Current Size: 100%
We understand that people are unique and have varying levels of control over their health. Each of us would like to define a healthy life on our own terms. At SBI General, its our aim to partner with you and help you achieve better health and a sense of security along the way. In times of rising health care costs, a sudden illness or injury can leave you financially devastated and highly stressed. With SBI General’s Health Insurance Policy – Retail, you can be in control by making medical treatment expenses more manageable. Thus ensuring quality health & happiness of your family.
- Wide Coverage – From Rs.50,000 up to Rs.500,000
- No medical test up to the age of 45 for people with no medical history
- Family Floater benefit giving comprehensive protection to your family members under one single Policy
- Flexible Plan Options–Metro Plan, Semi Metro Plan & Rest of India
- Assured renewal
- You can now renew your current Health Insurance Policy (any Insurer) with us
- The premium paid is exempt from Income Tax under Sec 80 D of Income Tax Act (Tax Benefits are subject to change in tax laws)
- Coverage of Pre and Post Hospitalisation Expenses - 30 days before and 60 days after the hospitalisation
- Free Medical check-up for every 4 claim free years up to a maximum limit of Rs.2,500
- "Add-on Covers available including removal of sub-limits on Room & ICU rent, Operation and Consultancy charges" after "Flexible Plan options..." point
This policy covers the following subject to the terms and conditions:
|S.No.||Expense Heads||Expense Limit (Rs.)|
|1||Medical Treatment with Room, Board & Nursing Expenses & Service Charges etc.||Up to 1% of the Sum Insured per day|
|2||Medical Treatment in Intensive Care Unit||Up to 2% of the Sum Insured per day|
|3||All admissible claims under 1 & 2 during the policy period||Up to 25% of the SI per illness/injury per claim|
|4||Consultants & Specialists Fees||Up to 40% of the SI per illness/injury per claim.|
|5||Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances||Up to 40% of the SI per illness/injury per claim.|
|6||Pre-hospitalisation||Up to 10% of the eligible hospitalisation expenses incurred 30 days prior to date of admission into the hospital.|
|7||Post-hospitalisation||Up to 10% of the eligible hospitalisation expenses incurred 60 days after the date of discharge from the hospital.|
|8||Ambulance charges||1% of SI up to a max of Rs. 1500.|
|9||Free Medical Check up||Free medical check-up - 1% of SI up to a max of Rs. 2500 for every 4 claim free years.|
|10||Parental Care: Attendant nursing charge to take care of you parents who are above 60 years of age.||Available for persons above 60 years old. Attendant nursing charges after discharge from the hospital for Rs 500 or actual whichever is less per day up to a max. 10 days per hospitalisation. The charges can be reimbursed for a period not exceeding 15 days during the entire Policy period.|
|11||Child Care: Attendant escort charges to take care of child below 10 years of age.||Available for child below 10 years. Attendant escort charges of Rs 500 for each completed day of hospitalisation subject to maximum of 30 days during the Policy Period.|
|12||Limit of Cataract||15% of sum insured subject to maximum of 25000 per eye subject to first two years exclusion.|
|13||Accidental Hospitalisation||Sum Insured Limit under the policy shall increase by 25% of the balance sum insured available subject to max of Rs.1 Lac. in case of accidental hospitalisation. Payable only once under the Policy per person.|
|14||Alternative Treatment (Subject to Treatment taken at a Ayurvedic hospital confirming with our definition of hospital and which is registered with any of the local Govt. bodies)||Reimbursement of Ayurvedic Treatment up to a maximum of 15% of Sum Insured per Policy period up to a maximum of Rs. 20000 & Homeopathy and Unani Treatment upto a maximum 10% of Sum Insured per Policy period up to a maximum of Rs. 15000.|
|15||Domiciliary Hospitalisation||Reasonable and Customary Charges towards Domiciliary Hospitalisation as defined in Policy definition subject to 20% of the Sum Insured maximum up to Rs.20000 whichever less is.|
|16||Convalescence Benefit- Benefit available for Insured above 10 years & below 60 years.||Covers the convalescence expense up to an amount not exceeding Rs. 5,000/- per Insured, if the Insured is hospitalised for any bodily injury or illness as covered under the Policy, for a period of 10 consecutive days or more. Admissible only once during the Period of Insurance.|
|17||Co-Payment on all eligible admissible claims in non-network hospitals||10% on all eligible admissible claims.|
|18||Cashless facility||Across SBI General's Network Hospitals|
|19||Coverage for select Day Surgery procedures where less than 24 hours hospitalisation is required.||Covers select Day Surgery where less than 24 hours hospitalisation for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery (Due to accident), Tonsillectomy, etc are covered.|
What is the minimum & maximum coverage possible under this Policy? The minimum coverage available for you and your family under this policy is for a Sum Insured of Rs.50,000. The Maximum coverage available under this policy is for a Sum Insured of Rs.500,000 subject to the Terms and Conditions of the Policy. The following Terms & Conditions apply while Sum Insured is finalised:
- Maximum Sum Insured would be restricted to Rs.200,000/- for insured persons aged 60 and above and taking a policy with SBI General Insurance for the first time.
