Policy review · SBI
General Arogya Supreme (Plus)
SBI's individual plan, reviewed on the clauses that actually decide your claim — room rent, co-pay, sub-limits, waiting periods and the insurer's claims record.
InsuranceScope score
3.5
★★★★☆
The verdict
General Arogya Supreme (Plus) is an individual health insurance plan from SBI. It stands out for built-in restoration. On the downside, a co-payment applies to claims — worth weighing before you buy. On the insurer side, it reports 91.68% of claims settled by count and a 18,300+ cashless hospital network.
Where it wins
Restoration is included — the sum insured refills once in a policy year, triggered on partial exhaustion of sum insured, for a related and unrelated illness.
Cover grows by 100% for each claim-free year, up to 25% of the base sum insured; the accumulated bonus is reduced if you make a claim.
Day-care procedures that take under 24 hours — cataract, dialysis, chemotherapy and similar — are covered.
Consumables like gloves, syringes and PPE are paid rather than deducted from your claim at discharge.
Strong claims record — 91.68% of claims settled by count across 18,300+ cashless network.
Where it stings
A co-payment applies — you pay a fixed share of every claim out of pocket; check the exact percentage in the policy wording.
Room rent is limited to Capped — choosing a costlier room can trigger proportionate cuts across the whole bill.
Disease-wise sub-limits apply — some treatments are capped below your sum insured, so verify the caps for conditions like cataract or joint replacement.
Premium positioning is on the expensive side of the market.
Waiting periods
No cover in this window except for accidental hospitalisation.
Named conditions such as cataract, hernia and joint replacements wait this long.
Conditions you already have are covered only after this period.
Claims snapshot
SBI, latest IRDAI disclosure year — how the insurer behind the plan actually performs.
Approved by number of claims.
Claims paid vs premium collected.
How quickly claims are paid.
On overall claims — lower is better.
Key features
Limited to Capped; a costlier room can reduce the rest of the claim.
No separate cap on ICU charges.
Applies — you share part of each claim (true).
Applies — certain treatments are capped below the sum insured.
The sum insured refills once in a policy year, triggered on partial exhaustion of sum insured, for a related and unrelated illness.
Cover grows by 100% for each claim-free year, up to 25% of the base sum insured; the accumulated bonus is reduced if you make a claim.
Pre-hospitalisation 60 days and post-hospitalisation 90 days of connected medical costs are covered.
Procedures under 24 hours, such as cataract and dialysis, are covered.
Non-medical items like gloves, syringes and PPE are paid, not deducted.
Donor hospitalisation costs are covered (Yes).
At-home treatment is covered when hospital admission is not possible.
Common exclusions
Typical across most Indian health plans — always confirm the exact exclusions in General Arogya Supreme (Plus)'s policy wording.
Cosmetic or aesthetic treatment, unless needed to reconstruct after an accident or burns.
Self-inflicted injuries and conditions arising from alcohol or substance abuse.
Treatment arising from war, nuclear or allied perils.
Admissions purely for investigation, evaluation or bed rest with no active treatment.
Unproven or experimental treatments not backed by established medical practice.
Frequently asked questions
Yes. General Arogya Supreme (Plus) has a co-payment clause, so you pay a share of every claim. Check the exact percentage in the policy wording.
Room rent under General Arogya Supreme (Plus) is Capped. Choosing a costlier room can reduce the rest of your claim.
3. Claims for conditions you already had are covered only after this waiting period.
Yes. General Arogya Supreme (Plus) refills the sum insured after it is exhausted (once in a policy year).
Yes. General Arogya Supreme (Plus) covers day care procedures that take under 24 hours, such as cataract surgery or dialysis.
18,300+ cashless network hospitals are reported for General Arogya Supreme (Plus), where the insurer settles bills directly.