HealthGain
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Arogya Sanjeevani
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Healthline
Value
Freedom
Enrich
Privilege
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Flexi Health
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Arogya Sanjeevani
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In-patient Treatment | ||||||
Covers hospitalisation expenses due to an disease/illness/injury | Covered | Covered | Covered | Covered | ||
Room Rent | ||||||
Covered | 2% of sum insured, maximum up to Rs.5,000 per day | Single occupancy AC room is allowed for all Sum Insured except for Rs. 1 Lakh / 2Lakhs. For Rs. 1 Lakh / 2Lakhs Sum Insured the maximum room rent allowed is Rs.1,500 and Rs.3,000 per day respectively. |
NIL Room Rent restrictions | Covered | ||
ICU Charges | ||||||
Covered | 5% of sum insured, maximum up to Rs.10,000 per day | Covered | Not Covered | Not Covered | ||
Pre-hospitalization | ||||||
Up to 60 days | Up to 30 days | Value Healthline: 30 days before the date of admission to the hospital Freedom, Enrich, Privilege Healthline: 60 days before the date of admission to the hospital |
30 days | 30 days | ||
Post-hospitalization | ||||||
Up to 60 days | Up to 60 days | Value Healthline: 60 days before the date of admission to the hospital Freedom, Enrich, Privilege Healthline: 90 days before the date of admission to the hospital |
60 days | 60 days | ||
Day Care Procedures | ||||||
Covered | All day care procedures are covered | Covered | Covered | All day care procedures covered | ||
Domiciliary Treatment | ||||||
Up to 10% of base sum insured,subject to maximum of Rs.50,000 | Not Covered | Covered (Maximum 7 days) | Covered | Covered | ||
Emergency Ambulance | ||||||
Plan A: Up to Rs.1,500 Plan B: Rs.3,000 per hospitalisation |
Up to Rs.2,000 per hospitalisation | Value Healthline: Rs.1,000 per hospitalisation Freedom & Enrich Healthline: Rs.2,000 per hospitalisation Privilege Healthline: Rs.5,000 per hospitalisation |
Up to 1% of SI subject to a maximum of `2,000/- per hospitalisation | Maximum of Rs. 2000 per hospitalisation | ||
Dental Treatment | ||||||
Not Covered | Dental treatment, necessitated due to disease or an injury | Value,Freedom & Enrich Healthline: Not Covered Privilege Healthline: Rs.10,000 every 2 Years (Additional benefit) |
Not Covered | Covered | ||
Bariatric Surgery | ||||||
Not covered | Not covered | Not Covered | Not Covered | Not Covered | ||
Ayush Benefit | ||||||
Not Covered | Covered | Covered | Covered | Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy | ||
Maternity Benefits | ||||||
Not covered | Not covered | Value,Freedom & Enrich Healthline: Not Covered; Privilege Healthline: Up to Rs.1 Lakh Per delivery (Up to 2 deliveries, after 3 consecutive renewals) |
Not Covered | Covered | ||
New Born baby cover | ||||||
Not covered | Not covered | Value,Freedom & Enrich Healthline: Not Covered Privilege Healthline: Covered up to Sum Insured of Mother / Floater Sum Insured |
Coverage from day one subject to mother being covered under the policy for 12 months continuously from policy commencement date | Not Covered | ||
Daily Cash for Accompanying an Insured Child | ||||||
Not covered | Not covered | Value Healthline& Freedom Healthline: Not Covered Enrich Healthline : Rs 500 per day for 7 days Privilege Healthline: Not Covered (Additional benefit) |
Not Covered | Not Covered | ||
Organ Donor Expenses | ||||||
50% of Sum Insured up to maximum Rs.5 Lakhs | Not Covered | Covered | Covered | Not Covered | ||
Vaccination (In case of post bite treatment) | ||||||
Not covered | Not covered | Not Covered | Covered | Not Covered | ||
Health Check-up | ||||||
Covered(Pre-Policy medical check-up) | Not Covered | Value Healthline: Not Covered Freedom Healthline: Once after 3 claim free years Enrich & Privilege Healthline: Once after 2 claim free years |
health check-up - once in every 2 claim-free years | No pre-policy health check-up before 50 years of age | ||
Hospital daily allowance | ||||||
Not Covered | Not Covered | Value Healthline& Freedom Healthline: Not Covered Enrich & Privilege Healthline: Rs.10,000 (Minimum 10 days Hospitalization) (Additional benefit) |
Daily benefit of `500/- per day towards accompanying person expenses, up to a maximum of 10 days per policy period | Not Covered | ||
Co-pay | ||||||
NIL for insureds below 61 years/ 20% co-pay for ages above 61 years | 5% Co-pay applicable on all claims | Value Healthline: 10% on all claims Freedom, Enrich, Privilege Healthline: Not Covered (for age above 55years) |
No co-pay | Co-pay fixed at 5% for all ages/sum insureds in this policy | ||
Pre-existing diseases coverage | ||||||
Covered after a waiting period of 3 years | Covered after a waiting period of 4 years | Pre-existing diseases covered after 4 years of continuous coverage | Pre-existing diseases covered after 3 years of continuous coverage | Benefits not available for any pre-existing condition(s) until 48 consecutive months of continuous coverage | ||
Restore Benefit | ||||||
Up to 100% of Base Sum Insured per year under certain plans | NIL restoration benefit | Not Covered | Covered | Not Covered | ||
General waiting period | ||||||
30 days | 30 days | 30 days | 30 days | 30 days (not applicable on renewal and for accidents) | ||
Renewal Benefit / Cumulative Bonus | ||||||
33.33% increase in Base Sum Insured for every claim free year; maximum up to 100% | 5% on base sum insured for every claim free year and up to 50% | Value Healthline: 5% of sum insured every claim free year subject to maximum of 25% of sum Insured Freedom Healthline: 5% of sum insured every claim free year subject to maximum of 50% of sum Insured Enrich Healthline: 50% of sum insured every claim free year subject to maximum of 100% of sum Insured Privilege Healthline: 5% of sum insured every claim free year subject to maximum of 50% of sum Insured |
10% for every claim-free year up to 50% of sum insured | Increase in the Sum Insured by 5% in respect of each claim free year subject to a maximum of 50% of SI | ||
Emergency Air Ambulance | ||||||
Not covered | Not covered | Not Covered | Not Covered | Not Covered | ||
Available sum insured options | ||||||
Plan A: Rs.3 to 9 Lakhs Plan B: Rs.12 lac,15 lac & 18 Lakhs |
Rs.1 to 5 Lakhs | Value Healthline: Rs.1 to 10 Lakhs Freedom Healthline: Rs.2 to 15 Lakhs Enrich Healthline: Rs.3 to 25 Lakhs Privilege Healthline: Rs.5 to 25 Lakhs |
Rs. 1/ 2 / 3 / 5 / 7.5 / 10 / 15 / 20 / 25 Lakhs | Minimum Sum Assured is ₹ 1 Lac Maximum Sum Assured is ₹ 5 Lacs (Sum Assured can be opted for in multiples of ₹50,000) |
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Policy can be purchased for | ||||||
1 year | 1 year | 1/2/3 years | 1/2/3 years | 1/2/3 years | ||
Eligibility criteria | ||||||
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 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 90 days to 26 years) | Adults from 18 to 65 years and Children 03 months to 26 years | Adults from 18 to 65 years and Children 03 months to 25 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 | ||||||
Reliance | Cholamandalam | |
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Claims Settlement Ratio ** | 80.61% | 73.87% |
Number of Lives Covered * | 22,48,000 | 1,806,000 |
Network Hospitals | 4,000 + | 7,250 + |
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