SAMPOORNA AROGYA – GROUP

Sampoorna Protection for you and

your family.

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Sampoorna Arogya – Group

In these uncertain times, it's a blessing to have a health insurance Policy

that is accessible, affordable and comprehensive; a Policy that protects
you and your family at all times.

Sampoorna Arogya – Group is all that and more. A comprehensive

Health Insurance Policy that goes the extra mile to make the Insured
Person's life convenient, it is designed to meet all the needs for today's
health problems. So you can opt for the best healthcare without having
to worry about the cost.

Who Can Buy This Policy?

Sampoorna Arogya – Group policy can be bought by SBI Bank

customers for themselves and their dependent family.

Entry Age: Adult – 18-65 Years, Children- 91 Days onwards

What are the Key Benefits of the Policy?

Hospitalisation expenses Pre and Post Hospitalisation

Mental Healthcare Domiciliary Hospitalisation

537 Day Care Procedures Alternative Treatments

HIV/AIDS Congenital Diseases

Advanced Treatments

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
Pre and Post Hospitalisation Included

What Does The Policy Cover?

Section I. HOSPITALIZATION COVERS
I A. Base Covers

1. Hospitalization
n Room rent and boarding expenses
n Intensive Care Unit expenses
n Surgeon, Anesthetist, Medical Practitioner, Consultant,
Specialist fees
n Anesthesia, blood, oxygen, operation theatre charges,
surgical appliances
n Medicines, drugs, and consumables
n Diagnostic procedures
n The cost of prosthetic and other devices or equipment if
implanted internally during a surgical procedure

2. Pre and Post-Hospitalization Cover

We will pay medical expenses incurred by you up to the days
speci ed in Policy Schedule immediately before your
hospitalization and after the date of your discharge from
hospital.

3. Mental Healthcare
Medical expenses due to hospitalisation for any mental
illness contracted during the Policy Period.

4. Day Care Procedure

Medical expenses on hospitalization of Insured Person in
hospital or Day Care centre for any of the listed 537 Day
Care treatments.

5. Ambulance Charges
We will pay for Road Ambulance services if required, for
admissible claims.

6. Domiciliary Hospitalization
We will pay the medical expenses up to 20% of the Sum
Insured subject to maximum of ` 50,000/- or `2,00,000/- as
speci ed in the Policy Schedule / Certi cate of Insurance.

7. Alternative Treatment / AYUSH

We will pay medical expenses of `50,000/- as speci ed in
Policy Schedule / Certi cate of Insurance on hospitalization
of Insured Person for following Alternative Treatments
prescribed by medical practitioner.
n Ayurvedic
n Unani
n Siddha
n Homeopathy

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
Mental Healthcare Cover

8. Organ Donor Expenses

We will pay medical expenses of 50% of the Sum Insured as
speci ed in Policy Schedule / Certi cate of Insurance,
towards organ donor's hospitalization for harvesting of the
donated organ where an Insured Person is the recipient.

9. Reinstatement Bene t
Automatic reinstatement of the Sum Insured immediately
upon exhaustion of the limit of coverage, as de ned, during
the policy period.

10. Genetic Disorder

Medical expenses if you are hospitalized due to any genetic
disorder illness.

11. Internal Congenital Anomaly

Medical expenses if you are hospitalized due to any Internal
Congenital diseases.

12. HIV / AIDS Cover

If you are diagnosed with HIV during the Policy Period and
require hospitalization, we will pay medical expenses
related HIV and/or HIV related illness, including AIDS.

13. Advance Procedures

We will pay medically necessary expenses either as In-
Patient hospitalization or as part of Day Care treatment up
to 25% of Sum Insured incurred on Advance Procedures as
below
n Uterine Artery Emobalization and HIFU
n Balloon Sinuplasty
n Deep Brain Stimulation
n Oral Chemotherapy (covered as OPD also)
n Immunotherapy - Monoclonal Antibody to be given as
injection
n Intra Vitreal Injections
n Robotic Surgeries
n Stereotactic Radio Surgeries
n Bronchical Thermoplasty
n Vaporisation of the Prostrate (Green laser treatment or
holmium laser treatment)
n IONM (Intra Operative Neuro Monitoring)
n Stem Cell Therapy (Haematopoietic stem cells for bone
marrow transplant for haematological conditions to be
covered)

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
Organ Donor Expenses Covered

