InsuranceScope India

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FeatureHDFC Ergo - Energy (Gold)Star Health and Allied - Star Health Red Carpet
Room Rent LimitCappedCapped
Co-PayYesYes
Disease Sub-limitNAYes
Initial Waiting (Days)3030
Specific Disease Waiting (Years)2NA
Pre-existing Disease Waiting (Years)21
Pre-HospitalisationNA30 days (Covered up to: sum insured)
Post-HospitalisationNA60 days (Covered up to: 7% of hospitalisation expenses – with a maximum limit of Rs)
Daycare ProceduresNAYes (Covered up to: sum insured)
DomiciliaryYesYes
Organ Donor CoverNo (Covered up to: sum insured)NA
Modern TreatmentsYes (Covered up to: sum insured)NA
Refill on ExhaustionAvailableNA
Refill Illness ApplicabilityRelated and unrelated illnessNA
Refill TriggerPartial exhaustion of Sum InsuredNA
Refill LimitOnce in a policy yearNA
Refill Applicable ClaimFirst paid claimNA
ConsumablesNAYes
Bonus Max Limit100%7%
Reduction in Bonus on ClaimNo reductionNA
% Settled < 30 Days96.63%97.69%
% Complaints on Claims0.15%0.52%
Incurred Claim Ratio87.04%70.53%
Claim Settlement Ratio (No.)95.19%87.17%
Claim Settlement Ratio (Value)77.69%84.62%
Claim Rejection Ratio2.47%11.32%
Cashless Hospitals15,000+14,000+
AffordabilityNAExpensive
Plan TypeIndividualIndividual