SBI Arogya Premier Policy

What is SBI Arogya Premier Policy

SBI General Arogya Premier is a health insurance plan that addresses the specific healthcare needs of HNIs. This health cover comes with various flexible options and offers access to the best medical treatment.

Feature & Benefits of SBI Arogya Premier Policy

This Policy offers a host of features that prove to be extremely beneficial to the policyholder. These features are listed below:

  • No pre-policy medical test is required for people up to the age of 55 years with no medical history.
  • This plan covers 142 Day Care expenses for all policyholders.
  • The plan provides coverage of 60 days for Pre Hospitalisation & 90 days for Post Hospitalisation expenses.
  • This policy also covers ambulance charges including air ambulance up to INR 1,00,000.
  • Maternity Expenses are covered after a waiting period of the first 9 months.
  • This health cover also takes care of organ donor expenses.
  • Automatic Reinstatement of Sum Insured is available.
  • Cumulative Bonus of 10% of Sum Insured is provided for each claim free year maximum up to 50%.
  • The plan has a wide coverage, right from INR 10,00,000 up to INR 30,00,000.
  • As a policyholder, you can save taxes under Section 80D of Income Tax Act, 1961 (Tax benefits are subject to change in tax laws).
  • Alternative treatment like Ayurveda, Unani, Siddha & Homeopathy are also covered under this plan.

Value Added Benefits of SBI Arogya Premier Policy

There are no additional value added benefits which a proposer can attach by paying an additional premium. Let’s highlight the standard benefits of SBI Arogya Premier Plan:

  • This plan gives you financial security and peace of mind in respect to claim settlement and its high claim settlement ratio is a proof of the same.
  • The policy offers a wide range of age limit and hassle-free buying process
  • SBI Arogrya Premier Plan covers a large array of medical conditions and situations
  • The accumulated bonus of SBI Arogrya Premier Plan increases your Sum Assured which can be used later
  • The health checkups offered by the plan at regular intervals helps you manage your health better
  • This plan not only provides the much needed financial protection but also helps you save taxes under Section 80D of the Income Tax Act, 1961

Coverage Of SBI Arogya Premier Policy

The following is covered in SBI Arogya Premier Plan:

  • Eligible hospitalisation expenses as under:
    • Room rent, boarding expenses
    • Medical practitioner’s fees
    • Intensive care unit
    • Nursing expenses
  • Anesthesia, blood, oxygen, operation theatre expenses, surgical appliances, medicines & consumables, diagnostic expenses and x-ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, prosthesis/internal implants and any medical expenses incurred which is integral part of the operation
  • Physiotherapy as inpatient care and being part of the treatment
  • Drugs, medicines and consumables consumed during hospitalization period
  • Diagnostic procedures
  • Dressing, ordinary splints and plaster casts
  • Pre-hospitalisation expenses up to 60 days for each of the admitted hospitalisation claim under the Policy.
  • Post-hospitalisation expenses up to 90 days for each of the admitted hospitalisation claim under the Policy.
  • Day Care expenses cover up to 142 Day Care Procedures.
  • Ambulance expenses including Air Ambulance up to INR 1,00,000.
  • Alternative treatment taken in a government hospital or in any institute recognized by government and/or accredited by quality council of India/national accreditation board on health.
  • Domiciliary hospitalisation
  • Maternity Expenses
  • Organ Donor Expenses
  • Health Check up reimbursement up to Rs. 5,000 insured after 4 consecutive claim free years.
  • Reinstatement of Sum Insured up to 100% when sum insured is reduced due to claim.
  • Cumulative Bonus at the rate of 10% of the Sum Insured for every claim free renewal which can be accumulated maximum up to 50%

Exclusion of SBI Arogya Premier Policy

Following are the exclusions of SBI Arogrya Premier Plan:

  • 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
  • Injuries or illnesses caused by war or warlike activities
  • Injuries or illnesses caused by nuclear weapons or radioactivity
  • Expenses related to treatments taken outside India
  • Intentional self-injury, suicide, or attempt to suicide
  • Cosmetic and aesthetic treatments of all kinds
  • Comfort-related expenses incurred during hospitalisation
  • Any pre-existing condition for the first 4 years of the policy
  • Maternity expenses for the first 9 months of the policy
  • Injuries caused while under the influence of alcohol or drugs
  • Injuries sustained while serving as a member of military or police force
  • Genetic disorders and internal or external congenital diseases
  • 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

Eligibility Criteria to Apply for SBI Arogya Premier Policy

Here is the eligibility criteria for SBI General Arogya Premier:

  • 3 months is the minimum age of entry age, while the maximum age of entry is 65 years.
  • For people less than the age of 55 years, in case there is no medical history, a pre-insurance medical examination is not required.
  • This plan is available for family as well as individuals.
  • A Family floater cover is offered for spouse, two dependent children up to the age of 23 and self in this plan

Documents Required To Buy SBI Arogya Premier Policy

The individual will have to fill out the application/proposal form and KYC documents to buy SBI’s Arogya Premier Plan. In certain cases, a medical treatment might seem necessary.

