Compare Niva Bupa vs SBI General Health Insurance Plans
| Niva Bupa | SBI General | |
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| Claims Settlement Ratio ** | 85.96% | 62.73% |
| Number of Lives Covered * | 54,33,000 | 27,48,000 |
| Network Hospitals | 4,500 + | 6,000 + |
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| Heartbeat | Companion | Go-Active | Retail Health | Arogya Premier | Arogya Plus | Arogya Sanjeevani | |
| In-patient Treatment | |||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered | Covered | Covered | |
| Room Rent | |||||||
Gold: Covered up to Sum Insured (except for Suite or above room category) Platinum: Covered up to Sum Insured |
Covered up to Sum Insured (except for Suite or above room category) | 4 Lakhs: Up to 1% of base sum insured per day 5 to 25 Lakhs: No restriction (except suite or above room category)(Limit included in Inpatient Care sum insured) |
1% of sum insured per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | |
| ICU Charges | |||||||
| Covered up to sum insured | Covered | 4 Lakhs: Up to 2% of Base Sum Insured 5 to 25 Lakhs: Covered up to Sum Insured |
2% of sum insured per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day. | |
| Pre-hospitalization | |||||||
| 60 days (Covered upto sum insured) | 30 days before the date of admission to the hospital | 90 days (Covered up to Sum Insured) | Up to 30 days | Up to 60 days | Up to 60 days | 30 days before the date of admission to the hospital | |
| Post-hospitalization | |||||||
| 90 days (Covered upto sum insured) | 60 days after discharge from the hospital | 180 days (Covered up to Sum Insured) | Up to 60 days | Up to 90 days | Up to 90 days | 60 days after discharge from the hospital | |
| Day Care Procedures | |||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments | |
| Domiciliary Treatment | |||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | 20% of the sum insured maximum up to Rs.20,000 | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation. | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation. | Not Covered | |
| Emergency Ambulance | |||||||
| Network Hospital: Covered up to Sum Insured Non-network Hospital: Covered up to Rs.2,000 per event |
Up to Rs.3,000 per hospitalisation | Up to Rs.3,000 per hospitalisation | 1% of sum insured per policy period up to a maximum of Rs.1,500 | Actual | Actual ambulance expenses or Rs.1,500 | Subject to a maximum of Rs.2,000 per hospitalisation. | |
| Dental Treatment | |||||||
| Not covered | Not covered | Not covered | Covered | Covered | Covered | Dental treatment necessitated due to disease or injury | |
| Bariatric Surgery | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | |
| Ayush Benefit | |||||||
| Covered | Covered upto Reasonable and Customary Charges | Covered Ayurveda, Unani, Sidha and Homeopathy | Ayurvedic medicine: Covered up to maximum 15% of sum insured per policy period up to a maximum of Rs.20,000 Homeopathic and Unani system of medicine:Covered up to maximum 10% of sum insured per policy period up to a maximum of Rs.15,000 |
Covered | Covered | Covered | |
| Maternity Benefits | |||||||
Gold (5 Lakhs): Covered up to Rs.40,000 7.5 Lakhs: Covered up to Rs.60,000 10 Lakhs: Covered up to Rs.70,000 15 Lakhs: Covered up to Rs.75,000 20 Lakhs: Covered up to Rs.80,000 30 & 50 Lakhs: Covered up to Rs.1,00,000 Platinum - 15 Lakhs: Covered up to Rs.120,000 20 Lakhs: Covered up to Rs.160,000 50 lakhs & 1 crore: Covered up to Rs.200,000 (After continuous coverage of 24 months, up to 2 pregnancy) |
Not Covered | Not Covered | Not Covered | Reasonable and customary charges towards maternity expenses during hospitalisation are covered after first 9months from the date of inception of first policy | Covered but only under OPD section and up to OPD Limit specified in policy schedule. | Not Covered | |
| New Born baby cover | |||||||
| Covered up to sum insured | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | |
| Vaccination of the new born baby | |||||||
| Covered until new born baby completes one year vaccinations (as mentioned in the policy document) |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | |
| Daily Cash for Accompanying an Insured Child | |||||||
| Not Covered | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours. | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours. | Rs.500 for each completed day of hospitalisation of a child below 10 years of age, subject to maximum of 30 days during the policy period. | Not Covered | Not Covered | Not Covered | |
