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SBI General Health Insurance

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Key highlights of SBI General Health Insurance

At SBI General, our goal is to partner with you and help you along the way to achieve better health and a sense of security. With SBI General's Health Insurance Policy you can be in control making medical expenses more manageable. This ensures your family's quality health and happiness.

Key features of SBI General Health Insurance

  • Room Rent: Payable at Actuals upto Sum Insured
  • Co-pay: NIL co-pay for all treatment
  • Restoration Benefit: Restoration benefit available upto 100% of Base SI

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

SBI General Health Insurance Products

Key Features:
  • Broad coverage from Rs. 10 lac to Rs. 30 lac
  • No pre-medical test for people without medical history up to the age of 55.
  • 142 day care expenses covered.
Key Features:
  • Coverage from Rs. 1 lac, Rs. 2 Lac and Rs. 3 Lac
  • No pre-medical test for people without medical history up to the age of 55.
  • Expenditure on maternity covered up to the OPD limit.
Key Features:
  • Wide coverage - From Rs. 1 lac to Rs. 50 lacs with Rs. 1 lac to Rs. 10 lacs deductible option
  • Expenditure on maternity after the first 9 months of waiting.
  • No pre-medical test for people without medical history up to the age of 55.
Key Features:
  • 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
Key Features:
  • Coverage of 13 most critical diseases
  • 2 plan options - 1 year and 3 years
  • Sum insured available up to Rs. 50 lacs
Key Features:
  • The plan offers 2 coverage options 30 days & 60 days
  • Free Look Period of 15 days
  • Daily cash benefit for hospitalization up to Rs.2,000 per day
Key Features:
  • No medical check - ups up to Rs.1 Crore and/or 55 years of age
  • Coverage for 13 critical illnesses, accidental death or permanent disablement and loss of job
  • The Loan Insurance Policy of SBI General is available for up to three years.
Key Features:
  • Coverage of 13 most critical diseases
  • 2 plan options - 1 year and 3 years
  • Sum insured available up to Rs. 50 lacs
  • Tax Exemption under Section 80D
Key Features:
  • No medical check-up up to the age of 45 years for people with no medical history
  • AYUSH coverage
  • Family Floater: one plan, full family
  • Road Ambulance Cover
  • Cumulative Bonus: 5% of SI for each claim-free year, up to 50%
  • Coverage from Rs 100,000 to Rs 500,000.
Key Features:
  • COVID Hospitalization Cover.
  • Home Care Treatment Expenses
  • AYUSH Covered
  • Covered for Individual / Floater
  • SBI Health Corona Kavach policy shall be offered with a policy term of 3 ½ months, 6 ½ months and 9 ½ months

Why Should One insure themselves through SBI General Health Insurance plans?

  • SBI General is one of India’s Fastest growing Private sector General Insurance companies in the Health Insurance space
  • Cashless Hospitalization Across the Large Network With More Than 6,000+ Hospitals in India for their insured customers
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹1 lacs to ₹30 lacs
  • SBI General Proudly retains the iAAA rating for its "highest claim paying ability"
  • Over 68 Million Happy Customers across all their product lines
  • Supported by State Bank of India’s enormous 24,000+ bank branch network, 350+ Satellite locations and 114 locations across India
  • Claims settled upto date of ₹110 billion across all product lines
SBI General Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the SBI General health insurance premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 6,000+ and growing and the SBI General health insurance hospital list is one of the most exhaustive in the industry today across India. Most of the customer’s SBI General health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the SBI General health insurance renewal link on eindiainsurance for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the SBI General health insurance claim form available on the same website.