Easy Procedure To Renew SBI Arogya Premier Policy

This policy by SBI can be renewed every year on payment of required premium to SBI General Insurance before the policy expires. However, a grace period of 30 days is provided for renewal of the policy. This period is counted from the day immediately after the premium due date. All the associated benefits shall continue and stay active to the insured once the premium has been received by the company.

What Is Claim Procedure for SBI Arogya Premier Policy

SBI Arogya Premier Plan offers cashless treatment benefit, which can be availed by calling the administrator before hospitalisation. The administrator needs to gather detailed information about the type of claim raised. Once the details are verified, he shall provide an authorisation letter to the hospital facility or the insured. With the authorisation letter, the insured must also provide his/her ID card that was issued at the time of commencement of the policy, when availing cashless treatment.

In case of any other normal claim, the claim should be notified within 48 hours of hospitalisation. However, the time to notify the claim may be relaxed up to 7 days at the sole discretion of the administrator. Next, the insured must duly fill the claim form with all the necessary details and submitted to the administrator. The following documents must be provided, along with the form to file a claim:

  • Valid photo identity card and 2 photos of the insured or nominee
  • Discharge certificate
  • Original investigation report
  • Bills and receipts for drugs
  • Death certificate, if applicable
  • Copies of diagnostic tests and treatments
  • Any other document requested by the administrator Once the aforementioned documents have been received, the administrator will start the process of settling the claim. Before he approves the claim, all conditions shall be assessed by the administrator. Once he is satisfied, the administrator shall inform the claimant of the acceptance of the claim. Then the insurer shall settle the payment within 7 days from the acceptance date of the claim.

Documents Required To Claim SBI Arogya Premier Policy

As mentioned above, the documents required to claim SBI Arogya Premier Plan are:

  • 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

Conclusion & Reviews

Conclusion

As healthcare costs are rising by the day, more and more people have started recognising the importance of healthcare, and understanding why it is vital to buy the right healthcare plan to safeguard against medical expenses. This is because at the time of need, everyone wishes for the best medical care that does not burn a hole in their pocket. Hence, SBI General Arogya Premier is a health plan that addresses these special healthcare requirements of millennial Indians. This health cover offers a range of options that give top notch medical treatment in the country.

Reviews of SBI Arogya Premier Policy

‘This Plan has proved to be beneficial for me. I did not have to pay hefty medical bills as I could avail the facility of cashless treatment’ – Rashmi Mehta, Delhi

‘I raised a claim against the policy and the entire process was quick and hassle-free. Surely recommending it to others as well!’ - Anurag Gupta, Mumbai

FAQ's On SBI Arogya Premier Policy

Is portability allowed under SBI Arogya Premier Policy?

Yes, you can port your existing Health indemnity policy into this policy

Does this policy cover treatment by Ayurvedic method?

Yes, alternative treatments such as Ayurvedic, Homeopathy or Unani, taken in a government hospital or in any institute recognized by government and/or accredited by Quality Council of India/ National Accreditation Board on Health) are covered under the plan up to Sum Insured.

Is there any grace period for renewal of the SBI Arogya Premier Policy?

Yes, there is a grace period of 30 days for renewal of the policy

Does SBI Arogya Premier Policy Covered Smoking, Alcohol and Tobacco Habits?

Yes, there is a loading of 5% in premium for each of the habits i.e. Smoking, Alcohol, and Tobacco consumption.

Is there any discount for long term policy?

Yes, there is a discount of 5% for 2 year term and 7.5% for three year term policies.

Is the policy available for long term?

Yes, the policy is available for a period of up to 3 years

Is there any pre-medical check-up required?

Pre-acceptance health check is not mandatory for people who are less than 55 years old and without any history of illness. Insured’s with following condition, acceptance of proposal is subject to a satisfactory medical examination as per SBI General’s requirements:

  • Insured with adverse medical history as declared in Proposal Form or,
  • Insured aged above 55 years & irrespective of Sum Insured.

The cost of Pre-acceptance medical tests has to be borne by the proposer. However, if the proposal is accepted, there will be a reimbursement of 50% of the cost incurred towards the medical tests so undertaken at our advice.

Is Maternity hospitalisation covered under the SBI Arogya Premier Policy?

Yes, Maternity hospitalisation expenses are payable under the policy with a waiting period of 9 months.

Is there any Cumulative bonus applicable under the SBI Arogya Premier Policy?

Yes, cumulative bonus of 10% for each claim free year is available and you can accumulate up to a maximum of 50% under each policy.

Is Ambulance charges payable under the SBI Arogya Premier Policy?

Yes, the ambulance charges including Air Ambulance charges up to Rs 1,00,000/- for the policy period are payable.

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