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Ensure Your Family's Happiness SBI GENERAL RETAIL HEALTH INSURANCE POLICY

SBI General Retail Health

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Page 1: SBI General Retail Health

Ensure Your Family's Happiness

SBI GENERAL RETAIL HEALTH INSURANCE POLICY

Page 2: SBI General Retail Health

SBI General's Retail Health Insurance Policy

Life is a wonderful journey, full of twists and turns. How wonderful it

would be to have someone to keep you safe in all the challenges life

throws at you?

SBI General's Retail Health Insurance Policy! Ensuring your peace of

mind by offering financial protection in case you fall sick.

Who Can Buy This Policy?

u Any individual above 18 years can buy this Policy for themselves

and/or their family.

u By Family we mean Insured, Insured's legal Spouse, Legal,

Dependent Children & Dependent Parents. The dependent parents

can't be covered under the �oater option available under the Policy.

What Are The Key Benefits Of This Policy?

Wide Coverage – From ` 50,000 to ` 5,00,000

No pre-policy medical test up tothe age of 45 for people with

no medical history

Wide Coverage- From`50,000 up to `500,000

Flexible Plan Options -Metro, Semi Metro &

Rest of India

Family Floater bene�t – o�ering comprehensive protection to

all your family members under one Policy

Add-on Covers available Coverage of 30 days Pre and 60 days Post

Hospitalisation Expenses

Free Medical check-up for every 4 claim free years up to

a maximum limit of ` 2,500

Premium exempt from Income Tax under Sec 80 D of

Income Tax Act

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 3: SBI General Retail Health

What Does The Policy Cover?

Eligible Hospitalisation Expenses:

u Room, Board & Nursing Expenses & Service Charges

Etc - Up to 1% of the SI per day.

u Intensive Care Unit - Up to 2% of the SI per day.

u All admissible claims under the points above during the

policy period - Up to 25% of the SI per illness/injury per

claim.

u Surgeon, Anaesthetist, Consultants, Specialists Fees -

Up to 40% of the SI per illness/injury per claim.

u Anaesthesia, Blood, Oxygen, OT Charges, Surgical

Appliances - Up to 40% of the SI per illness/injury per

claim.

Pre-hospitalisation Expenses Coverage: Up to 10% of

the eligible hospitalisation expenses incurred within 30

days prior to date of admission into the hospital.

Post-hospitalisation Expenses Coverage: Up to 10% of

the eligible hospitalisation expenses incurred within 60

days after the date of discharge from the hospital.

Ambulance Expenses: Ambulance charges - 1% of SI up

to a maximum of ̀ 1500.

Free Medical Check Up: 1% of SI up to a maximum of 2500 ̀

For every 4 claim free years.

Parental Care: Available for persons above 60 years.

Attendant nursing charges after discharge from the

hospital for 500 per day or actual whichever is less, up to a `

maximum 10 days per hospitalisation. The charges can be

reimbursed for a period not exceeding 15 days during the

entire Policy period.

Child Care: Available for a child below 10 years of age.

Attendant escort charges of 500 for each completed day `

of hospitalisation subject to maximum of 30 days during

the Policy Period.

Cataract: 15% of SI subject to maximum of 25000 per eye ̀

subject to �rst two years exclusion.

Parents' and Child Attendant Care Covered

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 4: SBI General Retail Health

Accidental Hospitalisation: In case of hospitalization

following an Accident, SI limit available for the Insured

Person will be 125% of the amount arrived after deducting

the claims paid and/or outstanding from sum insured for

the Insured Person under the policy excluding cumulative

bonus component and subject to a maximum of

` 1,00,000/-.

Alternative Treatment (Subject to Treatment taken in a

government hospital or in any institute recognised by

government and/or accredited by Quality Council of

India/National Accreditation Board on Health): Ayurvedic

Treatment covered maximum 15% of SI per Policy period

up to a maximum of 20000 & Homeopathy and Unani `

Treatment covered maximum 10% of SI per Policy period

up to a maximum of 15000. ̀

Domiciliary Hospitalisation: Reasonable and Customary

Charges towards Domiciliary Hospitalisation exceeding 3

days as de�ned in Policy de�nition subject to 20% of the SI

maximum up to 20000. `

Convalescence Bene�t: Bene�t available for Insured

above 10 years & below 60 years. Compensation to the

Insured, up to an amount not exceeding 5,000/- per `

Insured, for a period of 10 consecutive days or more. This

bene�t is payable only once per Insured during the Period of

Insurance.

Day Surgery: Less than 24 hours hospitalization

undertaken for speci�ed procedures like Dialysis,

Chemotherapy, Radio therapy, Eye Surgery, Dental Surgery

(Due to accident) , Tonsillectomy, etc is covered.

Co-Pay: 10% Co-Pay after deductible will apply on all

eligible admissible claims in non-network hospitals.

Cumulative Bonus: A bonus equaling 5% of SI on renewal

for every claim-free year. Cumulative bonus can be

accumulated up to 25% of SI and will get reduced by 5% in

case of claims.

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Alternative Treatment Covered

Page 5: SBI General Retail Health

From 3 months to 65 years

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

What Is The Minimum & Maximum Coverage Possible Under This

Policy?

What Are The Add-on Covers Available With This Policy?

On payment of additional premium the following Add-on Covers ore

available with this Policy.

u Removal of Room & ICU rent sub-limits.

u Removal of sub-limits on Operation and Consultancy charges.

What Is The Minimum & Maximum Entry Age For This Policy?

Minimum age of entry Maximum age of entry

Children from the age of 3months can be covered if either of the parents

is concurrently covered with SBI General's Retail Health Insurance Policy.

What Are The Tenure Plan Options Available Under This Policy?

