SBI General Health Insurance

SBI General Insurance is a great option to buy a health insurance policy. The insurer not only ensures financial protection of an individual, but an entire family and provides them with the much-desired peace of mind. Our health insurance policy covers Your hospital room rent, boarding expenses and doctor fees nursing expenses. Medicines that you consume during the hospital stay. Pre and Post hospitalisation expenses up to 30 and 60 days respectively.

Key Highlights

At SBI General, our goal is to partner with you and help you along the way to achieve better health and a sense of security. With SBI General’s Health Insurance Policy you can be in control making medical expenses more manageable. This ensures your family’s quality health and happiness.

Key features of SBI General Health Insurance

  • Room Rent: Payable at Actuals upto Sum Insured
  • Co-pay: NIL co-pay for all treatment
  • Restoration Benefit: Restoration benefit available upto 100% of Base SI
 

SBI General Health Insurance sum insured
1 lac − 30 lacs options available

SBI General Health Insurance tenure options
1 and 3 years options available

List of network hospitals
6,000+ hospitals

Maximum family floater coverage
Self, Spouse + 2 dependent children (upto age of 23 yrs)

Incurred Claims Ratio *
52.00%

Claims Settlement Ratio **
62.73%

Number of policies issued *
756,443

Number of lives covered *
2,748,000

* As per IRDAI report for 2018-19 | ** As per NL25 data published on the Insurance Company website

SBI General Health Insurance – Overview

Why Should One insure themselves through SBI General Health Insurance plans?

  • SBI General is one of India’s Fastest growing Private sector General Insurance companies in the Health Insurance space
  • Cashless Hospitalization Across the Large Network With More Than 6,000+ Hospitals in India for their insured customers
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹1 lacs to ₹30 lacs
  • SBI General Proudly retains the iAAA rating for its “highest claim paying ability”
  • Over 68 Million Happy Customers across all their product lines
  • Supported by State Bank of India’s enormous 24,000+ bank branch network, 350+ Satellite locations and 114 locations across India
  • Claims settled upto date of ₹110 billion across all product lines

SBI General Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the SBI General health insurance premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 6,000+ and growing and the SBI General health insurance hospital list is one of the most exhaustive in the industry today across India. Most of the customer’s SBI General health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the SBI General health insurance renewal link on site for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the SBI General health insurance claim form available on the same website.

Reliance mediclaim health insurance overview

Benefits under SBI General Health Insurance plans include :

  • Cashless facility – SBI General processes all cashless claims across 6000 + quality hospitals in their network across India
  • Hospitalisation expenses : Coverage for room rental expenses up to the sum insured for most of their plans. Pre and post hospitalisation expenses are covered up to the sum insured, 30/60 days prior and 60/90 days post hospitalisation depending on the plan opted for
  • Inpatient Treatment Covered expenses include: Hospital room rent, Boarding expenses and doctor fees, Operation Theatre and Intensive Care charges, Nursing expenses and Medicines that you consume during the hospital stay
  • Health Check up : Policy provides health check-up as per the applicable plan as specified in the Product Benefits Table, once every 4 claim free years.
  • Lifelong Renewability : SBI General assures you renewability for life without any extra loadings based on the claims
  • 142 Day Care procedures covered
  • No medical check-up if proposer doesn’t have any medical history up to 45 years of age
  • No Claims Bonus available at 10% increase after every claim free year upto maximum of 50% of Basic Sum insured
  • Income Tax Exemption under section 80D if the Income Tax Act.

