HDFC ERGO Health vs Universal Sompo Health Insurace

Compare HDFC ERGO Health vs Universal Sompo Health Insurace
Plan Type
Health
Coverage type
Coverage State
Coverage City
Coverage amount
Date of birth
  OR age    years
Policy duration
Gender
Start date
End date
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HDFC ERGO Health Universal Sompo
Claims Settlement Ratio ** 89.50% 95.31%
Number of Lives Covered * 1,07,13,000 1,137,000
Network Hospitals 7,400 + 4,000 +
  • * 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 universal-sompo universal-sompo
Easy Health Optima Restore Arogya Sanjeevani Complete Healthcare Arogya Sanjeevani
In-patient Treatment
Covered Covered up to sum insured Covered Covered Covered
Room Rent
Covered Covered Up to 2% of the sum insured subject to maximum of Rs.5,000 per day 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 Covered Up to 5% of the sum insured subject to maximum of Rs.10,000 per day
Pre-hospitalization
Up to 60 days Up to 60 days 30 days before the date of admission to the hospital 30 days before the date of admission to the hospital 30 days before the date of admission to the hospital
Post-hospitalization
Up to 90 days Up to 180 days 60 days after discharge from the hospital 60 days after discharge from the hospital 60 days after discharge from the hospital
Day Care Procedures
Covered All day care procedures are covered 150 day care procedures are covered 141 day care expenses covered Covered
Domiciliary Treatment
Covered Covered up to sum insured Not Covered Covered 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
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
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 Up to 100% of In-patient treatment sum insured
(In case of accident)
Dental treatment necessitated due to disease or injury
Bariatric Surgery
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 Covered up to sum insured 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
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
New Born baby cover
Standard: Not covered
Exclusive & Platinum: Additional Benefit on payment of additional premium
Not covered Not Covered
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
Organ Donor Expenses
Covered Covered up to sum insured Not Covered Covered Not Covered
Vaccination (In case of post bite treatment)
Not covered Not covered Not Covered Up to 100% of In-patient Treatment Sum Insured or actuals whichever is less 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
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
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
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
Co-pay
NIL Co-pay under this plan NIL Co-pay under this plan 5% Co-pay applicable on all claims 10% co-pay applicable for treatment in Non Network hospitals 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 3 years of continuous coverage Covered after a waiting period of 4 years
Restore Benefit
NIL Restoration Benefit under this plan Equal to 100% of Basic sum insured NIL Restoration benefit Up to 100% of Base Sum Insured per year 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% for every claim free year up to 100% of basic sum insured 5% for every claim free year up to 50% of sum insured 10% every year, maximum up to 50% of sum insured 5% for every claim free year up to 50% 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 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
Basic: Rs.1 & 2 Lakhs
Essential: Rs.3 to 5 Lakhs
Privilege: Rs.6 to 10 Lakhs
Rs.1 to 5 Lakhs
Policy can be purchased for
1/2 years 1/2 years 1 year 1/2/3 years 1 year
Eligibility criteria
Adults from 18 to 65 years (dependents 91 days to 5 years) Adults from 18 to 65 years (dependents 91 days to 5 years) Adults from 18 to 65 years (dependents 91 days to 17 years) Adults from 18 to 70 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
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
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
Applicable Applicable 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

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