Compare TATA AIG vs Universal Sompo
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| Medicare Protect
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Medicare
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Medicare Premier
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Complete Healthcare
Basic
Essential
Privilege
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Arogya Sanjeevani
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| 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 |
| 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 | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||
| Covered | Covered | Covered | Not 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 Covered | 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 Covered | 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 |
| Domiciliary Treatment | ||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | 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 | 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 | ||||
| Not covered | Covers expenses incurred towards hospitalization for dental treatment under anesthesia necessitated due to an accident/injury/illness | 10,000 (OPD Dental) | Inpatient Dental Treatment up to 100% of In-patient Treatment Sum Insured. | Dental treatment necessitated due to disease or injury |
| Bariatric Surgery | ||||
| Not covered | Covered | Covered | Covered | Not Covered |
| Ayush Benefit | ||||
| Covered up to Sum Insured | Covered up to Sum Insured | Covered up to Sum Insured | Up to Sum insured | 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. | 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 |
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. | 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 |
| Vaccination of the new born baby | ||||
| Not covered | Not covered | Up to Rs.10,000 (Rs.15,000 in case of girl child) up to one year after the birth of the child | Not covered | Not covered |
| Organ Donor Expenses | ||||
| Covered up to sum insured | Covered up to sum insured | Covered up to sum insured | Covered | Not Covered |
| Vaccination (In case of post bite treatment) | ||||
| Not covered | Covered | Covered | Inpatient treatment- Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less. | 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 |
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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 |
| Co-pay | ||||
| No co-pay | No co-pay | No co-pay | Covered | 5% Co pay applicable on all claims |
| Pre-existing diseases coverage | ||||
| Pre-existing diseases covered after 5 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 a waiting period 36 months | 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 | Covered | Not Covered |
| General waiting period | ||||
| 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. | 10% in increase in Sum insured for every claims free year subject to maximum of 50%. The increased Sum insured shall be decreased by 10% in event of claim but Sum insured shall not be reduced |
5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | ||||
| Not covered | Not covered | Covered | Not covered | Not Covered |
| Available sum insured options | ||||
| 2 lakhs to 5 lakhs | 3 lakhs to 20 lakhs | 5 lakhs to 50 lakhs | Basic: Rs.1 Lakh, Rs.2 Lakh
Essential: Rs.3 Lakh, 4 Lakh and 5 Lakh Privilege: Rs.6 Lakh, Rs.7 Lakh, Rs.8 Lakh , Rs.9 Lakh and Rs.10 Lakh | 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 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 | Minimum: 18 for adults and policyholder 91 days for dependent children 1 day for children under floater plan Maximum: 70 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 |
| 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. | 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 |
| Claims loading | ||||
| No Loading | No Loading | No Loading | No Loading | No Loading |
| Portablity (At the time of renewal) | ||||
| 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 |
| Useful Links | ||||
| TATA AIG | UNIVERSAL SOMPO | |
|---|---|---|
| Claims Settlement Ratio ** | 80.61% | 95.31% |
| Number of Lives Covered * | 22,48,000 | 1,137,000 |
| Network Hospitals | 4,000 + | 4,000 + |
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