Compare HDFC ERGO vs Kotak General Health Insurance Plans
| HDFC Ergo | Kotak General | |
|---|---|---|
| Claims Settlement Ratio ** | 62.73% | 77.71% |
| Number of Lives Covered * | 27,48,000 | 4,39,000 |
| Network Hospitals | 6,000 + | 3,900 + |
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| Health Suraksha | Health Suraksha Silver | Arogya Sanjeevani | Health Care | Health Premier | Arogya Sanjeevani |
| In-patient Treatment | |||||
| Covered | Covered | Covered | Covered | Up to base sum insured | Covered |
| Room Rent | |||||
| At Actual | capping on room rent | 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 | |||||
| At Actuals | Covered | Up to 5% of 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 | |||||
| 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 | Up to 30 days | Up to 60 days | Up to 30 days |
| Post-hospitalization | |||||
| 180 days after discharge from the hospital | 180 days after discharge from the hospital | 60 days after discharge from the hospital | Up to 60 days | Up to 90 days | Up to 60 days |
| Day Care Procedures | |||||
| Covered | Covered | Covered | 150 day care procedures are covered | 405 day care procedures are covered | All day care procedures are covered |
| Domiciliary Treatment | |||||
| Covered | Covered | Covered | Not Covered | Up to base sum insured | Not Covered |
| Emergency Ambulance | |||||
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 | Up to Rs.1,500 | Covers up to Rs.20,000 per year | Covered |
| Dental Treatment | |||||
| Not Covered | 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 | |||||
| Covered | Covered | Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy |
Not Covered | Up to base sum insured | Covered |
| Maternity Benefits | |||||
| Covered(Optional) (Waiting period : 3 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 | |||||
| Up to parent care sum insured(Optional) | Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge & Elite: Within Maternity Benefit Sum Insured(optional) (Waiting period: 3years) |
Not Covered |
| Organ Donor Expenses | |||||
| Covered | Covered | 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 | |||||
| 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 | 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 | |||||
| Covered up to Sum Insured | Covered up to Sum Insured | 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 |
| Daily Cash for Accompanying an Insured Child | |||||
| Not Covered | 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 |
| Co-pay | |||||
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 | NIL co-pay for all treatment | NIL co-pay for all treatment | 5% Co-pay applicable on all claims |
| Pre-existing diseases coverage | |||||
| 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 | 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 | |||||
| Sum Insured Rebound upto 100% of Sum Insured per year | Not Covered | Not Covered | 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 | |||||
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% | 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 | |||||
Silver Smart:Not Covered; Gold Smart: Up to 2 lakhs; Platinum Smart : Up to 5 lakhs. |
Not Covered | 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 | |||||
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 | 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 | |||||
| 1/2/3 Years | 1/2/3 Years | 1 Year | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | |||||
| 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 | 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 |
