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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. Cardiac Care Platinum is sold by Star Health and Complete Healthcare Privilege is sold by Universal Sompo. 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. Cardiac Care Platinum is specifically designed for people suffering from heart ailments. However, Complete Healthcare Privilege is quite comprehensive. It offers considerable protection and it doesn’t impose as many restrictions. So in many ways, you’re 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 Cardiac Care Platinum. 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%.


Complete Healthcare Privilege meanwhile 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.

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Compare Insurances

Insurance Parameters

Recommended
Not Recommended
Network hospitals
14,000+
5,000+
Claim settlement ratio

(avg. of last 3 years)

83%
95%
Co-payment

No

No

Room rent

Single Private room

Any Room

Disease sub-limit

Yes

No

Pre existing diseases waiting

4 years

3 years

Pre/Post hospitalization

30/60 days

30/60 days

No claim bonus

10% per year

(up to 100%)

5% per year

(up to 50%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(once for different illness)

100% restoration

(once for different illness)

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

Available

(up to ₹50,000 after 3 years)

Out Patient Department

Up to ₹3,500

Up to ₹7,500

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, Cardiac Care Platinum doesn’t impose a co-payment clause. And neither does Complete Healthcare Privilege.

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, Cardiac Care Platinum only lets you stay in a single private room but you can pick any room you want with Complete Healthcare Privilege.

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, Cardiac Care Platinum imposes disease-wise sub-limits on null whereas Complete Healthcare Privilege 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. In this case, Cardiac Care Platinum imposes a waiting period of 4 years on pre-existing diseases while Complete Healthcare Privilege extends a waiting period of 3 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, Cardiac Care Platinum covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Complete Healthcare Privilege covers expenses incurred 30 days before hospitalization and expenses incurred 60 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, Cardiac Care Platinum offers a no-claim bonus of 10% whereas Complete Healthcare Privilege offers a no-claim bonus of 5%. 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, Cardiac Care Platinum doesn’t offer domiciliary protection whereas Complete Healthcare Privilege 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 Cardiac Care Platinum doesn’t extend coverage for Ayush treatments whereas Complete Healthcare Privilege 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, Cardiac Care Platinum doesn’t offer protection for maternity-related hospitalizations whereas Complete Healthcare Privilege 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, Cardiac Care Platinum offers OPD coverage, and Complete Healthcare Privilege also offers OPD coverage, although the sub-limits may be different.

Final Conclusion

If you’re specifically looking to buy a policy for people suffering from heart ailments, Cardiac Care Platinum makes a lot of sense. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Universal Sompo has to offer, if the policy is made available to you.

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