Compare IFFCO Tokio vs Oriental Health Insurance Plans
| IFFCO Tokio | Oriental | |
|---|---|---|
| Claims Settlement Ratio ** | 102.43% | 99.48% |
| Number of Lives Covered * | 22,015,000 | 3,03,25,000 |
| Network Hospitals | 5,000 + | 4,300 + |
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| Family Health Protector | Swasthya Kavacha Policy | Individual Medishield Policy | Swasthya Raksha Bima | Individual Mediclaim | Happy Floater | Arogya Sanjeevani |
| In-patient Treatment | ||||||
Individual Health Protector: Covered. Family Health Protector: Covered. |
Not covered | Not covered | Not 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 | Silver & Gold: 1% of the sum insured per day Diamond: Rs.10,000 and 0.5% of the sum insured above Rs.10 lakhs 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 | Silver & Gold: 2% of the sum insured per day Diamond: Rs.20,000 and 1% of the sum insured above Rs.10 lakhs 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 | 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 | 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. | 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. | Covered up to sum insured | Covered up to 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. | Rs.2,000 or 1% of the sum insured not exceeding Rs.4,000 | Silver: Rs.1,000 per illness and 1% of the sum insured subject to maximum Rs.3,000 per policy period Gold: Rs.2,000 per illness and Rs.6,000 per policy period Diamond: Rs.3,000 per illness and Rs.8,000 per policy period |
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 | 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 | Covered | Covered | Covered |
| Maternity Benefits | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered | Not Covered | Silver & Gold: Not Covered Diamond: COvered up to 2.5% of the sum insured |
Not Covered |
| New Born baby cover | ||||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered | Not Covered | Silver & Gold: Not Covered Diamond: Covered up to 2.5% of the sum insured up to 90 days from the date of birth |
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 | Lumpsum payment of 10% of the 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 | Not Covered | Not 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% of the sum insured per day subject to maximum of 6 days per insured person | Silver: Not Covered Gold: 0.1% of Sum Insured (Rs.600 to RS.1,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the Sum Insured Diamond: 0.1% of Sum Insured (Rs.1,200 to RS.2,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the 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 Voluntary Co-pay of 10% or 20% with premium reduction | Mandatory Co-pay of 10% up to 70years / Additional 20% above 70 years | 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 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 |
| 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 | Not Covered | Not Covered | 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 | 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 10 Lakhs | Silver: Rs.2 to 5 Lakhs Gold: Rs.6 to 10 Lakhs Diamond: Rs.12 to 20 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. |
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 |
| 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 |
| Claims loading | ||||||
| No Loading | No Loading | No Loading | No Loading | Loading | Loading | No Loading |
| Portablity (At the time of renewal) |
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| 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 |