SBI General insurance review

  • Benefits
  • How to buy?
  • Claims
  • Exclusions

Benefits under SBI General Health Insurance plans include :

  • Cashless facility – SBI General processes all cashless claims across 6000 + quality hospitals in their network across India
  • Hospitalisation expenses : Coverage for room rental expenses up to the sum insured for most of their plans. Pre and post hospitalisation expenses are covered up to the sum insured, 30/60 days prior and 60/90 days post hospitalisation depending on the plan opted for
  • Inpatient Treatment Covered expenses include: Hospital room rent, Boarding expenses and doctor fees, Operation Theatre and Intensive Care charges, Nursing expenses and Medicines that you consume during the hospital stay
  • Health Check up : Policy provides health check-up as per the applicable plan as specified in the Product Benefits Table, once every 4 claim free years.
  • Lifelong Renewability : SBI General assures you renewability for life without any extra loadings based on the claims
  • 142 Day Care procedures covered
  • No medical check-up if proposer doesn’t have any medical history up to 45 years of age
  • No Claims Bonus available at 10% increase after every claim free year upto maximum of 50% of Basic Sum insured
  • Income Tax Exemption under section 80D if the Income Tax Act.

How can one Buy a SBI General Health Insurance policy?

There are many distribution channels that distribute SBI General Health insurance products that include Agents, Banks and Brokers. One of the key distributors is the Web Aggregators which are online distributors of insurance and the advantage is that they offer a comparison of all insurance products to the customer, to allow them to compare the plans before opting for a health insurance plan that most suits his/her needs.
  • Step 1- Visit a product comparison website https://www.eindiainsurance.com/ to review and compare policy benefits, coverage and premium details online
  • Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy
  • Step 3 - Fill the SBI General online Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate
  • Step 4 – If this is a Straight through proposal, the premium remitted online will be transferred directly to the insurance company, and the policy will be issued, dispatched and will reach you in 7 working days
  • Step 5 – For Non Straight through cases, SBI General will process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy tests at designated diagnostic centers or they may just levy a loading based on the health report
  • Step 6 - If the proposal is accepted, the same will be issued accordingly.
  • Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form in the prescribed Turn around time.

Claim Process

Assistance Contact Numbers:
For Health Claims
Call at: Toll Free 1800-22-1111
SMS at: "CLAIM" to 561612
Email ID: customer.care@sbigeneral.in
Write at: "Natraj" 301, Junction of Western Express Highway & Andheri Kurla – Road, Andheri (East), Mumbai - 400 069

Cashless Claims Process

Step 1 Get admitted to any one of SBI General network hospitals, currently they have 6000+ hospitals across the country…check out the hospital list at SBI General Health Insurance
(Note: Cashless Facility is only available at hospitals in the company’s cashless network)
Step 2 Use your SBI General Health Card or share your Policy number and Passport / PAN card / voter’s ID for identification purposes
Step 3 The Network Hospital will check your identity for validation and submit the pre-authorisation request form to SBI General as per the defined process / format
Step 4 SBI General will review and provide our confirmation to the Network Hospital regarding the coverage limits and admissibility for the treatment for which the insured has been admitted
Step 5 SBI General will settle the claim (as per policy terms & conditions) with the hospital after completion of all formalities of documentation as per submission by the hospital

Reimbursement Claims Process

Step 1 In case of hospitalization notify SBI General within 24-48 hours of your admission in our network or non network hospital. After getting admitted settle bills directly to the hospital.
Step 2 On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
Step 3 Send these documents and the completely filled and signed claim form to us along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well.
Step 4 We review your claim request and the supporting documents provided along with the claim form. Accordingly based on policy terms & conditions, SBI General will approve, query or reject the same
Step 5 Subject to the claim being approved, SBI General will settle the claim (as per policy terms & conditions) and reimburse the approved amount to the insured

Information to be kept ready while intimating the claim:

  • Policy Number
  • Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
  • Name of Insured/ claimant person, who is hospitalised
  • Relationship of insured with the person who is hospitalised.
  • Name of the hospital
  • Health Claims - Nature of ailment
  • Commencement date of the symptom of ailment
  • Accident Claims
    • Nature of accident
    • Date & time of accident
    • Location of accident

