{"uin":"SBIHLIP24141V022324","name":"Super Health Insurance","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324","insurer":{"slug":"sbi-general-insurance","name":"SBI General Insurance Company Limited","url":"https://indiainsurances.com/insurer/sbi-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":"Individual","kind":"product","status":"active","approved_on":"2022-06-23","withdrawn_on":null,"summary":"Super Health Insurance is an indemnity health policy sold in Prime, Elite, Premier, Platinum and Platinum Infinite plans with individual and family floater options. It has 30 days initial waiting period, 24 months pre-existing disease waiting period, ReInsure benefit and plan-wise covers such as maternity, OPD and medical treatment abroad.","analysis":{"state":"machine","analysed_at":"2026-10-19 21:46:11.599151+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Prime","Elite","Premier","Platinum","Platinum Infinite"],"display":"Prime, Elite, Premier, Platinum, Platinum Infinite","note":null,"quote":"Benefits | Prime | Elite | Premier | Platinum | Platinum Infinite","sources":[{"clause":"Annexure I","heading":"PRODUCT BENEFIT TABLE","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-annexure-i"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1/2/3 Years.","display":"1/2/3 Years","note":null,"quote":"Policy Term | 1/2/3 Years","sources":[{"clause":"B.1","heading":"Age Criteria & Eligibility","page":1,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-b-1"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless claims, intimation is within 24 hours of emergency hospitalisation and at least 72 hours before planned hospitalisation. For reimbursement claims, intimation is within 48 hours of admission or before discharge, whichever is earlier.","display":"Cashless: within 24 hours for emergency and at least 72 hours before planned hospitalisation; reimbursement: within 48 hours of admission or before discharge, whichever is earlier","note":null,"quote":"Claim Intimation timelines | Within 24 hours of the Emergency Hospitalization At least 72 hours prior to the planned Hospitalization | Within 48 hours of admission or before discharge from the Hospital, whichever is earlier","sources":[{"clause":null,"heading":"J. Claims Procedure","page":16,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-j-claims-procedure"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The company shall settle or reject a claim within 15 days from the date of receipt of claim submission. Delay in payment carries interest from receipt of claim submission to payment at 2% above the bank rate.","display":"Within 15 days from receipt of claim submission; delayed payment earns interest at 2% above bank rate","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of claim submission. ... the Company shall be liable to pay interest to the policyholder from the date of receipt of claim submission. to the date of payment of claim at a rate 2% above the bank rate.","sources":[{"clause":"A(c)(i)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-c-i"},{"clause":"A(c)(ii)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-c-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses related to the treatment of any Illness within 30 days from the Ĥrst Policy Commencement Date","Expenses related to the treatment of listed Conditions; Surgeries/treatments shall be excluded until the expiry of 24/12 months","Expenses related to the treatment of a Pre-Existing Diseases (PED) and its direct complications","Investigation and Evaluation (Code-Excl 04)","Rest Cure, rehabilitation, and respite care (Code- Excl 05)","Change of Gender Treatments (Code- Excl 07)","Cosmetic or Plastic Surgery (Code- Excl 08)","Hazardous or Adventure Sports (Code- Excl 09)","Breach of Law (Code- Excl 10)","Treatment for alcoholism, drug or substance abuse or any addictive condition and consequences thereof (Code- Excl 12)","Unproven Treatments (Code- Excl 16)","Sterility and Infertility (Code-Excl 17)","War (whether declared or not) and war like occurrence or invasion","Treatment taken outside India"],"display":"30-day illness waiting period, 24/12-month specific disease/procedure waiting period, 24-month PED waiting period, and exclusions such as investigation/evaluation, rest cure, change of gender treatment, cosmetic surgery, hazardous sports, breach of law, substance abuse, unproven treatments, sterility/infertility, war and treatment outside India","note":"Treatment outside India exclusion is not applicable for plan variants where C.24 Medical Treatment Abroad is covered.","quote":"Expenses related to the treatment of any Illness within 30 days from the Ĥrst Policy Commencement Date shall\nPilonidal sinus | Gout and rheumatism\nbe excluded excepts claims arising due to an Accident, ... Expenses related to the treatment of listed Conditions; Surgeries/treatments shall be excluded until the expiry\nSurgery for Perianal Abscesses | Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries\nof 24/12 months ... Expenses related to the treatment of a Pre-Existing Diseases (PED) and its direct complications shall be excluded until the expiry of 24 months ... I) Investigation and Evaluation (Code-Excl 04): ... II) Rest Cure, rehabilitation, and respite care (Code- Excl 05) ... IV. Change of Gender Treatments (Code- Excl 07) ... V. Cosmetic or Plastic Surgery (Code- Excl 08) ... VI. Hazardous or Adventure Sports (Code- Excl 09) ... VII. Breach of Law (Code- Excl 10) ... IX. Treatment for alcoholism, drug or substance abuse or any addictive condition and consequences thereof (Code- Excl 12) ... XIII. Unproven Treatments (Code- Excl 16) ... XIV. Sterility and Infertility (Code-Excl 17) ... I) War (whether declared or not) and war like occurrence or invasion ... Treatment taken outside India","sources":[{"clause":"E(I)(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-e-i-a"},{"clause":"Excl02","heading":null,"page":20,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-excl02"},{"clause":"Excl02(I)(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-excl02-i-a"},{"clause":"A","heading":"STANDARD EXCLUSIONS","page":21,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-2"},{"clause":"4(b)(iv)","heading":null,"page":21,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-4-b-iv"},{"clause":"B","heading":"SPECIFIC EXCLUSIONS","page":21,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-b-2"},{"clause":"B(II)(c)","heading":"Biological attack or weapons","page":22,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-b-ii-c"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Prime and Elite: 3 Lacs, 5 Lacs, 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs. Premier: 3 Lacs, 5 Lacs, 7 Lacs, 10 Lacs. Platinum: 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 30 Lac, 40 Lacs, 50 Lacs. Platinum Infinite: 50 Lacs, 75 Lacs, 1 Crore and 2 Crores.","display":"Prime/Elite: 3–25 Lacs; Premier: 3–10 Lacs; Platinum: 10–50 Lacs; Platinum Infinite: 50 Lacs, 75 Lacs, 1 Crore, 2 Crores","note":null,"quote":"Sum Insured (SI) | 3 Lacs, 5 Lacs, 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs | 3 Lacs, 5 Lacs, 7 Lacs, 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs | 3 Lacs, 5 Lacs, 7 Lacs, 10 Lacs | 10 Lacs, 15 Lacs, 20 Lacs, 25 Lacs, 30 Lac 40 Lacs, 50 Lacs | 50 Lacs, 75 Lacs,1 s, Crore and 2 Crores","sources":[{"clause":"Annexure I","heading":"PRODUCT BENEFIT TABLE","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-annexure-i"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accident claims if covered.","quote":"Expenses related to the treatment of any Illness within 30 days from the Ĥrst Policy Commencement Date shall\nPilonidal sinus | Gout and rheumatism\nbe excluded excepts claims arising due to an Accident,","sources":[{"clause":"E(I)(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-e-i-a"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":null,"quote":"Expenses related to the treatment of a Pre-Existing Diseases (PED) and its direct complications shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the Ĥrst Policy with Us.","sources":[{"clause":"Excl02(I)(a)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-excl02-i-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Internal Congenital diseases","Non infective Arthritis","Diseases of gall bladder including cholecystitis","Urogenital system e.g. Kidney stone, Urinary Bladder Stone","Pancreatitis","Ulcer and erosion of stomach and duodenum","All forms of Cirrhosis","Gastro Esophageal Reĥux Disorder (GERD)","Perineal Abscesses","Perianal Abscesses","Cataract","Fissure/Ĥstula in anus, Hemorrhoids including","Pilonidal sinus","Gout and rheumatism","Benign tumors, cysts, nodules, polyps including breast lumps","Osteoarthritis and osteoporosis","Polycystic ovarian diseases","Fibroids ( Ĥbromyoma)","Sinusitis, Rhinitis","Tonsillitis","Skin tumors","Benign Hyperplasia of Prostate","Genetic Disorder","Adenoidectomy, tonsillectomy","Tympanoplasty, Mastoidectomy","Dilatation and curettage (D&C)","Nasal concha resection","Myomectomy for Ĥbroids","Surgery of Genito urinary system","Surgery on prostate","Cholecystectomy","Hernia","Hydrocele/Rectocele","Surgery for prolapsed inter vertebral disc","Joint replacement surgeries","Surgery for varicose veins and varicose ulcers","Surgery for Nasal septum deviation","Surgery for Perianal Abscesses","Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries"],"display":"Listed illnesses and procedures include cataract, hernia, joint replacement, gall bladder disease, kidney/urinary bladder stone, sinusitis/rhinitis, tonsillitis, varicose veins and ENT surgeries","note":null,"quote":"Internal Congenital diseases | Non infective Arthritis\nDiseases of gall bladder including cholecystitis | Urogenital system e.g. Kidney stone, Urinary Bladder Stone\nPancreatitis | Ulcer and erosion of stomach and duodenum\nAll forms of Cirrhosis | Gastro Esophageal Reĥux Disorder (GERD)\nPerineal Abscesses | Perianal Abscesses\nCataract | Fissure/Ĥstula in anus, Hemorrhoids including\nPilonidal sinus | Gout and rheumatism\nBenign tumors, cysts, nodules, polyps including breast lumps | Osteoarthritis and osteoporosis\nPolycystic ovarian diseases | Fibroids ( Ĥbromyoma)\nSinusitis, Rhinitis | Tonsillitis\nSkin tumors | Benign Hyperplasia of Prostate\nGenetic Disorder ... Adenoidectomy, tonsillectomy | Tympanoplasty, Mastoidectomy\nDilatation and curettage (D&C) | Nasal concha resection\nMyomectomy for Ĥbroids | Surgery of Genito urinary system\nSurgery on prostate | Cholecystectomy\nHernia | Hydrocele/Rectocele\nSurgery for prolapsed inter vertebral disc | Joint replacement surgeries\nSurgery for varicose veins and varicose ulcers | Surgery for Nasal septum deviation\nSurgery for Perianal Abscesses | Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries","sources":[{"clause":"E.1(II)(e)(i)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-e-1-ii-e-i"},{"clause":"E.1(II)(e)(ii)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-e-1-ii-e-ii"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance Policy, no Policy and claim shall be contestable by the Insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"A(b)(vi)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-vi"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person can port the policy to other insurers by applying at least 30 days before, but not earlier