General Insurance

SBI General Group Health Insurance Plan

Eligibility Criteria

Minimum Entry Age 3 months for children, 18 years for adults
Maximum Entry Age 65 years of age

Benefits

  • No pre medical test before 65 years of age for people with no medical history
  • Wide Coverage from Rs. 1 lac to Rs. 5 lacs.

Product Features

Key Features

Sum Insured

Sum Insured is the amount of cover provided by the insurance company.
The plan provides a wide coverage of Rs. 1 lac to Rs. 5 lacs
In-patient hospitalisation

This covers hospitalization expenses due to an illness or accident.
The plan covers hospital accommodation, charges for stay in Intensive Care Unit, related hospitalization expenses such as surgeon’s fees, nursing, anesthesia, blood, oxygen, operation theater charges, surgical appliances, medicines, drugs and consumables up to the sum insured.
Pre-hospitalisation

It covers the medical expenses due to an illness before the insured is hospitalized.
The plan covers pre-hospitalization expenses incurred 30 days prior to date of admission into the hospital.
Post-hospitalisation

It covers the medical expenses due to an illness after the insured is discharged from hospitalization.
The plan covers pre-hospitalization expenses incurred 60 days after the date of discharge into the hospital.
Ambulance Cover

In case of an emergency, the ambulance charges are covered by the insurance company.
Ambulance expenses up to 1% of sum insured subject to maximum of Rs. 1,500/- hospitalization is covered under this plan.
Medical treatment with room boarding & nursing expenses

Room rent specifies the sub-limit on room rent charges you can avail in case of hospitalization which includes nursing expenses, service charges, etc.
In the event of hospitalization, the policyholder is entitled to get 1% per day for Non ICU and 2% per day for ICU. All incremental expenses pertaining to room rent, medical practitioners/specialists fees and other incidental expenses to be borne by the insured.
 

Other Features

Domiciliary Hospitalization

If a patient is in a condition that he cannot be moved to the hospital or there is lack of accommodation in the hospital, he is been treated at home and this process is known as domiciliary hospitalization.
Reasonable and customary charges towards domiciliary hospitalization as defined in policy definition subject to 20% of the sum insured maximum up to Rs. 20,000/- whichever is less
Domiciliary Hospitalization

If a patient is in a condition that he cannot be moved to the hospital or there is lack of accommodation in the hospital, he is been treated at home and this process is known as domiciliary hospitalization.
The plan covers domiciliary hospitalization up to Sum Insured.
Co-Payment

After a insured member turns a certain age, co-payment is applicable. Co-pay is that part of your claim amount, which you have to bear.
10% on all eligible admissible claims.
Day Care Treatments

These are treatments that don’t require a 24-hr hospitalization and conducted in a hospital or day-care center.
Covers Select Day care surgery where less than 24 hours hospitalization for specified procedures like Dialysis, Chemotherapy, Radio therapy, Eye Surgery, Dental surgery (due to accident), Tonsillectomy, etc. Are covered.
 

Exclusions

  • Any disease contracted during the first 30 days commencement of the policy.
  • Treatment arising from or traceable to pregnancy (whether uterine or extra uterine) and childbirth including Cesarean section and/or any treatment related to prenatal and post natal care.
  • Congenital diseases
  • All expenses related to AIDS and related diseases.
  • Use/Abuse of intoxicating drugs or alcohol.