SBI Arogya Premier Policy Health Insurance
About the SBI Arogya Premier Policy Health Insurance
SBI General Insurance is a joint venture organization between State Bank of India (SBI) and other investors, including Axis Bank Asset Management, Premji Invest and the Warburg Pincus Group. State Bank of India holds a 70% share in the total capital and the rest is held by other organizations.
SBI General Insurance provides a wide range of insurance policies, products, and services to its customers. The SBI Arogya Premier policy is one of the most popular health insurance policies provided by the organization. Other policies are also provided, including personal accident, travel, health, home, and motor insurance policies.
The Indian Bank Arogya Raksha is a similar plan that focuses on providing Arogya health care to policyholders and insureds. The SBI Arogya Premier Policy health insurance policy provides comprehensive coverage to individuals at an affordable premium. This policy can also be a good investment option for individuals with a higher net worth.
Arogya Premier covers a wide range of medical situations and conditions. The policy is available on an individual and family floater basis. SBI General Insurance also has a dedicated team of claim settlement experts. The organization has reported a claim settlement ratio of 66.08% and it also provides covers related to COVID-19 treatment.
As of now, there are over 6,000 hospitals in the SBI General Insurance affiliated network. The organization also provides several policies that come with lifelong renewability features.
SBI General Arogya Premier as a health insurance plan was designed to address the specific healthcare needs of individuals with a high net worth. The plan comes with several flexible options and provides access to the highest quality medical treatments.
The total policy term can vary from 1 year, 2 years, and 3 years. Purchasing this policy is a great way to stay free from worries related to unforeseen medical expenses. Some benefits provided with this policy are in-patient hospitalization, health check-ups, ambulance cover, organ donor charges, domiciliary hospitalization, pre-hospitalization, and post-hospitalization charges.
Customers also have a lot of choices in this plan in respect to the total sum insured, insurance type, age group of the insured, and other factors. Customers should know that they don’t need to undergo a pre-policy medical test if they are up to the age of 55 years. These individuals should also have no medical history.
The plan comes with 142 different day-care expenses covered for all policyholders. Other key features of this plan are:
- Pre-hospitalization coverage of up to 60 days before being admitted to the hospital
- Post-hospitalization coverage of up to 90 days after being discharged from the hospital
- After a waiting period of 9 months, maternity expenses are also covered
- Organ donor charges cover is provided
- The feature of automatic reinstatement of sum insured on exhaustion is provided
- For every claim-free year, a cumulative bonus of 10% of the sum insured value is provided for up to a maximum of 50%
- The coverage of this plan can range from INR 10 lakh to INR 30 lakh
- One can save taxes under Section 80D of the Income Tax Act, 1961. This tax benefit is subject to the extant rates as specified in the Finance Bill
- Alternative treatment cover for Unani, Ayurveda, Siddha, and Homeopathy is also available under the AYUSH alternate treatment facilities
- No additional value-added benefits are provided in this policy that one can avail of by paying an extra premium amount
- The SBI Arogya Premier plan has a very impressive claim settlement ratio
- The policy comes with a wide range of age limits
- The policy has a hassle-free purchasing process
- A large range of medical conditions and situations are covered under this policy
- All accumulated bonus of the SBI Arogya Premier plan will work to increase the sum assured value which can be used later
- Room rent, medical practitioner’s fees, intensive care unit charges, nursing expenses, and boarding expenses are covered
- Ambulance cover of up to Rs.1 lakh, in case of Air Ambulance, is provided
- Different diagnostic procedures are covered
- Consumables, medicines, and drugs during the hospitalization period are covered
- Physiotherapy as inpatient care and being part of the treatment is covered
- Charges related to oxygen, blood, operation theatre, anesthesia, surgical appliances, x-ray, dialysis, chemotherapy, radiotherapy, pacemaker, internal implants, prosthesis, or other medical charges that are integral to the process of the operation or medical treatment are covered
- Charges of ordinary splints, dressing of wounds, and plaster casts are covered
- Alternative treatments availed at government hospitals or in an institution recognized by the government or the quality council of India are covered
- A health check-up reimbursement of up to INR 5,000 is insured after four consecutive claim-free years
- The sum insured value is reinstated up to a total of 100% if the sum insured is reduced due to placing a claim
The SBI Arogya Premier Policy also has important eligibility criteria. Let’s look at what that criterion is below.
Requirement of Medical Examination
Not Required for anybody under the age of 55 years and with no previous medical history
Health Insurance Policy Type
Family Floater (This cover is provided for the spouse of the policyholder, two dependent children up to the age of 23 years, and self)
Apart from this, one must also know about the documents that are required to purchase the SBI Arogya Premier policy. These documents are:
- Application or proposal form
- KYC documents
- A medical test or check-up (Only required in select cases)
The process of renewing the SBI Arogya Premier policy is also simple. A grace period of 30 days is provided for the renewal of this policy every year. This period is counted right after the premium amount is due. One can renew the policy without any hassle either by visiting the official website online or by visiting the local branch office of SBI General Insurance.
Further, when it comes to placing a claim request for the SBI Arogya Premier plan one has to initiate the process by calling the administrator before hospitalization. This will allow the administrator to gather the necessary information in regards to the type of claim that has been raised.
After the details have been verified, the administrator will provide an authorization letter to the insured or the hospital facility. Along with the authorization letter, the insured will have to provide his or her ID card that was issued at the start of the policy. In this manner, one can avail of cashless treatments.
