Compare HDFC ERGO Health vs Universal Sompo Health Insurace
| HDFC ERGO Health | Universal Sompo | |
|---|---|---|
| Claims Settlement Ratio ** | 89.50% | 95.31% |
| Number of Lives Covered * | 1,07,13,000 | 1,137,000 |
| Network Hospitals | 7,400 + | 4,000 + |
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| Easy Health | Optima Restore | Arogya Sanjeevani | Complete Healthcare | Arogya Sanjeevani |
| In-patient Treatment | ||||
| Covered | Covered up to sum insured | Covered | Covered | Covered |
| Room Rent | ||||
| Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | Covered | 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 | 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 | 30 days before the date of admission to the hospital | 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 180 days | 60 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day Care Procedures | ||||
| Covered | All day care procedures are covered | 150 day care procedures are covered | 141 day care expenses covered | Covered |
| Domiciliary Treatment | ||||
| Covered | Covered up to sum insured | Not Covered | Covered | 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 | 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 | ||||
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 | Up to 100% of In-patient treatment sum insured (In case of accident) |
Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | ||||
| 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 | Covered up to 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 | 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 | ||||
Standard: Not covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not covered | 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 | Covered up to sum insured | Not Covered | Covered | Not Covered |
| Vaccination (In case of post bite treatment) | ||||
| 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 | ||||
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 | 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 |
| 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 | 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 | ||||
| NIL Co-pay under this plan | NIL Co-pay under this plan | 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 3 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 | ||||
| NIL Restoration Benefit under this plan | Equal to 100% of Basic 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 |
| 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% every year, maximum up to 50% 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 | 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 | 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 years | 1/2 years | 1 year | 1/2/3 years | 1 year |
| Eligibility criteria | ||||
| Adults from 18 to 65 years (dependents 91 days to 5 years) | Adults from 18 to 65 years (dependents 91 days to 5 years) | Adults from 18 to 65 years (dependents 91 days to 17 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 |
| 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 | 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 | ||||
| Applicable | Applicable | No Loading | No Loading | No Loading |
| Portablity (At the time of renewal) | ||||
| 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 |
