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About SBI Health Insurance

SBI General Insurance Company was established in the year 2010 by the coming together of State Bank of India, India’s largest and multinational public sector bank and Insurance Australia Group (IAG), Australia based multinational insurance company. SBI General Insurance Company is a combination of global expertise and domestic values. The company offers a wide array of general insurance products such as motor insurance, health insurance, personal accident, travel insurance and home insurance for the retail customer segment


The company offers various non-life insurance products like fire insurance, marine insurance, aviation insurance and liability insurance etc for the corporate segment along with specialised plans for a rural customer segment. The company has a nationwide presence through its branches and satellite offices in most of the cities along with the wider presence of State Bank of India branches in every corner of the country


Important Facts about SBI General Insurance Company : SBI General Insurance has been consistently recognised for innovative products and contribution to Indian Insurance sector. Following are some of the important facts to note about the company

  • SBI General Insurance has won the ‘ET Best BFSI Brand Award 2018’
  • The company has been awarded ISO 27001:2013 certification
  • The company has received ‘Best E-magazine award at the 57th ABCI awards
  • The company has received ‘Best ET BFSI Brand award 2016’
  • The company has received ‘Bancassurance Leader (Medium and Small Category)’ award by Fintelekt
  • SBI insurance products are easily accessible as the company currently has 125 branches and 350 satellite offices across India. SBI general insurance products are easily available through 22,000+ branches of State Bank of India across the country
  • The company has a collaboration with more than 6000 hospitals across the country
  • Insurance products offered by SBI General Insurance Company Limited can be accessed even in the remote areas through 5,500+ Regional Rural Banks (RRBs)
  • The Company has a robust multi-distribution channel including bancassurance, broking, digital, agency and retail direct channels etc.

SBI Claim Settlement Ratio

97.05%

SBI

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. SBI has a claim settlement ratio of 97.05%, as compared to the industry average of 94.21%.

SBI Health Insurance Plans

SBI health insurance offers 7 health insurance plans. The premium of these plans starts from Rs. 219/yr. The sum insured ranges from Rs. 500 - 30 Lakh. Details of the comprehensive coverage provided by the following 7 SBI health insurance plans are listed below:

SBI Arogya Supreme Health Insurance Policy

Starting Premium- ₹ 4,297/yr

The Arogya Supreme Health Insurance policy by SBI is a comprehensive health insurance plan that can help you in all kinds of medical urgencies that can arise anywhere and at any time. Along with wide coverage, the policy allows you to be confident about the future, as you know that in the case of hospitalisation, the sky-high treatment costs will not be out of your reach.

The salient features of the policy are discussed below:

  1. SBI Arogya Supreme Health Insurance policy offers you a wide range of 20 covers along with 8 optional benefits
  2. Apart from self and your spouse, you can cover your children, parents as well as in-laws
  3. In-patient hospitalsaition includes: Nursing,ICU,Doctors’ fee ,Diagnostic procedures etc
  4. You can opt for a policy tenure of up to 3 years
  5. The policy offers coverage for Covid-19
  6. 100% refil in case of full or partial use of your sum insured
  7. Alternate treatments, such as Ayurveda, Yoga, Unani, Sidha and Homeopathy are covered
  8. Benefits such as air ambulance, recovery benefit, compassionate benefit etc. make the plan very practical
  9. Preventive Health Check-ups are available
  10. The policy also offers a number of discounts that make it all the more affordable
  11. There is an HIV/ AIDS cover offered with the plan
  12. Coverage for mental health is also provided

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

3 Lakh - 5 Lakh

NCB

15% increase in cover; max upto 100%

SBI General’s Arogya Plus Policy

Starting Premium- ₹ 7,000/yr

SBI General’s Arogya Plus Policy provides financial protection against rising out-patient (OPD) medical expenses and hospitalisation expenses. This SBI health insurance policy provides amazing benefits to manage your healthcare expenses. The coverage under the plan can be availed on both individual and family floater basis.