Exclusions Under the Policy

Some of the permanent exclusions under the SBI General Health Insurance Plans are below, kindly review the policy wordings which are available with your policy kit for the entire list of exclusions under your opted plan. The exclusions include:
  • Treatment outside India
  • Epidemics recognized by WHO or/and Indian government. Government screening programs, etc are not covered by this policy
  • War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority
  • Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/materials
  • Circumcision unless necessary for treatment of a disease, illness or injury not excluded hereunder, or, as may be necessitated due to an accident
  • Cosmetic or aesthetic treatments of any description, treatment or surgery for change of life/gender, Lasik treatment for refractive error. Any form of plastic surgery (unless necessary for the treatment of Illness or Accidental bodily injury)
  • The cost of spectacles, contact lenses, hearing aids, crutches, wheelchairs, artificial limbs, dentures, artificial teeth and all other external appliances. Prosthesis and/or devices
  • Expenses incurred on Items for personal comfort like television, telephone, etc. incurred during hospitalization and which have been specifically charged for in the hospitalisation bills issued by the hospital
  • External medical equipment of any kind used at home as post Hospitalisation care including cost of instrument used in the treatment of Sleep Apnoea Syndrome (C.P.A.P), Continuous Ambulatory Peritoneal Dialysis (C.A.P.D) and Oxygen concentrator for Bronchial Asthmatic condition.
  • Dental treatment or surgery of any kind unless required as a result of Accidental Bodily Injury to natural teeth requiring hospitalization treatment
  • Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol) and any violation of law or participation in an event/activity that is against law with a criminal intent
  • Any complications arising out of or ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  • Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus or Variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS
  • Venereal disease or any sexually transmitted disease or sickness.
  • Treatment arising from or traceable to pregnancy childbirth, miscarriage, abortion or complications of any of this, including caesarean section. However, this exclusion will not apply to abdominal operation for extra uterine pregnancy (Ectopic Pregnancy), which is proved by submission of Ultra Sonographic Report and certification by Gynaecologist that it is life threatening
  • Any fertility, sub fertility or assisted conception operation or sterilization procedure and related treatment.
  • Vaccination or inoculation except as part of post-bite treatment for animal bite.
  • Treatment for any mental illness or psychiatric or psychological ailment / condition.
  • Outpatient Diagnostic, Medical and Surgical procedures or treatments, non-prescribed drugs and medical supplies, Hormone replacement therapy, Sex change or treatment which results from or is in any way related to sex change.
  • Any treatment required arising from Insured’s participation in any hazardous activity including but not limited to all forms of skiing, scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing etc unless specifically agreed by the Insurer
  • Treatments in health hydro, spas, nature care clinics and the like
  • Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy
  • Expenses incurred primarily for diagnostics, x-ray or laboratory examinations, or other diagnostics studies not consistent with or incidental to diagnosis and treatment of the positive existence or presence of any disease, illness or injury, for which confinement is required at a hospital or at home under domiciliary hospitalization as defined.
  • Hospitalization for donation of any body organs by an Insured Person including complications arising from the donation of organs
  • Treatment for obesity, weight reduction or weight management.
  • Disease / injury illness whilst performing duties as a serving member of a military or police force.
  • Any kind of Service charges, Surcharges, Admission fees / Registration charges etc levied by the hospital.

SBI General Health Insurance FAQ’s

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

SBI General has an extensive network of 6000+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through the SBI General network hospital list available on SBI General Health Insurance

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

A pre-existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.

In case of hospitalisation due to accident, your remaining Sum insured will become 125%, subject to maximum of INR 1,00,000/-

If you do not claim in any policy period then you will not get any refund, however you are eligible for a “Cumulative Bonus” of 5-10% which can be accumulated up to 25-50% depending on the plan you have chosen.

Health Insurance portability will allow the Policy Holder, protection against discontinuity and loss of coverage against pre-existing diseases consequent to his/ her decision to shift to another insurer at the time of renewal.

Most of the Health Insurance Policies offered by the General Insurance companies in India have waiting periods during which certain pre existing diseases are excluded in the coverage. They are excluded for certain predefined period (number of years) before they are covered i.e. The Policy holder is expected to have continuous cover for the predefined period before the pre existing diseases are covered under the policy. Portability will ensure that these accrued benefits are transferred (without any dilution) to the new insurer at the time of renewal and porting and the consumer do not lose on these accrued benefits while opting to switch the insurer using Health Insurance Portability. The Policy holder can port the following accrued credits: General waiting period Waiting periods pertaining to the coverage of pre-existing diseases/conditions Any time bound exclusions.

