Compare Tata AIG vs SBI General Health Insurance Plans
| TATA AIG | 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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| Medicare Protect | Medicare | Medicare Premier | 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 | Covers hospitalisation expenses due to an disease/illness/injury | Covered | 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 | 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 | 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 | ||||||
| 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 | Up to 30 days | Up to 60 days | Up to 60 days | 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 | Up to 60 days | Up to 90 days | Up to 90 days | 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 | 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments |
| Domiciliary Treatment | ||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | 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 | ||||||
| Up to Rs.1,000 per hospitalisation | Up to Rs.3,000 per hospitalisation | Up to Rs.5,000 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 | Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/injury/illness | 10,000 (OPD Dental) | Covered | Covered | Covered | Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | ||||||
| Not covered | Covered | Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||||
| Covered up to Sum Insured | Covered up to Sum Insured | Covered up to Sum Insured | 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 | Up to Rs.50,000 (Rs.60,000 in case of girl child) per policy. Waiting period 4 years. | 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 | 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 | Not Covered | Not Covered | Not Covered |
| Organ Donor Expenses | ||||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Covered | Not Covered | Not Covered |
| Vaccination (In case of post bite treatment) | ||||||
| Not covered | Covered | Covered | Not 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 | 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 | 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. | Not Covered | Not Covered | Not Covered | Not Covered |
| Co-pay | ||||||
| No co-pay | No co-pay | No 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 |
| 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 a waiting period of 4 years | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years |
| 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 | 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 |
| 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. | 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 | Covered | Not Covered | Up to Rs.100,000 | Not Covered | Not Covered |
| Available sum insured options | ||||||
| 2 lakhs to 5 lakhs | 3 lakhs to 20 lakhs | 5 lakhs to 50 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 /2/3 years | 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 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 |
| 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. | 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 |
| Claims loading | ||||||
| No Loading | No Loading | No Loading | No Loading | Loading | 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 |
