Compare SBI General vs Oriental Health Insurance Plans
| SBI General | Oriental | |
|---|---|---|
| Claims Settlement Ratio ** | 62.73% | 99.48% |
| Number of Lives Covered * | 27,48,000 | 3,03,25,000 |
| Network Hospitals | 6,000 + | 4,300 + |
| ||
 |
|
|
|
 |
|
|
|---|---|---|---|---|---|---|
| Retail Health | Arogya Premier | Arogya Plus | Arogya Sanjeevani | Individual Mediclaim | Happy Floater | Arogya Sanjeevani |
| In-patient Treatment | ||||||
| Covered | Covered | Covered | Covered | Covered | Covered | Covered |
| Room Rent | ||||||
| 1% of sum insured per day | Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | Not exceeding 1% of the sum insured per day | Silver & Gold: 1% of the sum insured per day Diamond: Rs.10,000 and 0.5% of the sum insured above Rs.10 lakhs per day |
2% of the sum insured subject to maximum of Rs.5,000 per day |
| ICU Charges | ||||||
| 2% of sum insured per day | Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | Not exceeding 2% of the Sum Insured per day | Silver & Gold: 2% of the sum insured per day Diamond: Rs.20,000 and 1% of the sum insured above Rs.10 lakhs per day |
Up to 5% of sum insured subject to maximum of Rs.10,000 per day |
| Pre-hospitalization | ||||||
| Up to 30 days | 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 | 30 days before the date of admission to the hospital |
| Post-hospitalization | ||||||
| Up to 60 days | Up to 90 days | Up to 90 days | 60 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day Care Procedures | ||||||
| 142 day care expenses covered | 142 day care expenses covered | 142 day care expenses covered | All the day care treatments | Covered | Covered | Covered |
| Domiciliary Treatment | ||||||
| 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 | Covered up to sum insured | Covered up to sum insured | Not Covered |
| Emergency Ambulance | ||||||
| 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 | Rs.2,000 or 1% of the sum insured not exceeding Rs.4,000 | Silver: Rs.1,000 per illness and 1% of the sum insured subject to maximum Rs.3,000 per policy period Gold: Rs.2,000 per illness and Rs.6,000 per policy period Diamond: Rs.3,000 per illness and Rs.8,000 per policy period |
Rs.2,000 per hospitalisation |
| Dental Treatment | ||||||
| Covered | Covered | Covered | Dental treatment necessitated due to disease or injury | Not Covered | Not 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 | ||||||
| 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 | Covered | Covered | Covered |
| Maternity Benefits | ||||||
| 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 | Not Covered | Silver & Gold: Not Covered Diamond: COvered up to 2.5% of the sum insured |
Not Covered |
| New Born baby cover | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Silver & Gold: Not Covered Diamond: Covered up to 2.5% of the sum insured up to 90 days from the date of birth |
Not Covered |
| Organ Donor Expenses | ||||||
| Covered | Covered | Not Covered | Not Covered | Covered | Lumpsum payment of 10% of the sum insured. | Not Covered |
| Vaccination (In case of post bite treatment) | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | ||||||
| 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 | Not Covered | Not Covered | Not Covered |
| Health Check-up | ||||||
| 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 | Not Covered | Not Covered | Not Covered |
| Hospital daily allowance | ||||||
| Not Covered | Not Covered | Not Covered | Not Covered | 0.1% of the sum insured per day subject to maximum of 6 days per insured person | Silver: Not Covered Gold: 0.1% of Sum Insured (Rs.600 to RS.1,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the Sum Insured Diamond: 0.1% of Sum Insured (Rs.1,200 to RS.2,000) per day of Hospitalisation,subject to a maximum compensation for 10 days per Illness. Overall liability of the Company during the Policy Period will be limited to 1.5% of the Sum Insured |
Not Covered |
| Co-pay | ||||||
| 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 | Option of voluntary Co-pay of 10% or 20% with premium reduction | Mandatory Co-pay of 10% up to 70years / Additional 20% above 70 years | 5% Co pay applicable on all claims |
| Pre-existing diseases coverage | ||||||
| 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 | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage | Covered after 4 years of continuous coverage |
| Restore Benefit | ||||||
| Not Covered | Covered up to 100% of base sum insured | Covered up to 100% of base sum insured | Not Covered | NIL Restoration benefit | NIL Restoration benefit | NIL Restoration benefit |
| General waiting period | ||||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | ||||||
| 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 | Not Covered | Not Covered | 5% for every claim free year up to 50% of sum insured |
| Emergency Air Ambulance | ||||||
| Not Covered | Up to Rs.100,000 | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Available sum insured options | ||||||
| Rs.50,000 to 5 Lakhs | Rs.10 to 30 Lakhs | Rs.1 to 3 Lakhs | Rs.1 to 5 Lakhs | Rs.1 to 10 Lakhs | Silver: Rs.2 to 5 Lakhs Gold: Rs.6 to 10 Lakhs Diamond: Rs.12 to 20 Lakhs |
Rs.1 to 5 Lakhs |
| Policy can be purchased for | ||||||
| 1/2/3 years | 1/2/3 years | 1/2/3 years | 1 year | 1/2/3 years | 1/2/3 years | 1 year |
| Eligibility criteria | ||||||
| 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) | Adults from 18 to 65 years (dependents 91 days to 17 years) | Adults from 18 to 65 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 | ||||||
| No Loading | No Loading | No Loading | Loading | Loading | No 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 |
