Health Insurance Claim Ratios - Last 3 Years Average
| Criteria | Aditya Birla | Bajaj General | Care Health | Generali Central | HDFC Ergo | ICICI Lombard | Manipal Cigna | Niva Bupa | Reliance General | SBI General | Star Health | Tata AIG |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Claim Incurred Ratio | 68 | 83 | 59 | 84 | 86 | 83 | 68 | 58 | 91 | 81 | 73 | 81 |
| Claim Settlement Ratio | 94 | 84 | 82 | 83 | 94 | 84 | 88 | 89 | 88 | 85 | 77 | 82 |
| Solvency Ratio | 2.02 | 3.61 | 1.80 | 2.00 | 1.71 | 2.53 | 1.63 | 1.98 | 1.62 | 1.94 | 2.00 | 2.00 |
OPD Plans
SBI Super Health Insurance
Versions: Prime, Elite, Premier, Platinum, Platinum Infinite
Features
- Room Rent- No Limit
- Pre/Post- 60/90 Days (More with higher versions)
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus upto 300% with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 2 Years
- Consumable Cover In-built
- OPD Cover with Higher Version Plan (Upto 40k for family)
- Maternity Cover with Higher Version Plan (Upto 2 Lacs)
- Aggregate Deductible with Optional Rider
- Global Cover with Higher Version Plan
- Health Reward Points (Upto 30% premium discount)
SBI Health Edge
Features
- Room Rent- No Limit
- Pre/Post- 30/60 Days
- Cumulative Bonus upto 200% (50% per year)
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 2 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Upto 5k per member)
- Maternity Cover with Optional Rider (Upto Rs.50k)
- Hospital Daily Cash with Optional Rider (Upto 2k per day)
- Global Cover with Optional Rider
Care Ultimate Care
Features
- Room Rent- No Limit
- Pre/Post- 60/90 Days
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus 100% Per Year Unlimited with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Consultations)
- Waiting Period Reduction with Optional Rider
- Jumpstart with Optional Rider
- Health Reward Points (Upto 30% premium discount)
- 1st Base Sum Insured Amount Addition Free after 7 Continuous Claim Free Years
- 1st Premium Payback for 5 Continuous Claim Free Years with Optional Rider
Care Supreme
Features
- Room Rent- No Limit
- Pre/Post- 60/180 Days
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus upto 500% with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Consultations)
- Waiting Period Reduction with Optional Rider
- Jumpstart with Optional Rider
- Health Reward Points (Upto 30% premium discount)
TATA AIG Medicare Select
Features
- Room Rent- Single Pvt AC Room
- Pre/Post- 90/90 Days (More with higher versions)
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus 100% Per Year Unlimited with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years\
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Consultations)
- Maternity Cover with Optional Rider (Upto Rs.1 Lac)
- Aggregate Deductible with Optional Rider
- Jumpstart with Optional Rider
- Infinite Claim Once in a Lifetime with Optional Rider
TATA AIG Medicare Premier
Features
- Room Rent- No Limit
- Pre/Post- 60/90 Days (More with higher sum insured)
- Cumulative Bonus upto 100% (50% per year)
- Restoration- Once (Upto 3 restorations in a year with long term payment)
- Pre-existing Waiting Period 2 Years
- Consumable Cover In-built
- OPD Cover In-built (Upto Rs.45k)
- Maternity Cover In-built (Upto Rs.1 lac/2 lacs for boy/girl child)
- Free Health Check-up Every Year
- Global Cover In-built
Star Health Super Star
Features
- Unlimited Sum Insured Option
- Room Rent- No Limit
- Pre/Post- 90/180 Days
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus 100% Per Year Unlimited with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover for Dental In-built
- Maternity Cover with Optional Rider (Upto Rs.1 Lac)
- Hospital Daily Cash with Optional Rider (Upto 5k per day)
- Aggregate Deductible with Optional Rider
- Waiting Period Reduction with Optional Rider
- Jumpstart with Optional Rider
- Infinite Claim Once in a Lifetime with Optional Rider
- Free Health Check up Every Year
- Health Reward Points (Upto 20% premium discount)
- Lock the Premium until Claim (with higher versions)
Star Health Comprehensive
Features
- Room Rent- Single Pvt AC Room
- Pre/Post- 60/90 Days (Post- 200 days for 75 lacs or above)