than 60 days from, the renewal date, with credits for sum insured, no claim bonus, specific waiting periods, pre-existing disease waiting period and moratorium period.","display":"Allowed; apply at least 30 days before but not earlier than 60 days from renewal, with waiting-period and other credits transferred","note":null,"quote":"The Insured Person will have the option to port the Policy to other Insurers by applying to such Insurer to port the entire Policy along with all the members of the Family, if any, at least 30 days before, but not earlier than 60 days from the Policy Renewal date ... the proposed Insured Person is entitled to transfer the credits gained to the extent of the Sum Insured, No Claim Bonus, SpeciĤc Waiting Periods, Waiting Period for Pre-existing Diseases, Moratorium Period, etc.","sources":[{"clause":"A(b)(i)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-i"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"quote-verified","value":true,"display":"Lifelong","note":null,"quote":"Renewability | Lifelong","sources":[{"clause":"B.1","heading":"Age Criteria & Eligibility","page":1,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-b-1"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading applies on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"No loading shall apply on Renewals based on individual Claims experience.","sources":[{"clause":"A(b)(vi)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-vi"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"You may cancel by giving 7 days’ written notice. For policies up to one year, the insurer refunds proportionate premium for the unexpired policy period if no claims were made; for terms over one year, it refunds premium for unexpired policy years where risk coverage has not commenced.","display":"7 days’ notice; proportionate refund for unexpired period for terms up to one year if no claim, and refund for unexpired policy years for terms over one year where risk has not commenced","note":null,"quote":"The Policyholder may cancel his/her Policy at any time during the term, by giving 7 days’ notice in writing. The Insurer shall\ni) refund proportionate premium for unexpired Policy Period, if the term of Policy upto one year and there is no Claim (s) made during the Policy Period.\nii) refund premium for the unexpired Policy Period, in respect of policies with term more than 1 year and risk coverage for such Policy years has not commenced.","sources":[{"clause":"A(a)","heading":null,"page":22,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-a-3"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Treatment is in India, except that Platinum and Platinum Infinite include Medical Treatment abroad for listed major illnesses or procedures diagnosed in India.","display":"India, with Medical Treatment abroad for applicable plan variants","note":"Medical Treatment abroad is shown as not available for Prime, Elite and Premier, and available for Platinum and Platinum Infinite.","quote":"Treatment taken outside India (Not applicable for product plan variants wherein C.24 – Medical Treatment Abroad is covered ) ... Global Cover | Medical Treatment abroad (Listed Illness, Diagnosis in India) | NA | NA | NA | Actuals up to Sum Insure | d Actuals up to Sum Insured","sources":[{"clause":"B(II)(c)","heading":"Biological attack or weapons","page":22,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-b-ii-c"},{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Applies to new individual health insurance policies except those with tenure of less than a year.","quote":"Every Policyholder of new individual health insurance policies except those with tenure of less than a year, shall be provided a free look period of 30 days beginning from the date of receipt of Policy document, whether received electronically or otherwise, to review the terms and conditions of such Policy.","sources":[{"clause":null,"heading":"Stage 2: Head – Customer Care","page":24,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-stage-2-head-customer-care"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Monthly instalment premium grace period is 15 days; single, half-yearly and quarterly instalment options have 30 days.","quote":"At the end of the Policy Period, the Policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of beneĤts without Break in Policy. ... In case of monthly instalment option, a Grace Period of 15 days is applicable. Whereas, in case of Single, Half Yearly, Quarterly instalment options, a Grace Period of 30 days is applicable.","sources":[{"clause":"A(b)(v)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-v"},{"clause":"A(b)(vi)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-vi"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"quote-verified","value":"Adults can enter from 18 years with no maximum age cap. Children can enter from 91 days to 30 years.","display":"Adult: Min - 18 years, Max - No capping; Child: 91 days to 30 years","note":null,"quote":"Entry Age (Adult) | Min - 18 years | Min - 18 years | Min - 18 years | Min - 18 years | Min - 18 years\nMax - No capping | Max - No capping | Max - No capping | Max - No capping | Max - No capping\nEntry Age (Child) | 91 days to 30 years | 91 days to 30 years | 91 days to 30 years | 91 days to 30 years | 91 days to 30 years","sources":[{"clause":"Annexure I","heading":"PRODUCT BENEFIT TABLE","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-annexure-i"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Single Premium","Annual","Half-yearly","Quarterly","Monthly"],"display":"Single Premium, Annual, Half-yearly, Quarterly, and Monthly","note":null,"quote":"Premium Payment Options | Single