- Minimum Sum Insured for Family Floater Policy would be Rs.200,000/-
- By Family we mean-
- For Individual Policy: You, your legal spouse, legal & dependent children and dependent parents.
- For Family Floater Policy: You, your legal spouse and legal & dependent children.
- Based on the medical history, Sum Insured opted and/or age, you/your family members may be subject to a Medical Examination.
- Renewal for people beyond 70 years will be allowed subject to Insured accepting to pay the premium and additional loading as applicable for the age band in which the Insured falls at the time of renewal and as approved by IRDA.
What are the Add-on Covers available with this Policy? On payment of additional premium the following Add-on Covers are available with his Policy. Any one or both Add-on Covers can be opted by the primary insured and which is applicable to all the members in the family. - Removal of Room & ICU rent sub-limits - Removal of sub-limits on Operation and Consultancy charges
The Company will not be liable under the Policy in respect of payment towards treatment taken due to:
- Any condition, ailment or injury or related condition(s) for which you have been diagnosed, received medical treatment, had signs and / or symptoms, prior to inception of your first policy, until 48 consecutive months have elapsed, after the date of inception of the first policy with us.
- Any disease contracted during the first 30 days of commencement of the policy.
- Certain diseases/surgeries like Hernia, Hydrocele etc shall be covered after a waiting period of 1 year.
- Certain diseases like Cataract, Hysterectomy shall be covered after a waiting period of 2 years from commencement of Policy.
- Joint replacement surgery shall be covered after a waiting period of 3 years from commencement of Policy except done due to an accident.
- Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy
- Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarean section, and/or any treatment related to prenatal and postnatal care.
- Congenital diseases.
- All expenses related to AIDS and related diseases.
- Use/Abuse of intoxicating drugs or alcohol.
SBI General firmly believes in providing you with flexible options in terms of where you would like to get treated should the need arise. In case you are living in a Metro or in a Semi Metro, and you would like to get treated there only, the Policy provides you with an option to choose a Plan. This way it helps you to choose a plan which is more appropriate to your need and hence priced accordingly. The Policy firmly puts you in control by giving you the flexibility to select an appropriate option that is just right on your purse. The three available plans are:
|Benefit Plan||Treatment Location A Mumbai & Delhi||Treatment Location B Chennai, Kolkata, Bangalore, Ahmedabad & Hyderabad||Treatment Location C Rest of India|
|Plan A (Mumbai & Delhi)||100%||100%||100%|
|Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad)||80%||100%||100%|
|Plan C (Rest of India)||70%||80%||100%|
- Plan A - 100% of the admissible claim amount for all Locations subject to the Policy termsand conditions.
- Plan B - 100% of the admissible claim amount for Locations B and C, and 80% forLocation A subject to the Policy terms and conditions.
- Plan C - 100% of the admissible claim amount for Locations C, 80% for Location B and70% for Location A subject to the Policy terms and conditions.
- The percentage of amount shown in the above table is with respect to the admissibleclaim amount. The Company will make payments only after being satisfied, with thenecessary bills and documents.
What do you mean by Co-payment? Is there any co- pay in this policy?
Co-payment refers to the amount expected to be paid by the insured for a medical services covered by the plan. This policy has a Plan based co-pay (between 20-30%), based on the geographical location of the hospitalisation. Also this policy attracts co- pay of 10% in case of hospitalisation in non- network hospital.
Can I change my sum insured from 3 lakh to 5 lakh if it is renewal case for age above 60 years?
You can change your sum Insured at the time of renewal, however please note that maximum Sum Insured would be restricted to INR 200,000/- for insured persons aged 60 and above and taking a policy with us for the first time.
Does this policy cover treatment by Homeopathy method?
Alternative Treatment, like Ayurvedic, Homeopathy or Unani, taken in a government hospital or in any institute recognised by government and/or accredited by Quality Council of India/ National Accreditation Board on Health) is covered under the policy. Ayurvedic Treatment is covered maximum up to 15% of Sum Insured per Policy period up to a maximum of INR 20000 & Homeopathy and Unani Treatment is covered up to maximum 10% of Sum Insured per Policy period up to a maximum of INR 15000.
Do I get some additional benefit on hospitalisation due to Accident?
In case of hospitalisation due to accident, your remaining Sum insured will become 125%, subject to maximum of INR 1,00,000/-
If I don’t claim in a policy period, can I get a refund of my money?
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% which can be accumulated up to 25%.
- 1 of 6
- next ›
Disclaimer: The above information is only indicative in nature. For full details of the coverage & exclusions please contact our nearest office and refer to the policy documents. Product Code - IRDA/NL-HLT/SBIGI/P-H/V.I/40/13-14 Disclaimer: The above information is indicative in nature, for more details on complete coverage and terms and conditions, please contact our nearest office and also read the policy document and sales brochure carefully before concluding a sale.