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Reviewed by Finzony Finance TeamLast updated:
Arogya Sanjeevani is a standard health insurance product introduced under IRDAI guidelines to provide a simple and common set of health insurance benefits. Care Health offers the policy for individuals and families, with coverage focused primarily on hospitalisation and related medical expenses.
IRDAI standard product with the same core terms across insurers
Arogya Sanjeevani is suitable for buyers who want a straightforward standardised health insurance product with a limited maximum sum insured. Its main advantages are simple structure, individual and family floater options, hospitalisation cover, AYUSH treatment and a relatively low mandatory 5% co-payment. However, room rent, ICU, cataract and modern treatment limits should be understood before purchase.
Care Health Insurance
Key Insights
Founded
2012
Care Health Insurance was established 14 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
95.2% CSR, calculated as a 3-year average
Care Health Insurance settles 95.2% of all claims it receives, demonstrating strong credibility.
Network Hospitals
11,400+
Care Health Insurance has a network of 11,400+ hospitals, ensuring wide accessibility and convenience for policyholders.
Eligible hospitalisation expenses are covered up to the applicable sum insured.
The plan provides basic hospitalisation protection for eligible treatment.
Eligible day care procedures are covered subject to the policy conditions and applicable limits.
Day care treatment can include procedures that do not require a 24-hour hospital stay.
Eligible medical expenses incurred before hospitalisation are covered for up to 30 days.
Current Care information specifies 30 days of pre-hospitalisation coverage.
Eligible medical expenses incurred after hospitalisation are covered for up to 60 days.
Current Care information specifies 60 days of post-hospitalisation coverage.
Eligible AYUSH treatment expenses are covered up to the sum insured.
Treatment must satisfy the applicable policy conditions.
Premium paid may qualify for tax benefits under applicable provisions of the Income Tax Act.
Tax rules are subject to change and applicable conditions.
Arogya Sanjeevani can be purchased as an individual health insurance policy.
Individual eligibility and age conditions apply.
Initial waiting period: 30 days. Named ailments: 24 to 36 months depending on the condition. Pre-existing diseases: 36 months.
Initial Waiting Period
A 30-day waiting period applies to illnesses, except injury/accidental cases.
Pre-existing Diseases
Pre-existing diseases are covered after 36 months of continuous coverage, subject to policy terms.
Named Ailments
Certain named ailments have a 24-month waiting period while some have a 36-month waiting period.
Policy Renewal Grace Period
A grace period is available for renewal subject to the applicable policy terms.
Conditions or treatments that the policy clearly says it will not cover.
Arogya Sanjeevani is designed for general medical and hospitalisation needs rather than a specific illness. It provides cover for eligible inpatient treatment, day care procedures, AYUSH treatment, pre/post hospitalisation expenses and selected modern treatments.
Insurer
Care Health Insurance plans and claim process
Arogya Sanjeevani is a standard health insurance product introduced under IRDAI guidelines with common core features and terms across insurers.
It can be suitable for buyers who want a simple and standardised health insurance product with coverage up to ₹5 lakh.
The maximum sum insured under Arogya Sanjeevani is ₹5 lakh.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official Care Health Insurance website before purchasing.
Contact Details
1800 102 6655
Headquarters: Tower C, 3rd Floor, Vipul Tech Square, Golf Course Road, Sector 43, Gurugram, Haryana – 122009
The aforementioned ratios have been averaged over three years (FY24-FY26)
The policy can also be taken as a family floater subject to the applicable family composition and age conditions.
At least one adult member is required for a floater policy.
Eligible hospitalisation expenses for COVID-19 treatment are covered under the policy.
Coverage remains subject to the policy terms and applicable exclusions.
Specified Treatments
Specified treatments remain subject to their applicable waiting period and policy conditions.
Yes. Care Health offers both individual and family floater options subject to the applicable eligibility conditions.
The minimum entry age for an individual policy is 5 years.
A dependent child can enter from 3 months in a family floater policy when at least one member is 18 years or above.
The pre-existing disease waiting period is 36 months.
A 30-day waiting period applies to illnesses, except injury/accidental cases.
Certain named ailments have waiting periods of 24 months while some have 36 months, depending on the condition.
Yes. Eligible inpatient hospitalisation expenses are covered up to the applicable sum insured.
Yes. Eligible day care procedures are covered subject to the applicable policy terms.
Yes. Eligible AYUSH treatment is covered up to the sum insured.
Yes. Cataract treatment is covered up to 25% of the sum insured or ₹40,000 per eye, whichever is lower.
The current Care product information specifies the lower of 2% of the sum insured or ₹5,000 per day.
The current Care product information specifies the lower of 5% of the sum insured or ₹10,000 per day.
Yes. A mandatory 5% co-payment applies to every eligible claim.
The sum insured increases by 5% for each claim-free policy year, up to a maximum increase of 50%, subject to policy terms.
Yes. Eligible pre-hospitalisation expenses are covered for up to 30 days.
Yes. Eligible post-hospitalisation expenses are covered for up to 60 days.
Eligible hospitalisation expenses related to COVID-19 treatment are covered subject to the policy terms.