Claim Process

Assistance Contact Numbers:
For Health Claims
Call at: Toll Free 1800-22-1111
SMS at: “CLAIM” to 561612
Email ID: customer.care@sbigeneral.in
Write at: “Natraj” 301, Junction of Western Express Highway & Andheri Kurla – Road, Andheri (East), Mumbai – 400 069

Cashless Claims Process

Step 1Get admitted to any one of SBI General network hospitals, currently they have 6000+ hospitals across the country…check out the hospital list at SBI General Health Insurance
(Note: Cashless Facility is only available at hospitals in the company’s cashless network)
Step 2Use your SBI General Health Card or share your Policy number and Passport / PAN card / voter’s ID for identification purposes
Step 3The Network Hospital will check your identity for validation and submit the pre-authorisation request form to SBI General as per the defined process / format
Step 4SBI General will review and provide our confirmation to the Network Hospital regarding the coverage limits and admissibility for the treatment for which the insured has been admitted
Step 5SBI General will settle the claim (as per policy terms & conditions) with the hospital after completion of all formalities of documentation as per submission by the hospital

Reimbursement Claims Process

Step 1In case of hospitalization notify SBI General within 24-48 hours of your admission in our network or non network hospital. After getting admitted settle bills directly to the hospital.
Step 2On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
Step 3Send these documents and the completely filled and signed claim form to us along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well.
Step 4We review your claim request and the supporting documents provided along with the claim form. Accordingly based on policy terms & conditions, SBI General will approve, query or reject the same
Step 5Subject to the claim being approved, SBI General will settle the claim (as per policy terms & conditions) and reimburse the approved amount to the insured

Information to be kept ready while intimating the claim:

  • Policy Number
  • Insured/Claimant contact details (phone no. , email id, address, landmark etc.)
  • Name of Insured/ claimant person, who is hospitalised
  • Relationship of insured with the person who is hospitalised.
  • Name of the hospital
  • Health Claims – Nature of ailment
  • Commencement date of the symptom of ailment
  • Accident Claims
    • Nature of accident
    • Date & time of accident
    • Location of accident

Exclusions Under the Policy

Some of the permanent exclusions under the SBI General Health Insurance Plans are below, kindly review the policy wordings which are available with your policy kit for the entire list of exclusions under your opted plan. The exclusions include:

  • Treatment outside India
  • Epidemics recognized by WHO or/and Indian government. Government screening programs, etc are not covered by this policy
  • War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority
  • Injury or Disease directly or indirectly caused by or contributed to by nuclear weapons/materials
  • Circumcision unless necessary for treatment of a disease, illness or injury not excluded hereunder, or, as may be necessitated due to an accident
  • Cosmetic or aesthetic treatments of any description, treatment or surgery for change of life/gender, Lasik treatment for refractive error. Any form of plastic surgery (unless necessary for the treatment of Illness or Accidental bodily injury)
  • The cost of spectacles, contact lenses, hearing aids, crutches, wheelchairs, artificial limbs, dentures, artificial teeth and all other external appliances. Prosthesis and/or devices
  • Expenses incurred on Items for personal comfort like television, telephone, etc. incurred during hospitalization and which have been specifically charged for in the hospitalisation bills issued by the hospital
  • External medical equipment of any kind used at home as post Hospitalisation care including cost of instrument used in the treatment of Sleep Apnoea Syndrome (C.P.A.P), Continuous Ambulatory Peritoneal Dialysis (C.A.P.D) and Oxygen concentrator for Bronchial Asthmatic condition.
  • Dental treatment or surgery of any kind unless required as a result of Accidental Bodily Injury to natural teeth requiring hospitalization treatment
  • Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol) and any violation of law or participation in an event/activity that is against law with a criminal intent
  • Any complications arising out of or ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  • Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus or Variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS
  • Venereal disease or any sexually transmitted disease or sickness.
  • Treatment arising from or traceable to pregnancy childbirth, miscarriage, abortion or complications of any of this, including caesarean section. However, this exclusion will not apply to abdominal operation for extra uterine pregnancy (Ectopic Pregnancy), which is proved by submission of Ultra Sonographic Report and certification by Gynaecologist that it is life threatening
  • Any fertility, sub fertility or assisted conception operation or sterilization procedure and related treatment.
  • Vaccination or inoculation except as part of post-bite treatment for animal bite.
  • Treatment for any mental illness or psychiatric or psychological ailment / condition.
  • Outpatient Diagnostic, Medical and Surgical procedures or treatments, non-prescribed drugs and medical supplies, Hormone replacement therapy, Sex change or treatment which results from or is in any way related to sex change.
  • Any treatment required arising from Insured’s participation in any hazardous activity including but not limited to all forms of skiing, scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing etc unless specifically agreed by the Insurer
  • Treatments in health hydro, spas, nature care clinics and the like
  • Treatment with alternative medicines like acupuncture, acupressure, osteopath, naturopathy, chiropractic, reflexology and aromatherapy
  • Expenses incurred primarily for diagnostics, x-ray or laboratory examinations, or other diagnostics studies not consistent with or incidental to diagnosis and treatment of the positive existence or presence of any disease, illness or injury, for which confinement is required at a hospital or at home under domiciliary hospitalization as defined.
  • Hospitalization for donation of any body organs by an Insured Person including complications arising from the donation of organs
  • Treatment for obesity, weight reduction or weight management.
  • Disease / injury illness whilst performing duties as a serving member of a military or police force.
  • Any kind of Service charges, Surcharges, Admission fees / Registration charges etc levied by the hospital.

