SBI General vs Oriental Health Insurance

Compare SBI General vs Oriental Health Insurance Plans
Plan Type
Health
Coverage type
Coverage State
Coverage City
Coverage amount
Date of birth
  OR age    years
Policy duration
Gender
Start date
End date
SBI General Oriental
Claims Settlement Ratio ** 62.73% 99.48%
Number of Lives Covered * 27,48,000 3,03,25,000
Network Hospitals 6,000 + 4,300 +
  • * As per IRDAI report for 2018-19
  • ** As per NL25 data published on the Insurance Company website
SBI General SBI General SBI General SBI General Oriental Oriental Oriental
Retail Health Arogya Premier Arogya Plus Arogya Sanjeevani Individual Mediclaim Happy Floater Arogya Sanjeevani
In-patient Treatment
Covered Covered Covered Covered Covered Covered 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 Not exceeding 1% of the sum insured per day
Silver & Gold: 1% of the sum insured per day
Diamond: Rs.10,000 and 0.5% of the sum insured above Rs.10 lakhs per day
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 Not exceeding 2% of the Sum Insured per day
Silver & Gold: 2% of the sum insured per day
Diamond: Rs.20,000 and 1% of the sum insured above Rs.10 lakhs per day
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 30 days before the date of admission to the hospital 30 days before the date of admission to the hospital 30 days before the date of admission to the hospital
Post-hospitalization
Up to 60 days Up to 90 days Up to 90 days 60 days after discharge from the hospital 60 days after discharge from the hospital 60 days after discharge from the hospital 60 days after discharge from the hospital
Day Care Procedures
142 day care expenses covered 142 day care expenses covered 142 day care expenses covered All the day care treatments Covered Covered 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 Covered up to sum insured Covered up to 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 Rs.2,000 or 1% of the sum insured not exceeding Rs.4,000
Silver: Rs.1,000 per illness and 1% of the sum insured subject to maximum Rs.3,000 per policy period
Gold: Rs.2,000 per illness and Rs.6,000 per policy period
Diamond: Rs.3,000 per illness and Rs.8,000 per policy period
Rs.2,000 per hospitalisation
Dental Treatment
Covered Covered Covered Dental treatment necessitated due to disease or injury Not Covered Not 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
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 Covered Covered 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
Silver & Gold: Not Covered
Diamond: COvered up to 2.5% of the sum insured
Not Covered
New Born baby cover
Not Covered Not Covered Not Covered Not Covered Not Covered
Silver & Gold: Not Covered
Diamond: Covered up to 2.5% of the sum insured up to 90 days from the date of birth
Not Covered
Organ Donor Expenses
Covered Covered Not Covered Not Covered Covered Lumpsum payment of 10% of the 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 Not Covered 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 Not Covered Not Covered Not Covered
Hospital daily allowance
Not Covered Not Covered Not Covered Not Covered 0.1% of the sum insured per day subject to maximum of 6 days per insured person
Silver: Not Covered
Gold: 0.1% of Sum Insured (Rs.600 to RS.1,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the Sum Insured
Diamond: 0.1% of Sum Insured (Rs.1,200 to RS.2,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the Sum Insured
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 Option of voluntary Co-pay of 10% or 20% with premium reduction Mandatory Co-pay of 10% up to 70years / Additional 20% above 70 years 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 4 years of continuous coverage Covered after 4 years of continuous coverage Covered after 4 years of continuous coverage
Restore Benefit
Not Covered Covered up to 100% of base sum insured Covered up to 100% of base sum insured Not Covered NIL Restoration benefit NIL Restoration benefit NIL Restoration benefit
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 Not Covered Not Covered 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 Not Covered 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 Rs.1 to 10 Lakhs
Silver: Rs.2 to 5 Lakhs
Gold: Rs.6 to 10 Lakhs
Diamond: Rs.12 to 20 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) Adults from 18 to 65 years (dependents 91 days to 17 years) Adults from 18 to 65 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
Claims loading
No Loading No Loading No Loading Loading Loading No Loading No 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
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022