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HDFC Ergo Optima Secure vs Niva Bupa ReAssure 2.0 (Bronze+)

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Notes

1- The health insurance data was last updated in September 2023. All data has been sourced from product brochures, policy wordings, prospectus, public disclosures (Q1, FY 2023-2024), insurer websites, and the IRDAI website. 

2- The Claims Settlement Ratio data is taken from NL-37, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the number of claims settled by the sum of claims outstanding at the beginning of the year and claims reported during the year.

3- The data related to claim complaints and policy purchase complaints is taken from NL-45, insurer public disclosures (Q1, FY 2023-2024).

4- The Solvency Ratio data is taken from NL-26, insurer public disclosures (Q1, FY 2023-2024).

5- The data related to claims settled within 30 days is taken from NL-39, insurer public disclosures (Q1, FY 2023-2024).

6- The Claims Incurred Ratio data is taken from NL-4 and NL-5, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the Net Claims Incurred by the Net Earned Premium.

7- For now, we have considered the most comprehensive plans from leading insurance companies. We will keep updating the product pages with new plans in the coming days.

8- We have rated only those plans that can be serviced by individual advisors. This is because of our strong belief that health insurance customers need professional assistance from individual advisors before and after purchase. We do not recommend and hence do not rate direct-to-customer health insurance plans or plans where there aren't enough advisors available to service. 

9- Affordability assessment of plans: 

  • The affordability of comprehensive plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹10 Lakhs. And, the premiums are as of 30th September 2023.
  • The affordability of Care Freedom Plan is assessed using premiums for a 30-year-old male residing in Zone 1, opting for a cover of ₹5 Lakhs. And, the premium is as of 30th September 2023.
  • The affordability of Acko Platinum Health Insurance is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹25 Lakhs. And, the premium is as of February 2024.
  • The affordability of ICICI Lombard MaxProtect (Premium) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹1 Crore. And, the premium is as of February 2024.
  • The affordability of Aditya Birla Activ One (VIP+) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹50 Lakhs. And, the premium is as of March 2024.
  • The affordability of Aditya Birla Activ One (VIP) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹50 Lakhs. And, the premium is as of April 2024.

10- We have considered the Inflation Protection benefit under Acko’s Platinum and Standard Health Plan instead of the No Claim Bonus Benefit.

11- The product benefits section is based on a sum insured of ₹10 Lakhs and only highlights the top benefits and features of health insurance plans. 

12- Only those hidden and special conditions that apply to the benefits and features we have considered are included on the product pages. 

13- The product pages only include the most significant specific exclusions under each plan, which we've simplified for better understanding.

14- The product pages do not include any generic terms, conditions, or exclusions (those that are the same and apply to all health insurance plans).

15- If the policy wording, brochure, or prospectus states that a benefit/feature is available with a specific plan but it is not available online when generating the premium quote, we have not considered that benefit/feature to be available with the plan.

16- The response time on Twitter was calculated using a sample set of tweets from February 2023 to August 2023 (analyzed in September 2023).

17- The metrics like claim complaints, policy purchase complaints, response time on Twitter and toll-free are not related to a specific product but are related to the overall performance of the insurance company.

18- The network hospitals' data was last updated on 5th March 2024.

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Compare HDFC Ergo Optima Secure and Niva Bupa ReAssure 2.0 (Bronze+)

Claims Track Record:

HDFC Ergo Optima Secure

HDFC ERGO General Insurance Company Limited has a claim settlement ratio of 83.31% and a claims incurred ratio of 83.53%. It has resolved 95.75% of claims within a 30-day timeframe. The company has received fewer complaints related to claims as compared to other insurers.
 

Service Experience:

HDFC Ergo Optima Secure

HDFC ERGO General Insurance Company Limited provides customer support through both a toll-free helpline and their Twitter handle. It's worth noting that their response time on both channels is average. 

 

Product Benefits:

HDFC Ergo Optima Secure

The HDFC Ergo Optima Secure Plan offers extensive coverage that includes hospitalisation costs, pre-hospitalisation, and post-hospitalisation expenses. It's important to note that pre-hospitalisation expenses are covered for up to 60 days before hospital admission and post-hospitalisation expenses up to 180 days after discharge, all up to the sum insured. Moreover, the policy covers all day care treatments, domiciliary treatments, inpatient expenses related to organ donation procedures, modern treatments, and consumables up to the sum insured. The HDFC Ergo Optima Secure Plan offers you the flexibility to choose any room  without imposing room rent limits. Furthermore, there is no ICU rent limit or copayments. However, an optional deductible is applicable under the policy and you have the flexibility to choose from the following options: Rs 25,000, Rs 50,000, or Rs 1,00,000. The policy does not impose restrictions on common medical treatments or surgeries, like cataract treatments, joint replacement surgeries, etc. ensuring they are covered up to the sum insured. It's essential to note that pre-existing diseases have a 36-month waiting period while specific diseases have a 24-month waiting period under this plan.