How Is The Premium For A Family Floater Policy Calculated?

Premium for Family Floater Policy is calculated basis the age of the

oldest family member to be insured.

Does The Plan Differ Based On Where I Stay?

In case you live in a Metro or in a Semi Metro, the Policy provides you with

an option to choose a plan which is more appropriate to your need and

hence priced accordingly.

Is Pre-acceptance Health Check Up Compulsory?

If you are younger than 45 years and have no history of illness, then pre-

acceptance health check up is not compulsory for you. For others, a

medical examination is mandatory as per SBI General's requirements.

Pre-acceptance medical tests will be done at the cost of the proposer.

However, if the proposal is accepted SBI General will reimburse 50%of

the cost incurred.

65Years

18Years

1Year

Min. Coverage

`50,000

Max. Coverage

`500,000

Page 6: SBI General Retail Health

Differentiated Plans Based On City Type

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

u Plan A - 100% of the admissible claim amount for all Locations

subject to the Policy terms and conditions.

u Plan B - 100% of the admissible claim amount for Locations B and C,

and 80% for Location A subject to the Policy terms and conditions.

u Plan C - 100% of the admissible claim amount for Locations C, 80%

for Location B and 70% for Location A subject to the Policy terms

and conditions.

The percentage of amount shown in the above table is with respect to

the admissible claim amount.

The Company will make payments only after being satisfied, with the

necessary bills and documents.

What Is SBI General's Renewal Policy?

This Policy may be renewed by mutual consent every year. u

u If renewed, the renewal premium needs to be paid to the Insurer

on or before the expiry or renewal date.

u A Grace Period of 30 days is allowed for renewal of the Policy.

During this period a payment can be made to continue the Policy

without losing any bene�t.

u Coverage is not available for the period for which no premium is

received.

Bene�t Plan Treatment Location A -Mumbai and

Delhi

Treatment Location B -

Chennai, Kolkata,

Bangalore, Ahmedabad,

Hyderabad

Treatment Location C - Rest of India

Plan A (Normal residential location -Mumbai & Delhi)

100% 100% 100%

Plan B (Normal residential location -Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad)

80% 100% 100%

Plan C (Normal residential location -Rest of India)

70% 80% 100%

Page 7: SBI General Retail Health

What Is Not Covered In The Policy?

Pre-existing conditions, until 48 months after the Policy was u

purchased.

Any disease contracted during the �rst 30 days of commencement u

of the Policy.

Certain diseases/surgeries shall be covered after a pre-de�ned u

waiting period .

Treatment with alternative medicines like acupuncture, u

acupressure, osteopath, naturopathy, chiropractic, re�exology

and aroma therapy.

Treatment arising from or traceable to pregnancy.u

Congenital diseases.u

All expenses related to AIDS and related diseases.u

Use/Abuse of intoxicating drugs or alcohol.u

Note: The above information on exclusions is only indicative in nature. For details please read the

policy wordings available on our website (www.sbigeneral.in)

What Is The Claim Procedure?

Our dedicated and experienced claims team aim to deliver you

superlative customer service with a fast, fair, convenient and

transparent claims process so your claim is settled without any hassle.

Our Claims Team Will:

Our dedicated and experienced claims team aim to deliver you

Provide assistance in Keep you informed of the progress

emergency situations of your claim

How Do You Make A Claim?

In case of an accident or illness that requires hospitalization or daycare,

please notify us by phone or email.

The above information is indicative in nature, for more details on complete

coverage and terms & conditions, please read the policy document

carefully before concluding a sale.

Fast, Fair & Transparent Claim Procedure

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 8: SBI General Retail Health

Premium Chart (Exclusive of GST)

Non Floater Policies

Plan A (Mumbai & Delhi) Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad, Pune) Plan C (Rest of India)

Age Band 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000

0.25-18 1,401 2,358 2,849 4,144 4,788 907 1,210 2,037 2,460 3,579 4,135 859 1,146 1,930 2,331 3,391 3,918

19-35 1,647 2,664 3,218 4,723 5,689 1,067 1,422 2,301 2,779 4,079 4,913 1,010 1,347 2,179 2,633 3,864 4,654

36-40 2,093 3,391 4,146 6,580 7,768 1,356 1,808 2,929 3,581 5,683 6,709 1,284 1,712 2,774 3,392 5,384 6,356

41-45 2,431 3,875 4,807 8,151 9,418 1,575 2,100 3,347 4,152 7,040 8,133 1,492 1,989 3,170 3,933 6,669 7,705

46-55 3,284 5,725 7,088 11,139 13,299 2,127 2,836 4,944 6,121 9,620 11,485 2,015 2,687 4,684 5,799 9,114 10,881

56-60 5,337 8,437 10,191 13,680 16,859 3,457 4,610 7,286 8,801 11,815 14,560 3,275 4,367 6,903 8,338 11,193 13,794

61-65 6,808 10,760 12,998 17,448 21,503 4,409 5,879 9,293 11,226 15,069 18,571 4,177 5,570 8,804 10,635 14,276 17,593

66 - 70 10,220 15,145 18,295 26,195 30,265 6,620 8,827 13,080 15,800 22,623 26,138 6,272 8,362 12,391 14,968 21,433 24,762

71 - 75 13,477 19,970 24,123 34,541 39,907 8,729 11,639 17,247 20,834 29,831 34,466 8,270 11,026 16,339 19,737 28,261 32,652

76 - 80 16,794 25,488 30,788 44,084 50,933 10,620 14,504 22,012 26,590 38,073 43,988 10,061 13,741 20,854 25,190 36,069 41,673

81 - 85 20,929 32,530 39,294 56,264 65,005 12,921 18,075 28,094 33,936 48,592 56,141 12,241 17,124 26,615 32,150 46,034 53,186