- Cumulative Bonus upto 100% (100% in a year)
- Restoration- Once (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover for Dental with Optional Rider (Consultations)
- Maternity Cover with Optional Rider (Upto Rs.1 Lac)
- Hospital Daily Cash with Optional Rider (Upto Rs.500 per day)
- Waiting Period Reduction with Optional Rider
- Health Reward Points (Upto 10% premium discount)
Generali Central Health Unlimited
Features
- Room Rent- Single Pvt AC Room (No limit for 25 lakhs & above)
- Pre/Post- 60/90 Days (Increase with optional rider)
- Cumulative Bonus upto 100% (50% per year)
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Upto 10k)
- Maternity Cover In-built (Upto 1.35 Lakhs)
- Hospital Daily Cash with Optional Rider (Upto 2.5k per day)
- Aggregate Deductible with Optional Rider
- Inflation based Sum Insured Increase with Optional Rider
- Infinite Claim Once in a Lifetime In-built
- Global Cover In-built (With higher sum insured)
- Health Reward Points (Upto 20% premium discount)
- Premium Payback for 4 Continuous Claim Free Years
Reliance Health Gain
Versions: Power, Prime
Features
- Room Rent- No Limit
- Pre/Post- 60/60 Days (Increase with optional rider)
- Cumulative Bonus upto 100% (33.33% per year)
- Restoration- Once (Other illness), Unlimited with Optional Rider
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Upto 5k per member)
- Hospital Daily Cash with Optional Rider (Upto 2.5k per day)
- Aggregate Deductible with Optional Rider
- Waiting Period Reduction with Optional Rider
- Health Check up with Optional Rider
- Global Cover with Optional Rider
- Sum Insured Enhancement with Call Option
Manipal Cigna Pro Health Prime
Versions: Protect, Advantage
Features
- Room Rent- Single Pvt AC Room
- Pre/Post- 60/180 Days
- Cumulative Bonus upto 200% (25% per year)
- Super Bonus 50% Per Year Upto 200% with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 2 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Upto Rs.50k)
- Free Health Check up Every Year
- Health Reward Points (Upto 20% premium discount)
ICICI Lombard Elevate
Features
- Unlimited Sum Insured Option
- Room Rent- No Limit
- Pre/Post- 60/180 Days
- Cumulative Bonus upto 100% (50% per year)
- Super Bonus upto 500% with Optional Rider
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider (Consultations)
- Maternity Cover with Optional Rider (Upto 1 Lac)
- Waiting Period Reduction with Optional Rider
- Jumpstart with Optional Rider
- Infinite Claim Once in a Lifetime with Optional Rider
- Health Reward Points (Upto 30% premium discount)
HDFC Ergo Optima Secure
Features
- Room Rent- No Limit
- Pre/Post- 60/180 Days
- Cumulative Bonus upto 100% (50% per year)
- 100% of Base Sum Insured Addition Instantly
- Restoration- Unlimited (Same & other illness) with Optional Rider
- Pre-existing Waiting Period 3 Years
- Consumable Cover In-built
- OPD Cover with Optional Rider (Consultations)
- Hospital Daily Cash with Optional Rider (Upto 10k per person)
- Aggregate Deductible with Optional Rider (Can remove after 5 Years)
Niva Bupa Aspire
Versions: Gold+, Diamond+, Platinum+, Titanium+
Features
- Room Rent- No Limit
- Pre/Post- 60/180 Days
- Unutilised Base Sum Insured Carry Forward upto 10x
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover with Optional Rider
- OPD Cover with Optional Rider
- Maternity Cover with Optional Rider (M-iracle)
- Hospital Daily Cash with Optional Rider (Upto 4k per day)
- Aggregate Deductible with Optional Rider
- Inflation linked Increase in Sum Insured with Optional Rider
- Global Cover with Optional Rider
- Health Reward Points (Upto 30% premium discount)
- Lock the Premium until Claim (with higher versions)
Bajaj My Healthcare Plan (Plan 1)
Versions: Gold+, Diamond+, Platinum+, Titanium+
Features
- Room Rent- Single Pvt AC Room (No limit with higher sum insured)
- Pre/Post- 60/90 Days (Customizable)
- Cumulative Bonus upto 100% (50% per year)
- Restoration- Unlimited (Same & other illness)
- Pre-existing Waiting Period 3 Years
- Consumable Cover In-built
- OPD Cover- Double Amount of Base Premium (Only with plan 1)
- Maternity Cover Upto 1 Lac (Only with Plan 1)
- Waiting Period Reduction Option
- Global Cover with Optional Rider (Emergency only)
