HDFC ERGO vs Universal Sompo Health Insurance

Compare HDFC ERGO vs Universal Sompo

Plan Type
Health
Coverage type
Coverage State
Coverage City
Date of birth
  OR age    years
Coverage amount
Gender
* Name, Email Id & Mobile No. are required 
Hdfc ergo Hdfc ergo Hdfc ergo universal-sompo universal-sompo
Health Suraksha
Gold Smart
Platinum Smart
Complete Healthcare
Basic
Essential
Privilege
Arogya Sanjeevani
In-patient Treatment
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. Covered 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 Up to 5% of the 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 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 60 days after discharge from the hospital
Day Care Procedures
Covered Covered Covered 141 day care expenses covered Covered
Domiciliary Treatment
Covered Covered Covered 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
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 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
Covered Covered
Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy
Covered up to sum insured Covered
Maternity Benefits
Covered(Optional)
(Waiting period : 3 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
Up to parent care sum insured(Optional) 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 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
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
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
Covered up to Sum Insured Covered up to Sum Insured 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
Daily Cash for Accompanying an Insured Child
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
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 10% co-pay applicable for treatment in Non Network hospitals 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 3 years of continuous coverage 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 per year Not Covered
General waiting period
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% every year, maximum 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 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
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 1/2/3 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 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
Claims loading
Loading Loading 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
Useful Links
HDFC Ergo Universal Sompo
Claims Settlement Ratio ** 62.73% 95.31%
Number of Lives Covered * 27,48,000 1,137,000
Network Hospitals 6,000 + 4,000 +
  • * As per IRDAI report for 2018-19
  • ** As per NL25 data published on the Insurance Company website
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022