86 - 90 26,081 41,517 50,150 71,809 82,965 15,721 22,525 35,856 43,312 62,017 71,651 14,893 21,339 33,968 41,032 58,753 67,880

91 - 95 32,502 52,987 64,006 91,648 1,05,886 19,127 28,070 45,762 55,278 79,151 91,447 18,120 26,592 43,353 52,368 74,985 86,634

96 - 100 40,503 67,627 81,690 1,16,969 1,35,141 23,271 34,980 58,405 70,550 1,01,019 1,16,713 22,046 33,139 55,331 66,837 95,702 1,10,570

101 - 105 50,474 86,311 1,04,259 1,49,285 1,72,478 28,312 43,591 74,541 90,042 1,28,928 1,48,958 26,822 41,297 70,618 85,303 1,22,143 1,41,118

106 - 110 62,900 1,10,157 1,33,064 1,90,530 2,20,130 34,446 54,323 95,135 1,14,919 1,64,549 1,90,112 32,633 51,464 90,128 1,08,870 1,55,888 1,80,107

111 - 115 78,385 1,40,591 1,69,827 2,43,170 2,80,948 41,909 67,696 1,21,420 1,46,668 2,10,010 2,42,637 39,703 64,133 1,15,029 1,38,949 1,98,957 2,29,867

Two Adults Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 4,795 5,631 8,501 10,240 - - 4,141 4,863 7,342 8,843 - - 3,923 4,607 6,955 8,378

36-40 - 4,917 6,012 8,555 10,331 - - 4,246 5,192 7,388 8,923 - - 4,023 4,919 6,999 8,453

41-45 - 6,200 7,451 12,227 14,127 - - 5,354 6,435 10,560 12,200 - - 5,073 6,096 10,004 11,558

46-55 - 9,732 9,923 15,038 17,953 - - 8,405 8,570 12,987 15,505 - - 7,962 8,119 12,304 14,689

56-60 - 15,186 17,834 23,940 29,504 - - 13,115 15,402 20,676 25,480 - - 12,425 14,592 19,587 24,139

61-65 - 19,369 22,747 30,534 37,630 - - 16,728 19,645 26,371 32,499 - - 15,847 18,611 24,983 30,788

66 - 70 - 27,261 32,015 45,842 52,964 - - 23,544 27,650 39,591 45,742 - - 22,305 26,194 37,507 43,334

71 - 75 - 35,947 42,215 60,447 69,838 - - 31,045 36,459 52,204 60,315 - - 29,411 34,540 49,457 57,140

76 - 80 - 41,672 51,362 73,543 84,969 - - 35,989 44,358 63,515 73,382 - - 34,095 42,023 60,172 69,520

81 - 85 - 48,309 62,489 89,477 1,03,377 - - 41,722 53,968 77,275 89,280 - - 39,526 51,128 73,208 84,582

86 - 90 - 56,004 76,028 1,08,862 1,25,774 - - 48,367 65,660 94,017 1,08,623 - - 45,821 62,205 89,069 1,02,906

91 - 95 - 63,585 76,807 1,09,978 1,27,064 - - 54,914 66,333 94,981 1,09,737 - - 52,024 62,842 89,982 1,03,961

96 - 100 - 81,152 98,027 1,40,363 1,62,169 - - 70,086 84,660 1,21,222 1,40,055 - - 66,397 80,204 1,14,842 1,32,684

101 - 105 - 99,257 1,19,898 1,71,678 1,98,349 - - 85,722 1,03,548 1,48,267 1,71,302 - - 81,211 98,098 1,40,464 1,62,286

106 - 110 - 1,26,680 1,53,023 2,19,110 2,53,150 - - 1,09,406 1,32,156 1,89,231 2,18,629 - - 1,03,647 1,25,201 1,79,271 2,07,123

111 - 115 - 1,61,680 1,95,301 2,79,645 3,23,090 - - 1,39,632 1,68,669 2,41,512 2,79,033 - - 1,32,283 1,59,791 2,28,801 2,64,347

Two Adults and One Child Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 5,461 6,596 9,682 11,377 - - 4,716 5,697 8,362 9,826 - - 4,468 5,397 7,921 9,309

36-40 - 6,104 7,463 9,871 12,040 - - 5,271 6,445 8,525 10,399 - - 4,994 6,106 8,076 9,851

41-45 - 8,137 9,134 12,635 16,010 - - 7,028 7,888 10,912 13,827 - - 6,658 7,473 10,337 13,099

46-55 - 11,449 13,467 20,050 22,608 - - 9,888 11,631 17,316 19,525 - - 9,368 11,018 16,405 18,497

56-60 - 18,560 20,382 27,360 33,718 - - 16,030 17,603 23,629 29,120 - - 15,186 16,676 22,386 27,588

61-65 - 23,673 25,996 34,897 43,006 - - 20,445 22,451 30,138 37,141 - - 19,369 21,269 28,552 35,187

66 - 70 - 33,319 36,589 52,391 60,530 - - 28,776 31,600 45,247 52,276 - - 27,261 29,937 42,865 49,525

71 - 75 - 43,935 48,246 69,082 79,815 - - 37,944 41,667 59,662 68,931 - - 35,947 39,474 56,522 65,303

76 - 80 - 50,932 58,699 84,049 97,107 - - 43,987 50,695 72,588 83,865 - - 41,672 48,026 68,768 79,451

81 - 85 - 59,045 71,416 1,02,259 1,18,146 - - 50,993 61,678 88,315 1,02,035 - - 48,309 58,432 83,666 96,665

86 - 90 - 68,449 86,889 1,24,414 1,43,742 - - 59,115 75,040 1,07,448 1,24,141 - - 56,004 71,091 1,01,793 1,17,607