SECTION II. CRITICAL ILLNESS

Medical expenses due to any of the following critical illnesses rst
diagnosed within the Policy Period, subject to certain conditions.
List of Critical Illnesses Covered
1. Cancer of speci ed severity
2. Open Chest CABG
3. Open Heart Replacement Or Repair OF Heart Valves
4. Myocardial Infarction (First Heart Attack of speci c severity)
5. Primary (Idiopathic) Pulmonary Hypertension
6. End Stage Lung Failure
7. Stroke Resulting In Permanent Symptoms
8. Permanent Paralysis of Limbs
9. Multiple Sclerosis With Persisting Symptoms
10. Benign Brain Tumor
11. Motor Neuron Disease with Permanent Symptoms
12. Coma of Speci ed Severity
13. Major head Trauma
14. Blindness
15. Major Organ / Bone Marrow Transplant
16. Third Degree Burns
17. Deafness
18. Loss of Speech
19. Kidney Failure Requiring Regular Dialysis
20. End Stage Liver Failure
21. Surgery of Aorta
22. Parkinson's Disease
23. Brain Surgery
24. Apallic Syndrome
25. Alzheimer's Disease
26. Aplastic Anaemia
27. Bacterial Meningitis
28. Loss of Independent Existence
29. Encephalitis
30. Fulminant Viral Hepatitis

SECTION III – HOSPITAL DAILY CASH

III.A. Base Cover

1. Sickness Hospital Cash Bene t

Daily Hospital Cash Bene t if the Insured Person is
hospitalized during the Policy Period for medically
necessary treatment.

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
Organ Donor Expenses Covered

2. Accident Hospital Cash Bene t

2 times the Daily Hospital Cash Bene t, if the Insured
Person is hospitalized during the Policy Period due to an
accident.

3. ICU Cash Bene t

3 times the Daily Hospital Cash Bene t if the Insured
Person is hospitalized in an Intensive Care Unit (ICU) during
the Policy Period.
Coverage under this bene t is limited to a maximum of 15
days in aggregate per Insured Person per Policy Year.

4. Convalescence Bene t
Lump sum amount of 5 times the Daily Hospital Cash
Bene t if the Insured Person is hospitalized during the
Policy Period and the continuation of such hospitalisation
is medically necessary for at least 10 consecutive days.

5. Compassionate Bene t
Lump sum amount of 10 times the Daily Hospital Cash
Bene t to the nominee if the Insured Person is hospitalized
for more than 24 hours and the Insured Person dies during
the course of such hospitalisation.

6. Day Care Treatment Bene t

If the Insured Person requires and avails a medically
necessary Day Care treatment during the Policy Period, we
will pay a lump sum bene t amount which is the lower of
either 5 times the Daily Hospital Cash Bene t or
`10,000/-.

What are the Waiting Periods?

First Thirty-days Period 30 days, except for accidents

Certain Specific Illnesses 1 year / 90 days/ 15 days
Pre-existing Diseases 4 years
Critical Illness 90 days and 28 days survival
period

What Is Not Covered In The Policy?

n Admission primarily for investigation & evaluation

n Rest cure, rehabilitation and respite care
n Surgical treatment of obesity that does not fulfill certain conditions
n Change-of-Gender treatments
n Cosmetic or plastic surgery
n Any treatment necessitated due to participation in hazardous or
adventure sports

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
Organ Donor Expenses Covered

n Breach of Law
n Excluded Providers

n Treatment for alcoholism, drug or substance abuse or any addictive

condition and consequences thereof

n OTC Dietary Supplements and substances

n Refractive Error

n Unproven Treatments

n Sterility and Infertility

n Maternity

n War and war-like situations

n Injury or disease caused by or contributed to by nuclear

weapons/materials

n Treatment taken outside India

n Circumcision

For complete details, refer to Policy Wordings

What Is SBI General's Renewal Policy?

n Sampoorna Arogya can be renewed every year upon payment of

premium before Policy expiry.

n A grace period of 30 days is allowed for renewal of the Policy. This

will be counted from the day immediately after the premium due
date.

Our Claims Team Will

Provide assistance in Keep you informed of the

emergency situations progress of your claim

How Do You Make A Claim?

In case of an accident or illness that requires hospitalization or day

care, please notify us or TPA by phone or email.

Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021
 AVAILABLE PLANS
Coverage - Description STANDARD CLASSIC SUPER ULTRA
`1 lakh, `2 lakhs, `3 lakhs, `4 `2 lakhs, `3 lakhs, `4 lakhs `2 lakhs, `3 lakhs, `4 `6 lakhs, `7 lakhs, `8 lakhs,
Sum Insured
lakhs & `5 lakhs & `5 lakhs lakhs & `5 lakhs `9 lakhs & `10 lakhs
Hospital Daily Cash (on Individual Basis) `500 * 30 days `1000 * 30 days `2000 * 30 days `2000 * 30 days

Critical Illness (on Individual Basis) – 30 CI NA NA Equal to Sum Insured Equal to Sum Insured

Hospitalization Medical Expenses Y Y Y Y

Room Rent & ICU 2% for Normal Room & 4% 2% for Normal Room & 4% 2% for Normal Room & 2% for Normal Room & 4%
for ICU for ICU 4% for ICU for ICU
Pre-hospitalization Medical Expenses 30 days 30 days 30 days 60 days
Post-hospitalization Medical Expenses 60 days 60 days 60 days 90 days

