Policy Comparison
Side-by-side analysis of Health policies (H1, H2, H3). All rows carry section citations (§).
| Dimension / Term | KV-H1-STD-IND Standard Individual | KV-H2-FAM-FLT Family Floater | KV-H3-SUP-TOP Super Top-Up |
|---|---|---|---|
Cover Scope & Sum Insured Annual coverage envelope and primary basis | ₹5,00,000 Standard Individual Hospitalisation §-1 ↗DEMO_SYNTHETIC | ₹10,00,000 Family Floater (Self, Spouse, 2 Children) §-1 ↗DEMO_SYNTHETIC | ₹25,00,000 Super Top-Up High Limit Hospitalisation §-1 ↗DEMO_SYNTHETIC |
Room Rent & ICU Limits Daily room category eligibility and cap (POL-07.TS1 golden test) | 2% of SI max ₹5,000/day [MKT] §-2-1 ↗CONFIRMED | Single private AC room [DEMO] §-2-1 ↗DEMO_SYNTHETIC | Single private room [DEMO] §-2-1 ↗DEMO_SYNTHETIC |
Deductibles & Co-Payments Out-of-pocket threshold before insurer liability kicks in | Nil deductible; Nil standard co-pay §-2 ↗CONFIRMED | Nil deductible; 10% co-pay on senior age band §-2-3 ↗CONFIRMED | ₹5,00,000 aggregate annual deductible across all claims §-1-2 ↗CONFIRMED |
Pre- & Post-Hospitalisation Coverage for medical expenses prior to and following hospital stay | 30 days pre / 60 days post §-2-3 ↗CONFIRMED | 60 days pre / 90 days post §-2-2 ↗CONFIRMED | 60 days pre / 90 days post (above deductible) §-2-2 ↗CONFIRMED |
Pre-Existing Diseases Waiting Period Waiting duration before pre-existing conditions are covered | 36 months continuous coverage §-3-1 ↗CONFIRMED | 36 months (reduced to 24 months with add-on) §-3-1 ↗CONFIRMED | 24 months continuous coverage §-3-1 ↗CONFIRMED |
Standard Exclusions Non-payable hospitalisation and treatment exclusions | Cosmetic surgery, obesity, unproven treatments, self-inflicted injury §-3-4 ↗CONFIRMED | Adventure sports, experimental drugs, non-medical comfort items §-3-4 ↗CONFIRMED | Exclusions match base IRDAI master list; claims under deductible §-3-3 ↗CONFIRMED |
Claim Notice Deadlines Statutory & contractual notification timelines | 48 hrs in emergency / 72 hrs prior planned admission §-4-1 ↗CONFIRMED | 48 hours from hospitalisation §-4-1 ↗CONFIRMED | Prompt notification upon expected exceedance of deductible §-4-1 ↗CONFIRMED |
Grievance Redressal & Ombudsman Internal grievance officer and IRDAI Ombudsman jurisdiction | Clause 30 Insurance Ombudsman Rules 2017 §-6-1 ↗CONFIRMED | Clause 30 Insurance Ombudsman Rules 2017 §-6-1 ↗CONFIRMED | Clause 30 Insurance Ombudsman Rules 2017 §-6-1 ↗CONFIRMED |