Features of SBI General’s Arogya Plus Policy

  1. The policy mainly covers OPD consultation and treatments expenses along with coverage offered for in-patient care, pre and post hospitalisation expenses, 142 daycare procedures, ambulance expenses, domiciliary hospitalisation, maternity expenses and alternative treatment
  2. Flexibility to choose the coverage term – 1 year, 2 years or 3 years
  3. Discounts on availing long-term cover

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

1 Lakh - 3 Lakh

NCB

NA

SBI General’s Arogya Premier Policy

Starting Premium- ₹ 7,433/yr

SBI General’s Arogya Premier Policy is a comprehensive healthcare plan that is exclusively designed to provide wider medical coverage with many attractive features. The plan aims to provide complete financial security and peace of mind during health emergencies. The coverage under the policy can be availed on both individual and family floater basis

Features of SBI General’s Arogya Premier Policy

  1. Coverage offered by the policy includes in-patient hospitalisation, pre and post hospitalisation, 142-day care procedures, ambulance expenses, alternative treatments, domiciliary hospitalisation, organ donor expenses, maternity expenses and health check-ups
  2. Auto reinstatement of 100% sum insured when the base cover gets exhausted
  3. Cumulative bonus of 10% every year up to a maximum of 50%
  4. Reimbursement of health check-up up to INR 5,000 in a block of four consecutive claim-free years
  5. Flexibility to choose the policy term – 1 year/2 year or 3 years

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

10 Lakh - 30 Lakh

NCB

10% increase in cover;max upto 50%

SBI Top-up Plans

SBI health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 2,109/yr. The sum insured ranges from Rs. 1 Lakh - 50 Lakh. SBI top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each SBI top-up insurance policy below:

SBI General’s Arogya Top Up Policy

Starting Premium- ₹ 2,109/yr

SBI General’s Arogya Top-up Policy is a great supplement to avail extra financial protection at a reasonable cost on top of the basic health insurance plan

Features of SBI General’s Arogya Top Up Policy

  1. The coverage offered by this SBI health insurance policy includes in-patient hospitalisation cover, pre and post hospitalisation cover, daycare expenses, ambulance expenses, domiciliary hospitalisation, alternative treatments and maternity expenses
  2. Alternative treatment cover includes treatments like Ayurvedic, Homeopathy, Siddha and Unani treatments taken in a government hospital or in any institute recognised by the government and/or accredited by the quality council of India/ national accreditation board on health
  3. The policy offers the benefit of reinstatement of sum insured on payment of additional premium
  4. Family discount of up to 20% is offered by the policy
  5. A long-term discount of up to 7.5% is offered by the policy
  6. Flexibility to choose the coverage term – 1 year, 2 years or 3 years

Eligible Age

91 days - 70 years

PED Waiting Period

4 years

Coverage

1 Lakh - 50 Lakh

NCB

NA

Top Features From SBI Health Plans

Benefits of SBI Health Insurance Plans

  • Wide coverage : SBI medical insurance plans provide comprehensive coverage with a wide variety of health risks covered for an individual and for his/her family
  • Convenience : SBI medical insurance plans can be conveniently bought online. The plans offered by the company are easily accessible with the huge presence of SBI bank branches. Pre-policy medical check-ups are not needed till 45 years of age for almost all SBI health insurance plans which makes it easy to avail
  • Flexible : Most of the SBI medical insurance plans come with an option of flexibility to choose from various coverage options.This helps the buyer to choose the plan variant based on their need
  • Customisation : One of the most important benefits offered by SBI medical insurance plans is the customisation which allows the buyer to customise the plan based on their need and affordability
  • Cashless facility : SBI General Insurance Company is tied up with 6,000+ network hospitals to offer cashless healthcare treatment facilities to customers. Network hospitals can be easily located with the help of their website
  • Quick claim settlement : Claim process for SBI health plans is quite easy and simple. With the easy and hassle-free process of claims, the settlement is done quickly
  • Additional coverage benefits: There are various riders or add-ons offered for SBI health plans which allows its buyers to enhance the coverage. Add-ons are optional and can be availed at an additional premium cost
  • Tax benefit : The premiums paid for SBI medical insurance plans qualify for tax deduction under Section 80D of the Income Tax Act, 1961. Premiums paid towards coverage availed for self, spouse, dependent children and parents can be claimed for a tax deduction. Following are the details of tax deductions allowed under Section 80D of the IT act.

