Reliance | IFFCO Tokio | |
---|---|---|
Claims Settlement Ratio ** | 80.61% | 102.43% |
Number of Lives Covered * | 22,48,000 | 22,015,000 |
Network Hospitals | 4,000 + | 5,000 + |
|
HealthGain | Healthwise | Health Infinity | Arogya Sanjeevani | Family Health Protector | Swasthya Kavacha Policy | Individual Medishield Policy | Swasthya Raksha Bima |
---|---|---|---|---|---|---|---|
In-patient Treatment | |||||||
Covers hospitalisation expenses due to an disease/illness/injury | Covers hospitalisation expenses due to an disease/illness/injury | Covered, No sub-limits | Covered | Individual Health Protector: Covered. Family Health Protector: Covered. |
Not covered | Not covered | Not covered |
Room Rent | |||||||
Covered | Covered | Covered | 2% of sum insured, maximum up to Rs.5,000 per day | Individual Health Protector: Covered up to sum insured. Family Health Protector: Covered up to sum insured. |
Base plan: 1.0% of the sum insured. Wider plan: 1.5% of basic sum insured. |
Covered up to a specified limit. | Normal Room expenses: 1% of the Sum Insured per day |
ICU Charges | |||||||
Covered | Covered | Covered | 5% of sum insured, maximum up to Rs.10,000 per day | Individual Health Protector: Covered up to sum insured. Family Health Protector: Covered up to sum insured |
Base plan: 2.0% of the sum insured. Wider plan: 2.5% of the sum insured. |
Covered up to a specified limit. | Sub limit per day for ICU : 2.0% of the Sum Insured per day. |
Pre-hospitalization | |||||||
Up to 60 days | Standard: 30 days before the date of admission to the hospital Silver & Gold: 60 days before the date of admission to the hospital |
Covered up to 90 days | Up to 30 days | Individual Health Protector: Up to 45 days. Family Health Protector: Up to 45 days. |
30 days before hospitalization | Covered Up to 60 days | Covered Up to 30 days |
Post-hospitalization | |||||||
Up to 60 days | Standard: 60 days after discharge from the hospital Silver & Gold: 90 days after discharge from the hospital |
Covered up to 90 days | Up to 60 days | Individual Health Protector: Up to 60 days. Family Health Protector: Up to 60 days. |
30 days after hospitalization | Covered Up to 60 days | Covered Up to 30 days |
Day Care Procedures | |||||||
Covered | Covered | Covered, No sub-limits | All day care procedures are covered | Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Up to 121 day care surgeries covered. | Defined day care surgeries. |
Domiciliary Treatment | |||||||
Up to 10% of base sum insured,subject to maximum of Rs.50,000 | Limited to 10% of Sum Insured | Covered, No sub-limits | Not Covered | Individual Health Protector: up to 20% of the sum insured are covered Family Health Protector: up to 20% of the sum insured are covered |
Maximum sub-limit of 20% of the basic sum insured. | Maximum sub-limit of 20% of the basic sum insured. | Covered up to a max sub-limit of 20% of sum insured. |
Emergency Ambulance | |||||||
Plan A: Up to Rs.1,500 Plan B: Rs.3,000 per hospitalisation |
Standard: 500 per hospitalisation Silver: 750 per hospitalisation Gold: 1,000 per hospitalisation |
Covered, No sub-limits | Up to Rs.2,000 per hospitalisation | Individual Health Protector: 1% of sum insured or Rs. 2500, whichever is less. Family Health Protector: 0.75% of sum insured or Rs. 2500, whichever is less. |
Base plan: Rs.750 or actual, whichever is less for each claim. Wider plan: Rs.1500 or actual, whichever is less . |
1% of sum insured up to a maximum of Rs.1500. | Maximum to Rs.750 for each admissible claim. |
Dental Treatment | |||||||
Not Covered | Dental treatment, necessitated due to disease or an injury | Not Covered | Dental treatment, necessitated due to disease or an injury | Individual Health Protector: Not covered Family Health Protector: Not covered |
Covered | Not covered | Not covered |
Bariatric Surgery | |||||||
Not covered | Not covered | Not covered | Not covered | Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered |
Ayush Benefit | |||||||
Not Covered | Not Covered | Covered, No Sub limits | Covered | Individual Health Protector: Covered Family Health Protector: Covered |
Not covered | Not covered | Not covered |
Maternity Benefits | |||||||
Not covered | Not covered | Not covered | Not covered | Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered |
New Born baby cover | |||||||
Not covered | Not covered | Not covered | Not covered | Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered |
Organ Donor Expenses | |||||||
50% of Sum Insured up to maximum Rs.5 Lakhs | Standard: Not Covered Silver & Gold: Covered |
Covered, No Sub-imits | Not Covered | Individual Health Protector: Covered Family Health Protector: Covered |
Covered | This plan offers coverage for medical expenses up to sum insured, on harvesting organ from the donor, for the insured. | Actual within the overall limit of Sum Insured |
Vaccination (In case of post bite treatment) | |||||||
