Site icon Antworks Money – The Blog on Personal Finance | Guide to Loans, Credit Cards, Insurance and Investments

Health Insurance Companies in India

Team Antworks

In 2011, 3.9% of India’s GDP was spent in the health sector. Out of this 3.9%, health insurance accounts for 5-10% of expenditure, employers account for around 9% while personal expenditure amounts to 82%.

Overview of Health Insurance Companies:

Company Features
United India Insurance Co. Ltd. Started in 1938 and nationalized in 1972, the company provides a variety of insurance products to over 1 crore customers.
  • Net worth of Rs.5,361 crores as on financial year 2013-14.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 20% co-payment for senior citizens on major illnesses.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • 10% deductible for claims by customers over the age of 60.
  • Cashless hospitalization in over 7,000 hospitals across India.
New India Assurance Co. Ltd. Founded in 1919 and wholly owned by the Indian Government, this company has over 2,097 offices and 1,041 micro-offices across India.
  • Net worth of over Rs.10,000 crore as on financial year 2012-13.
  • Coverage for up to 6 family members (2 adults and 4 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 10% co-payment for claims arising out of pre-existing medical conditions.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 1,200 network hospitals across India.
Oriental Insurance Co. Ltd. Founded in 1947, the company has over 30 regional and 1,800 operating offices across the country.
  • Underwritten premium of over Rs.7,282 crore.
  • Coverage for up to 7 family members including 4 adults.
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 10% co-payment of claim amount has to be paid by the insured.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 4,300 network hospitals across India.
National Insurance Co. Ltd. Established in 1906 and nationalised in 1972, this company functions out of 1,340 offices and 373 centres across India.
  • Direct premium income of over Rs.9,000 crore in financial year 2012-13.
  • Coverage for up to 6 family members.
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay, and 10% discount on premium on acceptance of 2% co-pay scheme.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 6,000 hospitals across India.
SBI General Insurance Co. Ltd. The resultant company of a joint venture between State Bank of India (which holds a 74% stake) and Insurance Australia Group (which holds a 26% stake), SBI General Insurance Co. Ltd. Operates out of 14,000 official branches of SBI.
  • Gross written premium of Rs.1,188 crore in financial year 2013-14.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 10% co-pay on all admissible claims.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 4,400 network hospitals across India.
Star Health and Allied Insurance Co. Ltd. India’s first standalone health insurance provider.
  • Just over Rs.736 crore net premium revenue as of December 2014.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay, but 20% of the claim to be paid by insured persons between 61 and 65 years old.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 6,000 network hospitals across India.
Religare Health Insurance Co. Ltd. Standalone health insurance provider comprising of three entities – Religare Enterprises Limited, Union Bank of India and Corporation Bank.
  • Gross written premium of Rs. 275.8 crore for the financial year 2014-15.
  • Coverage for up to 6 family members (with up to 2 adults).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay, first claim for insured persons over 61 years must pay 20% of the claim amount.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization at over 4,500 hospitals across India.
Apollo Munich Health Insurance Co. Ltd The result of a merger between Apollo Hospitals and Munich Health in August 2007.4
  • Net premium earned of over Rs.488 crore up to the quarter ending 31-12-2014.
  • Coverage for up to 6 family members (with up to 2 adults).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 3 years.
  • Cashless hospitalization at over 4,000 hospitals across India.
Max Bupa Health Insurance Co. Ltd The result of a joint venture between Max India Limited and Bupa Financial PLC, UK, Max Bupa Health Insurance Company serves a 29 million-strong customer base across 190 countries.
  • Net premiums earned of Rs.234 crores as of 31st December 2014.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay, except 20% if insured is over 65 years of age.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 3,500 hospitals across India.
Cigna TTK Health Insurance Co. Ltd Starting operations in February 2014, this company is the result of a joint venture between the TTK group and Cigna Corporation, USA.
  • Over Rs.82 crore in operating profit.
  • Coverage for up to 4 family members (with up to 2 adults and 2 children).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 4,000 network hospitals across India.
ICICI Lombard General Insurance Co. Ltd This is one of the largest private sector general insurance companies, and is the result of a merger between ICICI Bank Limited and Fairfax Financial Holdings Limited, Canada.
  • Gross written premium of Rs.71.34 billion for the financial year ended March 31st, 2014.
  • Coverage for up to 4 family members (with up to 2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 4,500 network hospitals across India.
Bharti AXA General Insurance Co. Ltd This joint venture between Bharti Enterprises (which holds a 74% stake) and AXA Group (which holds a 26% stake) commenced national operations in 2008 and operates out of 59 branch offices across India.