Exclusions Across SBI Health Plans

Though sbi medical insurance plans offer a wide range of coverages,there are certain general exclusions apply for the plans

Following are the exclusions under SBI health insurance plans

  • Expenses incurred for the treatment of illnesses or an injury incurred within 30 days of commencement of the policy
  • Expenses incurred for specific illnesses like benign prostatic hypertrophy, diabetes and related complications, cataract, non-infective arthritis, hypertension, heart disease, treatment of spondylosis, hysterectomy, surgery of varicose veins and surgery for prolapsed intervertebral disc etc are not covered for 24 months from commencement of the policy
  • Expenses incurred for the treatment of pre-existing illnesses is not covered for 48 months from the date of commencement of the policy
  • Any illness/injury directly or indirectly caused by war, hostilities, invasion, acts of foreign enemies, commotion, civil war, rebellion, unrest, insurrection, revolution and nuclear weapons/materials
  • Treatments outside the geographical limit of the policy
  • The cost of external appliances like contact lenses, spectacles, hearing aids, crutches, dentures, wheeling chair, artificial limbs, and artificial teeth etc are not covered
  • Cosmetic or aesthetic treatments, surgery for change of gender and plastic surgery etc. are not covered
  • Expenses incurred for the treatment of external or internal congenital illnesses are not covered
  • Sexually transmitted diseases, AIDS/HIV are not covered
  • Alcohol and drug abuse
  • Deliberate and intentional self-injury, suicide or attempt suicide are not covered

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SBI Claim Process

SBI supports both cashless claims and reimbursement claims. This section covers the information on how to check SBI health insurance claim status, fill SBI health insurance claim form, and the claim settlement process.

Cashless health insurance claim process If you take admission at a network hospital of SBI General Insurance Company, the following is the process to be followed for the cashless claim

  1. The cashless request needs to be submitted to TPA (Third party administrator) of SBI General Insurance Company Limited. In case of planned admission, the request needs to be submitted 48 hours in advance to the admission. In case of emergency admission at the hospital,the request needs to be submitted to TPA within 24 hours of admission at the hospital
  2. TPA of SBI General Insurance Company will review all the initial documents submitted by the hospital authorities along with cashless claim request
  3. Once the cashless claim request is approved by the insurance company, further documents are to be produced by the hospital to process the claim
  4. Once all the documents are verified, the claim amount will be directly settled with the network hospital

Reimbursement health insurance claim processIn the case of the medical treatment availed at a hospital which is not included in-network hospital of SBI General Insurance Company, medical expenses can be claimed via the reimbursement process. Following process needs to be followed for claim reimbursement

  1. Take admission at the non-network hospital of the insurance company and settle the bill out of your pocket
  2. Collect all the original documents from the hospital
  3. Register the claim with SBI General Insurance Company by submitting original documents received from the hospital along with duly filled and signed claim form and other relevant documents, if any
  4. TPA of SBI General Insurance Company will scrutinise all the documents and update the insured on status of a claim
  5. Once the claim is approved, the payment of claim will be made within a specified time period by SBI General Insurance Company Limited

SBI Health Insurance Renewal Process

Renewal Process For SBI Health Insurance 

In India, health insurance comes with a grace period of 15-30 days after the renewal date. This provides extra time to pay the premium. Opting for a multi-year renewal offers benefits like rate lock, continuous coverage, and savings on administrative costs. Insurers may also provide discounts and incentives, such as No-Claim Bonuses and long-term policy discounts. Timely renewal is crucial to maintain uninterrupted coverage. Explore SBI General Insurance Company’s offerings and choose the SBI Health Insurance renewal option that best aligns with your needs and preferences
 

Renewal Process For SBI Health Insurance - Online

Follow these steps for a seamless online renewal of your SBI health insurance policy:

Step 1: Visit the Official Website

Navigate to the official SBI General Insurance website

Step 2: Select 'Health'

Click on the 'Health' tab among the available options

Step 3: Opt for Renewal

Under the 'Health' section, choose the 'Renew' option

Step 4: Provide Policy Details

A dropdown menu of policies will appear. Select the specific health insurance policy for renewal. Additionally, input your Policy Number

