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
| INDIVIDUAL PERSONAL ACCIDENT - COMPARISON | |||
|---|---|---|---|
| NIVA BUPA | GO DIGIT | LIBERTY GENERAL | |
| SUM ASSURED OPTIONS | 5 Lacs - 10 Crores | 1 Lac - 1 Crore | 10 Lacs - 1 Crore |
| Accidential Death | Capital Sum Assured | Capital Sum Assured | Capital Sum Assured |
| Permant Total Disability | Percentage of Base Sum Assured | Capital Sum Assured | Capital Sum Assured |
| Permant Partial Disability | Percentage of Base Sum Assured | Depending upon the disability | Depending upon the disability |
| Weekly Indemnity (TTD) | Earning Members: 2% of Base Sum Insured per week. Maximum INR I Lac per week. For Maximum 100 weeks. Non-Earning Members: 1% of Base Sum Insured per week. Maximum INR 25,000 per week. For Maximum 50 weeks. | Limited to Rs 5,000/ week for a max. of 100 weeks | Limited to Rs 5,000/ week for a max. of 100 weeks |
| Accidental Hospitalization Expenses | Up to INR 1Lac, INR 2Lac, INR 3Lac, INR 4Lac & INR 5Lac. 10% of Base Sum Insured subject to maximum of INR 5 Lakh; in case 10% of Base Sum Insured falls between the two available AH Sum Insured then the higher available SI will be given to the insured. | Available upto Sum Assured opted | Ranges from 1 Lac - 2 Lacs based on the Capital Sum Assured |
| Accidental Hospital Daily Cash | 0.25% of Base Sum Insured per day. Maximum INR 5,000 per day. For Maximum 30 days in a policy year. | Options available from Rs. 500- Rs. 5000 | Max. upto 30 days |
| Child Education Support Benefit | 10% of Base Sum Insured. Maximum INR 5Lac | Available upto 10% of Capital Sum Assured opted | Ranges from Rs 10,000 - Rs 1 Lac based on the Capital Sum Assured |
| Broken Bone | Options available 5% - 20% of Sum Assured | Rs 1 Lac - Rs 3 Lacs (Based on Capital Sum Assured) | |
| Loan Protector | Percentage of Broken Bone/Fracture Sum Insured. Broken Bone/Fracture Sum Insured = Base Sum Insured. Maximum INR 10Lac. | EMI amount can be opted - upto 40% of Gross monthly income. EMI cover can be opted for 3 or 6 months | Rs. 12,000/- per month for max. of 12 months - For Sum Assured upto Rs 30 Lacs Rs. 24,000/- per month for max. of 12 months - For Sum Assured above Rs 30 Lacs |
| Ambulance Hiring Charges | Upto Rs 25,000 | Upto Rs. 5,000 | Rs. 1,500/- |
| Legal Bail Expenses | Not covered | Not covered | Rs. 5,000 |
| Cost of Transporting Mortal Remains | Up to 1% of Base Sum Insured. Maximum INR 1Lac | Options available 1% - 2% of Sum Assured | Rs. 10,000 |
| Cost of Performance of Death Ceremony | Funeral Expenses - Up to 1% of Base Sum Insured. Maximum INR 1Lac | Funeral expenses - Options available 1% - 2% of Sum Assured | Rs. 10,000 |
| Cumulative Bonus | Not available | 3 Options available - 5% of Base Sum Assured for each claim free year upto 25%/ 10% of Base Sum Assured for each claim free year upto 50%/ 20% of Base Sum Assured for each claim free year upto 100% | The Sum Insured under the Accident Benefit(s) will be progressively increased by 5% during the renewal policy for each claim free year subject to a maximum accumulation of 50% of the Capital Sum Insured. In the event of a claim under the Policy in respect of an Insured / Insured Person, the increased Sum Insured will be reduced by 10% at the time of renewal. |
| Domiciliary Hospitalization (Due to accident only) | Not available | Available upto the Sum Assured | |
| Marriage expenses for children | 20% of Base Sum Insured. Maximum INR 10Lac | Available 1% - 10% of the Sum Assured | |
| Long Hospitalization Cash Benefit | Not available | Lump sum benefit Rs 5000/Rs 10,000 | |
| Outpatient benefit | Up to 1% of Base Sum Insured. Maximum INR 25,000. | Options available - 2500/5000/7500/10000 | |
| Coma Benefit cover | 25% of Base Sum Insured. Maximum INR 10Lac | Options available - 5% -25% | |
| Burns Cover | Up to Base Sum Insured. Maximum INR 50Lac | Options available - 5% - 50% | |
| HIV Cover | Not available | Available upto 10% of Capital Sum Assured opted. Waiting period - 30 days | |
| Monthly Needs Benefit | 0.5% of Base Sum Insured per month. Maximum INR 50,000 per month. For 3 months. | ||
| Elderly Care | 10% of Base Sum Insured. Maximum INR 5Lac | ||
