Policy Name ICICI Lombard Complete Health InsuranceBase Cover

Sum Insured 500000 700000 1000000 700000

Deductible NA NA NA NA
Premium 11298 15710 16401 8026
SubLimit No No No No
(Optional addon to get
5000 10000 10000 0
OPD
Hospital Daily Cash 1000/day (Max 10 days) 2000/day (Max 2000/day (Max NA
10 days) 10 days)

Waiting Period 2 yrs

Room Rent Cap No Cap
Co-Pay 0
No Claim Bonus 10% upto 50%

Day Care Treatment Yes

Domiciliary hospitalisation Yes
Reset Benefit Yes (Once)
Road ambulance Yes (1500/event)
Pre & Post Hospitalization 30 & 60 days
Annual Health Check up NA

Misc Convalescence Benefit 10K

AYUSH Treatment

Claim Paid 1,680,709/1,894,100 = 88.7%

Incurred Claim Ratio (Health) 69.90%
Hospital Network 5000+

Color Coding:
Green Cells These features are good to have.
White/Transparent These features are expected
Yellow These features can be a problem in some rare scenarios
Light Red These features can be limitation in future
Dark Red These features are a huge limitation, better to avoid the policy with dark red in them
I LombardHealth Booster InsuranceSuper
Max BupaReAssure
Top up Health InsuranceBase Cover

2000000 (Max 50L) 500000 1000000

500000 NA NA
2928 7,306 8,694
No Yes
0 Robotic
0 Surgeries 0
NA 1000/day (Max 30 days) 2000/day (Max 30 days)
(Optional) (Optional)

2 yrs 3 yrs
No Cap No Cap
0 0
NA 50% upto 100%

Yes Yes
Yes Yes
Yes (Once) Yes (Unlimited)
Yes (5000/event) Yes (2000/event)
60 & 90 days 60 & 180 days
NA Yes (0.5% per 1L)

In Patient AYUSH treatment AYUSH Treatment

Wellness program Donor Expense

132,750/145,353 = 91.3%
53.51%
4500+

with dark red in them

Max BupaHealth Recharge InsuranceSuper
StarTop
HealthComprehensive
up InsuranceBase Cover

2500000 (Max 95L) 500000 1000000

500000 NA NA
1495 8,278 11,476
Yes Yes
Depression,
0 PTSD, Anxiety disorder Robotic
1200 surgeries, 2100
NA Dental+Eye:
500/day (Max5k120
in 3days)
yr Dental+Eye:
750/day (Max10k
120indays)
3 yr
(7days/event) (7days/event)

3 yrs 3 yrs
No Cap Private Single A/C room
0 0
5% upto 50% (For SI upto 25L) 50% upto 100% 100% upto 100%

Yes Yes
Yes Yes
No Yes (Once)
Yes (1500/event) Yes
60 & 90 days 60 & 90 days
NA Yes (Rs.2000) (Claim free yr)Yes (Rs.3000)(Claim free yr)

Pharmacy & diagnostic services Air Ambulance Expenses

Donor Expense AYUSH Treatment

892,369/1,092,692 = 81.6%
65.91%
10000+
ar HealthSuper Surplus Insurance GoldSuper
HDFC ErgoOptima
Top up Restore Health InsuranceBase Cover

2000000 (Max 100L) 500000 1000000

500000 NA NA
3,032 8,370 11,146
Yes No No
Robotic
0 surgeries, 0 0
NA 800/day in shared accomodation (Max 6 days)

1 yr 3 yrs
Private Single A/C room No Cap
0 0
No 50% upto 100%

Yes Yes
No Yes
Yes (Once upto 2.5L) Yes (Once)
Yes (3000/event) Yes (2000/event)
60 & 90 days 60 & 180 days
NA Yes (Rs.1500/2yr) Yes (Rs.2000)

Air Ambulance Expenses E-Opinion in respect of a Critical Illness

Donor Expenses Restore Benefit

1,446,143/1,481,221 = 97.6%
69.01%
10000+
C ErgoMedisure Super Top-up InsuranceSuper
ManipalCignaProHealth
Top up Insurance PlusBase Cover

2000000 (Max 20L) 550000 1000000

500000 NA NA
2200 6,810 8,374
No No
0 2000
NA NA

3 yrs 3 yrs
No Cap Any Room Category except Suite
0 0
No 10% upto 200%

Yes Yes
No Yes
No Yes (Once)
No Yes (3000/event)
30 & 60 days 60 & 180 days
NA Yes

E-Opinion in respect of a Critical Illness

Worldwide Emergency Cover

193,395/223,936 = 86.3%
61.64%
6500+
nipalCignaSuper Top-up InsuranceSuper
ReligareCare
Top up Health InsuranceBase
Religare Care
CoverEnhance InsuranceSuper Top u

2000000 (Max 30L) 500000 1000000 2500000 (Max 30L)

500000 NA NA 500000
2200 7,039 8,684 3,910
No No No
0 0 (Optional) 0 (Optional) 0
NA 1000/day (Max 30 days) NA
(Optional)

2 yrs 4 yrs 4 yrs

No Cap Private Single A/C room Private Single A/C room
0 0 0
5% upto 50% 10% upto 50% No

