Compare Bajaj Allianz vs HDFC Ergo
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| 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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Health Suraksha
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Gold Smart
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Platinum Smart
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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 / 2Lakhs. For Rs. 1 Lakh / 2Lakhs 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 | At Actuals | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | ||||||
| Up to 70 days | Up to 30 days | Up to 70 days | Up to 30 days | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 30 days before the date of admission to the hospital |
| Post-hospitalization | ||||||
| Up to 90 days | Up to 60 days | Up to 90 days | Up to 60 days | 170 days after discharge from the hospital | 180 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day care Procedures | ||||||
| All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | Covered | Covered | Covered | Covered |
| Domiciliary Treatment | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Covered | 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 | Silver Smart: Rs.2,000 Gold Smart: Rs.3,500 Platinum Smart: Sum insured 20 to 50 lakhs: Rs.3,500; Sum insured 50 & 75 lakhs : Rs.15,000 |
Covered | Maximum of Rs.2,000 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 | Not Covered | 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 | 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 | Expenses incurred for inpatient care treatment under Ayurveda, Yoga and 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 | Covered(Optional) (Waiting period : 3 years) |
Not Covered | Not Covered |
| New Born baby cover | ||||||
| 50% of Sum insured maximum up to Rs.5 lakhs | Not Covered | Covered if medically indicated | Not Covered | Up to parent care sum insured(Optional) | Not Covered | 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 | Covered up to sum insured | Covered up to sum insured | 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 | Not 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 | Covered | 1% of Sum Insured after every 4 consecutive and continuous claim free years with us (Subject to a maximum up to Rs.5,000) |
Not Covered |
| Hospital daily allowance | ||||||
| Not Covered | Not Covered | Up to Rs.1,000 per day | Not Covered | Covered up to Sum Insured | Covered up to Sum Insured | 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 | Silver Smart: No co-pay for all treatment, Optional Co pay available between 10%/20%; Gold Smart : No co-pay for all treatment, Optional Co pay available between 15%/25%; Platinum Smart: No co-pay for all treatment, Optional Co pay available between 15%/25% |
NIL / co-pay applicable upto 20% for treatment in higher class cities | 5% co-pay on all claims |
| 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 3 years of continuous coverage | Pre-existing diseases covered after 4 years of continuous coverage | Pre-existing diseases covered after 4 years 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 | Sum Insured Rebound upto 100% of Sum Insured per year | Not Covered | Not Covered |
| General waiting period | ||||||
| 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) | 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% | Silver Smart & Gold Smart: 10% on base sum insured for every claim free year and up to 100%; Platinum Smart: 25% on base sum insured for every claim free year and up to 200% |
5% 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% |
| Emergency Air Ambulance | ||||||
| Not Covered | Not Covered | Rs.50,000 to Rs.5 lakhs | Not Covered | Silver Smart:Not Covered; Gold Smart: Up to 2 lakhs; Platinum Smart : Up to 5 lakhs. |
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 | Silver Smart: Rs.3 to 5 Lakhs Gold Smart: Rs.7.5 to 15 Lakhs Platinum Smart: Rs.20 to 75 Lakhs |
Rs.3 to 50 Lakhs | Rs.1 to 5 Lakhs |
| 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 Year |
| Eligibility criteria | ||||||
| Adults from 17 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 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 to 65 years (dependents 91 days to 25 years).If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals |
| 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 | Loading | 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 | HDFC ERGO | |
|---|---|---|
| Claims Settlement Ratio ** | 94.55% | 85.97% |
| Number of Lives Covered * | 2,46,85,000 | 96.05,000 |
| Network Hospitals | 6,500 + | 6,500 + |
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