| Child Support | One Educational Counselling Service (13yrs to 23yrs). Maximum 2 Children. | ||
| Placement Services for Children (19-25yrs) who are currently not studying |
Individual Mediclaim
| INDIVIDUAL MEDICAL - BENEFITS COMPARISON | |||||
|---|---|---|---|---|---|
| Features | New India Mediclaim | Oriental Insurance - Individual plan | Niva Bupa- Re Assure | ICICI Lombard Health Shield | GO DIGIT-Digit Health Care Plus Policy (Digit Diamond) |
| Entry Age | 18 Years - 65 years | 18 Years - 65 years | 91 Days - 65 Years | 21 Years - 65 years | 18 years - 60 Years |
| Entry With Out Medical Check up | 50 Years | 55 Years | 60 years | 65 Year | 60 Year |
| Sum Insured | 1 Lakh - 15 Lakhs | 1 Lakh - 10 Lakhs | 3L - 1 Cr | 3 Lakh- 50 lakh | 2 Lakhs - 100 Lakhs |
| Policy Tenure | 1 Year | 1 Year | 1 Year | 1/2/3 Years | 1/2/3 Years |
| In-patient Hospitalisation | Hospital room 1% of Sum Insured, ICU 2% of Sum Insured | Hospital room 1% of Sum Insured, ICU 2% of Sum Insured | No restriction | No Restriction | No Restriction |
| Pre and Post Hospitalisation | 30 days/60 days | 30 days /60 days | 60 days/180 days | 30 days /60 days | 60days/90 days |
| Day Care Procedures | 139 procedures | Covered | Covered | 161 procedures | Covered up to SI |
| Ambulance Cover | 1% of Sum Insured | Rs.2,000/- OR 1% of the sum insured whichever is less | Rs. 2,000 per hospitalization | 1 % of Sum Assured Maximum Rs.10000/-, | 1% of Base SI up to INR 5000 |
| Organ Donor Expenses | Available | Available | Available | Available | Available |
| Proportionate Deduction | Applicable | Applicable | NIL | Nil | Nil |
| Restoration of Sum Insured | Not Available | Not Available | Unlimited reinstatement of Sum Insured applicable for any illness or anyone insured (Single claim under this benefit will be payable up to base sum insured) | unlimited reset benefit | Age <= 40 Years - Unlimited times Age > 40 Years - 1 time up to 100% SI Related Illness + Unrelated illness Exhaustion clause not appliable |
| Ayush Cover | 25 % Available | Covered upto Sum insured | Covered upto Sum insured | Covered upto Sum insured | Covered upto Sum insured |
| Features | New India Mediclaim | Oriental Insurance - Individual plan | Niva Bupa- Re Assure | ICICI Lombard Health Shield | GO DIGIT-Digit Health Care Plus Policy (Digit Diamond) |
| Cumulative Bonus | Cumulative Bonus @25% SI for claim free year with Max 50% of SI. | Not available | Cumulative Bonus @50% SI for claim free year with Max 100% | 10% each claim free year up to 50% | 50% each claim free year up to 100% |
| Renewals | Life time renewals | Life time renewals | Life time renewals | Life time renewals | Life time renewals |
| Daily Hospital Cash Cover | 0.1% Sum Insured per day, up to a maximum of 1% Sum Insured. | 0.1% of the sum insured per day subject to maximum of 6 days per insured person during the entire policy period. Deductible - 2 days | Optional benefit at additional premium | Daily benefit of Rs.1000/ Rs. 2000/Rs 3000 as per opted Sum insured - maximum 10 days | Daily benefit of INR 500 max up to 30 days with one day deductible |
| Pre-existing diseases | 48 months | 48 months | 36 months | 24 Months | 36 Months (Option to reduce the Pre ExistingDiseases waiting Period to 2 years) |
| Health Chech up | Available - for every 3 claim free years. Maximum Rs 5,000/- | Not Available | Annual (From Day 1); For defined list of tests; up to 500 for every 1 Lac sum insured (Individual policy: maximum 5,000 per Insured; Family Floater policy: maximum 10,000 per policy) | One coupon per individual policy and two coupons per Floater policy will be offered. | 0.5% of Base SI up to INR 5000 at each renewal |
| Co-payment | No | No | No | No | No |
| Claim settlement | Through TPA | Through TPA | InHouse (Niva Bupa) | In House (ICICI Lombard) | Through TPA |
Family Floater Mediclaim
| FAMILY FLOATER - BENEFITS COMPARISON | |||||
|---|---|---|---|---|---|
| Features | NEW INDIA FLOATER MEDICLAIM | GO DIGIT - DIAMOND | IFFCO TOKIO -HEALTH PROTECTOR | NIVA BUPA - REASSURE | TATA AIG - MEDICARE PREMIER |
| Entry Age | 91 days - 65 years | 91 days - 65 years | 91 days - 65 years | 91 Days - 65 Years | 91 days - 65 years |
