Importance of comparing policies from Different Insurers
To choose the right policy, one should:
- Understand his/her need
- Compare various plans – benefits and add-ons
- Be familiar with claim process
- Check the policy conditions and terms
It’s important to always be aware of what your coverage level is, how it matches your current needs, and how much you are paying for it. Our objective is to provide a comparative analysis of the major benefits covered under Individual Personal Accident and Individual/Floater Mediclaim policies offered by various insurance companies.
Hope this will help you choose the right policy for your needs.
Individual Personal Accident
Mediclaim
| MEDICLAIM - BENEFITS COMPARISON | X | |||||||
|---|---|---|---|---|---|---|---|---|
| Features | NIVA BUPA- Health Companion | TATA AIG - MEDICARE PREMIER | LIBERTY - SECURE SUPREME | DIGIT - EARLY START PLAN | MAGMA HDI - ONE HEALTH (Secure) | |||
| Entry Age | 91 days - 99 years | 91 days - 65 years | 91 days - 65 years | 1 Day - 45 Years | 91 days - Life long | |||
| Entry With Out Medical Check up | Tele Medical | 45 Years (Above 45 Year Tele Medical Avilable) | 55 Years | 45 Years | 50 Years | |||
| Sum Insured | 3L - 1Cr | 5L - 3Cr | 3L/4L/5L/7.5L/10L | 5L/10L/15L/20L/25L/50L/1Cr | 2L/3L/4L/5L/7.5L/10L | |||
| Policy Tenure | 1 Year | 1 Year | 1 Year | 1 Year | 1 Year | |||
| In-patient Hospitalisation | No restriction (except for Suite and above room category) | Single private or Shared Accommodation | Normal Room - Covered up to 1% of Sum Insured Per day Maximum 5,000/- ICU Charges:- 2% Sum insured per day Maximum 7500/- | No capping for Room Rent | Covered up to Sum Insured. Single private room | |||
| Pre and Post Hospitalisation | 30 days Pre Hospitalisation and 60 days Post Hospitalisation | 60 days Pre Hospitalisation and 90 days Post Hospitalisation | 45 days Pre Hospitalisation and 60 days Post Hospitalisation | 30 days Pre hospitalization & 60 days Post Hospitalization respectively | 30 days Pre Hospitalisation and 60 days Post Hospitalisation respectively | |||
| Day Care Procedures | Covered | Covered | Covered | Covered | Covered | |||
| Ambulance Cover | Covered upto Rs 3,000 | Covered upto Rs.5000 per Hospitalization | 1% of Sum Insured subject to Maximum Rs 3,000 per insured per year | 1% of Base Sum Insured , Maximum Rs 10,000 | Covered upto Rs 2,500 | |||
| Organ Donor Expenses | Covered | Covered | Covered | Covered | Covered | |||
| Proportionate Deduction | NIL | NIL | Applicable | NIL | NIL | |||
| Restoration of Sum Insured | Reinstate upto Base Sum Insured. Applicable for different illness | Restoration upto 100% of Sum Insured. This benefit is available for related/unrelated illness or diseases. However, this benefit for related illness/diseases would be available, in case of claimed insured person(s), for admissions after 45 days from the date of discharge of the earlier claim. | Available | Once Base Sum insured is used up, Backup sum insured equal to base Sum insured trigeers – Infinite times Both related & unrelated illnesses covered. Same insured person can use Backup Sum Insured multiple times | Recharge Up to 100% of Sum Insured, max 5 times a policy year | |||
| Ayush Cover | Covered upto Sum insured | Covered upto Sum insured | Not Covered | Not Covered | Covered upto 50% of Sum insured | |||
| Cumulative Bonus | In case of claim free year, increase of 20% of expiring base sum insured in a policy year; maximum up to 100% of Base Sum Insured | 50% increase in cumulative bonus for every claim free year, upto a maximum of 100%. In the case a claim is made during the policy year, the cumulative bonus would reduce by 50% in the following year | 30% of Sum Insured per claim free year, max up to 150% of Sum Insured. | 10% of Base Sum Insured per claim free year, Maximum 100% | 10% of Sum Insured, subject to a maximum of 50% | |||
| Renewals | Life Time Renewals | Life Time Renewals | Life Time Renewals | Life Time Renewals | Life Time Renewals | |||
| Daily Hospital Cash Cover | Optional benefit - Up to 4 Lac base sum insured: 1,000/day, 5 L to 12.5 Lacs base sum insured: 2,000/day ,15L - 1 Cr base sum insured: 4,000/day | Available for choosing shared accommodation. 0.25% of base Sum Insured; maximum Rs. 2000 per day | Not Covered | Not Available | Not Available | |||
| Pre-existing diseases | 36 months | 24 months | 36 months | 12 months | 36 months | |||
| Health Chech up | Variant 1 - Once in 2 years, Variant 2 &3 - Annually | Upto 50L Sum Insured - Upto 1% of Sum Insured; maximum `10,000 per policy | 1% of Sum Insured after every 4 continuos claim free years | After every policy year, reimbursement for Health Check up - Limit ₹1,500 (0.25% of Base Sum Insured) | Covered - Annually (For members aged 26 & above) | |||
| Co-payment | No | No | No | No | Mandatory Co-pay - 20% if entry age is above 60 years | |||
| Net Work Hospitals | InHouse (Niva Bupa) | InHouse | InHouse | InHouse (Digit Ins.) | TPA | |||
| OPD Benefit | Not Available | Once the insured has completed two years of continuous coverage , expenses related to consultations and pharmacy subject to Rs. 5000 per policy year shall be covered subject to policy terms and conditions. This benefit has a separate limit (over and above base sum insured) and does not affect cumulative bonus. Covers expenses related to root canal, filling, tooth extractions over and above sum insured. Limit - Rs 10,000/- . Does not impact cumulative bonus. - Subject to 24 months waiting period. | Not available | Not available | Not Available | |||
| Additional Benefits | *Global Cover * Vaccination Cover *Compassionate Travel *Wellness Services *Wellness program *First year vaccination for new born babies *Prolonged Hospitalization Benefit - 1% of Sum Insured * Hign End Diagnostics - upto Rs 25,000/- * Emergency Air Ambulance - upto Rs 5L *Accidental Death Cover -upto 100% Sum insured -Max 50L | In Built Personal Accident Cover Psychiatric Illness Maternity Benefit- with waiting period of 9 months . Auto Boost Maternity Wallet - Coverage starts from ₹15,000 and for every maternity claim-free year, ₹10,000 is added to the wallet up to ₹1,00,000. Spouse can be added at any time and shall be covered from Day 1 12 months waiting period only for Specific illness such as Cataract etc. Consumables Cover - Coverage of nonmedical expenses on approval of base claim (Optional benefit) with 10% additional premium | ||||||
| Terms and conditions | As per Standard policy to be issued | As per Standard policy to be issued | As per Standard policy to be issued | As per Standard policy to be issued | As per Standard policy to be issued | |||
| Portability | As Per IRDA Guideline | As Per IRDA Guideline | As Per IRDA Guideline | As Per IRDA Guideline | As Per IRDA Guideline | |||
| Annual Premium | Premium amount shall depend on the age of the members, size of the family etc. In case you wish to know the premium for your family insurance, please provide the details of the members to ecom@aimsinsurance.in | |||||||
