Reliance vs SBI General Health Insurance Plans
| Reliance | SBI General | |
|---|---|---|
| Claims Settlement Ratio** | 80.61% | 62.73% |
| Number of Lives Covered* | 22,48,000 | 27,48,000 |
| Network Hospitals | 4,000 + | 6,000 + |
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| HealthGain | Healthwise | Health Infinity | Arogya Sanjeevani | Retail Health | Arogya Premier | Arogya Plus | Arogya Sanjeevani |
| 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 | Covered | Covered | Covered | Covered |
| Room Rent | |||||||
| Covered | Covered | Covered | 2% of sum insured, maximum up to Rs.5,000 per day | 1% of sum insured per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | |||||||
| Covered | Covered | Covered | 5% of sum insured, maximum up to Rs.10,000 per day | 2% of sum insured per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 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 | Up to 30 days | Up to 60 days | Up to 60 days | 30 days before the date of admission to the hospital |
| 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 | Up to 60 days | Up to 90 days | Up to 90 days | 60 days after discharge from the hospital |
| Day Care Procedures | |||||||
| Covered | Covered | Covered, No sub-limits | All day care procedures are covered | 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments |
| 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 | 20% of the sum insured maximum up to Rs.20,000 | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation | Insurer will cover reasonable and customary charges towards domiciliary hospitalisation | Not Covered |
| 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 | 1% of sum insured per policy period up to a maximum of Rs.1,500 | Actual | Actual ambulance expenses or Rs.1,500 | Subject to a maximum of Rs.2,000 per hospitalisation. |
| Dental Treatment | |||||||
| Not Covered | Dental treatment, necessitated due to disease or an injury | Not Covered | Dental treatment, necessitated due to disease or an injury | Covered | Covered | Covered | Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||||
| Not Covered | Not Covered | Covered, No Sub limits | Covered | Ayurvedic medicine: Covered up to maximum 15% of sum insured per policy period up to a maximum of Rs.20,000 Homeopathic and Unani system of medicine: Covered up to maximum 10% of sum insured per policy period up to a maximum of Rs.15,000 |
Covered | Covered | Covered |
| Maternity Benefits | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Reasonable and customary charges towards maternity expenses during hospitalisation are covered after first 9months from the date of inception of first policy | Covered but only under OPD section and up to OPD Limit specified in policy schedule. | Not Covered |
| New Born baby cover | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Rs.500 for each completed day of hospitalisation of a child below 10 years of age, subject to maximum of 30 days during the policy period | 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 | Covered | Covered | Not Covered | Not Covered |
| Vaccination (In case of post bite treatment) | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | 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 | 1% of sum insured up to a maximum of Rs.2,500 for every 4 claims free year | Rs.5,000 for every 4 claims free year | Not Covered | Not Covered |
| Hospital daily allowance | |||||||
| Not Covered | Standard & Silver: No Covered Gold: Rs.250 per day up to 7 days |
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| 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 | No co-pay for treatment in Network / 10% in Non Network Hospitals | No co-pay for all treatment | No co-pay for all treatment | 5% Co-pay applicable on all claims |
| 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 | Covered after 4 years of continuous coverage | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years |
| 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 | Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered |
| General waiting period | |||||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| 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% | 5% every year, maximum up to 25% of sum insured | 10% every year, maximum up to 50% of sum insured | Not Covered | 5% every year, maximum up to 25% of sum insured |
| Emergency Air Ambulance | |||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Up to Rs.100,000 | 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 | Rs.50,000 to 5 Lakhs | Rs.10 to 30 Lakhs | Rs.1 to 3 Lakhs | Rs.1 to 5 Lakhs |
| Policy can be purchased for | |||||||
| 1 year | 1 year | 1/2/3 years | 1 year | 1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year |
| 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) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 115 years (dependents 91 days to 17 years) | Adults from 18 to 75 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 | Renewal for whole life | Renewal for whole life | Renewal for whole life |
| 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 | 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 | Income tax benefit under section 80D | Income tax benefit under section 80D |