Cover up to Sum
Cover up to Sum Insured Cover up to Sum Insured
Insured (Sub limit - Cover up to Sum Insured (Sub
(Sub limit - 10% of the SI, (Sub limit - 10% of the SI,
10% of the SI, max limit - 10% of the SI, max
Mental Healthcare max `50,000 whichever is max `50,000 whichever is
`50,000 whichever is `50,000 whichever is lower,
lower, applicable for few lower, applicable for few
lower, applicable for applicable for few conditions).
conditions). conditions).
few conditions)

537 Day Care Surgeries/Procedures Y Y Y Y

1% of Sum Insured subject 1% of Sum Insured 1% of Sum Insured subject to
1% of Sum Insured subject subject to maximum max of `10,000
Ambulance charges to maximum of
to maximum of `5,000/- of `5,000/-
`5,000/-

20% of Sum Insured 20% of Sum Insured

20% of Sum Insured subject 20% of Sum Insured subject
Domiciliary Hospitalisation subject to maximum of subject to maximum
to maximum of `50,000/- to maximum of `200,000/-
`50,000/- of `50,000/-

Alternative Treatments Max `50,000 Max `50,000 Max `50,000 Max `50,000
Covered up to 50% of Sum
Organ Donor Expenses N N N
Insured

Once up to 100% not for

same illness within the same
Reinstatement Bene t N N N
year & only if Sum Insured is
exhausted

1% of Sum Insured subject to

max `10,000;
Outpatient expenses N N N
Reimbursement only once a
year; Deductible - `500

HIV/AIDS Cover Y Y Y Y
Genetic Disorders Max `1Lakh Max `1Lakh Max `1Lakh Max `1Lakh
Internal Congenital Anomaly 25% of Sum Insured 25% of Sum Insured 25% of Sum Insured 25% of Sum Insured
12 Advance procedure (Refer PW) 25% of Sum Insured 25% of Sum Insured 25% of Sum Insured 25% of Sum Insured

Sampoorna Arogya – Group Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021 UIN: SBIHLGP21605V012021
 ILLUSTRATIVE PREMIUM TABLE
(Inclusive of 18% GST)
Standard Plan - 1 Adult

Age Band Sum Insured `1 Lakh Sum Insured `2 Lakhs Sum Insured `3 Lakhs Sum Insured `5 Lakhs

18-35 1805 2784 3538 4395

36-45 2375 3703 4732 5888

46-55 3025 4760 6117 7617

56-60 4651 7358 9491 11817

61-65 6068 9629 12444 15495

Classic Plan - 1 Adult

Age Band Sum Insured `2 Lakhs Sum Insured `3 Lakhs Sum Insured `4 Lakhs Sum Insured `5 Lakhs

18-35 2931 3685 4163 4542

36-45 3867 4896 5543 6053

46-55 4962 6319 7161 7819

56-60 7689 9821 11132 12147

61-65 10061 12876 14597 15927

Super - 1 Adult

Age Band Sum Insured `2 Lakhs Sum Insured `3 Lakhs Sum Insured `4 Lakhs Sum Insured `5 Lakhs

18-35 4642 5563 6148 6611

36-45 7369 8627 9418 10041

46-55 12200 13859 14888 15692

56-60 21242 23849 25450 26691

61-65 29824 33263 35367 36993

Ultra - 1 Adult

Age Band Sum Insured `6 Lakhs Sum Insured `7 Lakhs Sum Insured `9 Lakhs Sum Insured `10 Lakhs

18-35 8723 9643 10882 11364

36-45 11999 13308 15188 15952

46-55 16314 18159 21039 22272

56-60 24634 27394 32516 34569

61-65 32136 35740 42477 45288

Sampoorna Arogya – Group Sampoorna Arogya – Group

UIN: SBIHLGP21605V012021 UIN: SBIHLGP21605V012021
 Prohibition of Rebates
Section 41 in The Insurance Act, 1938 as amended by Insurance Law
(Amendment) Act, 2015:
1. No person shall allow or offer to allow, either directly or indirectly, as
an inducement to any person to take out or renew or continue an
insurance in respect of any kind of risk relating to lives or property in
India, any rebate of the whole or part of the commission payable or
any rebate of the premium shown on the policy, nor shall any person
taking out or renewing or continuing a policy accept any rebate,
except such rebate as may be allowed in accordance with the
published prospectuses or tables of the insurer.
2. Any person making default in complying with the provisions of this
section shall be punishable with fine which may extend to `10 lakhs.

For More Details Contact

Disclaimer: SBI General Insurance Company Limited | Corporate & Registered Office:
'Natraj', 301, Junction of Western Express Highway & Andheri - Kurla Road, Andheri (East),
Mumbai - 400 069. | 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 | Website : www.sbigeneral.in, Tollfree
18001021111 | SAMPOORNA AROGYA – GROUP | UIN: SBIHLGP21605V012021 |
ADVERTISEMENT NUMBER: ADBRO/APR/2021-22/2438

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