SBI General Health Insurance: Plans, Features, & Claim Ratio

SBI General Health Insurance: Overview

SBI General Health Insurance is a general insurance company that also sells health insurance products. There are multiple plans for cashless and reimbursement facilities, starting from basic coverage at just ₹50,000 to comprehensive policies going up to ₹2 crore. SBI General Health Insurance has tie-ups with over 16,000 network hospitals nationwide and insured 24 crore+ customers with an average claim settlement ratio (CSR) of 96% over 2022-25.

Introduction

Unlike other insurers, SBI General Health Insurance democratised health coverage reaching tier-3 cities in India. The brand name brought credibility and the plans are equally affordable for individuals, families, and senior citizens.

But is the public sector backing enough to make SBI General the best health insurance?

At Ditto, we've analyzed SBI General Health Insurance plans extensively to find the pros and cons and help you decide.

In this guide, you will learn :

Who should buy SBI General Health Insurance?
What are the key features of SBI General Health Insurance plans?
What Are The Different Types Of SBI General Health Insurance plans?
Is it worth buying SBI General Health Insurance in 2025?

Can’t decide what features you should have in your health plan? Fret not! Book your free call with Ditto and together we will design your perfect health cover.

Who Should Buy SBI General Health Insurance?

Existing SBI Customers

Get loyalty rewards and manage policies through the SBI portal.

Tier-2 & Tier-3 City Residents

SBI General reaches 114+ cities with 22,000+ branches and local claim support.

Senior Citizens (60+)

Shorter 2-year waiting period for pre-existing diseases unlike standard 36 months.

Health-conscious Individuals

Chance to build no-claim bonus (5-50% annually, up to 200%) with wellness rewards

SBI General Health Insurance: Key Metrics

Backed by India's largest public sector bank, SBI General is a trusted, government-owned insurer with robust metrics for safety and reliability.

Key Indicators	What the Numbers Tell	What This Means
Claim Settlement Ratio (CSR)	96.14% (Avg. CSR 2022-25)	Out of every 100 claims filed, SBI General settles approximately 96, demonstrating high efficiency and reliability in honoring policyholder claims.
Incurred Claim Ratio (ICR)	81.23% (FY 2021-24)	This balanced ratio indicates the company pays out a healthy proportion of premiums as claims while maintaining financial sustainability.
Complaint Volume	21 complaints per 10,000 claims (FY 2022-25)	Declining complaint trends shows improving customer satisfaction and service quality year-on-year.
Annual Business (Gross Written Premium)	₹3,329 Crores (FY 2022-25)	With an impressive year-on-year growth, SBI General demonstrates strong market presence and customer trust.
Network Hospitals	16,600+ hospitals nationwide	Access to cashless treatment at thousands of quality healthcare facilities across India ensures convenience during medical emergencies.
Number of Branches	140+ branches across India	Extensive physical presence with over 22,000+ SBI branches providing accessibility even in remote areas.
Solvency Ratio	2.03 times (FY 2024-25)	Well above the regulatory requirement of 1.5 times, ensuring the company has sufficient capital to meet all claim obligations.
Years of Operations	15+ years (Founded 2009, Operations started 2010)	Established track record with consistent growth from 17 branches in 2011 to over 140 branches today.

Smart Add-On Options When Buying SBI General Health Insurance:

Unlimited restoration/refill
OPD cover (₹5K-₹10K annual limit)
Maternity/ newborn cover: (₹25K-₹2L, depending on the plan)
Global treatment cover: (for specified illnesses diagnosed in India with 24-36 month waiting period)

Note: Benefits, limits, and waiting periods are plan-specific and updated periodically. Always refer to the latest brochure/policy wording before purchase.

Things to Consider when Buying a Health Plan

Exceeding room rent caps triggers proportionate deductions

Verify caps to save out-of-pocket expenses on the total bill.

“Unlimited restoration” is not really “unlimited”

The limit typically resets for new or unrelated claims while caps, co-payments, and sub-limits remain.

Add-ons like claim shields are good to buy

It protects against hospitals charging extra for non-medical items (consumables).

Hospital network numbers mean nothing if there aren’t any in your city

Always search your preferred hospital online before buying.

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What Are The Different Types Of SBI General Health Insurance Plans?

