IFFCO Tokio | Kotak General | |
---|---|---|
Claims Settlement Ratio ** | 102.43% | 77.71% |
Number of Lives Covered * | 22,015,000 | 4,39,000 |
Network Hospitals | 5,000 + | 3,900 + |
|
Family Health Protector | Swasthya Kavacha Policy | Individual Medishield Policy | Swasthya Raksha Bima | Health Care | Health Premier | Arogya Sanjeevani |
---|---|---|---|---|---|---|
In-patient Treatment | ||||||
Individual Health Protector: Covered. Family Health Protector: Covered. |
Not covered | Not covered | Not covered | Covered | Up to base sum insured | Covered |
Room Rent | ||||||
Individual Health Protector: Covered up to sum insured. Family Health Protector: Covered up to sum insured. |
Base plan: 1.0% of the sum insured. Wider plan: 1.5% of basic sum insured. |
Covered up to a specified limit. | Normal Room expenses: 1% of the Sum Insured 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 | ||||||
Individual Health Protector: Covered up to sum insured. Family Health Protector: Covered up to sum insured |
Base plan: 2.0% of the sum insured. Wider plan: 2.5% of the sum insured. |
Covered up to a specified limit. | Sub limit per day for ICU : 2.0% of the Sum Insured per day. | Covered | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000 per day |
Pre-hospitalization | ||||||
Individual Health Protector: Up to 45 days. Family Health Protector: Up to 45 days. |
30 days before hospitalization | Covered Up to 60 days | Covered Up to 30 days | Up to 30 days | Up to 60 days | Up to 30 days |
Post-hospitalization | ||||||
Individual Health Protector: Up to 60 days. Family Health Protector: Up to 60 days. |
30 days after hospitalization | Covered Up to 60 days | Covered Up to 30 days | Up to 60 days | Up to 90 days | Up to 60 days |
Day Care Procedures | ||||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Up to 121 day care surgeries covered. | Defined day care surgeries. | 150 day care procedures are covered | 405 day care procedures are covered | All day care procedures are covered |
Domiciliary Treatment | ||||||
Individual Health Protector: up to 20% of the sum insured are covered Family Health Protector: up to 20% of the sum insured are covered |
Maximum sub-limit of 20% of the basic sum insured. | Maximum sub-limit of 20% of the basic sum insured. | Covered up to a max sub-limit of 20% of sum insured. | Not Covered | Up to base sum insured | Not Covered |
Emergency Ambulance | ||||||
Individual Health Protector: 1% of sum insured or Rs. 2500, whichever is less. Family Health Protector: 0.75% of sum insured or Rs. 2500, whichever is less. |
Base plan: Rs.750 or actual, whichever is less for each claim. Wider plan: Rs.1500 or actual, whichever is less . |
1% of sum insured up to a maximum of Rs.1500. | Maximum to Rs.750 for each admissible claim. | Up to Rs.1,500 | Covers up to Rs.20,000 per year | Covered |
Dental Treatment | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Covered | Not covered | Not covered | Not Covered | Covered(covered from reward points) (1 Reward point = 0.25Rupees) |
Dental treatment, necessitated due to disease or injury |
Bariatric Surgery | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered | Not Covered | Not Covered | Not Covered |
Ayush Benefit | ||||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Not covered | Not covered | Not Covered | Up to base sum insured | Covered |
Maternity Benefits | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | ||||||
Individual Health Protector: Covered Family Health Protector: Covered |
Covered | This plan offers coverage for medical expenses up to sum insured, on harvesting organ from the donor, for the insured. | Actual within the overall limit of Sum Insured | Up to Base Annual Sum Insured (Optional) |
Up to base sum insured | Not Covered |
Vaccination (In case of post bite treatment) | ||||||
Individual Health Protector: Up to 10% of total premium paid at end of block of 2 continuous, claim free policies. Family Health Protector: Up to 7.5% of total premium paid at end of block of 2 continuous, claim free policies. |
Not covered | Not covered | Not covered | Not Covered | Not Covered | Not Covered |
Health Check-up | ||||||
Individual Health Protector: 1% of basic sum insured at end of block of 4 continuous, claim free policies. Family Health Protector: Up to 1% of basic sum insured at end of block of 4 continuous, claim free policies. |
Not Available | This plan offers health check-up benefit equal to 1% of sum insured once every 4 continuous claim free years. | 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 | ||||||
Individual Health Protector: 0.20% of sum insured. Family Health Protector: 0.15% of sum insured, subject to a maximum of Rs. 1,000. |
Base plan: Rs.150 per day Wider plan: Rs.250 per day |
Covered up to a maximum Rs. 250 per day during hospitalization. | Rs.150 per day of Hospitalization. | 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 | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | This plan does not have co-pay option. However, for packaged treatments, a sub limit equal to 80% of the sum insured is applicable. | 35% Co-pay if the insured person undergoes medical treatment in Zone A Cities/Towns | NIL co-pay for all treatment | NIL co-pay for all treatment | 5% Co-pay applicable on all claims |
Pre-existing diseases coverage | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Pre-existing diseases covered after 4 years of continuous coverage with us. | Any pre-existing disease for a period of 3 years is not covered. | 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 | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | Not covered | Not covered | Not covered | 30 days | 30 days | 30 days |
Renewal Benefit / Cumulative Bonus | ||||||
Individual Health Protector: 5% of sum insured, maximum of 50% for claim free policy. Family Health Protector: 5% of sum insured, maximum of 50% for claim free policy. |
Base plan: N/A Wider plan: Increase by 5% of basic sum insured at each renewal, maximum of 50% of basic sum insured |
5% is offered for each claim free year at renewals. It is subject to a maximum 50% of the basic sum insured. In case, a claim is made, the bonus gets reduced by 10% at next renewal. |
Not covered | 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 | ||||||
Individual Health Protector: 18 years and 65 years dependent kids from the age of 91 days. Family Health Protector: 18 and 65 years Dependent kids are insured from Day 1 |
18 years to 65 years dependent children above 3 months. |
The policy offers coverage for persons between the ages of 3 months to 80 years. |
18 years to 65 years dependent children above 3 months. |
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 Health Protector: Rs.50,000 to Rs.20 Lakh. Family Health Protector: Rs.1.5 Lakh to Rs.30 Lakh |
Rs.2 Lakh to Rs.5 Lakh in multiples of Rs.1 Lakh. | Rs.50, 000 to Rs.5,00,000. | Rs.1 Lakh to Rs.5 Lakh in multiples of Rs.1 Lakh. | 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 years | 1 years | 1/2/3 years | 1/2/3 years | 1 year |
Eligibility criteria | ||||||
Individual Health Protector: 18 years and 65 years dependent kids from the age of 91 days. Family Health Protector: 18 and 65 years Dependent kids are insured from Day 1 |
18 years to 65 years dependent children above 3 months. |
The policy offers coverage for persons between the ages of 3 months to 80 years. |
18 years to 65 years dependent children above 3 months. |
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 | Renewal for whole life |
Daily Cash for Accompanying an Insured Child | ||||||
Not covered | Not covered | Daily cash allowance of 1% of sum insured up to a maximum of Rs.250 is available in this plan. | 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 |
Claims loading | ||||||
No Loading | No Loading | No Loading | No Loading | Loading | Loading | Loading |
Portablity (At the time of renewal) |
||||||
Yes | Yes | Yes | No | 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 |
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