Compare SBI General vs Kotak General Health Insurance Plans
| SBI General | Kotak General | |
|---|---|---|
| Claims Settlement Ratio ** | 62.73% | 77.71% |
| Number of Lives Covered * | 27,48,000 | 4,39,000 |
| Network Hospitals | 6,000 + | 3,900 + |
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| Retail Health | Arogya Premier | Arogya Plus | Arogya Sanjeevani | Health Care | Health Premier | Arogya Sanjeevani |
| In-patient Treatment | ||||||
| Covered | Covered | Covered | Covered | Covered | Up to base sum insured | Covered |
| Room Rent | ||||||
| 1% of sum insured per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | No Cap on room rent for this plan | Capped at 1% for sum insured less than equal to 4 lakhs No cap on room rent for this plan | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||||
| 2% of sum insured per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Covered | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | ||||||
| Up to 30 days | Up to 60 days | Up to 60 days | 30 days before the date of admission to the hospital | Up to 30 days | Up to 60 days | Up to 30 days |
| Post-hospitalization | ||||||
| Up to 60 days | Up to 90 days | Up to 90 days | 60 days after discharge from the hospital | Up to 60 days | Up to 90 days | Up to 60 days |
| Day Care Procedures | ||||||
| 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments | 150 day care procedures are covered | 405 day care procedures are covered | All day care procedures are covered |
| Domiciliary Treatment | ||||||
| 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 | Not Covered | Up to base sum insured | Not Covered |
| Emergency Ambulance | ||||||
| 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 | Up to Rs.1,500 | Covers up to Rs.20,000 per year | Covered |
| Dental Treatment | ||||||
| Covered | Covered | Covered | Dental treatment necessitated due to disease or injury | Not Covered | Covered(covered from reward points) (1 Reward point = 0.25Rupees) |
Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||||
| 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 | Not Covered | Up to base sum insured | Covered |
| Maternity Benefits | ||||||
| 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 | Not Covered | Advantage: Not Covered Edge: Up to Rs.25,000 for normal and Rs.35,000 for Cesarean(optional) Elite: Up to Rs.50,000 for normal and Cesarean(optional) (Waiting period: 36 months) |
Not Covered |
| New Born baby cover | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge & Elite: Within Maternity Benefit Sum Insured(optional) (Waiting period : 36 months) |
Not Covered |
| Organ Donor Expenses | ||||||
| Covered | Covered | Not Covered | Not Covered | Up to Base Annual Sum Insured (Optional) |
Up to base sum insured | Not Covered |
| Vaccination (In case of post bite treatment) | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | ||||||
| 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 | Not Covered | Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.1,500 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Health Check-up | ||||||
| 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 | For each insured person above 18 years of age, each policy year for specified tests | For each insured person above 18 years of age, each policy year for specified tests | Covered 56 years and above |
| Hospital daily allowance | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Rs.500 per day for minimum of Extensions 3 days subject to maximum of 10 days (Optional) |
Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.3,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Co-pay | ||||||
| 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 | NIL co-pay for all treatment | NIL co-pay for all treatment | 5% Co-pay applicable on all claims |
| Pre-existing diseases coverage | ||||||
| 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 | Covered after a waiting period of 4 years | Advantage: Covered after a waiting period of 4 years Edge: Covered after a waiting period of 4 years Elite: Covered after a waiting period of 3 years |
Covered after a waiting period of 4 years |
| Restore Benefit | ||||||
| Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered | Up to 100% of base sum insured paid for unrelated illness/accidents | Up to 100% of base sum insured for unrelated illness/accidents | Not Covered |
| General waiting period | ||||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | ||||||
| 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 | 10% for every claim free year up to 50% of sum insured | Advantage: 10% for every claim free year up to 50% of sum insured Edge: 10% for every claim free year up to 100% of sum insured Elite: 10% for every claim free year up to 100% of sum insured |
5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | ||||||
| Not Covered | Up to Rs.100,000 | Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge: Not Covered Elite: Up to 10% of base sum insured and subject to a maximum of 5lakhs (optional) |
Not Covered |
| Available sum insured options | ||||||
| Rs.50,000 to 5 Lakhs | Rs.10 to 30 Lakhs | Rs.1 to 3 Lakhs | Rs.1 to 5 Lakhs | Individual: Excel: Rs.2 to 4 Lakhs Premium: Rs.5 to 25 Lakhs Floater: Excel: Rs.3 & 4 Lakhs Premium: Rs.5 to 25 Lakhs |
Advantage: Rs.3 to 10 Lakhs Edge: Rs.5 to 20 Lakhs Elite: Rs.10 to 25 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | ||||||
| 1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | ||||||
| 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) | 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 91 days to 17 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 | Renewal for whole life |
| Claims loading | ||||||
| No Loading | No Loading | No Loading | Loading | Loading | Loading | Loading |
| Portablity(At the time of renewal) | ||||||
| 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 |
