SBI General Arogya Top Up Health Insurance Plan

SBI General Arogya Top Up Health Insurance Plan

Overview

SBI General Insurance was founded in 2009. It started operations in 2010, as a joint venture between State Bank of India (SBI) and Insurance Australia Group (IAG). In September 2018, the company sold a 4 per cent stake to Axis Asset Management Company and Premji Invest for ₹4.82 billion (US$60 million) crore. <p>The company offers a range of general insurance products including insurance for automobile, home, personal accident, travel, energy, marine, property and casualty as well as specialized financial lines.</p>

Highlights For

Arogya Top

Up

Pre Policy Medical test

Maternity Benefit

Room Rent

Domiciliary

Organ Donor

product highlights for Arogya Top Up

Features

Sub-limits

Pre-Hospitalisation : 60 days

The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer

Post Hospitalisation : 90 days

The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer

Pre existing Disease cover : 48 Months

Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.

Waiting Period- Initial : 30 days

No claims are accepted within this period except due to accidents/ injury.

Waiting Period- Specific : 12 Months

Listed specific illness

Waiting Period- PED : 48 Months

No pre-existing ailment related claims are accepted within this period.

Room Rent : Yes,upto sum insured

Room rent for in-patient hospitalisation

ICU Charges : Yes,upto sum insured

Charges for ICU hospitalisation

Co pay : No

% of the claim that the policyholder needs to pay out-of-pocket

Restore Benefit/ Recharge/ Refill : No

If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.

Health Check up : No

Free annual health check-up for all insured members according to the list of tests specfied in the policy document.

No Claim Bonus : No

% of the sum insured that rises every claim free year.

Video/telephone consultation : Yes

E-consultation with expert doctors empanelled with the insurer for a second opinion.

Domiciliary hospitalization : Yes,upto sum insured

Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.

Ambulance : Actual ambulance expenses or INR 5000 whichever is lower will be reimbursed

Transportation of the patient to the hospital and back home

Convalescence benefit : No

A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.

Organ Donor : Yes,upto sum insured

The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.

Bariatric cover : Yes

Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.

Daycare : Yes,141 daycare expenses covered

Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments

AYUSH : Yes

Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.

Congenital Coverage : Yes

Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.

Modern Treatments : No

All advanced treatment with upgrade in technology.

Health Management/ Wellness : No

Benefits provided for staying fit and managing health

Maternity Benefit : Yes,Maternity expenses after first 9 months

All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.

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