In the case of a normal claim, one must notify the administrator within 48 hours of hospitalization. This duration can also be extended to 7 days at the sole discretion of the administrator. After that, the insured will have to fill a form and submit the following documents.
- Discharge certificate
- Original investigation report
- Valid photo identity card
- 2 photos of the insured
- 2 photos of the nominee, if applicable
- Death certificate, if applicable
- Bills and receipts of drugs
- Copies of treatment charges
- Copies of diagnostic test charges
- Any other document requested by the administrator
Once the documents mentioned above are received, the administrator will start the process of settling the claim. All conditions will be assessed by the administrator before providing approval. The payment will be settled within 7 days from the acceptance date of the claim.
Some key inclusions applicable in this policy are:
- Alternative treatment coverage
- Coverage for ambulance charges for a maximum of up to INR 1 lakh
- Pre-hospitalization and post-hospitalization charges
- 142 day-care procedure charges cover
There are also some factors that are excluded from the coverage of this policy. Those factors and parameters are:
- For the first 30 days of the policy, all conditions and illnesses apart from accidental injuries are not covered as the cooling period
- Illnesses caused due to war, warlike activities, nuclear weapons, radioactivity, attempt to suicide, suicide, or self-injury are not covered
- Any type of aesthetic, prosthetic or cosmetic procedure
- Expenses related to comfort during hospitalization
- Any pre-existing medical condition for the first 4 years of the policy
- Maternity expenses for the first nine months of the policy
- Any treatment costs incurred outside of India
- Injuries caused due to alcohol addiction and drug abuse
- Treatments of conditions like hernia, gastric ulcers, duodenal ulcers, diabetes, chronic renal failure, cataract, sinusitis, benign prostatic hypertrophy, and tonsillectomy during the first year of the policy
- Injuries sustained while serving as a member of the police or military force
- Genetic conditions
- Internal or external congenital diseases
- Treatments related to rehabilitation from alcohol or drugs
- Treatments related to HIV, AIDS, and other venereal diseases
- Treatments of weight loss, obesity, or weight management
- Treatments related to psychiatric disorders and mental illnesses
The SBI Arogya Premier policy is one of the most popular and promising health insurance policies in India. This is a unique plan that has been designed to meet the special healthcare needs of individuals with a high net worth.
This comprehensive plan provides the features of a classic health insurance policy and more to individuals and their family members. Customers and policyholders all across India love this policy and services offered by SBI General Insurance. You can go through some customer reviews mentioned below to gain a clearer picture.
- Excellent Digital Policy Initiative, says Rimil Nandy (5 stars / 5 stars): I have been a policyholder of the SBI Arogya Premier plan for only a few months only. And throughout this time, I love the fact that SBI General Insurance always sends me documents digitally instead of wasting paper. The services of this organization are truly exceptional and I’m very satisfied to be connected with them.
- Satisfied with SBI Arogya Premier Health Insurance Plan, says Daksh Rami (5 stars / 5 stars): As of now, I am very satisfied and happy with the services offered by SBI Arogya Premier policy. I have yet to make a claim so I cannot tell you anything about that but for me, the purchasing process and renewal process of this policy has been very easy. The SBI team always handles things exceptionally.
- The Best Plan in this Price Range, says Rohan Gupta (5 stars / 5 stars): My first insurance product with SBI General Insurance is the SBI Arogya Premier policy and I must say that I’m happy. The plan provides basic coverage like maternity, ambulance, domiciliary, and other benefits. The premium cost is affordable for me and it provides coverage to my entire family. The plan is very impressive.
SBI Arogya Premier Policy Health Insurance FAQs
Is there a cumulative benefit provided with my SBI Arogya Premier policy?
Yes, the SBI Arogya Premier policy does come with cumulative bonus benefits. The benefit is available at a rate of 10% of the total sum insured value for every claim-free renewal year. This bonus can be extended to a maximum of up to 50%.
I’m an SBI Arogya Premier Plan policyholder. Can I avail of tax benefits for the same?
Yes, if you are an SBI Arogya Premier Plan policyholder, then you can get tax benefits for the same. You can avail of deduction under Section 80D of the Income Tax Act from your taxable income for health insurance premium paid.
The deduction comes at a maximum of Rs. 25,000 for self, spouse, dependent children, and dependent parents. If the dependent parents are senior citizens, then the amount can be extended to Rs.30,000. These limits are subject to change from time to time.
Do I need to get a pre-medical check-up before purchasing the SBI Arogya Premier policy?
The answer to this question completely depends upon your age and your medical history. If you are under the age of 55 years and you do not have any previous medical history, then you do not need to get a medical check-up done. However, if you don’t fulfill these criteria, then you would have to get a pre-medical check-up done.
In this case, the cost of pre-acceptance medical has to be borne by the proposer. If the purchasing proposal is accepted, then one can get a reimbursement of up to 50% of the costs incurred.
I am an SBI Arogya Premier policyholder. Can I get my treatment cover for Ayurvedic treatment?
Yes, SBI Arogya Premier policy does provide coverage for alternative AYUSH treatments, including Homeopathy, Unani, and Ayurvedic treatments. These treatments should only be taken in a government hospital or an institution that has been recognized by the government. The institute should also be accredited by the Quality Council of India or the National Accreditation Board on Health. The cover will be subject to a percentage of the overall cover.