91 - 95 - 79,351 1,05,714 1,51,368 1,74,884 - - 68,530 91,298 1,30,727 1,51,037 - - 64,924 86,493 1,23,847 1,43,087

96 - 100 - 91,990 1,28,617 1,84,163 2,12,774 - - 79,446 1,11,078 1,59,050 1,83,759 - - 75,264 1,05,232 1,50,679 1,74,087

101 - 105 - 1,06,641 1,56,482 2,24,062 2,58,872 - - 92,099 1,35,143 1,93,508 2,23,571 - - 87,252 1,28,031 1,83,323 2,11,804

106 - 110 - 1,34,281 1,62,205 2,32,256 2,68,339 - - 1,15,970 1,40,086 2,00,585 2,31,747 - - 1,09,866 1,32,713 1,90,028 2,19,550

111 - 115 - 1,69,764 2,05,066 2,93,628 3,39,245 - - 1,46,614 1,77,102 2,53,588 2,92,984 - - 1,38,898 1,67,781 2,40,241 2,77,564

If we have a policy holder beyond age of 115, we will continue to charge premiums applicable for age of 115. This is applicable for �oater policies too.

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 9: SBI General Retail Health

Two Adults and Two Children Floater

Plan A (Mumbai & Delhi) Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad, Pune) Plan C (Rest of India)

Age Band 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 6,659 8,044 10,863 14,222 - - 5,751 6,947 9,381 12,283 - - 5,449 6,582 8,888 11,636

36-40 - 7,121 8,707 11,845 16,313 - - 6,150 7,520 10,230 14,088 - - 5,826 7,124 9,691 13,347

41-45 - 8,912 11,057 14,672 17,894 - - 7,697 9,549 12,672 15,454 - - 7,292 9,046 12,005 14,640

46-55 - 13,167 16,302 22,278 30,587 - - 11,371 14,079 19,240 26,416 - - 10,773 13,338 18,228 25,026

56-60 - 19,404 23,439 31,464 38,776 - - 16,758 20,243 27,174 33,488 - - 15,876 19,178 25,744 31,726

61-65 - 24,749 29,895 40,131 49,457 - - 21,374 25,819 34,659 42,713 - - 20,249 24,460 32,834 40,465

66 - 70 - 34,834 42,078 60,250 69,610 - - 30,084 36,340 52,034 60,118 - - 28,500 34,427 49,295 56,953

71 - 75 - 46,132 50,659 72,537 83,806 - - 39,841 43,751 62,645 72,378 - - 37,744 41,448 59,348 68,568

76 - 80 - 53,479 61,634 88,252 1,01,962 - - 46,186 53,229 76,218 88,058 - - 43,756 50,428 72,206 83,424

81 - 85 - 61,997 74,987 1,07,372 1,24,053 - - 53,543 64,762 92,730 1,07,137 - - 50,725 61,353 87,850 1,01,498

86 - 90 - 71,871 91,233 1,30,634 1,50,929 - - 62,071 78,792 1,12,821 1,30,348 - - 58,804 74,645 1,06,883 1,23,488

91 - 95 - 83,319 1,10,999 1,58,937 1,83,629 - - 71,957 95,863 1,37,263 1,58,588 - - 68,170 90,818 1,30,039 1,50,242

96 - 100 - 96,589 1,35,048 1,93,371 2,23,412 - - 83,418 1,16,632 1,67,002 1,92,947 - - 79,027 1,10,493 1,58,212 1,82,792

101 - 105 - 1,11,973 1,64,306 2,35,265 2,71,815 - - 96,704 1,41,901 2,03,183 2,34,749 - - 91,614 1,34,432 1,92,490 2,22,394

106 - 110 - 1,40,995 1,70,315 2,43,869 2,81,756 - - 1,21,769 1,47,090 2,10,614 2,43,334 - - 1,15,360 1,39,348 1,99,529 2,30,527

111 - 115 - 1,78,252 2,15,319 3,08,309 3,56,207 - - 1,53,945 1,85,957 2,66,267 3,07,633 - - 1,45,842 1,76,170 2,52,253 2,91,442

One Adult and One Child Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 4,395 5,148 7,793 9,386 - - 3,796 4,446 6,730 8,106 - - 3,596 4,212 6,376 7,680

36-40 - 4,578 5,597 7,897 9,710 - - 3,954 4,834 6,820 8,386 - - 3,746 4,580 6,461 7,945

41-45 - 5,425 6,490 10,597 12,243 - - 4,685 5,605 9,152 10,574 - - 4,439 5,310 8,670 10,017

46-55 - 8,301 8,151 12,253 14,628 - - 7,169 7,040 10,582 12,634 - - 6,791 6,669 10,025 11,969

56-60 - 12,233 14,267 19,152 23,603 - - 10,565 12,322 16,541 20,384 - - 10,009 11,673 15,670 19,311

61-65 - 15,065 17,547 23,555 29,029 - - 13,010 15,154 20,343 25,070 - - 12,326 14,357 19,272 23,751

66 - 70 - 21,203 24,698 35,364 40,858 - - 18,312 21,330 30,542 35,286 - - 17,348 20,207 28,934 33,429

71 - 75 - 27,958 32,566 46,631 53,875 - - 24,146 28,125 40,272 46,528 - - 22,875 26,645 38,152 44,080

76 - 80 - 32,412 39,622 56,733 65,547 - - 27,992 34,219 48,997 56,609 - - 26,519 32,418 46,418 53,630

81 - 85 - 37,574 48,206 69,025 79,748 - - 32,450 41,632 59,612 68,874 - - 30,742 39,441 56,475 65,249

