InsuranceScope India

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FeatureBajaj - General Health Guard (Platinum)Niva Bupa - ReAssure 3.0 (Black)
Room Rent LimitNo limitNo limit
ICU LimitNo limitNo limit
Co-PayNoYes
Disease Sub-limitYesYes
Initial Waiting (Days)30NA
Specific Disease Waiting (Years)2NA
Pre-existing Disease Waiting (Years)31
Pre-Hospitalisation30 days (Covered up to: sum insured)NA
Post-Hospitalisation90 days (Covered up to: sum insured)NA
Daycare ProceduresYesYes (Covered up to: sum insured)
DomiciliaryNoYes (Covered up to: sum insured)
Organ Donor CoverYes (Covered up to: sum insured)No (Covered up to: sum insured)
Modern TreatmentsYesYes
Refill on ExhaustionAvailableAvailable
Refill Illness ApplicabilityUnrelated illnessRelated and unrelated illness
Refill TriggerFull exhaustion of Sum Insured & BonusPartial exhaustion of Sum Insured
Refill LimitOnce in a policy yearUnlimited times in a policy year
Refill Applicable ClaimSubsequent claimsFirst paid claim
ConsumablesNoNo
Bonus Rate50% for forst 2 years, 10% for subsequent yearsNA
Bonus Max Limit150%1000%
Reduction in Bonus on ClaimYesNA
% Settled < 30 Days99.40%99.95%
% Complaints on Claims0.03%0.43%
Incurred Claim Ratio90.01%61.64%
Claim Settlement Ratio (No.)93.49%90.64%
Claim Settlement Ratio (Value)79.07%74.32%
Claim Rejection Ratio5.68%7.30%
Cashless Hospitals18,400+10,000+
AffordabilityExpensiveNA
Plan TypeIndividualIndividual
Extra FeaturesMaternity benefits on family plan upto 25k after 6 years waiting, Extra coverage of 20% of base sum insured maximum upto 5 lakhs in case the claim amount exceeds the base cover.NA