Premium, Annual, Half-yearly, Quarterly, and Monthly","sources":[{"clause":"B.1","heading":"Age Criteria & Eligibility","page":1,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-b-1"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Enhanced ReInsure Benefit","Enhanced Cumulative Bonus Safeguard (if claim amount is 1Lac or less, No reduction in Enhanced Cumulative Bonus)","Co-payment","Aggregate Deductible","Domestic help/staff Indemnity","Additional Basic Sum Insured (for Accident related Hospitalization)","Health Assistance (A.I. Personal Fitness coaching)","Dietician and Nutrition E-consultation","Walk Healthy Benefit (Collect health beneĤts by taking steps counted on our App and get discount up to 30% on renewal premium)","Unlimited Gym Membership","Early Start Add on"],"display":"Enhanced ReInsure Benefit, Enhanced Cumulative Bonus Safeguard, Co-payment, Aggregate Deductible, Domestic help/staff Indemnity, Additional Basic Sum Insured for Accident related Hospitalization, Wellness covers and Early Start Add on","note":"Enhanced ReInsure Benefit and Enhanced Cumulative Bonus Safeguard are not available for Platinum Infinite as per the table. Early Start is an add-on from the prospectus.","quote":"Base Cover Modifiers | Enhanced ReInsure Benefit | Unlimited up to 200% | Unlimited up to 200% | Unlimited up to 200% | Unlimited up to 200% | NA\nEnhanced Cumulative Bonus Safeguard (if claim amount is 1Lac or less, No reduction in Enhanced Cumulative Bonus) | Covered | Covered | Covered | Covered | NA\nCo-payment | 10/20% | 10/20% | 10%/20% | 10%/20% | 10%/20%\nAggregate Deductible | 1 Lac / 2 Lacs / 3Lacs | 1 Lac / 2 Lacs / 3Lacs | 1 Lac / 2 Lacs / 3Lacs | 3 Lacs / 5 Lacs | 5 Lacs/10 Lacs\nDomestic help/staff Indemnity ... Additional Basic Sum Insured (for Accident related Hospitalization) | 2x | 2x | 2x | 2x | 2x\nWellness | Health Assistance (A.I. Personal Fitness Dietician and Nutrition E-consultation Walk Healthy Benefit (Collect health beneĤts by taking steps counted on our App and get discount up to 30% on renewal premium) | Covered | Covered | Covered | Covered | Covered\nUnlimited Gym Membership | Covered (3+3+3+3 option) | Covered (3+3+3+3 option) | Covered (3+3+3+3 option) | Covered (6+6 option) | Covered (6+6 option) ... Early Start Add on - On payment of additional premium, we will reduce the Waiting Period of 90 days for Hypertension, Diabetes and Cardiac Condition to 30/60 days as opted","sources":[{"clause":null,"heading":"Optional Covers","page":31,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-optional-covers"},{"clause":"E.1","heading":"Early Start Add on","page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-e-1"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"Coverage is not available during the renewal grace period. If premium is paid in instalments, coverage will be available during the grace period from the instalment due date till receipt of premium by the company.","display":"No coverage during renewal grace period; coverage available during instalment premium grace period","note":"The policy states different treatment for renewal grace period and instalment premium grace period.","quote":"Coverage is not available during the Grace Period. ... During such Grace Period, coverage will be available from the due date of instalment premium till the date of receipt of premium by Company.","sources":[{"clause":"A(b)(v)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-v"},{"clause":"A(b)(vi)","heading":null,"page":23,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-a-b-vi"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"Room rent is payable at actuals up to the sum insured for all plans.","display":"Actuals up to Sum Insured","note":null,"quote":"Room Rent | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insure | d Actuals up to Sum Insured","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-applicable","value":null,"display":null,"note":"The policy gives a room rent limit as actuals up to Sum Insured, not a room-category limit.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU charges are payable at actuals up to the sum insured for all plans.","display":"Actuals up to Sum Insured","note":null,"quote":"ICU Charges | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insure | d Actuals up to Sum Insured","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"No base co-payment is stated unless the optional co-payment is chosen. Optional co-payment is 10% or 20% on each admissible claim after deductible, and OPD has 20% co-payment on professional fees, 30% on diagnostics/pharmacy, and 50% on OPD dental/vision.","display":"None unless opted; optional 10% or 20% on each admissible claim after deductible","note":"Optional co-payment is additive to any other co-payment in the policy.","quote":"On availing this option, 10% or 20% Co-Payment as speciĤed in the Policy Schedule, shall be applied on each and every admissible claim after Deductible wherever applicable under this Policy ... a) 20% Co-payment will be applicable on Professional Fees ... b) 30% Co-payment will be applicable on Diagnostics and Pharmacy Expenses to be borne by the Insured ... d) 50% Co-payment will be applicable for each and every admissible claim under this beneĤt.","sources":[{"clause":null,"heading":"D. 3. Co-payment","page":18,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-d-3-co-payment"},{"clause":"Row 1(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-row-1-a-2"},{"clause":"Row 1(b)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-row-1-b-2"},{"clause":"Row 1(d)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-row-1-d-3"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"quote-verified","value":"None