<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=7698356820180471&ev=PageView&noscript=1" />

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 Privilege is sold by Universal Sompo and Health Premia Platinum is sold by Max Bupa. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.

Second, we know that both products have subtle differences in their core structure. Complete Healthcare Privilege is reasonably comprehensive. Sure, it doesn’t have all the bells and whistles, but it also doesn’t impose any mindless restrictions. Health Premia Platinum, meanwhile, is a relatively expensive premium policy tailored to cover as many use cases as possible. So while the differences in features may be subtle, the pricing could be drastically different depending on the cover amount you pick.

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 Privilege. 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.


Health Premia Platinum meanwhile comes from Niva Bupa (erstwhile Max Bupa)’s stable:

Founded in 2008, Niva Bupa (erstwhile Max Bupa) is one of the leading health insurance companies in India. While they have had a bit of a tumultuous time with their promoters, they still sell an impressive suite of products across multiple categories.

And they also boast a claim settlement ratio of 91%, with a network of more than 10,000+ hospitals.

talk to us

Talk to IRDAI-certified experts

If you want help with selecting the best health policy tailored to your needs, book a FREE call with our experts today by clicking here.

Compare Insurances

Insurance Parameters

Recommended
Not Recommended
Network hospitals
5,000+
10,000+
Claim settlement ratio

(avg. of last 3 years)

95%
91%
Co-payment

No

No

Room rent

Any Room

Any Room

Disease sub-limit

No

No

Pre existing diseases waiting

3 years

2 years

Pre/Post hospitalization

30/60 days

90/180 days

No claim bonus

5% per year

(up to 50%)

10% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

100% restoration

(once for any illness)

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

Available

(up to ₹50,000 after 3 years)

Available

(up to ₹2,00,000 after 2 years)

Out Patient Department

Up to ₹7,500

Up to ₹50,000

(Annually)

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 Privilege doesn’t impose a co-payment clause. And neither does Health Premia Platinum.

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, Complete Healthcare Privilege doesn’t impose any restrictions on the kind of room you can pick. And Health Premia Platinum also doesn’t impose any restrictions on this front. You can pick any room you want.

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, neither Complete Healthcare Privilege imposes disease-wise sub-limits nor does Health Premia Platinum

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 Privilege imposes a waiting period of 3 years on pre-existing diseases while Health Premia Platinum extends a waiting period of 2 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 Privilege covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Health Premia Platinum covers expenses incurred 90 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. In this case, however, Complete Healthcare Privilege offers a no-claim bonus of 5% whereas Health Premia Platinum offers a no-claim bonus of 10%. And the no-claim bonus may be capped at different levels too.

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 Privilege offers domiciliary cover. And Health Premia Platinum 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 Privilege covers Ayush procedures and Health Premia Platinum 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, Complete Healthcare Privilege offers maternity cover and Health Premia Platinum offers maternity cover too, although the sub-limits for normal delivery and C-section procedures may be different, including the waiting period.

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 Privilege offers OPD coverage, and Health Premia Platinum also offers OPD coverage, although the sub-limits may be different.

Final Conclusion

It depends on your budget. Complete Healthcare Privilege is relatively more affordable when you compare the common use cases but Health Premia Platinum obviously offers better protection, since it offers a whole host of benefits that Complete Healthcare Privilege simply doesn’t offer. So yeah, depending on the use case you’re trying to optimize for, you can make a choice.

talk to us

Select the best plan with our help!

Get in touch to find out what plan works best for you. Zero fuss. Zero spam. Zero charges. Book a call now. Limited slots available!