86 - 90 - 45,669 55,165 78,990 91,261 - - 39,441 47,643 68,218 78,817 - - 37,365 45,135 64,628 74,668

91 - 95 - 58,286 70,406 1,00,813 1,16,475 - - 50,338 60,806 87,066 1,00,592 - - 47,689 57,605 82,483 95,298

96 - 100 - 74,389 89,858 1,28,666 1,48,655 - - 64,245 77,605 1,11,120 1,28,384 - - 60,864 73,521 1,05,272 1,21,627

101 - 105 - 94,942 1,14,685 1,64,214 1,89,726 - - 81,995 99,046 1,41,821 1,63,854 - - 77,680 93,833 1,34,357 1,55,230

106 - 110 - 1,21,172 1,46,370 2,09,583 2,42,143 - - 1,04,649 1,26,410 1,81,004 2,09,124 - - 99,141 1,19,757 1,71,477 1,98,117

111 - 115 - 1,54,650 1,86,809 2,67,487 3,09,043 - - 1,33,561 1,61,335 2,31,011 2,66,901 - - 1,26,532 1,52,844 2,18,853 2,52,853

Two Adults and Two Children Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 5,594 6,596 8,973 12,231 - - 4,831 5,697 7,750 10,563 - - 4,577 5,397 7,342 10,007

36-40 - 5,934 7,256 10,529 15,148 - - 5,125 6,266 9,093 13,082 - - 4,855 5,936 8,614 12,394

41-45 - 6,200 8,413 12,635 16,010 - - 5,354 7,265 10,912 13,827 - - 5,073 6,883 10,337 13,099

46-55 - 10,018 10,986 14,481 22,608 - - 8,652 9,488 12,506 19,525 - - 8,197 8,989 11,848 18,497

56-60 - 13,077 17,325 23,256 28,661 - - 11,294 14,962 20,085 24,752 - - 10,699 14,175 19,028 23,450

61-65 - 16,141 21,447 28,790 35,480 - - 13,940 18,522 24,864 30,642 - - 13,206 17,547 23,555 29,029

66 - 70 - 22,718 30,186 43,223 49,937 - - 19,620 26,070 37,329 43,128 - - 18,587 24,698 35,364 40,858

71 - 75 - 29,956 39,803 56,993 65,847 - - 25,871 34,375 49,221 56,868 - - 24,509 32,566 46,631 53,875

76 - 80 - 34,727 48,427 69,341 80,113 - - 29,991 41,823 59,885 69,189 - - 28,413 39,622 56,733 65,547

81 - 85 - 40,258 58,918 84,364 97,470 - - 34,768 50,884 72,860 84,179 - - 32,938 48,206 69,025 79,748

86 - 90 - 47,744 57,673 82,580 95,409 - - 41,234 49,808 71,319 82,399 - - 39,064 47,187 67,566 78,062

91 - 95 - 60,935 73,607 1,05,395 1,21,769 - - 52,626 63,569 91,023 1,05,164 - - 49,856 60,224 86,233 99,629

96 - 100 - 77,771 93,943 1,34,514 1,55,412 - - 67,166 81,133 1,16,171 1,34,219 - - 63,631 76,862 1,10,057 1,27,155

101 - 105 - 99,257 1,19,898 1,71,678 1,98,349 - - 85,722 1,03,548 1,48,267 1,71,302 - - 81,211 98,098 1,40,464 1,62,286

106 - 110 - 1,26,680 1,53,023 2,19,110 2,53,150 - - 1,09,406 1,32,156 1,89,231 2,18,629 - - 1,03,647 1,25,201 1,79,271 2,07,123

111 - 115 - 1,61,680 1,95,301 2,79,645 3,23,090 - - 1,39,632 1,68,669 2,41,512 2,79,033 - - 1,32,283 1,59,791 2,28,801 2,64,347

If we have a policy holder beyond age of 115, we will continue to charge premiums applicable for age of 115. This is applicable for �oater policies too.

Premium Chart (Exclusive of GST)

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 10: SBI General Retail Health

Premium Chart (Inclusive of GST)

Non Floater Policies

Plan A (Mumbai & Delhi) Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad, Pune) Plan C (Rest of India)

Age Band 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000

0.25-18 1,653 2,782 3,362 4,890 5,650 1,070 1,428 2,404 2,903 4,223 4,879 1,014 1,352 2,277 2,751 4,001 4,623

19-35 1,943 3,144 3,797 5,573 6,713 1,259 1,678 2,715 3,279 4,813 5,797 1,192 1,589 2,571 3,107 4,560 5,492

36-40 2,470 4,001 4,892 7,764 9,166 1,600 2,133 3,456 4,226 6,706 7,917 1,515 2,020 3,273 4,003 6,353 7,500

41-45 2,869 4,573 5,672 9,618 11,113 1,859 2,478 3,949 4,899 8,307 9,597 1,761 2,347 3,741 4,641 7,869 9,092

46-55 3,875 6,756 8,364 13,144 15,693 2,510 3,346 5,834 7,223 11,352 13,552 2,378 3,171 5,527 6,843 10,755 12,840

56-60 6,298 9,956 12,025 16,142 19,894 4,079 5,440 8,597 10,385 13,942 17,181 3,865 5,153 8,146 9,839 13,208 16,277

61-65 8,033 12,697 15,338 20,589 25,374 5,203 6,937 10,966 13,247 17,781 21,914 4,929 6,573 10,389 12,549 16,846 20,760

66 - 70 12,060 17,871 21,588 30,910 35,713 7,812 10,416 15,434 18,644 26,695 30,843 7,401 9,867 14,621 17,662 25,291 29,219

71 - 75 15,903 23,565 28,465 40,758 47,090 10,300 13,734 20,351 24,584 35,201 40,670 9,759 13,011 19,280 23,290 33,348 38,529

