Compare Niva Bupa vs HDFC ERGO Health Insurance Plans
| Niva Bupa | HDFC ERGO Health | |
|---|---|---|
| Claims Settlement Ratio** | 85.96% | 89.50% |
| Number of Lives Covered* | 54,33,000 | 51,16,000 |
| Network Hospitals | 4,500 + | 10,000 + |
| ||
 |
|
|
 |
|
|
|
|---|---|---|---|---|---|---|
| Heartbeat | Companion | Go-Active | Easy Health | Optima Restore | Arogya Sanjeevani | |
| In-patient Treatment | ||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | 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) |
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 |
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) | Covered up to 60 Days | Covered 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) | Covered up to 90 Days | Covered up to 180 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 | All day care treatments covered | All day care treatments covered | 142 day care expenses covered | |
| Domiciliary Treatment | ||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered upto sum insured | 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 | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | |
| Dental Treatment | ||||||
| Not covered | Not covered | Not covered | Individual - Standard & Exclusive: Not Covered Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500 Family - Standard & Exclusive: Not Covered Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000 (waiting period: 3 years) |
Not Covered | Dental treatment, necessitated due to disease or injury | |
| Bariatric Surgery | ||||||
| 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 | Standard: Up to Rs.20,000 Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000 |
Not 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 | Standard: Not Covered Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000 (Waiting Period: 4 Years) |
Not Covered | Not Covered | |
| New Born baby cover | ||||||
| Covered up to sum insured | Not Covered | Not Covered | Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
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 | |
| Organ Donor Expenses | ||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered up to sum insured | 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 | |
| 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 | Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim |
Individual - 3 Lakhs: Not Covered 5 Lakhs: Up to Rs.1,500 10 Lakhs: Up to Rs.2,000 15 Lakhs: Up to Rs.4,000 20 to 50 Lakhs: Up to Rs.5,000 Family - 3 Lakhs: Not covered 5 Lakhs: Up to Rs.2,500 10 Lakhs: Up to Rs.5,000 15 Lakhs: Up to Rs.8,000 20 to 50 Lakhs : Up to Rs.10,000 |
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 | Standard: Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800 Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800 20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
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 | NIL Co-pay under this plan | NIL Co-pay under this plan | 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 a waiting period of 3 years | Covered after a waiting period of 3 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 | NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit | |
| General waiting period | ||||||
| 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 | 10% on base sum insured for every claim free year and up to 100% | 50% for every claim free year up to 100% of basic sum insured | 5% for every claim free year up to 50% of sum insured | |
| Emergency Air Ambulance | ||||||
Gold: Not Covered Platinum: Covered up to Sum Insured |
Not Covered | Not Covered | Standard: Not Covered Exclusive & Platinum (3 to 10 lakhs): Not Covered Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation |
3 to 5 Lakhs: Not Covered 10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year |
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 | Individual - Standard Plan: Rs.1 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs Family - Standard Plan: Rs.2 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.1 to 5 Lakhs | |
| Policy can be purchased for | ||||||
| 1/2 years | 1/2 years | 1/2/3 years | 1/2 years | 1/2 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) | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 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) | |
| 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 | 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. | Standard: Not Covered Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000 Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000 |
Not Covered | Not Covered | |
| Portablity(At the time of renewal) | ||||||
| Yes | Yes | Yes | Yes | Yes | Yes | |
| Claims loading | ||||||
| No Loading | No Loading | No Loading | Loading | Loading | No Loading | |
| 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 | |
