Compare HDFC ERGO vs New India Assurance Health Insurance Plans
| HDFC Ergo | New India | |
|---|---|---|
| Claims Settlement Ratio ** | 62.73% | 97.32% |
| Number of Lives Covered * | 27,48,000 | 8,75,61,000 |
| Network Hospitals | 6,000 + | 3,000 + |
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| Health Suraksha | Health Suraksha Silver | Arogya Sanjeevani | Mediclaim | Premier Mediclaim | Floater Mediclaim | Arogya Sanjeevani |
| In-patient Treatment | ||||||
| Covered | Covered | Covered | Covered | Covered | Covered | 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. | Not exceeding 1% of the sum insured per day | Covered | Not exceeding 1% of the sum insured per day | 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 | Not exceeding 2% of the Sum Insured per day | Covered | Not exceeding 2% of the Sum Insured per day | 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 | 30 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 | 30 days before the date of admission to the hospital |
| Post-hospitalization | ||||||
| 180 days after discharge from the hospital | 180 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital | 90 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day Care Procedures | ||||||
| Covered | Covered | Covered | 139 Day Care procedures are covered | Covered | Covered | Covered |
| Domiciliary Treatment | ||||||
| Covered | Covered | Covered | Not Covered | Not Covered | Not Covered | 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 | 1% of the Sum Insured | Covered | 1% of the Sum Insured | Rs.2,000 per hospitalisation |
| Dental Treatment | ||||||
| Not Covered | Not Covered | Dental treatment, necessitated due to disease or injury | Not Covered | Not Covered | Not Covered | Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | ||||||
| Not Covered | 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 |
Up to 25% of sum insured | Up to 20% of Sum Insured | Up to 25% of sum insured | Covered |
| Maternity Benefits | ||||||
| Covered(Optional) (Waiting period : 3 years) |
Not Covered | Not Covered | 5 Lakhs and Above: 10% of the sum insured(Waiting period: 36 months) (Optional) |
Plan A: Up to Rs.50,000 Plan B: Up to Rs.100,000 |
5 Lakhs and Above: 10% of the sum insured(Waiting period: 36 months) (Optional) |
Not Covered |
| New Born baby cover | ||||||
| Up to parent care sum insured(Optional) | Not Covered | Not Covered | Covered | Covered for any Illness or Injury | Covered | Not Covered |
| Organ Donor Expenses | ||||||
| Covered | Covered | Not Covered | Covered | Covered hospitalisation expenses (excluding cost of organ) |
Covered hospitalisation expenses (excluding cost of organ) |
Not Covered |
| Vaccination (In case of post bite treatment) | ||||||
| Not Covered | 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 | Health check up for every 3 claim free years | Health check up for every 3 claim free years | Covered | Not Covered |
| Hospital daily allowance | ||||||
| Covered up to Sum Insured | Covered up to Sum Insured | Not Covered | 0.1% Sum Insured per day, up to a maximum of 1% Sum Insured | Plan A: Rs.2,000 per day Plan B: Rs.4,000 per day |
0.1% Sum Insured per day, up to a maximum of 1% Sum Insured | Not Covered |
| Daily Cash for Accompanying an Insured Child | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | 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 | Option of Co-pay upto 20% on certain mediclaim plans | NIL Co-pay under this plan | NIL Co-pay under this plan | 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 4 years of continuous coverage | Covered after 3 years of continuous coverage | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage |
| Restore Benefit | ||||||
| Sum Insured Rebound upto 100% of Sum Insured per year | Not Covered | Not Covered | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit |
| General waiting period | ||||||
| 30 days | 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% | 25% for every claim free year up to 50% of sum insured | Not Covered | 25% for every claim free year up to 50% 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 | Up to Rs.1,00,000 for any one illness | Not Covered | 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 | Rs.1 to 15 Lakhs | Rs.15 Lakhs to 1 Crore | Rs.2 to 15 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 | 1/2/3 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 | Adults from 18 to 65 years (dependents 91 days to 17 years) | Adults from 18 to 65 years (dependents 91 days to 17 years) | Adults from 18 to 65 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 |
| Claims loading | ||||||
| Loading | Loading | No Loading | No Loading | No Loading | No Loading | No Loading |
| Portablity(At the time of renewal) | ||||||
| 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 |