| Entry With Out Medical Check up | 50 Years | 60 Year | 60 Year | 60 years | 45 Years (Above 45 Year Tele Medical Avilable) |
| Sum Insured | 2 Lacs - 15 Lacs | 2 Lacs - 1 Cr | 50K - 20 Lacs | 3 Lacs - 1 Cr | 5 Lacs - 50 Lacs |
| Policy Tenure | 1 Year | 1 Year/2 years/3 years | 1 year | 1 Year/2 years/3 years | 1 Year/2 years/3 years |
| In-patient Hospitalisation | Hospital room 1% of Sum Insured, ICU 2% of Sum Insured | No Restriction | 1.5% of the Sum Insured | No Restriction | No Restriction |
| Pre and Post Hospitalisation | 30 days Pre Hospitalisation and 60 days Post Hospitalisation | 60 days Pre Hospitalisation and 90 days Post Hospitalisation | 60 days Pre Hospitalisation and 90 days Post Hospitalisation | 60 days Pre hospitalization & 180 days Post Hospitalization | 60 days Pre Hospitalisation and 90 days Post Hospitalisation |
| Day Care Procedures | 141 procedures | Covered | 161 Procedures | covered | 541 up to SI |
| Ambulance Cover | 1% of Sum Insured | 1% of Sum Insured subject to Max. Rs 5,000 | 1% of the sum insured or Rs. 2500/- whichever is lower | Rs. 2,000 per hospitalization | Rs.5000 per Hospitakisation |
| Organ Donor Expenses | Available | Available | Available | Available | Available |
| Proportionate Deduction | yes | NIL | Yes, can be waived at additional premium | NIL | Nil |
| Restoration of Sum Insured | Not Available | One time restoration for related Illness | Available | Unlimited reinstatement of Sum Insured applicable for any illness or anyone insured (Single claim under this benefit will be payable up to base sum insured) | Automatically restores your sum insured to 100% |
| Ayush Cover | 25 % Available | Covered upto Sum insured | Covered upto Sum insured | Covered upto Sum insured | Covered upto Sum insured |
| Cumulative Bonus | Cumulative Bonus @25% SI for claim free year with Max 50% of SI. | 50% of Base SI for each claim free year upto max 100% | Add on cover | 50% of base sum insured in a policy year; maximum up to 100% | 50% increase in cumulative bonus for every claim free year. |
| Renewals | Life time renewals | Life time renewals | Life time renewals | Life time renewals | Life time renewals |
| Daily Hospital Cash Cover | 0.1% Sum Insured per day, up to a maximum of 1% Sum Insured. | 500 Rs./day for 30 days with 1 day deductible | 0.15% of Sum Insured subject to Maximum of Rs-1000/- | Optional benefit with additional premium | 0.25% of base sum insured and max. Rs. 2000 per day. |
| Pre-existing diseases waiting period | 48 months | 36 months | 48 months | 36 months | 24 Months |
| Features | NEW INDIA FLOATER MEDICLAIM | GO DIGIT - DIAMOND | IFFCO TOKIO -HEALTH PROTECTOR | NIVA BUPA - REASSURE | TATA AIG - MEDICARE PREMIER |
| Health Chech up | Not Available | Covered - 0.50% of the Sum Insured | 4 continuous claim free year 1% of sum insured. | Annual (From Day 1); For defined list of tests; up to 500 for every 1 Lac sum insured (Individual policy: maximum 5,000 per Insured; Family Floater policy: maximum 10,000 per policy) | 1% of policy sum insured subject to a maximum of Rs. 10,000/- per policy. |
| Co-payment | No | No | No | No | No |
| World Wide cover/ Emergency Assistance | Not Available | Not available | Not Available | Not Available | Available |
| Claim settlement | Through TPA | Through TPA/INHOUSE | In House (Iffco Tokio) | InHouse (Niva Bupa) | In House (TATA AIG) |
| OPD Benefit | Not Available | Optional - Rs. 2,500/Rs. 5,000 | Not available | Not available | Available after two years. Limit -Rs 5,000/- for consultations and pharmacy |
| Maternity Benefit | Available as optional benefit - Limit - 1% of the Sum insured | Not available | Not available | Not available | up to a maximum of Rs. 50,000/- per policy subject to a waiting period of 4 years of continuous coverage under this policy subject to IRDAI portability guidelines. (in case of birth of girl child cover would be for Rs. 60,000) per policy. No limit on number of delivery events. |
| New Born Baby Cover | Not available | Not available | Not available | Covers medical expenses incurred for the medically necessary treatment of the new born baby up to Rs.10, 000 for complications related to delivery. This benefit will trigger only if there is a payable maternity claim |