• SBI General Arogya Premier Policy

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    With the rising cost of healthcare, people have become aware of the importance of the right health insurance cover to protect themselves against unforeseen medical expenses. In addition to upper and lower middle-class people, high net worth individuals (HNIs) also seek proper health insurance cover that can provide them access to the best medical treatment. Most importantly, these individuals do not compromise when it comes to healthcare expenses.

    SBI General Arogya Premier is a health insurance policy designed to address the special healthcare requirements of HNIs. This cover comes with a range of flexible options and provides access to the best medical treatment.

    Eligibility For SBI General Arogya Premier

    The eligibility criteria for SBI General Arogya Premier is as follows:

    • Minimum entry age is 3 months, and maximum entry age is 65 years.
    • Pre-insurance medical examination is not required for people less than 55 years of age provided there is no medical history.
    • This policy is available for individuals and/or family.
    • Family floater cover is also available for self, spouse, and two dependent children up to the age of 23.

    Premium Charges

    SBI General Arogya Premier comes with a wide range of coverage options ranging from Rs.10 lakh to Rs.30 lakh. The premium charges for this cover vary based on the sum insured chosen, insurance type, and age group of the insured.

    Features Of SBI General Arogya Premier

    This policy cover comes with a range of features that ensure comprehensive coverage for HNIs. Some of the key features of SBI General Arogya Premier are as follows:

    • Coverage provided for 142 day care treatments
    • Cumulative bonus of 10% of the sum insured for every claim-free year subject to a maximum of 50% of sum insured
    • Coverage for alternative treatments such as siddha, ayurveda, unani, homeopathy, etc.
    • Coverage for medical expenses against the insured organ donor’s treatment
    • Coverage available for reasonable and customary expenses related to maternity
    • Automatic reinstatement of the sum insured once it gets reduced due to a claim
    • Income tax benefit under Section 80D of Income Tax Act
    • Coverage for pre-hospitalisation expenses for up to 60 days subject to the same condition of hospitalisation
    • Coverage for post-hospitalisation expenses for up to 90 days subject to the same condition of hospitalisation
    • Free-look period of 15 days to decide whether the policy is satisfactory

    Benefits of SBI General Arogya Premier

    People who have taken this cover can avail plenty of benefits within the range of the sum insured they have chosen. Some of the key benefits available under SBI General Arogya Premier policy are as follows:

    Types of expenses Scope
    Hospitalisation benefits offered within the limit of sum insured amount Room rent, boarding expenses, medical practitioner fees, intensive care unit charges, nursing charges, diagnostic charges, medicines and drugs, physiotherapy as part of the primary treatment, etc.
    Expenses related to medical treatments and procedures Anaesthesia, blood, surgical appliances, operation theatre charges, x-ray, dialysis, chemotherapy, radiotherapy, prosthesis and internal implants, cost of pacemaker, etc.
    Ambulance and air ambulance expenses Actual ambulance expenses or Rs.1 lakh (whichever is lower)
    Domiciliary hospitalisation cover Available for reasonable medical treatments
    Health check up costs Reimbursement offered up to Rs.5,000 after 4 continuous claim-free years

    Exclusions From SBI General Arogya Premier

    Some of the key exclusions applicable to SBI General Arogya Premier Policy are as follows:

    • Any pre-existing condition for the first 4 years of the policy
    • All conditions (except accidental injuries) for the first 30 days of the policy
    • Conditions such as gastric or duodenal ulcers, hernia, hydrocele, chronic renal failure, diabetes and related complications, benign prostatic hypertrophy, sinusitis, tonsillectomy, cataract, etc. for the first year of the policy
    • Maternity expenses for the first 9 months of the policy
    • Expenses related to treatments taken outside India
    • Injuries or illnesses caused by war or warlike activities
    • Injuries or illnesses caused by nuclear weapons or radioactivity
    • Cosmetic and aesthetic treatments of all kinds
    • Comfort-related expenses incurred during hospitalisation
    • Intentional self-injury, suicide, or attempt to suicide
    • Injuries caused while under the influence of alcohol or drugs
    • Treatments associated with rehabilitation from drugs or alcohol
    • Treatments related to HIV, AIDS, and other venereal diseases
    • Treatments related to mental illnesses and psychiatric disorders
    • Treatments related to weight loss, obesity, and weight management
    • Injuries sustained while serving as a member of military or police force
    • Genetic disorders and internal or external congenital diseases

    Claim Procedure For SBI General Arogya Premier

    Cashless treatment benefit is available under this policy. It can be availed by calling the administrator prior to hospitalisation. Detailed information about the type of claim must be provided to the administrator. After verifying the details, the administrator will provide an authorisation letter to the insured or the hospital facility. Along with the authorisation letter, the insured must produce the ID card issued at the time of commencement of the policy while availing cashless treatment.

    For other normal claims, notification of claim must be made within 48 hours of hospitalisation. However, the administrator of the policy, at his/her sole discretion, may relax the time of notification for a particular claim up to a maximum of 7 days. The claim form must be filled by the insured with all the necessary details and submitted to the administrator. Along with the claim form, the following documents must be provided while filing a claim.

    • Valid photo identity card and 2 photos of the insured or nominee
    • Discharge certificate
    • Original investigation report
    • Death certificate, if applicable
    • Copies of diagnostic tests and treatments
    • Bills and receipts for drugs
    • Any other document requested by the administrator

    Upon receiving all the above mentioned documents, the administrator will initiate the claim proceedings. All the conditions will be assessed by the administrator before approving the claim. After satisfactory verification, the administrator will inform the claimant about the acceptance of the claim. The insurer will settle the payment within 7 days from the date of acceptance of claim.

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