Compare IFFCO Tokio vs Universal Sompo Health Insurance Plans
| IFFCO Tokio | Universal Sompo | |
|---|---|---|
| Claims Settlement Ratio ** | 102.43% | 95.31% |
| Number of Lives Covered * | 22,015,000 | 1,137,000 |
| Network Hospitals | 5,000 + | 4,000 + |
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| Family Health Protector | Swasthya Kavacha Policy | Individual Medishield Policy | Swasthya Raksha Bima | Complete Healthcare | Arogya Sanjeevani |
| In-patient Treatment | |||||
Individual Health Protector: Covered. Family Health Protector: Covered. |
Not covered | Not covered | Not 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 | Covered | 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 | Up to 5% of the 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 |
| 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 |
| Day Care Procedures | |||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Up to 121 day care surgeries covered. | Defined day care surgeries. | 141 day care expenses 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 | 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. | 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 | |||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Covered | Not covered | Not covered | Up to 100% of In-patient treatment sum insured (In case of accident) |
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 |
| Ayush Benefit | |||||
Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Not covered | Not covered | Covered up to sum insured | Covered |
| Maternity Benefits | |||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | |||||
Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | 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 | |||||
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 | 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 | Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less | 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 | 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 | |||||
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. | 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 |
| 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 | 10% co-pay applicable for treatment in Non Network hospitals | 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 3 years of continuous coverage | 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 per year | Not Covered |
| General waiting period | |||||
| 30 days | Not covered | Not covered | Not covered | 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% every year, maximum 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 | 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. | 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 years | 1 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 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 | 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 | 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 |
| Claims loading | |||||
| No Loading | No Loading | No Loading | No Loading | No Loading | No Loading |
| Portablity (At the time of renewal) |
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| Yes | Yes | Yes | No | 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 |