unless the optional aggregate deductible is chosen. Aggregate deductible options are 1 Lac, 2 Lacs or 3 Lacs for Prime, Elite and Premier; 3 Lacs or 5 Lacs for Platinum; and 5 Lacs or 10 Lacs for Platinum Infinite.","display":"None unless opted; optional aggregate deductible of 1 Lac / 2 Lacs / 3 Lacs, 3 Lacs / 5 Lacs, or 5 Lacs / 10 Lacs by plan","note":"It is an optional aggregate deductible; a deductible does not reduce the sum insured.","quote":"On availing this option, The Insured Person shall bear on his/her own account an amount equal to the opted Deductible speciĤed in the Policy Schedule for all admissible claims made by the Insured Person and assessed by the Company in a Policy Year. ... Aggregate Deductible | 1 Lac / 2 Lacs / 3Lacs | 1 Lac / 2 Lacs / 3Lacs | 1 Lac / 2 Lacs / 3Lacs | 3 Lacs / 5 Lacs | 5 Lacs/10 Lacs","sources":[{"clause":null,"heading":"D. 4. Aggregate Deductible","page":18,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-d-4-aggregate-deductible"},{"clause":null,"heading":"Optional Covers","page":31,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-optional-covers"}],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"quote-verified","value":["Bariatric Surgery Cover | Up to INR 50,000","Bariatric Surgery Cover | Up to INR 2 Lacs","Maternity Expenses | Up to INR 25,000 (N)/INR 50,000(C-sec)","Maternity Expenses | Up to INR 50,000 (N)/IN 75,000(C-sec)","Maternity Expenses | Up to 2 Lac","Child Vaccination (Up to 12 years of age) | 5000 per annum","Child Vaccination (Up to 12 years of age) | 10,000 per annum","Out-Patient and Prescribed Diagnostic test (Cancer Diagnosed Patients) | INR 5000/Policy","Out-Patient and Prescribed Diagnostic test (Cancer Diagnosed Patients) | INR 10000/Policy","Out-Patient and Prescribed Diagnostic test (Cancer Diagnosed Patients) | INR 15000/Policy"],"display":"Bariatric surgery: up to INR 50,000 or INR 2 Lacs by plan; maternity: up to INR 25,000/50,000, INR 50,000/75,000 or 2 Lac by plan; child vaccination: 5000 or 10,000 per annum by plan; cancer OPD diagnostic test: INR 5000/10000/15000 per policy by plan","note":"Only named treatment/procedure caps are listed here; other benefit limits are plan-wise but not disease/procedure sub-limits.","quote":"Bariatric Surgery Cover | Up to INR 50,000 | Up to INR 50,000 | Up to INR 50,000 | Up to INR 2 Lacs | Up to INR 2 Lacs ... Maternity Expenses | NA | NA | Up to INR 25,000 (N)/INR 50,000(C-sec) | Up to INR 50,000 (N)/IN 75,000(C-sec) | R Up to 2 Lac\nNew Born Baby Cover | NA | NA | Up to Maternity SI | Up to Maternity SI | Up to Maternity SI\nChild Vaccination (Up to 12 years of age) | NA | NA | NA | 5000 per annum | 10,000 per annum ... Out-Patient and Prescribed Diagnostic test (Cancer Diagnosed Patients) | NA | NA | INR 5000/Policy | INR 10000/Policy | INR 15000/Policy","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":60},"display":"60 Days","note":null,"quote":"Pre-Hospitalization Medical Expenses | 60 Days | 60 Days | 60 Days | 60 Days | 60 Days","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"quote-verified","value":{"unit":"days","amount":90},"display":"90 Days","note":"Platinum Infinite has 180 Days.","quote":"Post-Hospitalization Medical Expenses (up to Sum Insured) | 90 Days | 90 Days | 90 Days | 90 Days | 180 Days","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"All day care treatments are covered up to the sum insured. The day care treatment must be medically necessary, advised in writing, and the insured must be admitted for more than 2 hours; angiography, dialysis, radiotherapy or chemotherapy for cancer are also covered.","display":"All day care covered; admission for more than 2 hours and specified cancer/dialysis/radiotherapy/angiography treatments covered","note":null,"quote":"Day Care Treatment (up to Sum Insured) | All day care covered | All day care covered | All day care covered | All day care covered | All day care covered ... The Day Care Treatment would be covered if the Insured Person is admitted for more than 2 hours and would also cover treatment taken for Angiography, Dialysis, Radiotherapy or Chemotherapy for cancer.","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":"37(III)(b)","heading":null,"page":11,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-b-3"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"AYUSH inpatient treatment is covered at actuals up to the sum insured in an AYUSH hospital.","display":"Actuals up to Sum Insured for AYUSH inpatient hospitalisation","note":null,"quote":"AYUSH (In-patient Hospitalization) | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insure | d Actuals up to Sum Insured ... We shall indemnify the Medical Expenses incurred by the Insured Person for Inpatient Care under Ayurveda, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to the Sub-limit speciĤed against this Cover in the Policy Schedule, in any AYUSH Hospital.","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":"37(III)(b)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-b-9"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"quote-verified","value":"Modern treatments and advanced procedures are covered at actuals up to the sum insured, including uterine artery embolization and HIFU, balloon sinuplasty, deep brain stimulation, oral chemotherapy, immunotherapy, intra vitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, prostate vaporisation, IONM and hematopoietic stem cell therapy for bone marrow transplant for haematological conditions.","display":"Covered at actuals up to Sum Insured; includes robotic surgeries, oral chemotherapy, immunotherapy and listed advanced procedures","note":null,"quote":"Modern Treatments/Advanced