SBI Health Insurance

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Health Insurance

SBI Health insurance was formed with the motive to serve the emerging medical needs of growing population. In today’s world, every person desires to live a tension free life and which is why they search for various alternative through which they can get financial stability from eventualities. SBI Health insurance took birth with the help of two major contributors namely, State Bank of India (SBI), leading public sector bank and Insurance Australia Group (IAG), an international general insurance company.

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On SBI Health insurance Official Website

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Updated: 29-05-2024 10:46:09 AM

SBI General Insurance Company: Facts and Figures

Start Date of the company 2010
Number of Branches 110+ cities
Major Contributors SBI Banks and IAG (Insurance Australia Group)
Insurance Products Offered Health, motor, travel, home, personal accident
Number of Employees 21,000 IRDA certified employees

Important Features of SBI Health Insurance

A policyholder can extract plenty of benefits from SBI Health insurance after investing their money.

  • A policyholder can extract plenty of benefits from SBI Health insurance after investing their money.
  • First, the medical benefits like pre and post hospitalization expenses, cashless treatment on demand for a particular diseases/ injury/ accidents, medical expert opinion, free health checkup, treatment facility at home, ICU and room services, AYUSH treatment, emergency ambulance, etc.
  • Second is tax benefits up to Rs 50,000 in favor of the premium paid for health plan chosen.
  • Third is the Cumulative bonus which can be earned if no claim has been made during the policy period and the maximum bonus will be equal to 50% of the sum insured.
  • Fourth one is reloading of the sum insured if the previous coverage amount has been completely drained up in making claims. SBI Health insurance guarantees all these benefits along with other related advantages specific to each health plan under SBI.
  • Anybody i.e. children, senior citizens, adults (65 years), family are eligible to purchase this health insurance plan.
  • Family Members can be included under SBI family floater health plan.
  • The policy can be renewed online on the SBI website for the customer’s convenience.
  • Flexibility in choosing the sum insured between Rs 50,000 to 50 lakhs.
  • Cover serious illnesses such as Kidney Failure (End Stage Renal Failure),Cancer, heart attack, paralysis,lung failure, etc.
  • Discounts are offered on the premium if family members are included and higher sum insured is opted by the policyholder.

Highlights of SBI Health Insurance

Number of Network Hospitals 5884
Claim Settlement Ratio (for health) 98%
Portability Yes
Renewability of the Policy Lifetime
Discounts Available
Free Look Period 15 days
Grace Period 30 days
Pre-Policy Medical Checkup Not Required

Things To Know Before Buying SBI Health Insurance

  • Claim Settlement Ratio: Claim Settlement is key to health insurance company profitability as it creates a sense of trustworthiness among customers who buy their policies. SBI Health with 98% of settlement ratio displays that company entertain the maximum number of claims raised by the policyholders.
  • Quick Customer Service: The customer care unit of SBI health insurance extensively look over each claim and strives to address the claim within a specified time limit i.e. 30 days. Also, the customer care team will acknowledge the documents required for the process of making a claim.
  • Better communication: SBI Health Insurance provides various methods for claim communication through direct calling, emailing or SMS. The policyholder can simply dial their toll-free number 1800 22 1111 or throw an SMS by writing “CLAIM” to 561612 or email at [email protected]. Also, if the insured wants to renew the policy then he can easily process online on the SBI General’s website.
  • Brand Power and Value: The company SBI general insurance contains the name of the biggest and oldest nationalized bank of India which is been offering banking services all across the country. SBI has record of millions of customers
  • Wide Presence all over India: SBI General Insurance has been operating in every state and city which become highly accessible and convenient for
  • Cashless Treatment: SBI General Insurance provides a cashless facility where an insured can receive round the clock treatment at any of the network hospitals registered by the company and located near to your location. The policyholders have to present health card at the time of availing treatment.
  • Flexible Policy Terms: All the health insurance policies of SBI General provide flexible policy terms for various plans. A policyholder can select one year/ two years/three-year policy.
  • Portability: If a policyholder is not interested and upset with their health policies, then Star Health insurance offers the option of portability. After exercising this option, the policyholder can convert his previous policy into Star Health policy without affecting the profits and benefits earned in the previous policy.
  • Tax Benefits: How can one forget about tax benefits or exemption when we are talking about SBI health Insurance. Buying health insurance nor only preserves your wealth from draining into medical cost but also provide a yearly tax deduction. The insured can get maximum of 1.25 lakhs of tax deduction in the annual payment income tax under section 80D of Income Tax Act.
  • Coverage for the family: The SBI health plans gives the option to individuals to add their family members to avail the health benefits. The family which can be included are self, spouse, parents, parents-in-law, and 2 dependent children. The company offers this benefit under family floater option and family individual option.
  • High Coverage Values: SBI Health insurance comes with a wide range of sum insured under each plan from Rs 1 lakh to Rs 50 lakhs that is formulated to give advance financial protection from medical urgencies.
  • Cheaper Rates of Premium: Premium rates under each health insurance plan are deployed after giving proper consideration to the budget and requirement of the insured. Moreover, SBI Health insurance awards a discount on choosing a policy term of 2 or 3 years.