Yes Yes Yes

No Yes Yes
No Yes (Once) No
Yes Yes No
60 & 90 days 30 & 60 days 30 & 60 days
NA Yes Yes

Donor Expense AYUSH Treatment Donor Expense

Donor Expense

980,518/1,036,711 = 94.5%
59.51%
8,250+
New India Mediclaim/Premier Mediclaim PolicyBase
New India
Cover
Top-up InsuranceTop
Royal SundaramLifeline
up Supreme Insuran

500000 1500000 2200000 (Max 22L) 500000

NA NA 800000 NA
~6700 ~17000 ~4200 4,800
Yes Yes No
Robotic
0 surgeries, 5000 Robotic surgeries,
0 0
500/day (Max 10 days) 2000/day (Max 10 days)800/day (Max 10 days) 2000/day (Max 30 days)

4 yrs 3 yrs 4 yrs 3 yrs

1% sum Insured No Cap 1% sum Insured No Cap
0 0 0
25% upto 50% No No 20% upto 100%

Yes Yes Yes

No No Yes
Yes (once) No Yes (Max 8000) Yes (Once)
Yes (Max 5000) Yes (Max 8000) Yes (5000/event)
60 & 90 days No (not metioned in policy) 60 & 90 days
Yes (5000/yr) NA Yes

Donor Expense Donor Expense Donor Expense Donor Expense

AYUSH Cover Air Ambulance AYUSH Cover Maternity Expenses

5,730,150/5,812,400 = 98.3% 569,167/596,284 = 95.4%

100.83% 63.55%
1,500+ 5,000+
eline Supreme InsuranceBase
GoCover
DigitHealth InsuranceBase Cover Go Digit
Super Top-up Insurance
1000000 500000 1000000 2000000 (Max 20L)
NA NA NA 500000
6,363 5,751 7,468 3,475
No No
2500 5000 0
(Max 30 days) 500/day (Max 30 days) 1000/day (Max 30 days)NA

4 yrs 4 yrs
No Cap No Cap
0 0
100% 50% upto 100% No

Yes Yes
Yes Yes
e) Yes Yes (5000/yr)
0/event) Yes (Once) No
days 60 & 90 days 30 & 60 days
Yes (1250/yr) Yes (5000/yr)

pense AYUSH Treatment Post Hospitalization Lumpsum

Expenses Donor Expense Bariatric Surgery

596,284 = 95.4% 163,170/194,499 = 83.8%

51.83%
5000+
 Company Name ICICI Lombard Max Bupa Star Health

FY 2021 (Upto Dec 2020)

Claims Paid Ratio 76.10% 82.20% 75.30%
Incurred Claim Ratio -- -- --
Total no. of policies 15,672,457 1,133,490 4,889,285
Policy complaints per 10,000 policies 0.6 2.45 1.07
Total no. of claims 1,141,573 85,492 700,228
Claim Complaints per 10,000 claims 7.43 49.83 31.66

FY 2020
Claims Paid Ratio 88.70% 91.30% 81.60%
Incurred Claim Ratio 69.90% 53.51% 65.91%
Total no. of policies 26,222,039 905,066 5,058,544
Policy complaints per 10,000 policies 0.59 1.17 2.01
Total no. of claims 1,894,100 145,711 870,176
Claim Complaints per 10,000 claims 5.64 38.57 74.41

FY 2019
Claims Paid Ratio 88.20% -- --
Incurred Claim Ratio 76.45% 54.00% 63.00%
Total no. of policies 26,484,078 388,129 4,295,469
Policy complaints per 10,000 policies 0.71 2.19 2.78
Total no. of claims 1,620,705 92,189 783,966
Claim Complaints per 10,000 claims 5.39 60.96 57.62

directly in NL-41, I have

calculated it separately

Color Coding:
Green Cells Better than Average
White/Transparent Average
Light Red Worse than Average

NL-25, NL-41 public while some have put cumulative data till date in public disclosu
Source of Info: disclosures of companies So there might be some errors here
 Royal
HDFC Ergo Manipal Cigna Religare New India Sundaram

(Upto Sep 2020)

83.40% 87.30% 84.70% 94.80% 82.90%
-- -- -- -- --
4,100,959 225,973 804,571 -- 1,421,929
0.37 1 2.08 -- 1.96
152,822 173,406 207,864 2,166,973 460,596
5.89 19 22.27 16.23 6.8

97.60% 86.30% 94.50% 98.50% 95.40%

69.01% 61.64% 59.51% 100.83% 63.55%
6,051,992 246,489 1,104,070 -- 2,061,015
1.15 2 1.2 -- 0.93
437,667 224,192 1,068,639 4,196,814 596,284
10.42 21 5.54 9.5 6.49

92.70% -- -- 99.50% 92.60%

62.00% 62.00% 55.00% 103.00% 61.00%
7,973,609 239,884 838,045 -- 1,926,884
1.01 5 1.03 -- 1.14
323,777 152,878 695,631 3,814,535 438,061
12.32 18 5.95 8.93 7.94

L-41, I have directly in NL-41, I have

separately calculated it separately

e data till date in public disclosures,

here
Go Digit

76.40%
--
3,748,567
0.19
45,292
27.82

83.80%
51.83%
5,151,681
0.08
163,170
5.09

81.60%
60.00%
2,090,852
0.16
32,435
13.87