Reliance vs HDFC ERGO Health Insurace
| Reliance | HDFC ERGO Health | |
|---|---|---|
| Claims Settlement Ratio ** | 80.61% | 89.50% |
| Number of Lives Covered * | 22,48,000 | 51,16,000 |
| Network Hospitals | 4,000 + | 10,000 + |
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| HealthGain | Healthwise | Health Infinity | Arogya Sanjeevani | Easy Health | Optima Restore |
| In-patient Treatment | |||||
| covered illnesses /injuries, where the insured person is hospitalised for more than 24 consecutive hours. | Covers hospitalisation expenses due to an disease/illness/injury per policy period | Covered, No Sub limits | Covers hospitalisation expenses | Covered | Covered up to sum insured |
| Room Rent | |||||
| Actual | No sub-limit | No sub-limit | Up to 2% of the sum insured subject to maximum of Rs.5000 per day. | Covered | Covered |
| ICU Charges | |||||
| Not covered | Not covered | Covered | expenses up to 5% of sum insured subject to maximum of Rs.10,000 per day. | Covered | Covered |
| Pre-hospitalization | |||||
| Up to 60 days | Standard Plan 30 days Silver & Gold Plan 60 days |
90 days before the date of admission to the hospital | Covers medical expenses incurred 30 days prior to the date of hospitalisation. | Up to 60 days | Up to 60 days |
| Post-hospitalization | |||||
| Up to 60 days | Standard Plan 60 days Silver & Gold Plan 90 days |
180 days after discharge from the hospital | Covers medical expenses incurred up to 60 days from the date of discharge. | Up to 90 days | Up to 180 days |
| Day Care Procedures | |||||
| All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | Medical expenses incurred for day care procedures taken at a hospital or day care centre. 24 hour mandatory hospitalization is not necessary in the day care procedure. | Covered | All day care procedures are covered |
| Domiciliary Treatment | |||||
| Up to 10% of base sum insured,subject to maximum of Rs.50000 | Yes - Limited to 10% of Sum Insured, for medical expenses incurred for availing Medical treatment at home which would have otherwise required hospitalisation | Covered up to sum insured | Not covered | Covered | Covered up to sum insured |
| Emergency Ambulance | |||||
| Up to Rs.1,500 to Rs.3000 per hospitalisation | Standard Plan 500 per hospitalisation Silver Plan 750 per hospitalisation Gold Plan 1000 per hospitalisation |
Covered, No Sub-limits | 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 | 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 |
| Bariatric Surgery | |||||
| Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| Ayush Benefit | |||||
| Not covered | Not covered | Covered, No Sub limits | Covered, No Sub limits | 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 |
| Maternity Benefits | |||||
| Not covered | Not covered | 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 |
| New Born baby cover | |||||
| Not covered | Not covered | Not covered | Not covered | Standard: Not covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not covered |
| Organ Donor Expenses | |||||
| 50% of SI up to max Rs.5 lakh | available only under Gold and Silver plans | NO-SUBLIMIT | Not covered | Covered | Covered up to sum insured |
| Vaccination (In case of post bite treatment) | |||||
| Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| Health Check-up | |||||
| Not covered | Standard Plan: No Silver Plan 7: Rs.250 per day for a maximum period of 5 days Gold Plan: Rs.300 per day for a maximum period of 5 days |
10% discount on health check-up | Not covered | 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 |
| Hospital daily allowance | |||||
| Not covered | Standard Plan: No Silver Plan: No Gold Plan:Rs.250 per day up to 7 days |
Not covered | 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) |
| Co-pay | |||||
| NIL for insureds lesserthan 61 years/ 20% co-pay for ages graterthan 61 years | Not covered | 10%, if opted | 5% for all claims | NIL Co-pay under this plan | NIL Co-pay under this plan |
| Pre-existing diseases coverage | |||||
| Pre-existing diseases covered after 36 months of continuous coverage. | Covered after 4 continuous renewals for Standard plan & 2 continuous renewals for Silver and Gold plan.. | Pre-existing diseases covered after 36 months of continuous coverage. | Pre-existing diseases covered after 48 months of continuous coverage. | Covered after a waiting period of 3 years | Covered after a waiting period of 3 years |
| Restore Benefit | |||||
| Not applicable | Not applicable | Equal to 100% of Sum Insured | Not applicable | NIL Restoration Benefit under this plan | Equal to 100% of Basic Sum Insured |
| General waiting period | |||||
| 30 days | 30 days | 30 days | 48 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||
| 33.33% increase in Base SI for every claim free year; Max up to 100%. 33.33% decrease in Base SI for every claim year; Max up to Cumulative Bonus earned. | Continuity Benefits Shall be available only if the policy is renewed within 30 days from the previous policy expiry date. | 10% discount on renewal premium | Increase in the sum insured by 5% in respect of each claim free year subject to a maximum of 50% of SI. | 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 |
| Emergency Air Ambulance | |||||
| Not covered | Not covered | 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 |
| Available sum insured options | |||||
| Plan A: 3 lakh, 6 lakh & 9 lakhs Plan B: 12 lakh,15 lakh & 18 lakhs |
5 lakhs | 3 lakhs to 1 CRORE | 1 lakh, 1.5 lakhs, 2 lakhs, 2.5 lakhs, 3 lakhs, 3.5 lakhs, 4 lakhs, 4.5 lakhs and 5 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 |
| Policy can be purchased for | |||||
| 1 years | 1 years | 1 year, 2 years & 3 Years | 1 year | 1 year / 2 years | 1 year / 2 years |
| Eligibility criteria | |||||
| 65 years. No entry age bar for an insured sum of 3 lakh covered under the policy | Maximum age to enter the plan is 65 years covered under the policy | Child: 91 days to 25 years Adult: 18 years to 65 years covered under the policy |
Child: 91 days to 25 years Adult: 18 years to 65 years |
Adults from 18 to 65 years (dependents 91 days to 5 years) | Adults from 18 to 65 years (dependents 91 days to 5 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 | Not covered | Not covered | 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 |
| Claims loading | |||||
| No Loading | No Loading | No Loading | No Loading | Applicable | Applicable |
| Portablity(At the time of renewal) | |||||
| 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 |
