Compare Universal Sompo vs Kotak General Health Insurance Plans
| Universal Sompo | Kotak General | |
|---|---|---|
| Claims Settlement Ratio ** | 95.31% | 77.71% |
| Number of Lives Covered * | 11,37,000 | 4,39,000 |
| Network Hospitals | 4,000 + | 3,900 + |
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| Complete Healthcare | Arogya Sanjeevani | Health Care | Health Premier | Arogya Sanjeevani |
| In-patient Treatment | ||||
| Covered | Covered | Covered | Up to base sum insured | Covered |
| Room Rent | ||||
| Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | No Cap on room rent for this plan | Capped at 1% for sum insured less than equal to 4 lakhs No cap on room rent for this plan | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||
| Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Covered | Covered | 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 | 30 days before the date of admission to the hospital | Up to 30 days | Up to 60 days | Up to 30 days |
| Post-hospitalization | ||||
| 60 days after discharge from the hospital | 60 days after discharge from the hospital | Up to 60 days | Up to 90 days | Up to 60 days |
| Day Care Procedures | ||||
| 141 day care expenses covered | Covered | 150 day care procedures are covered | 405 day care procedures are covered | All day care procedures are covered |
| Domiciliary Treatment | ||||
| Covered | Not Covered | Not Covered | Up to base sum insured | Not Covered |
| Emergency Ambulance | ||||
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 | Up to Rs.1,500 | Covers up to Rs.20,000 per year | Covered |
| Dental Treatment | ||||
| Up to 100% of In-patient treatment sum insured (In case of accident) |
Dental treatment necessitated due to disease or injury | Not Covered | Covered(covered from reward points) (1 Reward point = 0.25Rupees) |
Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | ||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | ||||
| Covered up to sum insured | Covered | Not Covered | Up to base sum insured | Covered |
| Maternity Benefits | ||||
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 | Not Covered | Advantage: Not Covered Edge: Up to Rs.25,000 for normal and Rs.35,000 for Cesarean(optional) Elite: Up to Rs.50,000 for normal and Cesarean(optional) (Waiting period: 36 months) |
Not Covered |
| New Born baby cover | ||||
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 | Not Covered | Advantage: Not Covered Edge & Elite: Within Maternity Benefit Sum Insured(optional) (Waiting period: 36 months) |
Not Covered |
| Daily Cash for Accompanying an Insured Child | ||||
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 | Not Covered | Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.1,500 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Organ Donor Expenses | ||||
| Covered | Not Covered | Up to Base Annual Sum Insured (Optional) |
Up to base sum insured | Not Covered |
| Vaccination (In case of post bite treatment) | ||||
| Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less | Not Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | ||||
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 | For each insured person above 18 years of age, each policy year for specified tests | For each insured person above 18 years of age, each policy year for specified tests | Covered 56 years and above |
| Hospital daily allowance | ||||
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 | Rs.500 per day for minimum of Extensions 3 days subject to maximum of 10 days (Optional) |
Advantage: Rs.500 per day for minimum 3 days of hospitalization subject to maximum of 10 days Edge: Rs.1,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days Elite: Rs.3,000 per day for minimum 3 days of hospitalization subject to maximum of 10 days (Optional) |
Not Covered |
| Co-pay | ||||
| 10% co-pay applicable for treatment in Non Network hospitals | 5% Co pay applicable on all claims | NIL co-pay for all treatment | NIL co-pay for all treatment | 5% Co-pay applicable on all claims |
| Pre-existing diseases coverage | ||||
| Covered after 3 years of continuous coverage | Covered after a waiting period of 4 years | Covered after a waiting period of 4 years | Advantage: Covered after a waiting period of 4 years Edge: Covered after a waiting period of 4 years Elite: Covered after a waiting period of 3 years |
Covered after a waiting period of 4 years |
| Restore Benefit | ||||
| Up to 100% of Base Sum Insured per year | Not Covered | Up to 100% of base sum insured paid for unrelated illness/accidents | Up to 100% of base sum insured for unrelated illness/accidents | Not Covered |
| General waiting period | ||||
| 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | ||||
| 10% every year, maximum up to 50% of sum insured | 5% for every claim free year up to 50% of sum insured | 10% for every claim free year up to 50% of sum insured | Advantage: 10% for every claim free year up to 50% of sum insured Edge: 10% for every claim free year up to 100% of sum insured Elite: 10% for every claim free year up to 100% of sum insured |
5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | ||||
| Not Covered | Not Covered | Not Covered | Advantage: Not Covered Edge: Not Covered Elite: Up to 10% of base sum insured and subject to a maximum of 5lakhs (optional) |
Not Covered |
| Available sum insured options | ||||
Basic: Rs.1 & 2 Lakhs Essential: Rs.3 to 5 Lakhs Privilege: Rs.6 to 10 Lakhs |
Rs.1 to 5 Lakhs | Individual: Excel: Rs.2 to 4 Lakhs Premium: Rs.5 to 25 Lakhs Floater: Excel: Rs.3 & 4 Lakhs Premium: Rs.5 to 25 Lakhs |
Advantage: Rs.3 to 10 Lakhs Edge: Rs.5 to 20 Lakhs Elite: Rs.10 to 25 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | ||||
| 1/2/3 years | 1 year | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | ||||
| Adults from 18 to 70 years (dependents 91 days to 17 years) | Adults from 18 to 65 years (dependents 91 days to 17 years) | 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 5 years) |
| Renewability | ||||
| 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 | Loading | Loading | 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 |