Procedures | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insure | d Actuals up to Sum Insured ... i) Uterine Artery Embolization and HIFU (High intensity focused ultrasound)\nii) Balloon Sinuplasty\niii) Deep Brain stimulation\niv) Oral chemotherapy\nv) Immunotherapy- Monoclonal Antibody to be given as injection\nvi) Intra vitreal injections\nvii) Robotic surgeries\nviii) Stereotactic radio surgeries\nix) Bronchical Thermoplasty\nx) Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)\nxi) IONM - (Intra Operative Neuro Monitoring)\nxii) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":"37(III)(a)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-a-10"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"Organ donor hospitalisation expenses for harvesting the donated organ are covered at actuals up to the sum insured where the insured person is the recipient. Donor pre- and post-hospitalisation expenses and other expenses consequent to harvesting are excluded.","display":"Covered: organ donor hospitalisation for harvesting, actuals up to Sum Insured","note":null,"quote":"Organ Donor Expenses | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insured | Actuals up to Sum Insure | d Actuals up to Sum Insured ... We will pay Medical Expenses up to the Sum Insured as speciĤed in the Policy Schedule, towards organ donor’s Hospitalization for harvesting of the donated organ where an Insured Person is the recipient ... The Organ Donor’s Pre-Hospitalization | and\nPost-Hospitalization expenses are excluded under the Policy\niv. Any other Medical Expenses or Hospitalization consequent to the harvesting is excluded under the Policy","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":"37(III)(f)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-f"},{"clause":"37(III)(f)(ii)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-f-ii"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Emergency road ambulance is covered per hospitalisation: INR 3000 for Prime and Elite, INR 4000 for Premier, INR 5000 for Platinum, and covered up to SI for Platinum Infinite. Domestic air ambulance is covered up to 2 Lacs for Prime, Elite, Premier and Platinum, and up to 10 Lacs for Platinum Infinite.","display":"Road ambulance: INR 3000/3000/4000/5000/covered up to SI by plan; air ambulance: up to 2 Lacs or up to 10 Lacs","note":null,"quote":"Emergency Road Ambulance Cover (per Hospitalization) | INR 3000 | INR 3000 | INR 4000 | INR 5000 | Covered up to SI\nAir Ambulance Cover (Domestic) | Up to 2 Lacs | Up to 2 Lacs | Up to 2 Lacs | Up to 2 Lacs | Up to 10 Lacs","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"The ReInsure benefit is triggered and payable for each and every claim from the first claim in a policy year. A single claim under it is payable up to 100% or 200% of base sum insured as specified, and the any-one-illness clause does not apply.","display":"ReInsure benefit: unlimited up to 100% for most plans and 200% for Platinum Infinite; payable from the first claim and for related and unrelated illness","note":"Enhanced ReInsure Benefit is optional and can refill up to 200% instead of 100% for eligible plans.","quote":"This beneĤt is triggered and becomes payable for each and every claim from the Ĥrst claim itself in a policy year. ... Single claim under this beneĤt will be payable up to 100%/200% of Base Sum Insured as speciĤed in the Policy Schedule. ... Any one Illness clause will not be applicable under this beneĤt. ... ReInsure Benefit (Related and Unrelated Illness both) | Unlimited up to 100% | Unlimited up to 100% | Unlimited up to 100% | Unlimited up to 100% | Unlimited up to 200%","sources":[{"clause":null,"heading":"C. 12. ReInsure Benefit (Related and Unrelated Illness both)","page":12,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-12-reinsure-benefit-related-and-unrelated-illn"},{"clause":"37(III)(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-a-8"},{"clause":"37(III)(d)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-d-4"},{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"Enhanced Cumulative Bonus applies at 50% of the base sum insured for each claim-free policy year, up to 100% or 200% as specified, and reduces at the same rate after a claim. Platinum Infinite instead has Loyalty Credit of 50% of base sum insured for each successive renewal, up to 100%, irrespective of claim.","display":"ECB: 50% of Base Sum Insured per claim-free year, max 100%/200%, reduced at same rate on claim; Platinum Infinite Loyalty Credit: 50% per renewal up to 100% irrespective of claim","note":"The benefit table shows ECB as not applicable for Platinum Infinite and Loyalty Credit only for Platinum Infinite.","quote":"Enhanced Cumulative Bonus (ECB) will be applied by 50% of the Base Sum Insured of immediate preceding Policy Year in respect of each claim free Policy Year (where no claims are reported), provided the Policy is renewed with the Company without a break, subject to maximum cap of 100%/200% (as speciĤed in the Policy Schedule) of the Base Sum Insured under the current Policy Year. If a claim is made in any particular Policy Year, the ECB accrued shall be reduced at the same rate at which it has accrued. ... If the Insured Person cover under the Policy is renewed with Us without a break, We will increase the Base Sum Insured applicable under the Policy by 50% of Base Sum Insured of immediate preceding Policy Year for each successive renewal. The Sum Insured increase will be subject to the maximum of 100% of Base Sum Insured.","sources":[{"clause":null,"heading":"C. 22. Enhanced Cumulative Bonus","page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-22-enhanced-cumulative-bonus"},{"clause":null,"heading":"C. 