IFFCO Tokio | New India Assurance | |
---|---|---|
Claims Settlement Ratio ** | 102.43% | 97.32% |
Number of Lives Covered * | 22,015,000 | 8,75,61,000 |
Network Hospitals | 5,000 + | 3,000 + |
|
Family Health Protector | Swasthya Kavacha Policy | Individual Medishield Policy | Swasthya Raksha Bima | Mediclaim | Premier Mediclaim | Floater Mediclaim | Arogya Sanjeevani |
---|---|---|---|---|---|---|---|
In-patient Treatment | |||||||
Individual Health Protector: Covered. Family Health Protector: Covered. |
Not covered | Not covered | Not covered | Covered | Covered | Covered | 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 | 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 | |||||||
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. | 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 | |||||||
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 | 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 | |||||||
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 | 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 | |||||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Up to 121 day care surgeries covered. | Defined day care surgeries. | 139 Day Care procedures are covered | Covered | Covered | 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 | Not Covered | Not Covered | 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. | 1% of the Sum Insured | Covered | 1% of the Sum Insured | Rs.2,000 per hospitalisation |
Dental Treatment | |||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Covered | Not covered | Not covered | Not Covered | Not Covered | Not Covered | 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 | Not Covered |
Ayush Benefit | |||||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Not covered | Not covered | Up to 25% of sum insured | Up to 20% of Sum Insured | Up to 25% of sum insured | Covered |
Maternity Benefits | |||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | |||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered | Covered | Covered for any Illness or Injury | Covered | 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 | Covered | Covered hospitalisation expenses (excluding cost of organ) |
Covered hospitalisation expenses (excluding cost of organ) |
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 | 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 | Health check up for every 3 claim free years | Health check up for every 3 claim free years | Covered | Not Covered |
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. | 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 |
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 | 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 | |||||||
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 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 | |||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit |
General waiting period | |||||||
30 days | Not covered | Not covered | Not covered | 30 days | 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 | 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 | |||||||
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 | Up to Rs. 1,00,000 for any one illness | Not Covered | 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. | 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 years | 1 years | 1/2/3 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. |
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 | 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 | Not Covered | Not Covered | Not Covered |
Claims loading | |||||||
No Loading | No Loading | No Loading | No Loading | No Loading | No Loading | No Loading | No Loading |
Portablity (At the time of renewal) |
|||||||
Yes | Yes | Yes | No | 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 | Income tax benefit under section 80D |
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