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Introduction

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

Both products are marketed by different insurance companies. Complete Healthcare Essential is sold by Universal Sompo and myHealth Koti Suraksha is sold by HDFC Ergo. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.

Second, we know that both products have massive differences in their core structure. Complete Healthcare Essential is more comprehensive. It covers a lot more use cases and doesn’t have any egregious conditions. However, myHealth Koti Suraksha is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. So fundamentally, they’re two very different products.

And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?

That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.


Let’s start with Complete Healthcare Essential. The product comes from Universal Sompo’s stable:

Universal Sompo General Insurance Company is a public-private venture floated by two nationalized banks (Indian Overseas Bank and Allahabad Bank), one private bank (Karnataka Bank), an FMCG giant (Dabur Investment Corporation), and a well-known Japanese insurance firm (Sompo Japan Nipponkoa Insurance Incorporation).

The insurer also sells 135 IRDAI approved products and boasts over 5,000 network hospitals with a claim setllement ratio of 95%. Needless to say, the company isn’t exactly stellar when it comes to processing claims.


myHealth Koti Suraksha meanwhile comes from HDFC Ergo’s stable:

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

More importantly, HDFC Ergo boasts a claim settlement ratio of 98%, with a network of 11,500+ hospitals

All in all, an impressive resume.

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Compare Insurances

Insurance Parameters

Recommended
Not Recommended
Network hospitals
5,000+
11,500+
Claim settlement ratio

(avg. of last 3 years)

95%
98%
Co-payment

No

20%

Room rent

Any Room

Single Private room

Disease sub-limit

No

Yes

Pre existing diseases waiting

3 years

4 years

Pre/Post hospitalization

30/60 days

60/180 days

No claim bonus

10% per year

(up to 50%)

10% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

Health check-up
Once every 2 years
Once every year
Maternity

Available

(up to ₹25,000 after 3 years)

Out Patient Department

Up to ₹5,000

Day care

Feature Comparison

coPay

Co payment

With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Complete Healthcare Essential doesn’t impose a co-payment clause whereas myHealth Koti Suraksha if purchased after turning 61 or during PED Waiting Period.

roomRent

Room rent

If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, you can pick any room you want with Complete Healthcare Essential but myHealth Koti Suraksha only lets you stay in a single private room. Nothing fancy.

diseaseSublimit

Sub limits

Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Complete Healthcare Essential doesn’t impose a disease wise sub-limit whereas myHealth Koti Suraksha imposes disease-wise sub-limits on Cataract, Benign - Tumours/Cysts/Nodule/Polyp, Stone in Urinary System, Hernia Related, Appendectomy, Hysterectomy.

ped

Waiting periods for pre-existing diseases

If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Complete Healthcare Essential imposes a waiting period of 3 years on pre-existing diseases while myHealth Koti Suraksha extends a waiting period of 4 years on existing conditions.

prePost

Pre and post Hospitalization expenses

Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Complete Healthcare Essential covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, myHealth Koti Suraksha covers expenses incurred 60 days before hospitalization and expenses incurred 180 after hospitalization, although there may be different sub-limits

ncb

No claim bonus

Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. And in this case, Complete Healthcare Essential offers a no-claim bonus of 10% and myHealth Koti Suraksha similarly extends a 10% no-claim bonus.

domiciliary

Domiciliary

Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Complete Healthcare Essential offers domiciliary cover. And myHealth Koti Suraksha also coves domiciliary expenses.

ayush

Ayush treatments

Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Complete Healthcare Essential covers Ayush procedures and myHealth Koti Suraksha also extends coverage for Ayush treatments.

maternity

Maternity benefits

If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Complete Healthcare Essential offers maternity cover whereas myHealth Koti Suraksha doesn’t offer protection for maternity-related hospitalizations.

opd

Out Patient Department (OPD)

Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Complete Healthcare Essential offers OPD cover whereas myHealth Koti Suraksha doesn’t offer OPD protection.

Final Conclusion

After considering all the features on hand, we believe that Complete Healthcare Essential is a better alternative to myHealth Koti Suraksha for most use cases that we’ve evaluated so far.

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