Compare HDFC ERGO Health vs Kotak General Health Insurance Plans
| HDFC ERGO Health | Kotak General | |
|---|---|---|
| Claims Settlement Ratio** | 89.50% | 77.71% |
| Number of Lives Covered* | 51,16,000 | 4,39,000 |
| Network Hospitals | 10,000 + | 3,900 + |
| ||
 |
|
|
 |
|
|
|---|---|---|---|---|---|
| Easy Health | Optima Restore | Arogya Sanjeevani | Health Care | Health Premier | Arogya Sanjeevani |
| In-patient Treatment | |||||
| Covered up to sum insured | Covered | Covered | Covered | Up to base sum insured | Covered |
| Room Rent | |||||
| Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | No Cap on room rent for this plan | Capped at 1% for sum insured less than equal to 4 lakhs No cap on room rent for this plan | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | |||||
| Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Covered | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | |||||
| Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital | Up to 30 days | Up to 60 days | Up to 30 days |
| Post-hospitalization | |||||
| Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital | Up to 60 days | Up to 90 days | Up to 60 days |
| Day Care Procedures | |||||
| Covered | All day care treatments covered | All day care treatments covered | 150 day care procedures are covered | 405 day care procedures are covered | All day care procedures are covered |
| Domiciliary Treatment | |||||
| Covered | Covered upto sum insured | Not Covered | Not Covered | Up to base sum insured | Not Covered |
| Emergency Ambulance | |||||
| Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.1,500 | Covers up to Rs.20,000 per year | Covered |
| Dental Treatment | |||||
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 | Not Covered | Covered(covered from reward points) (1 Reward point = 0.25Rupees) |
Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||
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 | Not Covered | Up to base sum insured | Covered |
| Maternity Benefits | |||||
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 | Not Covered | Advantage: Not Covered Edge: Up to Rs.25,000 for normal and Rs.35,000 for Cesarean(optional) Elite: Up to Rs.50,000 for normal and Cesarean(optional) (Waiting period: 36 months) |
Not Covered |
| New Born baby cover | |||||
Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge & Elite: Within Maternity Benefit Sum Insured(optional) (Waiting period: 3years) |
Not Covered |
| Vaccination of the new born baby | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge: Up to Rs.5,000(optional) Elite: Up to Rs.7,500(optional) (Waiting period: 3years) |
Not Covered |
| Daily Cash for Accompanying an Insured Child | |||||
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 | Not Covered | Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.1,500 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Organ Donor Expenses | |||||
| Covered | Covered up to sum insured | Not Covered | Up to Base Annual Sum Insured (Optional) |
Up to base sum insured | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||
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 | For each insured person above 18 years of age, each policy year for specified tests | For each insured person above 18 years of age, each policy year for specified tests | Covered 56 years and above |
| Hospital daily allowance | |||||
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 | Rs.500 per day for minimum of Extensions 3 days subject to maximum of 10 days (Optional) |
Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.3,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Co-pay | |||||
| NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims | NIL co-pay for all treatment | NIL 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 4 years | Covered after a waiting period of 4 years | Advantage: Covered after a waiting period of 4 years Edge: Covered after a waiting period of 4 years Elite: Covered after a waiting period of 3 years |
Covered after a waiting period of 4 years |
| Restore Benefit | |||||
| NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit | Up to 100% of base sum insured paid for unrelated illness/accidents | Up to 100% of base sum insured for unrelated illness/accidents | Not Covered |
| General waiting period | |||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||
| 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 | 10% for every claim free year up to 50% of sum insured | Advantage: 10% for every claim free year up to 50% of sum insured Edge: 10% for every claim free year up to 100% of sum insured Elite: 10% for every claim free year up to 100% of sum insured |
5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | |||||
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 | Not Covered | Advantage: Not Covered Edge: Not Covered Elite: Up to 10% of base sum insured and subject to a maximum of 5lakhs (optional) |
Not Covered |
| Available sum insured options | |||||
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 | Individual: Excel: Rs.2 to 4 Lakhs Premium: Rs.5 to 25 Lakhs Floater: Excel: Rs.3 & 4 Lakhs Premium: Rs.5 to 25 Lakhs |
Advantage: Rs.3 to 10 Lakhs Edge: Rs.5 to 20 Lakhs Elite: Rs.10 to 25 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | |||||
| 1/2 years | 1/2 years | 1 year | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | |||||
| 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) | 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) | Adults from 18 to 65 years (dependents 91 days to 5 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 |
| Claims loading | |||||
| Loading | Loading | No Loading | Loading | Loading | Loading |
| Portablity(At the time of renewal) | |||||
| 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 |