  • Over Rs.690 crores in net premiums earned.
  • Coverage for up to 4 family members (with up to 2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 5,000 network hospitals across India.
Cholamandalam MS General Insurance Co. Ltd Headquartered in Chennai, the Cholamandalam MS General Insurance Company is the result of a joint venture between Murugappa Group, India, and Mitsui Sumitomo Insurance Group, Japan.
  • Over Rs.1,370 crore revenue from direct written premium.
  • Coverage for up to 5 family members (up to 2 adults and 3 children).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization at over 2,600 hospitals across India
Future Generali India Insurance Co. Ltd. This is joint venture between Future Group, India and Generali group, Italy began operations in 2006, headquartered in Mumbai.
  • Over Rs.899 crore in net premium earned.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • 30% co-pay for customers in Zone-A (Mumbai, Delhi, NCR) and 20% co-pay for those in Zone-B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad). No co-payment for remaining areas.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Over 4,300 network hospitals across India.
HDFC ERGO General Insurance Co. Ltd This company is a joint venture between HDFC Ltd (which holds a 74% stake) and ERGO International AG (which holds a 26% stake). ERGO International AG is the primary insurance unit of the Munch RE Group. HDFC ERGO is India’s 4th largest private sector general insurance provider with 104 branches in 87 cities across India.
  • Over Rs.1,409 crore in net premium earned.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 4,800 hospitals across India.
IFFCO Tokio General Insurance Co. Ltd This joint venture between Indian Farmers Fertilizer Co-operative (IFFCO) and Tokio Marine and Nichido Fire Group came into force in December, 2000. It provides insurance products through its 65 Strategic Business Units, 120 lateral Spread Centres and 255 Bima Kendras – across India.
  • Over Rs.177 crore in profits (before taxation) for the period ended 31st December, 2014.
  • Coverage for up to 5 family members (up to 2 adults and 3 children).
  • Medical expenses covered 60 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 3 years.
  • Cashless hospitalization in over 3,000 hospitals across India
L&T General Insurance Co. Ltd This company is a wholly owned subsidiary of Larsen &Toubro Limited.
  • Over Rs.175 crore in new premium earned.
  • Coverage for up to 4 family members (with up to 2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 10% co-pay if the age of the insured is above 80.
  • Lifetime renewability.
  • Pre-existing diseases covered after 3 years.
  • Over 2,800 network hospitals across India.
Reliance General Insurance Co. Ltd One of the largest private sector insurance providers in the country with a wide presence in over 102 cities and various distribution channels.
  • Profit of over Rs.837 crore as of the period ended 31st December, 2014.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 4,000 network hospitals across India.
Royal Sundaram Alliance Insurance Co. Ltd The first private sector general insurance company to be licensed in India since 2001, Royal Sundaram Alliance Insurance Company provides financial services to over 5 million customers.
  • Profit of over Rs.172 crore for the quarter ending on 31st December 2014.
  • Coverage for up to 5 family members.
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 3 years.
  • Cashless hospitalization in over 3,000 network hospitals across India.
TATA AIG General Insurance Co. Ltd. This company is the result of a joint venture between the Indian Tata Group (which holds a 74% stake) and the American International Group (AIG) (which holds a 26% stake) and started operations on January 22nd, 2001.
  • Over Rs.1,334 crore in net premium earned.
  • Coverage for up to 5 family members (up to 2 adults and 3 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • No co-pay.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 3,000 network hospitals across India.
Bajaj Allianz General Insurance Co. Ltd. This company is the result of a joint venture between Bajaj Finserv Limited (which holds a 74% stake) and Allianz SE (which holds a 26% stake) on 31st March 2013.
  • Over Rs.1424 crore in net premium earned.
  • Coverage for up to 6 family members (with up to 2 adults and 4 children).
  • Medical expenses covered 60 days before and 90 days after hospitalization.
  • 10% co-payment in non-network hospitals which can be waived off on payment of an additional 10% of loading on premium.
  • Lifetime renewability.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 3,700 network hospitals across India.
Universal Sompo General Insurance Co. Ltd. This is a first-of-its-kind public-private partnership company in the Indian General Insurance industry. It is a joint venture between Allahabad Bank, Indian Overseas Bank, Karnataka Bank Ltd., Dabur Investment Corporation and Sompo Japan Nipponkoa Insurance Inc.
  • Over Rs.331 crore in net premium earned.
  • Coverage for up to 4 family members (2 adults and 2 children).
  • Medical expenses covered 30 days before and 60 days after hospitalization.
  • 20% co-pay for all insured persons’ claims who are above the age of 55.
  • Policy can be renewed up to the age of 70 without any breaks in payment.
  • Pre-existing diseases covered after 4 years.
  • Cashless hospitalization in over 5,000 network hospitals across India.

