SBI General Insurance Retail Health Insurance Policy

Product Overview

SBI- Retail Health Plan is an inpatient hospitalization policy. Option to Choose the flexible plan - Metro Plan, Semi Metro Plan and rest of India.

Unique Features of SBI General Insurance Retail Health Insurance Policy

• Ayurvedic Medicine Homeopathic and Unani system of medicine are covered
• Flexible Plan Options–Metro Plan, Semi Metro Plan & Rest of India
• Add on covers available including zero sub-limits on room & ICU rent, doctor’s fees etc.

Features of edit Edit Details

Critical features of SBI General Insurance Retail Health Insurance Policy

• Room rent:
  Limits imposed towards room and ICU rent expenses

1. Up to 1% of sum insured per day for normal hospitalization
2. Up to 2% of sum insured per day for ICU expenses
3. All Admissible claims under Normal & ICU Hospitalization shall be covered - upto 25% of the Sum Insured per illness/injury per claim.
4. Consultants & Specialists Fees - Upto 40% of the Sum Insured per illness/ injury per claim
5. Anaesthesia, Blood, Oxygen, OT Charges, Surgical Appliances - Upto 40% of the Sum Insured per Illness/ injury per claim.

• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured
  This plan has a co-payment of 10% in non network hospital.
  Flexible Options available for Claim Purpose at per zone as mentioned in the grid.

1. Plan A - 100% of the admissible claim amount for all Locations subject to the Policy terms and conditions.
2. Plan B - 100% of the admissible claim amount for Locations B and C, and 80% for Location A subject to the Policy terms and conditions
3. Plan C - 100% of the admissible claim amount for Locations C, 80% for Location B and 70% for Location A subject to the Policy terms and conditions

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal
  5% of basic sum insured up to a maximum of 25 % for each unclaimed year in case opted for (The cumulative bonus is reduced by 5% of the sum insured once a claim is made)
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
  This plans has a waiting period of 4 years is case of pre-existing diseases

Eligibility Criteria

• Minimum Age of Entry:- 91 days / Adults-18 years
• Maximum age of Entry:- 65 years
• Renewal Age:- Life Long Renewal
• Sum Insured:-
  Individual - 50 Thousands to 5 lakhs
  Family Floater - 2 lakhs to 5 lakhs
• Family Definition:-
  Individual Plan - Self, Spouse, Dependant Children, Dependant Parents
  Family Floater - Self, Spouse, Dependant Children & Dependant Parents
• Policy Tenure:- 1 year
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Chosen)

Add-ons

• Removal of Room & ICU Rent sub-limits
• Removal of sub-limits on Operation and Consultancy charges

Exclusions

• Treatment with alternative medicines like acupuncture, acupressure, osteopathy, naturopathy, chiropractic, reflexology and aromatherapy
• Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including caesarean section, and/or any treatment related to prenatal and postnatal care.
• Congenital diseases
• All expenses related to AIDS and related diseases.
• Use/Abuse of intoxicating drugs or alcohol.
• Treatment for any mental Illness
• Personal comfort and convenience items or services.

Note: Any claims arising out of or attributable to any of the following is not covered, Please refer policy T & C for a detailed list of exclusions.

Tax Benefits

The premium paid for health insurance policy is liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below

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