Introduction

Before we start comparing these two policies we have to set out some ground rules.

Both products are marketed by different insurance companies. Cardiac Care Platinum is sold by Star Health and National Parivar Mediclaim policy is sold by National Insurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.

Second, we know that both products have massive differences in their core structure. Cardiac Care Platinum is specifically designed for people suffering from heart ailments. However, National Parivar Mediclaim policy is quite basic. It offers little protection and it’s a generic policy that anybody could pick off the shelf. So in many ways, you’re comparing apples and oranges here.

And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?

That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.


Let’s start with Cardiac Care Platinum. The product comes from Star Health’s stable:

Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.

The company also boasts a network of over 13,000+ hospitals and a decent claim settlement ratio of 83.07%.


National Parivar Mediclaim policy meanwhile comes from National Insurance’s stable:

National Insurance is the country's oldest general insurance firm and is wholly owned by the Government of India. That means, despite a claim settlement ratio of 94.14% and over 7,012 network hospitals it can be a bit difficult to reach the insurer when you need them the most. Perhaps due to the fact that they are still a public sector enterprise.

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Compare Insurances

Network hospitals13,000+7,012
Claim settlement ratio

(avg. of last 3 years)

83.07%94.14%
Co-payment

No

No

Room rent

Single Private room

Any Room

(up to 1% of sum insured)

Disease sub-limit

No

No

Pre existing diseases waiting

4 years

4 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

10% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for any illness)

Health check-up
Once every 3 years
Once every year
Maternity

Available

(up to ₹50,000 after 3 years)

Out Patient Department

Up to ₹3,500

Day care

Feature Comparison

co_pay

Co payment

With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Cardiac Care Platinum doesn’t impose a co-payment clause. And neither does National Parivar Mediclaim policy.

room_rent

Room rent

If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Cardiac Care Platinum lets you stay in a single private room and National Parivar Mediclaim policy only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured. In effect, both policies impose restrictions on the kind of room you can pick.

disease_sublimit

Sub limits

Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, neither Cardiac Care Platinum imposes disease-wise sub-limits nor does National Parivar Mediclaim policy

ped

Waiting periods for pre-existing diseases:

If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Cardiac Care Platinum imposes a 4 year waiting period on pre-existing diseases and National Parivar Mediclaim policy will similarly tell you to wait 4 years before making a claim related to your pre-existing diseases

pre_post

Pre and post Hospitalization expenses

Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Cardiac Care Platinum covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, National Parivar Mediclaim policy covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits

ncb

No claim bonus

Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Cardiac Care Platinum offers a no-claim bonus whereas National Parivar Mediclaim policy doesn’t offer a no-claim bonus.

domiciallary

Domiciliary

Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Cardiac Care Platinum doesn’t offer domiciliary protection whereas National Parivar Mediclaim policy offers domiciliary cover.

ayush

Ayush treatments

Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case Cardiac Care Platinum doesn’t extend coverage for Ayush treatments whereas National Parivar Mediclaim policy covers Ayush treatments.

maternity

Maternity benefits

If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Cardiac Care Platinum doesn’t offer protection for maternity-related hospitalizations whereas National Parivar Mediclaim policy offers maternity cover.

opd

Out Patient Department (OPD)

Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Cardiac Care Platinum offers OPD cover whereas National Parivar Mediclaim policy doesn’t offer OPD protection.

Final Conclusion

If you’re specifically looking to buy a policy for people suffering from heart ailments, Cardiac Care Platinum makes a lot of sense. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that National Insurance has to offer, if the policy is made available to you.

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