HDFC ERGO Health vs SBI General Health Insurance

HDFC ERGO Health vs SBI General Health Insurance Plans
Plan Type
Health
Coverage type
Coverage State
Coverage City
Coverage amount
Date of birth
  OR age    years
Policy duration
Gender
Start date
End date
* Name, Email Id & Mobile No. are required 
HDFC ERGO Health SBI General
Claims Settlement Ratio** 89.50% 62.73%
Number of Lives Covered* 51,16,000 27,48,000
Network Hospitals 10,000 + 6,000 +
  • * As per IRDAI report for 2018-19
  • ** As per NL25 data published on the Insurance Company website
HDFC ERGO Health Premium HDFC ERGO Health Optima Restore HDFC ERGO Health Arogya sanjeevani SBI General SBI General SBI General SBI General
Easy Health Optima Restore Arogya Sanjeevani Retail Health Arogya Premier Arogya Plus Arogya Sanjeevani
In-patient Treatment
Covered up to sum insured Covered Covered Covered Covered Covered Covered
Room Rent
Covered Covered Up to 2% of the sum insured subject to maximum of Rs.5,000 per day 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 Up to 5% of the sum insured subject to maximum of Rs.10,000 per day 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
Covered up to 60 Days Covered up to 60 Days 30 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
Covered up to 90 Days Covered up to 180 Days 60 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
Covered All day care treatments covered All day care treatments covered 142 day care expenses covered 142 day care expenses covered 142 day care expenses covered All the day care treatments
Domiciliary Treatment
Covered Covered upto sum insured Not Covered 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.2,000 per hospitalisation Up to Rs.2,000 per hospitalisation Up to Rs.2,000 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
Individual - Standard & Exclusive: Not Covered
Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000
Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500
Family - Standard & Exclusive: Not Covered
Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000
Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000
(waiting period: 3 years)
Not Covered Dental treatment, necessitated due to disease or injury Covered Covered Covered Dental treatment necessitated due to disease or injury
Bariatric Surgery
Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Ayush Benefit
Standard: Up to Rs.20,000
Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000
Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000
Not Covered Covered 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
Standard: Not Covered
Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000
Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000
(Waiting Period: 4 Years)
Not Covered Not Covered 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
Standard: Not Covered
Exclusive & Platinum: Additional Benefit on payment of additional premium
Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Daily Cash for Accompanying an Insured Child
Standard: Not Covered
Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000
Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000
Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000
Not Covered Not Covered 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
Organ Donor Expenses
Covered Covered up to sum insured Not Covered Covered Covered Not Covered Not Covered
Cataract Treatment
Not Covered Not Covered Up to 25% of Sum insured or Rs.40,000, whichever is lower, per eye, under one policy year
(Waiting period: 2 years)
15% of the sum insured subject to a maximum of Rs.25,000 per eye Not Covered Not Covered 25% of sum insured or Rs.40,000, whichever is lower, per each eye in one policy year
Vaccination (In case of post bite treatment)
Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Health Check-up
Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim
Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim
Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim
Individual - 3 Lakhs: Not Covered
5 Lakhs: Up to Rs.1,500
10 Lakhs: Up to Rs.2,000
15 Lakhs: Up to Rs.4,000
20 to 50 Lakhs: Up to Rs.5,000
Family - 3 Lakhs: Not covered
5 Lakhs: Up to Rs.2,500
10 Lakhs: Up to Rs.5,000
15 Lakhs: Up to Rs.8,000
20 to 50 Lakhs : Up to Rs.10,000
Covered 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
Standard: Rs.500 per day, maximum Rs.3,000
Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000
Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800
Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000
(Choosing shared accommodation)
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800
20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000
(Choosing shared accommodation)
Not Covered Not Covered Not Covered Not Covered Not Covered
Co-pay
NIL Co-pay under this plan NIL Co-pay under this plan 5% Co-pay applicable on all claims 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
Covered after a waiting period of 3 years Covered after a waiting period of 3 years Covered after a waiting period of 4 years 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
NIL Restoration Benefit under this plan Up to 100% of Base Sum Insured per year NIL Restoration benefit 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% for every claim free year up to 100% of basic sum insured 5% for every claim free year up to 50% of sum insured 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
Standard: Not Covered
Exclusive & Platinum (3 to 10 lakhs): Not Covered
Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation
3 to 5 Lakhs: Not Covered
10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year
Not Covered Not Covered Up to Rs.100,000 Not Covered Not Covered
Available sum insured options
Individual - Standard Plan: Rs.1 to 15 Lakhs
Exclusive Plan: Rs.3 to 50 Lakhs
Platinum Plan: Rs.4 to 50 Lakhs
Family - Standard Plan: Rs.2 to 15 Lakhs
Exclusive Plan: Rs.3 to 50 Lakhs
Platinum Plan: Rs.4 to 50 Lakhs
Individual: Rs.50,000 to 10 Lakhs
Floater: Rs.2 to 10 Lakhs
Rs.1 to 5 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 years 1/2 years 1 year 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 Adults from 18 to 65 years (dependents 91 days to 17 years) 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
Claims loading
Loading 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
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022