76 - 80 19,817 30,076 36,330 52,019 60,101 12,532 17,115 25,974 31,376 44,926 51,906 11,872 16,214 24,608 29,724 42,561 49,174

81 - 85 24,696 38,385 46,367 66,392 76,706 15,247 21,329 33,151 40,044 57,339 66,246 14,444 20,206 31,406 37,937 54,320 62,759

86 - 90 30,776 48,990 59,177 84,735 97,899 18,551 26,580 42,310 51,108 73,180 84,548 17,574 25,180 40,082 48,418 69,329 80,098

91 - 95 38,352 62,525 75,527 1,08,145 1,24,945 22,570 33,123 53,999 65,228 93,398 1,07,907 21,382 31,379 51,157 61,794 88,482 1,02,228

96 - 100 47,794 79,800 96,394 1,38,023 1,59,466 27,460 41,276 68,918 83,249 1,19,202 1,37,721 26,014 39,104 65,291 78,868 1,12,928 1,30,473

101 - 105 59,559 1,01,847 1,23,026 1,76,156 2,03,524 33,408 51,437 87,958 1,06,250 1,52,135 1,75,770 31,650 48,730 83,329 1,00,658 1,44,129 1,66,519

106 - 110 74,222 1,29,985 1,57,016 2,24,825 2,59,753 40,646 64,101 1,12,259 1,35,604 1,94,168 2,24,332 38,507 60,728 1,06,351 1,28,467 1,83,948 2,12,526

111 - 115 92,494 1,65,897 2,00,396 2,86,941 3,31,519 49,453 79,881 1,43,276 1,73,068 2,47,812 2,86,312 46,850 75,677 1,35,734 1,63,960 2,34,769 2,71,243

Two Adults Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 5,658 6,645 10,031 12,083 - - 4,886 5,738 8,664 10,435 - - 4,629 5,436 8,207 9,886

36-40 - 5,802 7,094 10,095 12,191 - - 5,010 6,127 8,718 10,529 - - 4,747 5,804 8,259 9,975

41-45 - 7,316 8,792 14,428 16,670 - - 6,318 7,593 12,461 14,396 - - 5,986 7,193 11,805 13,638

46-55 - 11,484 11,709 17,745 21,185 - - 9,918 10,113 15,325 18,296 - - 9,395 9,580 14,519 17,333

56-60 - 17,919 21,044 28,249 34,815 - - 15,476 18,174 24,398 30,066 - - 14,662 17,219 23,113 28,484

61-65 - 22,855 26,841 36,030 44,403 - - 19,739 23,181 31,118 38,349 - - 18,699 21,961 29,480 36,330

66 - 70 - 32,168 37,778 54,094 62,498 - - 27,782 32,627 46,717 53,976 - - 26,320 30,909 44,258 51,134

71 - 75 - 42,417 49,814 71,327 82,409 - - 36,633 43,022 61,601 71,172 - - 34,705 40,757 58,359 67,425

76 - 80 - 49,173 60,607 86,781 1,00,263 - - 42,467 52,342 74,948 86,591 - - 40,232 49,587 71,003 82,034

81 - 85 - 57,005 73,737 1,05,583 1,21,985 - - 49,232 63,682 91,185 1,05,350 - - 46,641 60,331 86,385 99,807

86 - 90 - 66,085 89,713 1,28,457 1,48,413 - - 57,073 77,479 1,10,940 1,28,175 - - 54,069 73,402 1,05,101 1,21,429

91 - 95 - 75,030 90,632 1,29,774 1,49,936 - - 64,799 78,273 1,12,078 1,29,490 - - 61,388 74,154 1,06,179 1,22,674

96 - 100 - 95,759 1,15,672 1,65,628 1,91,359 - - 82,701 99,899 1,43,042 1,65,265 - - 78,348 94,641 1,35,514 1,56,567

101 - 105 - 1,17,123 1,41,480 2,02,580 2,34,052 - - 1,01,152 1,22,187 1,74,955 2,02,136 - - 95,829 1,15,756 1,65,748 1,91,497

106 - 110 - 1,49,482 1,80,567 2,58,550 2,98,717 - - 1,29,099 1,55,944 2,23,293 2,57,982 - - 1,22,303 1,47,737 2,11,540 2,44,405

111 - 115 - 1,90,782 2,30,455 3,29,981 3,81,246 - - 1,64,766 1,99,029 2,84,984 3,29,259 - - 1,56,094 1,88,553 2,69,985 3,11,929

Two Adults and One Child Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 6,444 7,783 11,425 13,425 - - 5,565 6,722 9,867 11,595 - - 5,272 6,368 9,347 10,985

36-40 - 7,203 8,806 11,648 14,207 - - 6,220 7,605 10,060 12,271 - - 5,893 7,205 9,530 11,624

41-45 - 9,602 10,778 14,909 18,892 - - 8,293 9,308 12,876 16,316 - - 7,856 8,818 12,198 15,457

46-55 - 13,510 15,891 23,659 26,677 - - 11,668 13,725 20,433 23,040 - - 11,054 13,001 19,358 21,826

56-60 - 21,901 24,051 32,285 39,787 - - 18,915 20,772 27,882 34,362 - - 17,919 19,678 26,415 32,554

61-65 - 27,934 30,675 41,178 50,747 - - 24,125 26,492 35,563 43,826 - - 22,855 25,097 33,691 41,521

66 - 70 - 39,316 43,175 61,821 71,425 - - 33,956 37,288 53,391 61,686 - - 32,168 35,326 50,581 58,440

71 - 75 - 51,843 56,930 81,517 94,182 - - 44,774 49,167 70,401 81,339 - - 42,417 46,579 66,696 77,058

