Compare SBI General vs Universal Sompo
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| Retail Health
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Arogya Premier
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Arogya Plus
Arogya Plus Plan1
Arogya Plus Plan2
Arogya Plus Plan3
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Arogya Sanjeevani
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Complete Healthcare
Basic
Essential
Privilege
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Arogya Sanjeevani
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| In-patient Treatment | |||||
| 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 | Covered | 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 | Up to 5% of the 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 |
| 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 |
| Day Care Procedures | |||||
| 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments | 141 day care expenses 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 | 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 | Basic: Up to 1% of sum insured or Rs.1,000 or actuals whichever is less Essential: Up to 1% of sum insured or Rs.2,000 or actuals whichever is less Privilege: Up to 1% of sum insured or Rs.3,000 or actuals whichever is less |
Subject to a maximum of Rs.2,000 per hospitalisation |
| Dental Treatment | |||||
| Covered | Covered | Covered | Dental treatment necessitated due to disease or injury | Up to 100% of In-patient treatment sum insured (In case of accident) |
Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | |||||
| 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 up to 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 | Basic: Not Covered Essential: Normal Delivery: Up to Rs.15,000 or actuals whichever is less Caesarean Delivery: Up to Rs 25,000 (including pre and post natal expenses up to Rs.2,000) or actuals whichever is less Privilege: Normal Delivery: Up to Rs.25,000 or actuals whichever is less Caesarean Delivery: Up to Rs.50,000 (including pre and post natal expenses up to Rs.2,000) or actuals whichever is less (waiting period: 3 years) |
Not Covered |
| New Born baby cover | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Basic: Not Covered Essential & Privilege: Up to Basic sum insured from 1st Day till expiry of Policy or the child is 91 days old whichever is earlier |
Not Covered |
| Organ Donor Expenses | |||||
| Covered | Covered | Not Covered | Not Covered | Covered | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less | 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 | Individual: 1 Coupon at the end of every claims two continuous claims free year Family Floater: 2 Coupon at the end of every claims two continuous claims free year |
Not Covered |
| Hospital daily allowance | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Basic: Rs.200 per day Essential: Rs.500 per day Privilege: Rs.1,000 per day (Hospitalisation exceeds 3 days for a maximum number of 7 days) |
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 | Basic: Not Covered Essential: Rs.300 per day subject to maximum of Rs.9,000 Privilege: Rs.500 per day subject to maximum of Rs.15,000 |
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 | 10% co-pay applicable for treatment in Non Network hospitals | 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 3 years of continuous coverage | 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 per year | Not Covered |
| General waiting period | |||||
| 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% every year, maximum up to 50% 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 | 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 | Basic: Rs.1 & 2 Lakhs Essential: Rs.3 to 5 Lakhs Privilege: Rs.6 to 10 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 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 70 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 |
| Claims loading | |||||
| No Loading | Loading | Loading | No Loading | No Loading | No Loading |
| 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 |
| Useful Links | |||||
| SBI General | Universal Sompo | |
|---|---|---|
| Claims Settlement Ratio ** | 62.73% | 95.31% |
| Number of Lives Covered * | 27,48,000 | 1,137,000 |
| Network Hospitals | 6,000 + | 4,000 + |
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