Plan (Coverage)	Who is it for	What it offers
Arogya Sanjeevani(₹1L–₹5L)	First-time buyers on low budget	IRDAI standard health plan with fixed coverage limits and straightforward renewal process. Basic hospitalization benefits with limited variants.
Health Edge(₹3L–₹25L)	Families with custom needs	Unlimited refill option, covers consumables, OPD benefits, maternity coverage, and global treatment access. Customizable coverage up to ₹25L.
Arogya Supreme(₹3L–₹25L)	Families wanting extras	Base coverage with 8 rider options for customization, includes mental health benefits, flexible plan structure to match individual needs.
Super Health(₹3L–₹2Cr)	Families looking for max coverage with premium option	Health Multiplier feature, automatic reinstatement of coverage post-claim, Claims Shield protection, and worldwide treatment coverage for comprehensive protection.
Super Top-Up(₹5L–₹4Cr)	Families that need higher add-on cover	Top-up plan with high sum insured, aggregate annual bill coverage, large deductible options to keep premiums economical while adding to base plan coverage.

Which SBI General Health Insurance Plan Is Right For You?

What Are The Inclusions and Exclusions In SBI General Health Insurance?

SBI General plans cover a wide range of medical expenses, but some services are excluded. Let’s have a closer look.

Common inclusions:

In-patient hospitalization and day-care procedures
Pre and post-hospitalization expenses
Ambulance and organ donor expenses
AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, Homeopathy)
Wellness check-ups, consumables cover (Claims Shield) on select plans
OPD, maternity/newborn care, and specified global treatment add-ons
Waiting periods apply (initial, listed illnesses, pre-existing conditions)

Common exclusions:

Self-inflicted injury, war-related injuries, and breach of law
Cosmetic treatments, weight management, infertility, surrogacy unless covered
Experimental or unproven treatments
Other permanent exclusions listed in the policy

Is It Worth Buying SBI General Health Insurance in 2025: Ditto’s Take

For millions of Indians seeking affordable and reliable health insurance in 2025, SBI General is a fairly good option. But despite decent metrics and helpful inhouse claims team, the complaint volume is on the higher side and TPA assigning varies by the location.

That’s where Ditto’s 5-point checklist can guide you to buy the right health plan:

Review the Customer Information Sheet (CIS), plan brochure, and policy details thoroughly.
Avoid plans with strict room rent caps that trigger large out-of-pocket bills due to proportionate deductions.
Prioritize checking room rent limits, sub-limits on specific diseases, waiting periods, and exclusions.
Get consumables cover, restoration/refill, annual health checkups, if possible.
Use SBI General’s cashless hospital search tool and call hospitals to verify current cashless policies in your city.
Work with a trusted agent or advisor for post-sales support and seamless claims assistance. Individual experiences vary by location.
Verify TPA details and in-house claims processes before purchasing a plan.

Important Disclosure:

All data and metrics in this article are sourced from SBI General's official website, policy documents, and public disclosures. SBI General is not a current partner of Ditto. Their retail presence is limited and most customers hold group plans through employers or banks.

Why Choose Ditto For Health Insurance?

At Ditto, we’ve helped 7,00,000+ customers become smart insurance buyers by matching their unique needs to the right health insurance policy. That’s why customers like Pramey trust Ditto and recommend us to others.

✅ Honest advice – no sales pitches, no commission-driven recommendations

✅ 12,000+ 5-star reviews (Rated 4.9 on Google)

✅ Real claim experience – we've helped customers through actual claims

✅ Backed by Zerodha and other leading fintech companies

Final Thoughts

Credible and affordable, SBI General Health Insurance offers a wide range of plans with reliable coverage and strong claim settlement ratio. But don't just pick any plans on offer. Instead, get personalized advice to meet your real-life needs. Book a free call with Ditto’s expert advisors for end-to-end guidance.

FAQs

What is the SBI General Health Insurance claim settlement process?

For cashless, choose a network hospital, get pre-authorization via the insurer/TPA, and the hospital will raise the bill to the insurer. For reimbursement, submit the filled SBI claim form, discharge summary, bills, prescriptions, diagnostics and KYC documents within timelines.

How fast claims are settled?

Insurers must settle or reject a claim within 30 days of receiving all necessary documents. If there’s an ongoing investigation, it needs to be completed within 45 days. Any unexplained delay leads to a penalty.

Can I cancel my SBI General Health Insurance if I felt pressured at the bank?

Yes, health policies carry a 30-day free-look period. If the branch forces a sale on you, escalate the matter to the insurer’s GRO and, if needed, register a complaint on IRDAI’S Bima Bharosa (IGMS) portal.

Does cashless work at any hospital now?

Under Cashless Everywhere scheme, it may, but one must follow conditions like prior intimation. Sometimes, hospital adoption varies, so pre-check for planned procedures. In emergencies, notify within 48 hours.

How do I port from or into SBI General without losing my waiting-period credits?

To port SBI General Health Insurance or port into SBI General from another insurer, apply 45–60 days before renewal. All acquired credits will move to an equal or superior plan and a fresh waiting period will only apply if you increase your cover.

Last updated on: 3 Nov, 2025