76 - 80 - 60,100 69,265 99,178 1,14,586 - - 51,905 59,820 85,654 98,961 - - 49,173 56,671 81,146 93,752

81 - 85 - 69,673 84,271 1,20,666 1,39,412 - - 60,172 72,780 1,04,212 1,20,401 - - 57,005 68,950 98,726 1,14,065

86 - 90 - 80,770 1,02,529 1,46,809 1,69,616 - - 69,756 88,547 1,26,789 1,46,486 - - 66,085 83,887 1,20,116 1,38,776

91 - 95 - 93,634 1,24,743 1,78,614 2,06,363 - - 80,865 1,07,732 1,54,258 1,78,224 - - 76,610 1,02,062 1,46,139 1,68,843

96 - 100 - 1,08,548 1,51,768 2,17,312 2,51,073 - - 93,746 1,31,072 1,87,679 2,16,836 - - 88,812 1,24,174 1,77,801 2,05,423

101 - 105 - 1,25,836 1,84,649 2,64,393 3,05,469 - - 1,08,677 1,59,469 2,28,339 2,63,814 - - 1,02,957 1,51,077 2,16,321 2,49,929

106 - 110 - 1,58,452 1,91,402 2,74,062 3,16,640 - - 1,36,845 1,65,301 2,36,690 2,73,461 - - 1,29,642 1,56,601 2,24,233 2,59,069

111 - 115 - 2,00,322 2,41,978 3,46,481 4,00,309 - - 1,73,005 2,08,980 2,99,234 3,45,721 - - 1,63,900 1,97,982 2,83,484 3,27,526

If we have a policy holder beyond age of 115, we will continue to charge premiums applicable for age of 115. This is applicable for �oater policies too.

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 11: SBI General Retail Health

Two Adults and Two Children Floater

Plan A (Mumbai & Delhi) Plan B (Chennai, Kolkata, Bangalore, Ahmedabad, Hyderabad, Pune) Plan C (Rest of India)

Age Band 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000 50,000 1,00,000 2,00,000 3,00,000 4,00,000 5,00,000

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 7,858 9,492 12,818 16,782 - - 6,786 8,197 11,070 14,494 - - 6,430 7,767 10,488 13,730

36-40 - 8,403 10,274 13,977 19,249 - - 7,257 8,874 12,071 16,624 - - 6,875 8,406 11,435 15,749

41-45 - 10,516 13,047 17,313 21,115 - - 9,082 11,268 14,953 18,236 - - 8,605 10,674 14,166 17,275

46-55 - 15,537 19,236 26,288 36,093 - - 13,418 16,613 22,703 31,171 - - 12,712 15,739 21,509 29,531

56-60 - 22,897 27,658 37,128 45,756 - - 19,774 23,887 32,065 39,516 - - 18,734 22,630 30,378 37,437

61-65 - 29,204 35,276 47,355 58,359 - - 25,221 30,466 40,898 50,401 - - 23,894 28,863 38,744 47,749

66 - 70 - 41,104 49,652 71,095 82,140 - - 35,499 42,881 61,400 70,939 - - 33,630 40,624 58,168 67,205

71 - 75 - 54,436 59,778 85,594 98,891 - - 47,012 51,626 73,921 85,406 - - 44,538 48,909 70,031 80,910

76 - 80 - 63,105 72,728 1,04,137 1,20,315 - - 54,499 62,810 89,937 1,03,908 - - 51,632 59,505 85,203 98,440

81 - 85 - 73,156 88,485 1,26,699 1,46,383 - - 63,181 76,419 1,09,421 1,26,422 - - 59,856 72,397 1,03,663 1,19,768

86 - 90 - 84,808 1,07,655 1,54,148 1,78,096 - - 73,244 92,975 1,33,129 1,53,811 - - 69,389 88,081 1,26,122 1,45,716

91 - 95 - 98,316 1,30,979 1,87,546 2,16,682 - - 84,909 1,13,118 1,61,970 1,87,134 - - 80,441 1,07,165 1,53,446 1,77,286

96 - 100 - 1,13,975 1,59,357 2,28,178 2,63,626 - - 98,433 1,37,626 1,97,062 2,27,677 - - 93,252 1,30,382 1,86,690 2,15,695

101 - 105 - 1,32,128 1,93,881 2,77,613 3,20,742 - - 1,14,111 1,67,443 2,39,756 2,77,004 - - 1,08,105 1,58,630 2,27,138 2,62,425

106 - 110 - 1,66,374 2,00,972 2,87,765 3,32,472 - - 1,43,687 1,73,566 2,48,525 2,87,134 - - 1,36,125 1,64,431 2,35,444 2,72,022

111 - 115 - 2,10,337 2,54,076 3,63,805 4,20,324 - - 1,81,655 2,19,429 3,14,195 3,63,007 - - 1,72,094 2,07,881 2,97,659 3,43,902

One Adult and One Child Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 5,186 6,075 9,196 11,075 - - 4,479 5,246 7,941 9,565 - - 4,243 4,970 7,524 9,062

36-40 - 5,402 6,604 9,318 11,458 - - 4,666 5,704 8,048 9,895 - - 4,420 5,404 7,624 9,375

41-45 - 6,402 7,658 12,504 14,447 - - 5,528 6,614 10,799 12,477 - - 5,238 6,266 10,231 11,820

46-55 - 9,795 9,618 14,459 17,261 - - 8,459 8,307 12,487 14,908 - - 8,013 7,869 11,830 14,123

56-60 - 14,435 16,835 22,599 27,852 - - 12,467 14,540 19,518 24,053 - - 11,811 13,774 18,491 22,787

61-65 - 17,777 20,705 27,795 34,254 - - 15,352 17,882 24,005 29,583 - - 14,545 16,941 22,741 28,026