23. Loyalty Credit (Sum Insured enhancement irrespective of","page":15,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-23-loyalty-credit-sum-insured-enhancement-irre"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Medicines, drugs and consumables are part of inpatient hospitalisation expenses, and the Claims Shield benefit makes payable the List I items that would otherwise be non-payable for an accepted hospitalisation claim.","display":"Covered through inpatient expenses and Claims Shield for non-payable items","note":null,"quote":"g) Medicines, drugs, and consumables ... If We have accepted a Hospitalization claim under Section C, then the items which are not payable as per List I – ‘Expenses not covered’ under Annexure II related to that particular claim will become payable","sources":[{"clause":"C","heading":"HOSPITALIZATION COVERS","page":6,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c"},{"clause":null,"heading":"C. 17. Claims Shield","page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-17-claims-shield"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses including pre-natal and post-natal check-ups are covered in Premier, Platinum and Platinum Infinite, subject to plan limits and waiting periods. Waiting period is 48 months for a single adult on individual basis and 24 months for other family combinations.","display":"Premier: up to INR 25,000 (N)/INR 50,000 (C-sec); Platinum: up to INR 50,000 (N)/INR 75,000 (C-sec); Platinum Infinite: up to 2 Lac; waiting period 48 months single adult or 24 months other family combinations","note":"Not available for Prime and Elite.","quote":"Maternity Expenses | NA | NA | Up to INR 25,000 (N)/INR 50,000(C-sec) | Up to INR 50,000 (N)/IN 75,000(C-sec) | R Up to 2 Lac ... We will indemnify the Medical Expenses incurred up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Maternity Expenses including Pre-natal Medical Expenses & Post-natal check-ups incurred in respect of the Hospitalization of the Insured Person for the delivery of the child during the Policy Period. ... after a waiting period of 48 months ... after a waiting period of 24 months","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":null,"heading":"C.20.1. Maternity Expenses (including Pre and Post Natal check-","page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-20-1-maternity-expenses-including-pre-and-post"},{"clause":"37(III)(b)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-b-11"},{"clause":"37(III)(c)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-c-8"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New born baby cover is available in Premier, Platinum and Platinum Infinite up to the maternity sum insured, for 90 days from date of delivery, where the maternity claim is admissible.","display":"Covered up to Maternity SI for 90 days from date of delivery, where maternity claim is admissible","note":"Not available for Prime and Elite.","quote":"New Born Baby Cover | NA | NA | Up to Maternity SI | Up to Maternity SI | Up to Maternity SI ... We will indemnify up to the amount speciĤed against this BeneĤt in the Policy Schedule for the Medical Expenses incurred in respect of a New Born Baby whose claim under Section - C.20.1 (Maternity Expenses) is admissible by the Company. ... The coverage will be available in respect of a New Born Baby for 90 days from date of delivery and will be covered under Maternity Expenses Sum Insured as speciĤed in the Policy Schedule.","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"},{"clause":null,"heading":"C.20.2. New Born Baby Cover","page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-20-2-new-born-baby-cover"},{"clause":"37(III)(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-a-13"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"Preventive annual health check-up is available once in a policy year up to the plan sub-limit: INR 2500 from first renewal for Prime, Elite and Premier, INR 5000 since inception for Platinum, and INR 10,000 since inception for Platinum Infinite.","display":"Once in a Policy Year; up to INR 2500, INR 5000 or INR 10,000 by plan","note":null,"quote":"The Insured Person may avail a health check-up, only for preventive purposes, up to a sub-limit as speciĤed in Your Policy Schedule. ... This beneĤt is available only once in a Policy Year ... Annual Health Check-up | Up to INR 2500 (1st renewal onwards/year) | Up to INR 2500 (1st renewal onwards/year) | Up to INR 2500 (1st renewal onwards/year) | Up to INR 5000 (since inception) | Up to INR 10,000 (since inception)","sources":[{"clause":null,"heading":"C. 19. Annual Health Check-up","page":13,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-c-19-annual-health-check-up"},{"clause":"37(III)(a)","heading":null,"page":14,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-37-iii-a-11"},{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD cover including diagnostics and pharmacy is available in Platinum and Platinum Infinite, with single adult limits of INR 5,000 and INR 10,000 respectively and family limits of INR 10,000 and INR 20,000 respectively. OPD cancer diagnosed patient diagnostic cover is available in Premier, Platinum and Platinum Infinite, and OPD dental/vision is available in Platinum Infinite.","display":"Platinum: Single Adult INR 5,000 or family INR 10,000; Platinum Infinite: Single Adult INR 10,000 or family INR 20,000; cancer OPD diagnostic and dental/vision vary by plan","note":"OPD professional fees have 20% co-payment; diagnostics and pharmacy have 30% co-payment; OPD dental/vision has 50% co-payment.","quote":"We will indemnify the Medical Expenses incurred up to the per member amount speciĤed (subject