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Insurance Plans Comparison

ICICI Lombard Smart Super Health vs Niva Bupa Health Premia Gold

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...

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ICICI Lombard

Smart Super Health

Restore up to 100% of the sum insured once in a policy year for a new illness after the cover is exhausted, with 60 days of pre-hospitalisation, 90 days after discharge and inpatient AYUSH treatment.

What Makes It Special:

Smart Super Health is an ICICI Lombard floater offered in Value, Classic and Uber variants, with sum insured options from ₹5 lakh to ₹1 crore. It covers in-patient hospitalisation, daycare, AYUSH and domiciliary treatment, with optional add-ons for maternity, critical illness and hospital cash.

Best For:

  • Buyers who may add maternity, critical illness or hospital cash cover later

  • Buyers who want restoration of the sum insured for a new illness in the same year

  • Buyers who need air ambulance cover within India, on the Uber variant

  • Buyers who want domiciliary treatment cover

  • Families who want a hospitalisation floater with a choice of three variants

VS
Niva Bupa

Health Premia Gold

Health Premia Gold offers ₹10-50 Lakh cover with 100% refill, 10% yearly loyalty additions, maternity cover and in-built single-trip travel insurance.

What Makes It Special:

Health Premia Gold is the mid-tier plan of Niva Bupa's Health Premia product. Along with hospitalisation up to Sum Insured (any room except suite), 90/180 days pre/post-hospitalisation and AYUSH cover, it adds LASER surgery cover and an in-built international cover of up to ₹30 Lakh for one trip of up...

Best For:

  • Extended families (Family First) wanting up to 19 relationships in one policy

  • Buyers who want a 100% refill plus 10% yearly loyalty additions regardless of claims

  • People who want LASER surgery and mental health cover included

  • Frequent-ish travellers who value in-built overseas emergency cover for one trip a year

  • Families wanting ₹10-50 Lakh cover with maternity and newborn benefits

Insurance Plans Comparison

Get Personalized Advice

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

Quick Decision Guide

  • Confirm the variant’s sum insured and feature list on the current policy schedule, since the wording reviewed is from around 2018 to 2019.

  • Confirm the co-payment position with ICICI Lombard on 1800 2666 before buying, since a third-party source mentions 20% in some cases.

  • Maternity needs a 3-year term and a 9-month wait, so decide early if you plan a pregnancy.

  • The 48-month PED waiting period is long, so buy early if you have existing conditions.

  • Choose the variant by need: Value is the lowest-cost option, and Uber adds air ambulance, dental and the highest sum insured.

  • Things to Consider: Domestic OPD cover and Second Medical Opinion are not included in Gold.

  • Things to Consider: Robotic surgery, some mental disorders and HIV/AIDS have sub-limits; mental illness has a 36-month waiting period.

  • Things to Consider: Non-payable items (consumables like gloves) need the paid Safeguard add-on.

  • Things to Consider: Choosing Zone 2 pricing means a 20% co-payment for treatment in Mumbai, Delhi NCR, Kolkata and Gujarat.

  • Things to Consider: Maternity cover is only for Family Floater / Family First policies and needs 24 months of continuous cover.

  • Reasons to Consider: In-built international cover (₹30 Lakh, one trip) and LASER surgery cover are included.

  • Reasons to Consider: PED waiting period is 24 months and specific disease waiting period is just 12 months.

  • Reasons to Consider: Pre and post-hospitalisation are covered for 90 and 180 days.

  • Reasons to Consider: A 100% Re-fill of Base Sum Insured is available once a year for any illness.

  • Reasons to Consider: Loyalty Additions grow your cover by 10% of Base Sum Insured every year (up to 100%), even if you make a claim.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Smart Super Health
Smart Super Health

Health Insurance Plan

VS
Health Premia Gold
Health Premia Gold

Health Insurance Plan

Room Rent

Smart Super Health

  1. Normal: Covered Up to Sum Insured
  2. ICU: Covered Up to Sum Insured
VS

Health Premia Gold

Covered up to Sum Insured, any room except Suite or above (all Gold variants incl. Family First). Proportionate deduction applies if a higher room than eligible is taken

Advanced Treatments

Smart Super Health

  1. Robotic surgeries
  2. Stem cell therapy
  3. Deep brain stimulation
  4. Bronchial thermoplasty

     

  5. Intra-operative neuro monitoring (IONM)
VS

Health Premia Gold

Information Unavailable

ICU Charges

Smart Super Health

Covered within the sum insured under in-patient treatment. ICU charges are part of the room and ICU charges covered under in-patient treatment.