66 - 70 - 25,020 29,144 41,730 48,212 - - 21,608 25,169 36,040 41,637 - - 20,471 23,844 34,142 39,446

71 - 75 - 32,990 38,428 55,025 63,573 - - 28,492 33,188 47,521 54,903 - - 26,993 31,441 45,019 52,014

76 - 80 - 38,246 46,754 66,945 77,345 - - 33,031 40,378 57,816 66,799 - - 31,292 38,253 54,773 63,283

81 - 85 - 44,337 56,883 81,450 94,103 - - 38,291 49,126 70,342 81,271 - - 36,276 46,540 66,641 76,994

86 - 90 - 53,889 65,095 93,208 1,07,688 - - 46,540 56,219 80,497 93,004 - - 44,091 53,259 76,261 88,108

91 - 95 - 68,777 83,079 1,18,959 1,37,441 - - 59,399 71,751 1,02,738 1,18,699 - - 56,273 67,974 97,330 1,12,452

96 - 100 - 87,779 1,06,032 1,51,826 1,75,413 - - 75,809 91,574 1,31,122 1,51,493 - - 71,820 86,755 1,24,221 1,43,520

101 - 105 - 1,12,032 1,35,328 1,93,773 2,23,877 - - 96,754 1,16,874 1,67,349 1,93,348 - - 91,662 1,10,723 1,58,541 1,83,171

106 - 110 - 1,42,983 1,72,717 2,47,308 2,85,729 - - 1,23,486 1,49,164 2,13,585 2,46,766 - - 1,16,986 1,41,313 2,02,343 2,33,778

111 - 115 - 1,82,487 2,20,435 3,15,635 3,64,671 - - 1,57,602 1,90,375 2,72,593 3,14,943 - - 1,49,308 1,80,356 2,58,247 2,98,367

Two Adults and Two Children Floater

0.25-18 - - - - - - - - - - - - - - - - -

19-35 - 6,601 7,783 10,588 14,433 - - 5,701 6,722 9,145 12,464 - - 5,401 6,368 8,664 11,808

36-40 - 7,002 8,562 12,424 17,875 - - 6,048 7,394 10,730 15,437 - - 5,729 7,004 10,165 14,625

41-45 - 7,316 9,927 14,909 18,892 - - 6,318 8,573 12,876 16,316 - - 5,986 8,122 12,198 15,457

46-55 - 11,821 12,963 17,088 26,677 - - 10,209 11,196 14,757 23,040 - - 9,672 10,607 13,981 21,826

56-60 - 15,431 20,444 27,442 33,820 - - 13,327 17,655 23,700 29,207 - - 12,625 16,727 22,453 27,671

61-65 - 19,046 25,307 33,972 41,866 - - 16,449 21,856 29,340 36,158 - - 15,583 20,705 27,795 34,254

66 - 70 - 26,807 35,619 51,003 58,926 - - 23,152 30,763 44,048 50,891 - - 21,933 29,144 41,730 48,212

71 - 75 - 35,348 46,968 67,252 77,699 - - 30,528 40,563 58,081 67,104 - - 28,921 38,428 55,025 63,573

76 - 80 - 40,978 57,144 81,822 94,533 - - 35,389 49,351 70,664 81,643 - - 33,527 46,754 66,945 77,345

81 - 85 - 47,504 69,523 99,550 1,15,015 - - 41,026 60,043 85,975 99,331 - - 38,867 56,883 81,450 94,103

86 - 90 - 56,338 68,054 97,444 1,12,583 - - 48,656 58,773 84,156 97,231 - - 46,096 55,681 79,728 92,113

91 - 95 - 71,903 86,856 1,24,366 1,43,687 - - 62,099 75,011 1,07,407 1,24,094 - - 58,830 71,064 1,01,755 1,17,562

96 - 100 - 91,770 1,10,853 1,58,727 1,83,386 - - 79,256 95,737 1,37,082 1,58,378 - - 75,085 90,697 1,29,867 1,50,043

101 - 105 - 1,17,123 1,41,480 2,02,580 2,34,052 - - 1,01,152 1,22,187 1,74,955 2,02,136 - - 95,829 1,15,756 1,65,748 1,91,497

106 - 110 - 1,49,482 1,80,567 2,58,550 2,98,717 - - 1,29,099 1,55,944 2,23,293 2,57,982 - - 1,22,303 1,47,737 2,11,540 2,44,405

111 - 115 - 1,90,782 2,30,455 3,29,981 3,81,246 - - 1,64,766 1,99,029 2,84,984 3,29,259 - - 1,56,094 1,88,553 2,69,985 3,11,929

If we have a policy holder beyond age of 115, we will continue to charge premiums applicable for age of 115. This is applicable for �oater policies too.

Premium Chart (Inclusive of GST)

SBI General Retail Health Insurance PolicyUIN: SBIHLIP11002V021011

Page 12: SBI General Retail Health

Disclaimer: The information in the advertisement is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale. | Tax benefits are subject to changes in tax laws. | For SBI General Insurance Company Limited | IRDAI Reg. No. 144 dated 15/12/2009 | CIN: U66000MH2009PLC190546 | SBI Logo displayed belongs to State Bank of India and used by SBI General Insurance Co. Ltd.under license| UIN: SBIHLIP11002V021011 | ADVERTISEMENT NUMBER: ADBRO/20-21/MAY/264

Call Now (Toll Free)

1800 22 1111 | 1800 102 1111 www.sbigeneral.in

SBI General Insurance Company Limited

Corporate & Registered Office:

'Natraj', 301, Junction of Western Express Highway &

Andheri - Kurla Road, Andheri (East), Mumbai - 400 069.