Compare Bajaj Allianz vs Universal Sompo
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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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Complete Healthcare
Basic
Essential
Privilege
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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 |
| 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 | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| 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 | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | |||||
| Up to 60 days | Up to 30 days | Up to 60 days | Up to 30 days | 30 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 | 60 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 | 141 day care expenses covered | Covered |
| Domiciliary Treatment | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Covered | Not 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 | Basic: Up to 1% of sum insured or Rs.1,000 or actuals whichever is less Essential: Up to 1% of sum insured or Rs.2,000 or actuals whichever is less Privilege: Up to 1% of sum insured or Rs.3,000 or actuals whichever is less |
Subject to a 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 | Up to 100% of In-patient treatment sum insured (In case of accident) |
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 |
| Ayush Benefit | |||||
| Covered | Covered up to 20% of Sum Insured | Covered | In-patient hospitalization covered up to sum insured | Covered up to sum insured | 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 | Up to Rs.25,000 to Rs.1 lakh ( waiting period: 2 years) |
Not Covered | Basic: Not Covered Essential: Normal Delivery: Up to Rs.15,000 or actuals whichever is less Caesarean Delivery: Up to Rs 25,000 (including pre and post natal expenses up to Rs.2,000) or actuals whichever is less Privilege: Normal Delivery: Up to Rs.25,000 or actuals whichever is less Caesarean Delivery: Up to Rs.50,000 (including pre and post natal expenses up to Rs.2,000) or actuals whichever is less (waiting period: 3 years) |
Not Covered |
| New Born baby cover | |||||
| 50% of Sum insured maximum up to Rs.5 lakhs | Not Covered | Covered if medically indicated | Not Covered | Basic: Not Covered Essential & Privilege: Up to Basic sum insured from 1st Day till expiry of Policy or the child is 91 days old whichever is earlier |
Not Covered |
| Organ Donor Expenses | |||||
| Covered up to sum insured | Covered up to sum insured | Available up to Rs.500,000 | Not Covered | Covered | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less | 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 | Individual: 1 Coupon at the end of every claims two continuous claims free year Family Floater: 2 Coupon at the end of every claims two continuous claims free year |
Not Covered | Covered |
| Hospital daily allowance | |||||
| Not Covered | Not Covered | Upto Rs.1,000 per day | Not Covered | Basic: Rs.200 per day Essential: Rs.500 per day Privilege: Rs.1,000 per day (Hospitalisation exceeds 3 days for a maximum number of 7 days) |
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 | 10% co-pay applicable for treatment in Non Network hospitals | 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 2 years | Covered after a waiting period of 2 years | Covered after a waiting period of 4 years | Covered after 3 years of continuous coverage | Covered after a waiting period of 4 years |
| 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 | Up to 100% of Base Sum Insured per year | Not Covered |
| General waiting period | |||||
| 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% | 10% every year, maximum up to 50% of sum insured | 5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | |||||
| Not Covered | Not Covered | Rs.50,000 to Rs.5 lakhs | 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 | Basic: Rs.1 & 2 Lakhs Essential: Rs.3 to 5 Lakhs Privilege: Rs.6 to 10 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 year |
| 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 70 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 |
| 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 | Basic: Not Covered Essential: Rs.300 per day subject to maximum of Rs.9,000 Privilege: Rs.500 per day subject to maximum of Rs.15,000 |
Not Covered |
| Claims loading | |||||
| No Loading | Loading | Loading | No Loading | No Loading | No Loading |
| Portablity (At the time of renewal) |
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| 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 |
| Useful Links | |||||
| Bajaj Allianz | Universal Sompo | |
|---|---|---|
| Claims Settlement Ratio** | 94.55% | 95.31% |
| Number of Lives Covered* | 2,46,85,000 | 1,137,000 |
| Network Hospitals | 6,500 + | 4,000 + |
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