Bajaj Allianz vs SBI General Health Insurance Plans
| Bajaj Allianz | SBI General | |
|---|---|---|
| Claims Settlement Ratio** | 94.55% | 62.73% |
| Number of Lives Covered* | 2,46,85,000 | 27,48,000 |
| Network Hospitals | 6,500 + | 6,000 + |
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| Health Guard | Health Infinity | Health Ensure | Health Care Supreme | Arogya Sanjeevani | Retail Health | Arogya Premier | Arogya Plus | 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 | 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 |
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 maximum Rs.5,000 per day | Actual | 2% of sum insured, maximum up to Rs.5,000 per day | 1% of sum insured 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 | 2% of sum insured 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 | Up to 30 days | Up to 60 days | 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 | Up to 60 days | Up to 90 days | Up to 90 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 | 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments |
| Domiciliary Treatment | ||||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | 20% of the sum insured maximum up to Rs.20,000 | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation | 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 | 1% of sum insured per policy period up to a maximum of Rs.1,500 | Actual | Actual ambulance expenses or Rs.1,500 | Subject to a maximum of 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 | Covered | Covered | Covered | Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | ||||||||
| 50% of Sum insured max upto Rs.5 lakhs(waiting period: 3years) | Not Covered | Not Covered | Covered if medically indicated | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||||||
| Covered | Not Covered | Covered up to 20% of sum Insured | Covered | Covered | Ayurvedic medicine: Covered up to maximum 15% of sum insured per policy period up to a maximum of Rs.20,000 Homeopathic and Unani system of medicine: Covered up to maximum 10% of sum insured per policy period up to a maximum of Rs.15,000 |
Covered | 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 | Not Covered | Reasonable and customary charges towards maternity expenses during hospitalisation are covered after first 9months from the date of inception of first policy | Covered but only under OPD section and up to OPD Limit specified in policy schedule. | 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 | Not Covered | Not Covered | 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 | Not Covered | Rs.500 for each completed day of hospitalisation of a child below 10 years of age, subject to maximum of 30 days during the policy period | Not Covered | Not Covered | Not Covered |
| Organ Donor Expenses | ||||||||
| Covered up to sum insured | Not Covered | Covered up to sum insured | Covered up to Rs.500,000 | Not Covered | Covered | Covered | Not Covered | 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 | 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 | 1% of sum insured up to a maximum of Rs.2,500 for every 4 claims free year | Rs.5,000 for every 4 claims free year | Not Covered | Not Covered |
| Hospital daily allowance | ||||||||
| Not Covered | Not Covered | Not Covered | Up to Rs.1,000 per day | Not Covered | Not Covered | Not Covered | Not Covered | 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 | No co-pay for treatment in Network / 10% in Non Network Hospitals | No co-pay for all treatment | No co-pay for all treatment | 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 4 years of continuous coverage | Covered after a waiting period of 4 years | Covered after a waiting period of 4 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 | Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered |
| General waiting period | ||||||||
| 30 days | 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% | 5% every year, maximum up to 25% of sum insured | 10% every year, maximum up to 50% of sum insured | Not Covered | 5% every year, maximum up to 25% of sum insured |
| Emergency Air Ambulance | ||||||||
| Not Covered | Not Covered | Not Covered | Rs.50,000 to Rs.5 Lakhs | Not Covered | Not Covered | Up to Rs.100,000 | Not Covered | 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 | Rs.50,000 to 5 Lakhs | Rs.10 to 30 Lakhs | Rs.1 to 3 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 | 1/2/3 years | 1/2/3 years | 1/2/3 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) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 75 years (dependents 91 days to 17 years) | 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 | Renewal for whole life |
| Claims loading | ||||||||
| No Loading | No Loading | Loading | Loading | No Loading | No Loading | Loading | Loading | No Loading |
| Portablity(At the time of renewal) | ||||||||
| Yes | 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 | Income tax benefit under section 80D |