Every renewal premium shall be so paid and accepted upon the distinct understanding that no alteration has taken place in the facts contained in the proposal or declaration herein before mentioned and that nothing is known to the Insured that may increase the risk to the Insurer. No renewal receipt shall be valid unless it is on the printed form of Insurer and signed by an authorised official of Insurer. In case any disease/ illness is contracted during the last 12 months (whether a claim is made or not with the insurers), the information of the same needs to be provided to us at the time of renewal. We may require that an additional premium be paid for the enhanced risk profile arising out of such diseases contracted and policy would only be renewed upon collection of premium and such additional premium. In the event of any failure to either provide or disclose any change in medical condition by the insured/ proposer/ beneficiaries said act would amount to suppression of material fact and company will not be liable for any claim.

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.

Individual plan has to be separate for every individual. Floater covers all in family (max. 2 Adults and 2 Children) and provides one sum insured to all, hence there is saving of premium.

There is No maximum exit age for this policy.

The minimum age of entry for SBI General’s Health Insurance Policy - Retail is 18 years. However Children from the age of 3 months can be covered subject to both parents concurrently covered with SBI General’s Health Insurance Policy - Retail. The Maximum age of entry for the policy is 65 years.

In a floater option single policy under one Sum Insured covers all in the family for e.g. 2Adults, 2 A 1C, 2A 2C, 2A, 1A2C , 1A 1C. The Sum Insured can be used by anyone in the family or all covered in the policy for multiple number of times till the time the Sum Insured limit is exhausted.

Sub limit defines the capping of insurance amount, for specific surgeries and medical procedures, which reduces the premium of the plan. You can also opt for an add on cover by paying extra premium to remove the sub- limits under the policy.

Yes, waiting periods will be applicable afresh in relation to the amount by which the Sum Insured has been enhanced. For example, if the waiting period for pre- existing disease is 4 years, any expenses under this cover can be claimed only after 4 years from the date of policy inception.

The duration only after which a claim can be made is called the waiting period.

Sum Insured is the maximum amount that an insurance company will pay to the insured, according to the insurance contract, in the event of a claim.

A medical checkup may be necessary when you sign up for a new health insurance policy. However, medical checkups are not usually needed for renewal of policies. It is in your best interests to undergo a medical check-up at the time of enrollment so that when you need us, we‘re there to provide speedy and efficient support and faster settlement of claims.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

No, it is not possible to revise the sum insured during the policy period, the same can be carried out at the time of renewal of the policy.

Co-payment is a cost-sharing requirement under a health insurance policy, where the Policy Holder / insured will bear a specified percentage of the admissible costs

A waiting period is the length of time you, the insured, will have to wait before the benefits under the health policy can be utilised.

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

A grace period refers to a period of 30 days immediately following the premium due date of the medical insurance policy. During this period you can pay the premium of your expired policy and avail continuity benefits such as waiting periods and coverage of pre-existing disease.

The following KYC documents are required from the insured person/proposer in cases of reimbursement-
  • If claim amount is below 1 lakh- Photo Id proof & address proof
  • If claim amount is above 1 lakh- Photo Id proof, address proof and a recent photograph

A deductible is a cost-sharing requirement. It states that the insurer will not be liable for a specified amount in case of indemnity policies. This is applicable for a specified number of days/hours in case of hospital cash policies which apply before any benefits are payable by the insurer. Remember that a deductible does not reduce your sum insured.

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SBI General health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

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Network hospitals

SBI General Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 6,000+ Hospitals

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Compare health plans

Compare Indian health insurance policies, Health insurance India comparison


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Health insurance benefits

Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.

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Portability

Portability Information for Mediclaim Insurance in India.


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Health insurance FAQ

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Keep in touch

  • Address

    InstantCover Insurance Web Aggregator Private limited
    710, 6th B Cross, 16th Main Road, Koramangala 3rd Block, Bangalore - 560 034.

  • +91-(80)-41744345
  • Send an email
CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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