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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. Health Guard Platinum is sold by Bajaj Allianz and Optima Secure 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. Health Guard Platinum is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. However, Optima Secure is more comprehensive. It covers a lot more use cases and doesn’t have any egregious conditions. 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 Health Guard Platinum. The product comes from Bajaj Allianz’s stable:

Founded in 2001, the company is a joint venture between Bajaj Finserv Limited (of the Bajaj Group) and Allianz SE, a German financial services corporation.

And while they may not be the biggest insurer out there, they do have a claim settlement ratio of 95%, with a network of more than 8,000 hospitals.


Optima Secure 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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Insurance Parameters

Recommended
Not Recommended
Network hospitals
8,000+
11,500+
Claim settlement ratio

(avg. of last 3 years)

95%
98%
Co-payment

No

No

Room rent

Single Private room

Any Room

Disease sub-limit

Yes

No

Pre existing diseases waiting

3 years

3 years

Pre/Post hospitalization

60/90 days

60/180 days

No claim bonus

50% per year

(up to 150%)

50% per year

(up to 100%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness

after complete exhaustion of sum insured)

100% restoration

(once for any illness)

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

Available

(up to ₹25,000 after 6 years)

Out Patient Department
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, Health Guard Platinum doesn’t impose a co-payment clause. And neither does Optima Secure.

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, Health Guard Platinum only lets you stay in a single private room but you can pick any room you want with Optima Secure.

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, Health Guard Platinum imposes disease-wise sub-limits on null whereas Optima Secure doesn’t impose a disease wise sub-limit.

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. This cooling period is referred to as the Pre-existing-disease waiting period. In this case, Health Guard Platinum imposes a 3 year waiting period on pre-existing diseases and Optima Secure will similarly tell you to wait 3 years before making a claim related to your pre-existing diseases

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, Health Guard Platinum covers expenses incurred 60 days before hospitalization and expenses incurred 90 days post-hospitalization. Meanwhile, Optima Secure 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, Health Guard Platinum offers a no-claim bonus of 50% and Optima Secure similarly extends a 50% 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, Health Guard Platinum doesn’t offer domiciliary protection whereas Optima Secure offers domiciliary cover.

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, Health Guard Platinum covers Ayush procedures and Optima Secure 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, Health Guard Platinum offers maternity cover whereas Optima Secure 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, neither Health Guard Platinum extends coverage for outpatient consultations, nor does Optima Secure.

Final Conclusion

After considering all the features on hand, we believe that Optima Secure is a better alternative to Health Guard Platinum for most use cases that we’ve evaluated so far.

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