Step 5: Proceed with Payment

After entering your details, click 'Go' to initiate the policy renewal payment

Step 6: Confirmation Email

Upon successful payment, you will receive an email confirming the renewal of your SBI health insurance policy

Offline Renewal Process for SBI Health Insurance Policy

While online renewal is convenient, SBI also facilitates an offline renewal option for policyholders' ease. If you prefer this method, simply dial SBI's toll-free number at 1800-102-1111 and provide the necessary details

Alternatively, you can visit the nearest SBI branch to renew your health insurance policy

FAQs

Following are the major and important 13 critical illnesses covered under SBI General’s critical illness insurance plan

  • Open Chest CABG
  • Cancer of specified severity
  • Open heart replacement and repair of heart valves
  • Aorta graft surgery
  • Stroke resulting in permanent symptoms
  • Kidney failure requiring regular dialysis
  • First heart attack of specified severity
  • Major organ/bone marrow transplant
  • Primary pulmonary arterial hypertension
  • Coma of specified severity
  • Multiple sclerosis with persisting symptoms
  • Permanent paralysis of limbs
  • Total blindness

Health insurance portability refers to the shifting of health insurance plans from one insurance provider to another insurance provider with all the existing benefits carried along. Portability gives the benefit of selecting the suitable plan of your choice with the existing benefits like no claim bonus accumulated and waiting period etc continued

SBI health insurance plans come with a free look period of 15 days during which the policyholder can decide whether to continue with the policy or not. In case, insured is not satisfied with the terms and conditions of the policy, he/she can cancel it without any charges within this free look period of 15 days. However, it’s important and mandatory to state the reason for the cancellation of the policy

Premiums for SBI health insurance plans can be paid online or also through offline mode. Following are the modes through which online payments can be made

  • Net banking
  • Credit card
  • Debit card

However, payment can also be done offline through the below ways

  • Cash/cheque at nearby SBI bank branches
  • Electronic Clearing System (ECS)
  • Drop boxes

Co-payment is a system of cost-sharing in health insurance plans wherein the insured is required to bear a fixed out-of-pocket cost for covered services. This can also be in a fixed percentage. A fixed percentage of the claim amount needs to be paid by the insured and the remaining will be paid to the insurance company

Yes. SBI health insurance plans come with a 30 days grace period. In case you fail to make a premium payment within the due date for premium payment, you can still make the payment within 30 days from the due date. The benefits will continue during the grace period

Below are the treatments and illnesses that are excluded from domiciliary treatment cover

  • Asthma
  • Diarrhoea and all types of Dysenteries and Gastroenteritis
  • Insipidus and Diabetes Mellitus
  • Influenza, Cough and cold
  • Bronchitis
  • Nephritic Syndrome and Chronic Nephritis
  • Epilepsy
  • Hypertension
  • Arthritis, Rheumatism and Gout
  • All Psychiatric and Psychosomatic disorders
  • Pyrexia of unknown origin for less than 10 days
  • Tonsillitis and Upper Respiratory Tract infection including Laryngitis and pharyngitis

SBI health insurance is quite beneficial as the plans offered by the company offer a range of comprehensive coverage benefits which ensure that most medical costs get covered. Moreover, the company offers a range of health insurance plans so that you can choose a plan as per your coverage needs. The claim process of SBI health insurance plans is simple ensuring that you get cashless assistance in emergencies for a smoother experience

You can make a claim under your SBI health insurance policy in a cashless manner or through reimbursement. Cashless claims are available if you get admitted to a networked hospital. In case of a non-networked hospital or if your cashless claim is not approved, you can opt for reimbursement claims wherein you bear the medical expenses initially and then get them reimbursed by the company. The claim process for each of these types of claims has been explained earlier above

SBI believes in a quick and easy claim settlement process and allows you to get your claims settled in the easiest possible manner. In case of claims, you can contact the toll-free number of the company 1800 102 1111 and register your claim. You can also send a SMS to 561612 by writing ‘CLAIMS’ in the message text. You can send an email to customer.care@sbigeneral.in to intimate the company about your claim or simply intimate it online at the link https://www.sbigeneral.in/portal/claim/claims-intimation. Once your claim is intimated, the company would get in touch with you and guide you with the claim settlement process.

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