Documents Required for Sbi Health Insurance

  • Completely filled Claim Intimation Form declaring the required information for acceptance of the claim.
  • Valid photo identity card issued by the government, residence proof and 2 recent photos of Insured and/or his nominee.
  • Original Discharge certificate/ death summary
  • Copies of diagnostic test reports, consultation notes, medical references, prescriptions paper, pharmacy bills, and other hospital bills.
  • Original set of investigation report Investigation Reports like laboratory tests, X-rays and indoor case papers significant to prove the presence of injury.
  • Copy of First Information Report/ Punchnama/ Post Mortem report for accident cases.
  • Disability certificate from concerned Doctor or hospital declaring the extent and nature of the disability, if applicable.
  • Death certificate, if applicable
  • Other documents as asked by the SBI General under a health insurance plan.

Renewal Process Of SBI Health Insurance

SBI General’s Guidelines before Renewal

  • The renewal will only be accepted and approved if the insured person has submitted due amount of premium on the policy anniversary.
  • The renewal receipt on the payment of premium should bear the signature of an authorized person of the insurance provider and the receipt must be on the printed form with the insurer.
  • If the insured has been infected by any illnesses/ diseases in any month before the renewal date, should be conveyed to SBI General at the time of applying for renewal. As concealing this fact can hinder the claim process that may highlight in the future.

Online Renewal Process

  • First, the insured have to visit the website of SBI General Insurance.
  • Then, click on the SBI health insurance plan page you want to renew in the health section. You will see a renewal button, by clicking a form will flash on your screen.
  • Fill the asked details like last name and age of policyholder, mobile number, email ID and at last the policy number.
  • After providing all relevant details about yourself and policy, they will process your request.

SBI Health Insurance Premium Calculation

While purchasing the SBI health insurance plan, you have to highlight or mention some personal details at the hour of purchase. By using SBI premium calculator, insured can determine the correct value they have to submit every policy year.

  • Age of the policyholder: The age is the foremost factor that affect a large portion of the premium. The rule is higher the age greater will be the premium and lower the age smaller will be the premium.
  • Type of Plan: The type of SBI Health plan also defines the premium value of the policy. For instance premium for Arogya Premier plan is Rs 8,938 for sum insured of Rs 10 lakhs for a 35 year old individual. Whereas for Arogya Top-Up policy, the premium rate under the same sum insured of Rs 10 lakhs is Rs 3,009 (exclusive of tax). This gap in prices is because of the quantity of benefits and coverage offered in each plan.
  • Type of Policy (individual/ family floater): Also, the premium is calculated on the type of policy chosen by the main policyholder. SBI health insurance plans give three option – Individual policy, Family Floater policy, and Family Individual policy. As under family floater, any family members can be included under the same sum insured which increases the total amount of premium.
  • Sum Insured: Another significant contributor to the premium calculation process is sum insured value. If the sum insured opted is of higher i.e. Rs 30 lakhs to 50 lakhs then the premium is definitely going to be fancy whereas lower sum insured have cheaper rate of premiums.
  • Number of Members included: Family is priority for every individual which why SBI Health insurance provides the option to include the family member in the coverage. This gradually pinches the rate of premium and may fluctuate the price.

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There are 142 processes that are included by the SBI General. Some of the treatments covered are operation of tongue, eye, ear, nose, skin, mouth, face, tonsils, breast, digestive tract, female sexual organs, prostate vesicles, scrotum, urinary system, cancer chemotherapy, radiotherapy, etc.

If the policyholder fails to submit the premium on the due date, then 30 days of grace period is allotted to pay the due premiums.

The company promises to pay the claim amount within 7 days after the claim has been dictated by the insurer and the claim has been accepted by the insurer. If the insurer fails to fulfill the claim settlement within this time limit, then an interest amounting to 2% above the bank rate will be given in addition to the actual amount.

The claims must be informed within 15 days after the hospitalization period is completed and discharge letter is issued to the insured.

The insured is required to submit all the documents in supplementary to the claim intimation form. The insured must genuinely declare each and every detail asked on the form in order to avoid repudiation/ rejection of a claim.

The post-hospitalization claims must get verbalized over a call or in written within 15 days after the post-hospitalization terminates. Also, it is the responsibility of the insured to preserve original as well photocopies of all the medical bills, diagnosis reports, consultation notes, pharmacy bills, etc for reimbursement of claims.

Yes, the company will provide you 15 days starting just after the purchase of SBI health insurance. In this period, the insured person can examine policy benefits, its terms and conditions, and other associated factors.

The premiums will be returned after the deduction of tax and other medical cost arrived during the 15 days period.

Yes, if you are bearing any kind of diseases during the purchase of the policy, the disease will get covered after a waiting period of 48 months. The insured must comply following conditions to get coverage for the same-

  • The pre-existing disease must be disclosed in the proposal form so that it may not hinder claim made in the future.
  • The health policy must be renewed with the SBI General on the due dates.

The treatment taken at home must be more than 3 days and the insured must be accomplished either of the two conditions-

  • Hospital bed/ room was not vacant or available in the hospital OR
  • Insured health condition is highly feeble making him unable to move out of the bed.
  • The treatment must be approved by a medical practitioner.

Yes, SBI health insurance policies do contain this feature of “No Claim Bonus or Cumulative Bonus” where the insured will get a maximum bonus equal to 50% of the sum insured.