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National insurance mediclaim policies - Comparison

Name of policy Mediclaim insurance policy Sampoorna arogya bima policy Parivaar- Mediclaim for family Varistha bima
Types of policy Individiual/family Individual/family policy Family floater policy- single premium For senior citizens
Eligibility/Requirement
Entry age limit 3 months - 59 years 3months - 59 years 3 months- 60 years 60 years - 80 years
Min -Max sum assured limit Rs 50000 - 500000 Rs 25000-500000 Rs. 200000 - 500000 100000- 200000
Expense covered per illness
Room rent up to 1% of S.I,
<=5000 per day
ICU - 2 % of S.I
<=10000 per day
up to 1% of S.I
<=5000 per day
ICU - 2 % of S.I
<= 10000 per day
up to 1% of S.I per day
ICU - 2 % of S.I per day
up to 1% of S.I per day
ICU - 2 % of S.I per day
Doctor,surgeon fees etc. upto 25% of S.I upto 25% of S.I Actual upto 25% of S.I
Medical, O.T. charges etc. &
Medical Exp. Relating to person donating organ
upto 50% of S.I upto 50% of S.I Actual and Limit of 7% of S.I for any disposable surgical consumables upto 50% of S.I
Package Hospt. Expenses Not indicated 80% of S. I unless full break-up given Total Expenses Incurred
for ony one illness is
limited to 50% of the
sum insured per person
Limit for Cataract Rs. 10000 &
Benign Prostatic Hyperthropathy Rs 20000
Pre- hospitalzation Expenses Upto 30days Upto 30days upto 15 days Upto 30days
Post- hospitalzation Expenses Upto 60 days Upto 60 days upto 30 days Upto 60 days
Other benefits
Family Discount 10 % on total premium, Yes 10 % on total premium, Yes Nil Nil
Cumulative Bonus 10% of S.I claim free yrs max 50% 10% of S.I claim free yrs max 60% Nil 5%-S.I upto 10 claim free yrs
Emergency Ambulance Charges 1% of S.I Max. Rs. 1000 Upto Rs. 1000 Not Indicated Upto Rs. 1000
Policy Extention Geographical & Abroad Nepal, Bhutan approval required Not Indicated Not Indicated
Anyone illness relapse with 105 days relapse with 45 days relapse with 45 days relapse with 45 days
IT deduction if paid by cheque Max. Limit as per Section 80D Max. Limit as per Section 80D Max. Limit as per Section 80D Max. Limit as per Section 80D
Critical Illness cover Not Available Not Available Not Available Available
TPA - cash less facility Available Available Available Available
"Reimbursement of cost of health check-up" "1% of Avg. S.I, once every block of 4 claim free years" "1% of Avg. S.I, once every block of 4 claim free years" Nil "2% of Avg. S.I, once every block of underwriting 3 yrs"
Waiting Period or Exclusions
"During 1st 30 days Except for Accidental & Emergency cases" "All illness / sickness other than 4.1, 4.2, 4.3" "All illness / sickness other than 4.1, 4.2, 4.3" "All illness / sickness other than 4.1, 4.2, 4.3" "All illness / sickness other than 4.1, 4.2, 4.3"
"4.1 During 1st Yr" "Benign, ENT disorders & surgeries like Tonsilectomy / Andenoidectomy / Mastoidectomy / Typanoplasty" Nil Nil Cataract, Benign Prostatic Hyperthropathy, Hysterectomy, Hernia, Hydrocele, Congenital Internal Diseases, Chronic Fissures in anus, Fitsula in Anul, Piles, Pilonidal Sinus, Sinusitis, stone disease of any site, Benign Lumps/ growth in any part of the body, CSOM ( Chronic Suppurative Otitis Media) , Joint replacements, of any kind unless arising out of accident, Surgical treatment of Tonsils, Adenoids and deviated nasal septums and related disorders.
" 4.2 During 2nd Yr" "Cataract, Benign Prostatic Hyperthropathy, Hysterectomy, Hernia, Hydrocele, Congenital Internal Diseases, Fissures/fitsula in Anul, Piles, Sinusitis and related disorders, Polycystic ovarian diseases, Non- infective arthritis, undiscended testis, surgery of gall bladder & bile duct excluding malignancy, surgery of Genitourinary system excluding maligancy, Pilonidal Sinus, Gout & Rheumatism, Hypertension, Diabetes, Calculus disease, Surgery for prolapsed intervertebral disc unless arising from accident, surgery of varicose veins" "Cataract, Benign Prostatic Hyperthropathy, Hysterectomy, Hernia, Hydrocele, Congenital Internal Diseases/defects, Fitsula in Anul, Piles, Arthrtis,Gout & Rheumatism, Joint replacements, Sinusitis, Gall bladder stone , Kidney stone and related disorders" Cataract, Benign Prostatic Hyperthropathy, Hysterectomy, Hernia, Hydrocele, Congenital Internal Diseases, Chronic Fissures in anus, Fitsula in Anul, Piles, Pilonidal Sinus, Sinusitis, stone disease of any site, Benign Lumps/ growth in any part of the body, CSOM ( Chronic Suppurative Otitis Media) , Joint replacements, of any kind unless arising out of accident, Surgical treatment of Tonsils, Adenoids and deviated nasal septums and related disorders. Nil
Pre-existing Disease 4.3 upto 4 continuos claim free yrs upto 3 continuos claim free yrs upto 4 continuos claim free yrs upto one claim free years
Heart and circulatory disorders upto 4 continuos claim free yrs upto 5 continuos claim free yrs upto 4 continuos claim free yrs upto 1 claim free years
Diabities if pre-existing upto 4 continuos claim free yrs upto 3 continuos claim free yrs "can be covered from inception * less10 % of addm. Claim/ 25 for both" "can be covered from inception * (excluding any ailment already manifested )"
Hypertenstion if pre-existing upto 4 continuos claim free yrs upto 3 continuos claim free yrs "can be covered from inception * less10 % of addm. Claim/ 25 for both" "can be covered from inception * (excluding any ailment already manifested )"
Pre-existing knee joint problem upto 4 continuos claim free yrs upto 3 continuos claim free yrs upto 4 continuos claim free yrs
"Joint Replacement due to degenerative condition, Age related osteoarthritis" first 4 yrs of the policy first 2 yrs of the policy first 2 yrs of the policy first 1 yr of the policy
Medical Requirement :
"Blood / Urine Sugar, Blood Pressure, ECG, Eco-cardiography and eye -check-up including retinoscopy + MDs Report" "No Medical test : 1. For persons < 50 Yrs 2. Renewal of 3 yrs old policy"
Must for person above 50 years
"No Medical test : 1. For persons < 50 Yrs 2. Renewal of 3 yrs old policy"
Must for person above 50 years
Not indicated
Not indicated
"No Medical test : 1. For renewal policy of preceeding 3 yrs of National "
Must for person above 60 Yrs
 
 
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