VS

Health Premia Gold

Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated

Co-payment

Smart Super Health

A co-payment applies in certain cases. If treatment is availed in a higher-tier city while paying a lower-tier premium, a 20% co-payment applies.

VS

Health Premia Gold

No mandatory co-payment with Zone 1 pricing. With Zone 2 pricing, 20% co-pay applies to treatment in Mumbai (incl. Navi Mumbai & Thane), Delhi NCR, Kolkata and Gujarat. OPD claims under International Coverage have 20% co-pay

Disease-wise sublimits

Smart Super Health

No disease sublimit schedule is listed in the wording. Procedures under the 2-year waiting period apply. Convalescence and outpatient emergency have separate per-policy sub-limits.

VS

Health Premia Gold

No sublimits on common conditions like cataract or joint replacement. Sublimits apply to: robotic surgeries (₹1 Lakh, with exceptions), specified mental disorders (₹50,000), HIV/AIDS (₹50,000 per year), LASER surgery (up to ₹50,000), non-network road ambulance (₹2,000 per event)

Cashless Healthcare Providers

Smart Super Health

The policy provides access to over 10,000+ network hospitals, ensuring cashless treatment at recognized healthcare facilities​.

VS

Health Premia Gold

Cashless treatment at Niva Bupa network hospitals across India; 10,000+ network hospitals (approximate, per Platinum brochure and Annual Report FY 2024-25; subject to change). Pre-authorisation target of 30 minutes

Restoration Benefit

Smart Super Health

Restores up to 100% of the sum insured once per policy year, when the sum insured and bonus are exhausted. Restoration applies only to a new illness, not one already claimed in that year. Unused restoration does not carry forward. It does not apply to add-ons.

VS

Health Premia Gold

Re-fill Benefit: up to 100% of Base Sum Insured once per policy year, for the same or a different illness, after the Sum Insured is partly or fully used. Not available under the Family First variant

Daycare Treatment

Smart Super Health

Covers all day care procedures requiring hospitalization of less than 24 hours. Treatments such as cataract surgery, chemotherapy, and minor surgical procedures are included​.

VS

Health Premia Gold

All listed day care procedures (Annexure III) covered up to Sum Insured

Cumulative Bonus

Smart Super Health

Under age 45 at first policy inception: 50% of the expiring sum insured per year, up to 100% of the current sum insured. Age 45 to 65: 20% per year, up to 100%. A claim reduces the bonus proportionately in the following year (Appendix III).

VS

Health Premia Gold

Loyalty Additions of 10% of expiring Base Sum Insured every policy year, up to 100%, even if you claim. Optional Enhanced Loyalty Addition: 20% per year, up to 200%

AYUSH Treatment

Smart Super Health

Alternative treatments under Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH) are covered.

VS

Health Premia Gold

In-patient Ayurveda, Unani, Siddha and Homeopathy treatment in an AYUSH hospital covered up to Sum Insured, with 90/180 days pre/post-hospitalisation

Consumable Cover

Smart Super Health

Non-medical items such as toiletries, gloves and cotton are not payable. Prescribed medicines and certain items are payable (Appendix IV).

VS

Health Premia Gold

Allowable consumables paid within hospital bills; IRDAI non-payable items are not covered in the base plan. Covered with the optional Safeguard (List I) or Safeguard+ (Lists I-IV) add-on (Add-on UIN NBHHLIA24109V022324)

Initial Waiting Period

Smart Super Health

30 days from inception, except for accidents

VS

Health Premia Gold

30 days (not for accidents or renewals)

Specific Waiting Period

Smart Super Health

2 years for listed illnesses and procedures (clause 6.1.2)

VS

Health Premia Gold

12 months for listed conditions (e.g. cataract, hernia, joint/spine disorders, piles). Accidents covered from day 1; cancer after the 30-day wait. Mental illness and LASER surgery: 36 months. HIV/AIDS: 48 months

PED Waiting Period

Smart Super Health

48 months (clause 6.1.3)

VS

Health Premia Gold

24 months of continuous cover

Modern Treatment

Smart Super Health

Robotic surgery is excluded (exclusion 36). Other modern treatments are not listed in the wording. Confirm with ICICI Lombard on 1800 2666.

