Star Health Diabetes Safe vs Oriental Insurance Mediclaim Insurance Policy
Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Diabetes Safe is sold by Star Health and Mediclaim Insurance Policy is sold by Oriental 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. Diabetes Safe is specifically designed for people suffering from diabetes/hypertension. However, Mediclaim Insurance 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 Diabetes Safe. 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%.
Mediclaim Insurance Policy meanwhile comes from Oriental Insurance’s stable:
Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.
Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 2,988 network hospitals across the country.
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Compare Insurances | ||
---|---|---|
Network hospitals | 13,000+ | 2,988 |
Claim settlement ratio (avg. of last 3 years) | 83.07% | 99.89% |
Co-payment | No | No |
Room rent | Single Private room | Any Room (up to 1% of sum insured) |
Disease sub-limit | Yes | No |
Pre existing diseases waiting | 4 years | 4 years |
Pre/Post hospitalization | 30/60 days | 30/60 days |
No claim bonus | ||
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for any illness) | |
Health check-up | Once every year | |
Maternity | ||
Out Patient Department | Up to ₹5,500 | |
Day care |
Feature Comparison
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, Diabetes Safe doesn’t impose a co-payment clause. And neither does Mediclaim Insurance Policy.
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, Diabetes Safe lets you stay in a single private room and Mediclaim Insurance 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.
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, Diabetes Safe imposes disease-wise sub-limits on null whereas Mediclaim Insurance Policy doesn’t impose a disease wise sub-limit.
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, Diabetes Safe imposes a 4 year waiting period on pre-existing diseases and Mediclaim Insurance Policy will similarly tell you to wait 4 years before making a claim related to your pre-existing diseases
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, Diabetes Safe covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Mediclaim Insurance Policy covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
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, Diabetes Safe doesn’t offer a no-claim bonus and neither does Mediclaim Insurance Policy.
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, Diabetes Safe doesn’t offer domiciliary protection whereas Mediclaim Insurance Policy offers domiciliary cover.
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 Diabetes Safe doesn’t extend coverage for Ayush treatments whereas Mediclaim Insurance Policy covers Ayush treatments.
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, neither Diabetes Safe offers maternity cover nor does Mediclaim Insurance Policy.
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, Diabetes Safe offers OPD cover whereas Mediclaim Insurance Policy doesn’t offer OPD protection.
Final Conclusion
If you’re specifically looking to buy a policy for people suffering from diabetes/hypertension, Diabetes Safe 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 Oriental Insurance has to offer, if the policy is made available to you.
Other Star Health Diabetes Safe Comparisons
Other Oriental Insurance Mediclaim Insurance Policy Comparisons
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