Introduction

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

Both products are marketed by different insurance companies. Energy Gold is sold by HDFC Ergo and Medi Classic is sold by Star Health. 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. Energy Gold is specifically designed for people suffering from diabetes/hypertension. However, Medi Classic 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 Energy Gold. The product comes from HDFC Ergo’s stable:

Founded in the year 2002, the company is a joint venture between India’s HDFC and Germany’s ERGO International AG. It offers policies across motor, travel, health and other sectors. And it also happens to be one of the largest insurers in the country.

More importantly, HDFC Ergo boasts a claim settlement ratio of 97.55%, with a network of 12,000+ hospitals

All in all, an impressive resume.


Medi Classic meanwhile 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%.

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Compare Insurances

Network hospitals12,000+13,000+
Claim settlement ratio

(avg. of last 3 years)

97.55%83.07%
Co-payment

No

10%

(if purchased after turning 61)

Room rent

Any Room

Any Room

(max ₹5,000)

Disease sub-limit

No

No

Pre existing diseases waiting

2 years

4 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

10% per year

(up to 100%)

5% per year

(up to 25%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for any illness)

200% restoration

(once for different illness)

Health check-up
Once every year
Once every 4 years
Maternity
Out Patient Department
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, Energy Gold doesn’t impose a mandatory co-payment clause whereas Medi Classic imposes a co-payment clause of 10% if you purchase after turning 61.

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, you can pick any room you want with Energy Gold but Medi Classic only lets you stay in a room whose rent doesn’t exceed 5000

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 Energy Gold imposes disease-wise sub-limits nor does Medi Classic

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. In this case, Energy Gold imposes a waiting period of 2 years on pre-existing diseases while Medi Classic extends a waiting period of 4 years on existing conditions.

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, Energy Gold covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Medi Classic 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, Energy Gold offers a no-claim bonus of 10% whereas Medi Classic offers a no-claim bonus of 5%. And the no-claim bonus may be capped at different levels too.

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, neither Energy Gold offers domiciliary cover nor does Medi Classic

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 Energy Gold doesn’t extend coverage for Ayush treatments whereas Medi Classic 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, neither Energy Gold offers maternity cover nor does Medi Classic.

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, neither Energy Gold extends coverage for outpatient consultations, nor does Medi Classic.

Final Conclusion

If you’re specifically looking to buy a policy for people suffering from diabetes/hypertension, Energy Gold 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 HDFC Ergo has to offer, if the policy is made available to you.

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