Star Health Comprehensive vs Oriental Insurance Happy Family Floater Policy Gold
Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Comprehensive is sold by Star Health and Happy Family Floater Policy Gold is sold by Oriental Insurance. 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. Comprehensive is more comprehensive. It covers a lot more use cases and doesn’t have any egregious conditions. However, Happy Family Floater Policy Gold 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 Comprehensive. The product comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
Happy Family Floater Policy Gold meanwhile comes from Oriental Insurance’s stable:
Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.
Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 3,264 network hospitals across the country.
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Compare Insurances Insurance Parameters Recommended Not Recommended | ||
---|---|---|
Network hospitals | 14,000+ | 3,264 |
Claim settlement ratio (avg. of last 3 years) | 83% | 96% |
Co-payment | 10% (if purchased after turning 61) | No |
Room rent | Single Private room | Any Room (up to 1% of sum insured) |
Disease sub-limit | Yes | Yes |
Pre existing diseases waiting | 3 years | 3 years |
Pre/Post hospitalization | 60/90 days | 30/60 days |
No claim bonus | 50% per year (up to 100%) | |
Domiciliary | ||
Ayush treatments | ||
Restoration benefit | 100% restoration (once for any illness after complete exhaustion of sum insured) | |
Health check-up | Once every year | |
Maternity | Available (up to ₹20,000 after 2 years) | |
Out Patient Department | Up to ₹1,200 (cap of ₹300 on each consultation) | |
Day care |
Feature Comparison
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, Comprehensive requires you to co-pay a part of the bill 10% if you purchase after turning 61 whereas Happy Family Floater Policy Gold doesn’t impose a co-payment clause
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, Comprehensive lets you stay in a single private room and Happy Family Floater Policy Gold only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured. In effect, both policies impose restrictions on the kind of room you can pick.
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, Comprehensive imposes disease-wise sub-limits on Modern treatments whereas Happy Family Floater Policy Gold imposes sub-limits on Modern treatments
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. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Comprehensive imposes a 3 year waiting period on pre-existing diseases and Happy Family Floater Policy Gold will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases
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, Comprehensive covers expenses incurred 60 days before hospitalization and expenses incurred 90 days post-hospitalization. Meanwhile, Happy Family Floater Policy Gold covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits
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, Comprehensive offers a no-claim bonus whereas Happy Family Floater Policy Gold doesn’t offer a no-claim bonus.
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, Comprehensive offers domiciliary cover. And Happy Family Floater Policy Gold also coves domiciliary expenses.
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, Comprehensive covers Ayush procedures and Happy Family Floater Policy Gold also extends coverage for Ayush treatments.
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, Comprehensive offers maternity cover whereas Happy Family Floater Policy Gold doesn’t offer protection for maternity-related hospitalizations.
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, Comprehensive offers OPD cover whereas Happy Family Floater Policy Gold doesn’t offer OPD protection.
Final Conclusion
After considering all the features on hand, we believe that Happy Family Floater Policy Gold is a better alternative to Comprehensive for most use cases that we’ve evaluated so far.
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Other Oriental Insurance Happy Family Floater Policy Gold Comparisons
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