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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. Digit Insurance Smart Option is sold by Digit and ProHealth Premier is sold by Manipal Cigna. 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. Digit Insurance Smart Option is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. However, ProHealth Premier is a premium policy tailored to cover as many use cases as possible. So in all honesty, you are comparing apples and oranges here.

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 Digit Insurance Smart Option. The product comes from Digit’s stable:

Digit Insurance is a 4-year-old InsurTech start-up financed by the Fairfax Group, a prominent Financial Services company. And despite not having the most extensive track record, they have managed to market products that are truly affordable.

They also have a claim settlement ratio of 94.23% alongside 16,400+ network hospitals and they are brimming with potential.


ProHealth Premier meanwhile comes from Manipal Cigna’s stable:

ManipalCigna Health Insurance Company is a collaborative partnership between Manipal Group and Cigna and together they have over 200 years of expertise in the healthcare business. And while the company has shown some potential recently, it still only corners a small part of the Indian market.

Also, they have a settlement ratio of 90.08% with more than 8,500+ network hospitals in tow.

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Insurance Parameters

Recommended
Not Recommended
Network hospitals
16,400+
8,500+
Claim settlement ratio

(avg. of last 3 years)

94.23%
90.08%
Co-payment

No

20%

(if purchased after turning 65)

Room rent

Any Room

(up to 1% of sum insured)

Any Room

(Except suite)

Disease sub-limit

No

No

Pre existing diseases waiting

4 years

2 years

Pre/Post hospitalization

30/60 days

60/180 days

No claim bonus

10% per year

(up to 50%)

10% per year

(up to 200%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(unlimited no. of times

for different illness)

Health check-up
Once every year
Once every year
Maternity

Available

(up to ₹2,00,000 after 4 years)

Out Patient Department

Up to ₹15,000

(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, Digit Insurance Smart Option doesn’t impose a co-payment clause whereas ProHealth Premier requires you to co-pay a part of the bill 20% if you purchase after turning 65

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, Digit Insurance Smart Option only lets you stay in a room whose rent doesn’t exceed 1% of the total sum insured, whereas ProHealth Premier lets you stay in any room except a Suite.

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 Digit Insurance Smart Option imposes disease-wise sub-limits nor does ProHealth Premier

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, Digit Insurance Smart Option imposes a waiting period of 4 years on pre-existing diseases while ProHealth Premier 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, Digit Insurance Smart Option covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, ProHealth Premier 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, Digit Insurance Smart Option offers a no-claim bonus of 10% and ProHealth Premier 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, Digit Insurance Smart Option offers domiciliary cover. And ProHealth Premier 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 Digit Insurance Smart Option doesn’t extend coverage for Ayush treatments whereas ProHealth Premier covers 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, Digit Insurance Smart Option doesn’t offer protection for maternity-related hospitalizations whereas ProHealth Premier offers maternity cover.

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, Digit Insurance Smart Option doesn’t offer OPD protection whereas ProHealth Premier offers OPD cover.

Final Conclusion

It should be obvious that ProHealth Premier offers substantially better features when compared to Digit Insurance Smart Option. But considering Manipal Cigna has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Digit has to offer.

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