Not covered | Not covered | Not covered | Not covered | Individual Health Protector: Up to 10% of total premium paid at end of block of 2 continuous, claim free policies. Family Health Protector: Up to 7.5% of total premium paid at end of block of 2 continuous, claim free policies. |
Not covered | Not covered | Not covered |
Health Check-up | |||||||
Covered | Individual: Covered up to 1% of sum insured Family Floater: Covered up to 1.25% of sum insured |
Annual health check-up is avilable | Not Covered | Individual Health Protector: 1% of basic sum insured at end of block of 4 continuous, claim free policies. Family Health Protector: Up to 1% of basic sum insured at end of block of 4 continuous, claim free policies. |
Not Available | This plan offers health check-up benefit equal to 1% of sum insured once every 4 continuous claim free years. | Covered |
Hospital daily allowance | |||||||
Not Covered | Standard & Silver: No Covered Gold: Rs.250 per day up to 7 days |
Not Covered | Not Covered | Individual Health Protector: 0.20% of sum insured. Family Health Protector: 0.15% of sum insured, subject to a maximum of Rs. 1,000. |
Base plan: Rs.150 per day Wider plan: Rs.250 per day |
Covered up to a maximum Rs. 250 per day during hospitalization. | Rs.150 per day of Hospitalization. |
Co-pay | |||||||
NIL for insureds below 61 years/ 20% co-pay for ages above 61 years | Not Covered | NIL for Regular Treatments / Up to 50% for Special Treatments | 5% Co-pay applicable on all claims | Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | This plan does not have co-pay option. However, for packaged treatments, a sub limit equal to 80% of the sum insured is applicable. | 35% Co-pay if the insured person undergoes medical treatment in Zone A Cities/Towns |
Pre-existing diseases coverage | |||||||
Covered after a waiting period of 3 years | Standard: Covered after a waiting period of 4 years Silver & Gold: covered after 2 years of continuous coverage |
Covered after a waiting period of 3 years | Covered after a waiting period of 4 years | Individual Health Protector: Not covered Family Health Protector: Not covered |
Pre-existing diseases covered after 4 years of continuous coverage with us. | Any pre-existing disease for a period of 3 years is not covered. | Covered after 4 years of continuous coverage. |
Restore Benefit | |||||||
Up to 100% of Base Sum Insured per year under certain plans | NIL restoration benefit | Up to 100% of Base Sum Insured per year under certain plans | NIL restoration benefit | Individual Health Protector: Not covered Family Health Protector: Not covered |
Not covered | Not covered | Not covered |
General waiting period | |||||||
30 days | 30 days | 30 days | 30 days | 30 days | Not covered | Not covered | Not covered |
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 20% | Not Covered | 5% on base sum insured for every claim free year and up to 50% | Individual Health Protector: 5% of sum insured, maximum of 50% for claim free policy. Family Health Protector: 5% of sum insured, maximum of 50% for claim free policy. |
Base plan: N/A Wider plan: Increase by 5% of basic sum insured at each renewal, maximum of 50% of basic sum insured |
5% is offered for each claim free year at renewals. It is subject to a maximum 50% of the basic sum insured. In case, a claim is made, the bonus gets reduced by 10% at next renewal. |
Not covered |
Emergency Air Ambulance | |||||||
Not covered | Not covered | Not covered | Not covered | Individual Health Protector: Not covered Family Health Protector: 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 | Rs.3 Lakhs to 1 Crore | Rs.1 to 5 Lakhs | Individual Health Protector: Rs.50,000 to Rs.20 Lakh. Family Health Protector: Rs.1.5 Lakh to Rs.30 Lakh |
Rs.2 Lakh to Rs.5 Lakh in multiples of Rs.1 Lakh. | Rs.50, 000 to Rs.5,00,000. | Rs.1 Lakh to Rs.5 Lakh in multiples of Rs.1 Lakh. |
Policy can be purchased for | |||||||
1 year | 1 year | 1/2/3 years | 1 year | -- | -- | 1 years | 1 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 18 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Individual Health Protector: 18 years and 65 years dependent kids from the age of 91 days. Family Health Protector: 18 and 65 years Dependent kids are insured from Day 1 |
18 years to 65 years dependent children above 3 months. |
The policy offers coverage for persons between the ages of 3 months to 80 years. |
18 years to 65 years dependent children above 3 months. |
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 | Renewal for whole life |
Daily Cash for Accompanying an Insured Child | |||||||
Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Daily cash allowance of 1% of sum insured up to a maximum of Rs.250 is available in this plan. | Not covered |
Claims loading | |||||||
No Loading | No Loading | No Loading | No Loading | No Loading | No Loading | No Loading | No Loading |
Portablity (At the time of renewal) |
|||||||
Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
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 | Income tax benefit under section 80D |
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