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Group Health Insurance

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You can be in control with SBI General's Group Health Insurance Policy for individuals and families by making medical treatment expenses more manageable, ensuring your family's quality health and happiness.

SBI General Group Health Insurance - eligibility

  • Minimum Entry age is 3 months
  • Maximum Entry Age is 65 years

SBI General Health Insurance Review

SBI General Health Insurance
SBI General Health Insurance sum insured
1 lac − 30 lacs options available
Incurred Claims Ratio *
52.00%
SBI General Health Insurance tenure options
1 and 3 years options available
Claims Settlement Ratio **
62.73%
List of network hospitals
6,000+ hospitals
Number of policies issued *
756,443
Maximum family floater coverage
Self, Spouse + 2 dependent children (upto age of 23 yrs)
Number of lives covered *
2,748,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Group Health Insurance overview

  • Coverage
  • Benefits
  • Exclusions

Coverage of SBI Group Health Insurance

Ambulance charges 1% of SI up to a max of Rs. 1500.
Domiciliary Hospitalisation Reasonable and Customary Charges towards Domiciliary Hospitalisation as defined in Policy subject to 20% of the Sum Insured maximum up to Rs. 20000 whichever is less.
Co-Payment on claims in non-network hospitals 10% on all eligible admissible claims.
Cashless facility Across SBI General's Network Hospitals
Day Care Surgery procedures Covers select Day Care Surgery where less than 24 hours hospitalisation for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery (Due to accident), Tonsillectomy, etc are covered.
Room boarding and Nursing charges ICU Charges 1%/day for Non ICU and 2%/day for ICU. All incremental Expenses pertaining to room rent, medical practitioners / specialists fees and other incidental Expenses to be borne by the insured.
Pre-hospitalisation Expenses Coverage 30 days prior to date of admission into the hospital.
Post-hospitalisation Expenses Coverage 60 days after the date of discharge from the hospital.

Benefits of SBI Group health insurance Policy

  • Coverage from 1 lac to 5 lac
  • No pre-policy medical test up to the age of 65 years for people with no medical history
  • Multiple Coverage Options – Individual & Family Floater options for Sum Insured
  • The premium paid is exempt under Section 80 D of the Income Tax Act from income tax
  • Cashless treatment in more than 3,000 hospitals in the network

Exclusions of SBI group health Insurance

  • Any condition, ailment or injury or related condition(s) for which you have been diagnosed, received medical treatment, had signs and / or symptoms, prior to inception of your first policy, until 48 consecutive months have elapsed, after the date of inception of the first policy with us.
  • Any disease contracted during the first 30 days of commencement of the policy.
  • Certain diseases/surgeries like Hernia, Hydrocele etc shall be covered after a waiting period of 1 year.
  • Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy.
  • Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarean section, and/or any treatment related to prenatal and postnatal care.
  • Congenital diseases
  • All expenses related to AIDS and related diseases.
  • Use/Abuse of intoxicating drugs or alcohol.

SBI General Health Insurance FAQ’s

It refers to payment of the Medical Expenses incurred by the insured, immediately 30/60 days before and 60/90 days after Hospitalization.

It refers to payment of the Medical Expenses incurred by the insured while undergoing Specified Day Care Procedures/ Treatment (as mentioned in the Day Care Surgeries list), which require less than 24 hours Hospitalization.

Pre-acceptance Health check is not mandatory for people who are less than 45 years old and without any history of illness. Insured’s with following condition, acceptance of proposal is subject to a satisfactory medical examination as per SBI General’s requirements: Insured with adverse medical history as declared in Proposal Form or, Insured aged above 45 years & irrespective of SI. The cost of Pre-acceptance medical tests has to be borne by the proposer. However, if the proposal is accepted by Us, we will reimburse 50% of the cost incurred towards the medical tests so undertaken at our advice.

The medical tests can be conducted at any designated centers identified by SBI General.

Premium for Family Floater Policy is calculated basis the age of the oldest member of the family to be insured.

Brochure

Review SBI General Group health insurance brochure to understand coverage details.


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Proposal form

Fill the online SBI General Group Health Insurance proposal form.


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Policy wordings

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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