 

 

Insurance Provider Coverage Pre and post hospitalization expenses cover Co-pay Renewability Pre-existing disease cover Network hospitals Incurred Claim Ratio*
Public Sector
United India Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. 20% for senior citizens on major illnesses. Lifetime. After 4 years. 7000 97.68%
New India Assurance Co. Ltd. Up to 6 family members (2 adult and 4 children). 30 days pre and 60 days post hospitalization. 10% on pre-existing medical conditions. Lifetime. After 4 years. 1200 97.24%
Oriental Insurance Co. Ltd. Up to 7 family members including 4 adults. 30 days pre and 60 days post hospitalization. 10%. Lifetime. After 4 years. 4300 102.38%
National Insurance Co. Ltd. Up to 6 family members. 30 days pre and 60 days post hospitalization. No co-pay. 10% discounted premium if opted for 2% co-pay scheme. Lifetime. After 4 years. 6000 105.09%
SBI General Insurance Co. Ltd. Up to 4 family members. 30 days pre and 60 days post hospitalization. 10%. Lifetime. After 4 years. 4400 122.82%
Private Sector
Star Health and Allied Insurance Co. Ltd. Up to 4 family members (2 adults and 2 children). 30 days pre and 60 days post hospitalization. 20% for those 61 – 65 years old. Lifetime. After 4 years. 6000 95.76%
Religare Health Insurance Co. Ltd. Up to 6 family members (with up to 2 adults). 30 days pre and 60 days post hospitalization. 20% on first claim only for those above 61 years of age. Lifetime. After 4 years. 4500 Data unavailable.
Apollo Munich Health Insurance Co. Ltd. Up to 6 family members (with up to 2 adults). 60 days pre and 90 days post hospitalization. No co-pay. Lifetime. After 3 years. 4000 58.20%
Max Bupa Health Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. 20% if insured is above 65 years of age. Lifetime. After 4 years. 3500 56.15%
Cigna TTK Health Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 60 days pre and 90 days post hospitalization. No co-pay. Lifetime. After 4 years. 4000 Data unavailable.
ICICI Lombard General Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 4 years. 4500 86.19%
Bharti Axa General Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 4 years. 5000 80.44%
Cholamandalam MS General Insurance Co. Ltd. Up to 5 family members (up to 2 adults and 3 children) 60 days pre and 90 days post hospitalization. No co-pay. Lifetime. After 4 years. 2600 76.51%
Future Generali India Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 60 days pre and 90 days post hospitalization. 30% in Zone-A (Mumbai, Delhi, NCR) and 20% in Zone-B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad). No co-pay for remaining areas. Lifetime. After 4 years. 4300 85.58%
HDFC ERGO General Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 60 days pre and 90 days post hospitalization. No co-pay. Lifetime. After 4 years. 4800 67.53%
IFFCO Tokio General Insurance Co. Ltd. Up to 5 family members (up to 2 adults and 3 children) 60 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 3 years. 3000 85.79%
L&T General Insurance Co. Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. 10% if insured person is above 80 years old. Lifetime. After 3 years. 2800 183.40%
Reliance General Insurance Co, Ltd. Up to 4 family members (2 adult and 2 children). 30 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 4 years. 4000 85.77%
Royal Sundaram Alliance Insurance Co. Ltd. Up to 5 family members. 30 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 3 years. 3000 50.86%
TATA AIG General Insurance Co. Ltd. Up to 5 family members (2 adults and 3 children). 30 days pre and 60 days post hospitalization. No co-pay. Lifetime. After 4 years. 3000 49.65%
Bajaj Allianz General Insurance Co. Ltd. Up to 6 family members (2 adults and 4 children). 60 days pre and 90 days post hospitalization. 10% in non-network hospitals. Waived off if 10% loading is paid on premium. Lifetime. After 4 years. 3700 66.52%
Public-Private Sector
Universal Sompo General Insurance Co. Ltd. Up to 4 family members (2 adults and 2 children). 30 days pre and 60 days post hospitalization. 20% if insured person is over 55 years old. Renewable up to 70 years of age. After 4 years. 5000 102.59%
Exit mobile version