ||||||
Silver Plan: Rs.1.5 Lakhs, 2 Lakhs; Gold Plan: Rs.3 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs; Floater: Rs.2 to 10 Lakhs |
Rs.5 to 50 Lakhs | Rs.1 to 5 Lakhs | Value Healthline: Rs.1 to 10 Lakhs Freedom Healthline: Rs.2 to 15 Lakhs Enrich Healthline: Rs.3 to 25 Lakhs Privilege Healthline: Rs.5 to 25 Lakhs |
Rs. 1/ 2 / 3 / 5 / 7.5 / 10 / 15 / 20 / 25 Lakhs | Minimum Sum Assured is ₹ 1 Lac Maximum Sum Assured is ₹ 5 Lacs (Sum Assured can be opted for in multiples of ₹50,000) |
Policy can be purchased for | ||||||
1/2/3 years | 1/2/3 years | 1 year | 1 year | 1/2/3 years | 1/2/3 years | 1/2/3 years |
Eligibility criteria | ||||||
Adults from 18 to 65 years (dependents 3 months to less than 30 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) | Adults from 18 to 65 years (dependents 90 days to 26 years) | Adults from 18 to 65 years and Children 03 months to 26 years | Adults from 18 to 65 years and Children 03 months to 25 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 |
Claims loading | ||||||
No Loading | Loading | Loading | No Loading | No Loading | No Loading | No Loading |
Portablity(At the time of renewal) | ||||||
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 |
Useful Links | ||||||
Bajaj Allianz | Cholamandalam | |
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Claims Settlement Ratio ** | 94.55% | 73.87% |
Number of Lives Covered * | 2,46,85,000 | 1,806,000 |
Network Hospitals | 6,500 + | 7,250 + |
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