SBI General Health Insurance Products

Arogya Premier Policy

Key Features:

  • Broad coverage from Rs. 10 lac to Rs. 30 lac
  • No pre-medical test for people without medical history up to the age of 55.
  • 142 day care expenses covered.
Arogya Plus Policy

Key Features:

  • Coverage from Rs. 1 lac, Rs. 2 Lac and Rs. 3 Lac
  • No pre-medical test for people without medical history up to the age of 55.
  • Expenditure on maternity covered up to the OPD limit.
Arogya Top Up Policy

Key Features:

  • Wide coverage – From Rs. 1 lac to Rs. 50 lacs with Rs. 1 lac to Rs. 10 lacs deductible option
  • Expenditure on maternity after the first 9 months of waiting.
  • No pre-medical test for people without medical history up to the age of 55.
Group Health Insurance

Key Features:

  • Coverage from 1 lac to 5 lac
  • No pre-policy medical test up to the age of 65 years for people with no medical history
  • Multiple Coverage Options – Individual & Family Floater options for Sum Insured
Critical Illness Policy

Key Features:

  • Coverage of 13 most critical diseases
  • 2 plan options – 1 year and 3 years
  • Sum insured available up to Rs. 50 lacs
Hospital Daily Cash Policy

Key Features:

  • The plan offers 2 coverage options 30 days & 60 days
  • Free Look Period of 15 days
  • Daily cash benefit for hospitalization up to Rs.2,000 per day
Loan Insurance

Key Features:

  • No medical check – ups up to Rs.1 Crore and/or 55 years of age
  • Coverage for 13 critical illnesses, accidental death or permanent disablement and loss of job
  • The Loan Insurance Policy of SBI General is available for up to three years.
Retail Health Insurance

Key Features:

  • Coverage of 13 most critical diseases
  • 2 plan options – 1 year and 3 years
  • Sum insured available up to Rs. 50 lacs
  • Tax Exemption under Section 80D
Arogya Sanjeevani Policy

Key Features:

  • No medical check-up up to the age of 45 years for people with no medical history
  • AYUSH coverage
  • Family Floater: one plan, full family
  • Road Ambulance Cover
  • Cumulative Bonus: 5% of SI for each claim-free year, up to 50%
  • Coverage from Rs 100,000 to Rs 500,000.
Corona Kavach

Key Features:

  • COVID Hospitalization Cover.
  • Home Care Treatment Expenses
  • AYUSH Covered
  • Covered for Individual / Floater
  • SBI Health Corona Kavach policy shall be offered with a policy term of 3 ½ months, 6 ½ months and 9 ½ months