Compare Niva Bupa vs Universal Sompo
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| Heartbeat
Gold
Platinum
Gold
Platinum
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Companion
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Go-Active
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Complete Healthcare
Basic
Essential
Privilege
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Arogya Sanjeevani
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| In-patient Treatment | |||||
| 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 | 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 | 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) | 30 days before the date of admission to the hospital | 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) | 60 days after discharge from the hospital | 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 | 141 day care expenses covered | Covered | |
| Domiciliary Treatment | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | 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 | 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 | |||||
| Not 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 | |||||
| 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 | Covered up to sum insured | 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 | 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 | |||||
| Covered up to sum insured | 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 | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | 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 | Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less | 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. | 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 | |
| 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 | 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 | |||||
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 | 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 | |||||
| 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 | 10% co-pay applicable for treatment in Non Network hospitals | 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 3 years of continuous coverage | 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 | Up to 100% of Base Sum Insured per year | Not Covered | |
| General waiting period | |||||
| 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% every year, maximum up to 50% of 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 | 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 | 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 | |||||
| 1/2 years | 1/2 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 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 | |
| Claims loading | |||||
| No Loading | No Loading | No Loading | No Loading | No Loading | |
| Portablity(At the time of renewal) | |||||
| 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 | |
| Useful Links | |||||
| Niva Bupa | Universal Sompo | |
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| Claims Settlement Ratio ** | 85.96% | 95.31% |
| Number of Lives Covered * | 54,33,000 | 1,137,000 |
| Network Hospitals | 4,500 + | 4,000 + |
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