| Organ Donor Expenses | |||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered | Not Covered | Not Covered | |
| Vaccination (In case of post bite treatment) | |||||||
| Not Covered | Varient1 ( 2 to 4 Lakhs): Up to Rs.2,500 Varient2 ( 5 to 12.5 Lakhs): Up to Rs.5,000 Varient3 ( 15 to 100 Lakhs): Up to Rs.7,500(OPD benefit upto defined limit as part of overall limit) |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | |
| Health Check-up | |||||||
Gold - 5 Lakhs: Annually covered up to Rs.1,250 per insured person 7.5 Lakhs: Annually covered up to Rs.1,875 per insured person 10 to 50 Lakhs: Annually covered up to Rs.2,500 per insured person Platinum - 15 Lakhs: Annually covered up to Rs.3,750 per insured person 20 Lakhs to 1 Crore: Annually covered upto Rs.5,000 per insured person |
Silver (5 Lakhs): Covered up to worth Rs 1,250 per insured person Silver (7.5 Lakhs): Covered up to worth Rs 1,875 per insured person Gold (10 to 20 Lakhs): Covered up to worth Rs 2,500 per insured person; Gold (30 Lakhs): Covered up to worth Rs 5,000 per insured person Gold (50 Lakhs) : Covered up to worth Rs 7,500 per insured person Platinum (1crore to 3Crores): Covered up to worth Rs 10,000 per insured person |
Available | 1% of sum insured up to a maximum of Rs.2,500 for every 4 claims free year | Rs.5,000 for every 4 claims free year | Not Covered | Not Covered | |
| Hospital daily allowance | |||||||
Gold: Rs.3,000 per day Platinum: Rs.6,000 per day |
Varient1: Rs.1,000 per day Varient2: Rs. 2,000 per day Varient3: Rs. 4,000 per day (Min 48hrs contineous hospitalisation required) (optional) |
Not covered | Not Covered | Not Covered | Not Covered | Not Covered | |
| Co-pay | |||||||
| Gold : a. If you select Zone 2, then 20% co-payment will apply for treatment in Mumbai (including Navi Mumbai & Thane), Delhi NCR, Kolkata & Gujarat State b. Options of 10% and 20% co-payment Paltinum : Options of 10% and 20% co-payment |
NIL co-pay for all inpatients, 10% for OPD treatment | No co-pay | No co-pay for treatment in Network / 10% in Non Network Hospitals | No co-pay for all treatment | No co-pay for all treatment | 5% Co pay applicable on all claims | |
| Pre-existing diseases coverage | |||||||
| Pre-existing diseases covered after 2 years of continuous coverage | Pre-existing diseases for 2 to 4 Lakhs is covered after 4 years and for 5 to 100 Lakhs is covered after 3 years of continuous coverage | Pre-existing diseases covered after 3 years of continuous coverage | Covered after 4 years of continuous coverage. | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years. | Covered after a waiting period of 4 years. | |
| Restore Benefit | |||||||
| Up to 100% of Base Sum Insured per year | Up to 100% of Base Sum Insured per year | Up to 100% of Base Sum Insured per year | Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered | |
| General waiting period | |||||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | |
| Renewal Benefit / Cumulative Bonus | |||||||
| 10% on base sum insured for every claim free year and up to 100% | 20% on base sum insured for every claim free year and up to 100% | Not Covered | 5% every year, maximum up to 25% of sum insured | 10% every year, maximum up to 50% of sum insured | Not Covered | 5% every year, maximum up to 25% of sum insured | |
| Emergency Air Ambulance | |||||||
Gold: Not Covered Platinum: Covered up to Sum Insured |
Not Covered | Not Covered | Not Covered | Up to Rs.100,000 | Not Covered | Not Covered | |
| Available sum insured options | |||||||
Gold: 5 to 50 Lakhs Platinum: 15 Lakhs to 1 Crore |
Varient1: 2 to 4 Lakhs Varient2: 5 to 12.5 Lakhs Varient3: 15 to 100 Lakhs |
Rs.4 to 25 Lakhs | 50,000 to 5 Lakhs | 10 to 30 Lakhs | 1 to 3 Lakhs | 1 to 5 Lakhs | |
| Policy can be purchased for | |||||||
| 1/2 years | 1/2 years | 1/2/3 years | 1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year | |
| Eligibility criteria | |||||||
| Adults from 18 to 99 years (dependents 91 days to 17 years) | Adults from 18 to 99 years (dependents 91 days to 17 years) | Entry age for Adults is 18 years - 65 Years (last birthday) and from 91 days to 21 years (last birthday) for children (dependent children) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 75 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 | |
| Claims loading | |||||||
| No Loading | No Loading | No Loading | No Loading | Loading | Loading | No Loading | |
| Portablity(At the time of renewal) | |||||||
| Yes | Yes | 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 | Income tax benefit under section 80D | Income tax benefit under section 80D | |
