Compare Tata Aig vs Oriental Health Insurance Plans
| Tata AIG | Oriental | |
|---|---|---|
| Claims Settlement Ratio ** | 80.61% | 99.48% |
| Number of Lives Covered * | 22,48,000 | 3,03,25,000 |
| Network Hospitals | 4,000 + | 4,300 + |
| ||
 |
|
|
 |
|
|
|---|---|---|---|---|---|
| Medicare Protect | Medicare | Medicare Premier | Individual Mediclaim | Happy Floater | Arogya Sanjeevani |
| In-patient Treatment | |||||
| Covers hospitalisation expenses due to an disease/illness/injury | Covers hospitalisation expenses due to an disease/illness/injury | Covers hospitalisation expenses due to an disease/illness/injury | Covered | Covered | Covered |
| Room Rent | |||||
| Shared Accommodation / 10% co pay for higher Room category | Shared Accommodation(with 10% co-pay)/ Single Private A/c Room | NIL room rent restrictions | 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 | |||||
| Covered | Covered | Covered | 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 | |||||
| 30 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 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 | |||||
| 60 days after discharge from the hospital | 90 days after discharge from the hospital | 90 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 | |||||
| 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | 540+ listed Day Care Treatment covered | Covered | Covered | Covered |
| Domiciliary Treatment | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Not Covered |
| Emergency Ambulance | |||||
| Up to Rs.1,000 per hospitalisation | Up to Rs.3,000 per hospitalisation | Up to Rs.5,000 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 | |||||
| Not covered | Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/injury/illness | 10,000 (OPD Dental) | Not Covered | Not Covered | Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | |||||
| Not covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered | Covered |
| Maternity Benefits | |||||
| Not covered | Not covered | Up to Rs.50,000 (Rs.60,000 in case of girl child) per policy. Waiting period 4 years. | 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 | If a claim is admitted under the maternity benefit, then the company covers for medical expenses incurred on the treatment of new born baby up to Rs.10,000 for complications related to delivery. | 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 up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Lumpsum payment of 10% of the sum insured. | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not covered | Covered | Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||
| Up to 1% of previous sum insured subject to a maximum of Rs.10,000 per policy | Up to 1% of previous sum insured per policy | Up to 1% of sum insured subject to a maximum of Rs.10,000 per policy | Not Covered | Not Covered | Not Covered |
| Hospital daily allowance | |||||
| Not covered | If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day. | If the insured is hospitalized in shared accommodation in a network hospital for more than 24 hours. Then the company pays 0.25% of base sum insured and maximum of Rs.2,000 per day. | 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 | No co-pay | No co-pay | 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 | |||||
| Pre-existing diseases covered after 4 years of continuous coverage. | Pre-existing diseases covered after 3 years of continuous coverage. | Pre-existing diseases covered after 2 years of continuous coverage. | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage |
| Restore Benefit | |||||
| 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | 100% of base sum insured for you and your family members | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit |
| General waiting period | |||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||
| 10% on base sum insured for every claim free year and up to 100%. | 50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim. | 50% on base sum insured for every claim free year and up to 100%. Reduced by 50% and up to 100% in case of claim. | Not Covered | Not Covered | 5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | |||||
| Not covered | Not covered | Covered | Not Covered | Not Covered | Not Covered |
| Available sum insured options | |||||
| 2 lakhs to 5 lakhs | 3 lakhs to 20 lakhs | 5 lakhs to 50 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 | 1/2/3 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 | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 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 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 |
| Daily Cash for Accompanying an Insured Child | |||||
| Not covered | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours. | If an insured child aged 12 years or less is hospitalized. The company pays 0.25% of base sum insured and maximum of Rs.2,000 per day for one accompanying adult for 24 hours. | Not Covered | Not Covered | Not Covered |
| Claims loading | |||||
| No Loading | No Loading | No Loading | Loading | 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 |