to per family limit) against this BeneĤt in the Policy Schedule for the OPD expenses including Diagnostics and Pharmacy. ... Out-Patient (OPD) Cover | NA | NA | NA | Single Adult – INR 5,000 | Single Adult – INR 10,000\nAll other family combinations - Up to IN 10,000/Family | All other family R combinations - Up to INR 20,000/Family\nOut-Patient Dental / Vision Cover | NA | NA | NA | NA | Up to INR 5000/Family\nOut-Patient and Prescribed Diagnostic test (Cancer Diagnosed Patients) | NA | NA | INR 5000/Policy | INR 10000/Policy | INR 15000/Policy","sources":[{"clause":null,"heading":"Pharmacy Expenses)","page":17,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-pharmacy-expenses"},{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"quote-verified","value":"The product benefit table states the premium type is zone agnostic.","display":"Zone Agnostic","note":null,"quote":"Premium Type [Zone Agnostic] | Age Banded | Age Banded | Age Banded | Age Banded | Age Banded","sources":[{"clause":null,"heading":"Base Covers","page":30,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-base-covers"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility can be availed only at network providers. The company pays the cashless authorised amount directly to the network provider.","display":"Available only at network providers; insurer pays the authorised amount directly to the network provider","note":"The complete list of network providers and empanelled service providers is available on the insurer's website.","quote":"Cashless Facility can be availed only at Our Network Providers. ... We will make payment for the Cashless authorized amount items, if applicable or directly to the Network Provider.","sources":[{"clause":"10(i)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-10-i"},{"clause":"10(iv)","heading":null,"page":26,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-10-iv"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims documents are to be sent to the Accident & Health claims team, SBI General Insurance Company Limited.","display":"Accident & Health claims team, SBI General Insurance Company Limited","note":null,"quote":"Accident & Health claims team SBI General Insurance Company Limited\n9th Floor, Westport, Pan Card Club Road, Baner, Pune, Maharashtra – 411 045","sources":[{"clause":null,"heading":"Accident & Health claims team SBI General Insurance Company Limited","page":26,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910#c-accident-health-claims-team-sbi-general-insuranc"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Individual/Family Floater basis","note":null,"quote":"How can You cover Yourself | Individual/Family Floater basis.\nIn a family ĥoater Policy, a maximum of 4 adults and any number of children can be included in a single Policy.","sources":[{"clause":"B.1","heading":"Age Criteria & Eligibility","page":1,"url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904#c-b-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Super Health Insurance Policy Wording","pages":31,"fetched_at":"2026-10-17 19:57:05+00","source_url":"https://content.sbigeneral.in/uploads/Super_Health_Insurance_Policy_Wording_New_1512_1a70d6d07a.pdf","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14910"},{"kind":"wording","label":"Super Health Insurance (IRDAI copy)","pages":75,"fetched_at":"2026-10-20 02:33:43+00","source_url":"https://irdai.gov.in/documents/37343/931203/SBIHLIP23050V012223.pdf/de34fc22-e5b0-d313-41b1-9bcd4243d600?version=1.0&t=1669351245742&download=true","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/28771"},{"kind":"prospectus","label":"Super Health Insurance Prospectus","pages":23,"fetched_at":"2026-10-17 19:57:03+00","source_url":"https://content.sbigeneral.in/uploads/Super_Health_Insurance_Prospectus_d913e89b45.pdf","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14904"},{"kind":"cis","label":"Super Health Insurance Customer Information Sheet","pages":8,"fetched_at":"2026-10-17 19:57:02+00","source_url":"https://content.sbigeneral.in/uploads/Super_Health_Insurance_CIS_25b887f5ae.pdf","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14901"},{"kind":"brochure","label":"Super Health Insurance Platinum Infinite Brochure","pages":16,"fetched_at":"2026-10-17 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19:55:57+00","source_url":"https://content.sbigeneral.in/uploads/14483b5983be4c92929a6967cdc31cf3.pdf","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14880"},{"kind":"brochure","label":"Super Health Insurance Elite Brochure","pages":16,"fetched_at":"2026-10-17 19:56:16+00","source_url":"https://content.sbigeneral.in/uploads/1cc096f4a15b48ac8a50fe5d99b1724f.pdf","url":"https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324/document/14884"},{"kind":"brochure","label":"Super Health Insurance Prime Brochure","pages":16,"fetched_at":"2026-10-17 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We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Health claims","url":"https://www.sbigeneral.in/claim/health","note":null},{"purpose":"claim","kind":"insurer","name":"Home claims","url":"https://www.sbigeneral.in/claim/home","note":null},{"purpose":"claim","kind":"insurer","name":"Motor claims","url":"https://www.sbigeneral.in/claim/motor","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.sbigeneral.in/grievance-redressal","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Policy renewal","url":"https://www.sbigeneral.in/policy-renewal","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Super Health Insurance (UIN SBIHLIP24141V022324), IndiaInsurances, https://indiainsurances.com/policy/sbi-general-insurance/super-health-insurance-sbihlip24141v022324"}