VS

Health Premia Gold

Covered up to Sum Insured (12 listed procedures, e.g. robotic surgery, oral chemotherapy, immunotherapy, stem cell therapy). Robotic surgeries capped at ₹1 Lakh, except robotic radical prostatectomy, cardiac, partial nephrectomy and cancer surgeries

Annual Health Checkup

Smart Super Health

Available at renewal for insured persons aged 18 and over, through the insurer’s empanelled providers. Basic, extended or comprehensive, depending on variant (Appendix II).

VS

Health Premia Gold

Annual from Day 1: tests up to ₹2,500 per insured (₹10-20L SI), ₹5,000 (₹30L), ₹7,500 (₹50L). Family First Gold: ₹2,500

Pre-Hospitalisation

Smart Super Health

Up to 60 days before admission, within the sum insured

VS

Health Premia Gold

Up to 90 days before admission, covered up to Sum Insured

Post-Hospitalisation

Smart Super Health

Up to 90 days after discharge, within the sum insured

VS

Health Premia Gold

Up to 180 days after discharge, covered up to Sum Insured

Outpatient Department Cover (OPD Expense)

Smart Super Health

Up to 90 days after discharge, within the sum insured

VS

Health Premia Gold

Domestic OPD: Not available under Gold. (OPD abroad is covered only within the in-built International Coverage, with 20% co-pay). Unlimited e-consultations included in all plans

Deductible Option

Smart Super Health

No deductible option is listed in the wording. Hospital cash has a one-day deductible.

VS

Health Premia Gold

Not available (the policy wording has no deductible option for Health Premia)

Coverage Options

Smart Super Health

Value (₹5 lakh and ₹7.5 lakh), Classic (₹10 lakh to ₹20 lakh), Uber (₹20 lakh to ₹1 crore). Optional add-ons are hospital cash, maternity, critical illness and personal accident.

VS

Health Premia Gold

Individual / Family Floater: ₹10, 15, 20, 30 or 50 Lakh Base Sum Insured. Family First variant: Base Individual SI ₹5-10 Lakh per person with a shared floater layer on top. Policy types: Individual, Family Floater (up to 6 members, max 4 children) and Family First (up to 19 relationships). Entry age: adults 18-65, children 91 days-30 years. 1, 2 or 3-year terms; lifelong renewal

Claim Settlement Ratio

Smart Super Health

FY 24-25: ~84%

VS

Health Premia Gold

93.5% of claims settled (by number) for Health Premia in FY 2025-26. Source: Niva Bupa Public Disclosures FY2025-26 (Form NL-47), https://transactions.nivabupa.com/pages/doc/pub-dis/quarterly-reports/Website-Public-Disclosures-Mar-2026.pdf. Company-level: 94.4% (Niva Bupa Annual Report FY 2025-26)

Maternity Cover

Smart Super Health

Optional add-on, available only on a 3-year floater term with a 9-month waiting period. Covers up to 2 deliveries or terminations in a lifetime, for insured persons aged 18 to 45. Maternity limits are ₹35,000 to ₹1,00,000 by variant, and newborn cover is ₹25,000 to ₹1,00,000 for the first 90 days.

VS

Health Premia Gold

Covered only under Family Floater / Family First (not Individual), after 24 months continuous cover, up to 2 pregnancies/terminations: ₹70,000 (₹10L), ₹75,000 (₹15L), ₹80,000 (₹20L), ₹1,00,000 (₹30L/₹50L); Family First Gold ₹50,000. New born covered up to SI till end of policy year; newborn vaccination in first year

Insurance Plans Comparison

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Senior Citizen Health Plan

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  • Tailored for seniors healthcare needs

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Family Health Plan

Family Health Plan

  • One policy covers the entire family

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Maternity Health Plan

Maternity Health Plan

  • Covers delivery, newborn care, and maternity expenses

  • Reduces financial stress of childbirth costs

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