Acko Standard Health
Overview
Acko Standard Health is a decent and comprehensive health insurance plan offered by Acko General Insurance Limited. The plan offers all the basic benefits with no restrictions or room rent limit. Acko offers health insurance plans via its online platforms only, eliminating intermediaries and commissions. Hence, it is one of the most affordable health plans. If you still want better features, you can consider Acko Platinum Health Plan.
Acko General Insurance showcases a good claim settlement record. The company was founded in 2016 and started operations in 2018. Initially, Acko focused mainly on the motor insurance business. It started selling health insurance recently. Hence, it has a limited business track record.
Pros and Cons
- No room restrictions – Covers all room types with no sub-limits.
- No copayment – Does not impose any copayment clause.
- Unlimited restorations – Restores the sum insured multiple times when exhausted.
- The plan is quite affordable.
- The insurer has a limited business track record.
Plan Benefits
Covers inpatient hospitalisation expenses with no sub-limits
Acko Standard Health plan covers hospitalisation and related expenses without any restrictions or sub-limits. The expenses are fully covered up to the sum insured.
No room rent capping
The plan does not restrict the room rent expenses. You can choose the room you like to get the treatment you deserve, and the insurer fully covers the cost.
Covers pre and post-hospitalisation expenses
You get coverage for hospitalisation-related expenses for up to 60 days before and 120 days after the hospitalisation. The insurer covers expenses such as consultation fees, diagnostic tests, and medication, among others, providing comprehensive coverage.
Full coverage for daycare treatments
Many treatments or surgeries done under anaesthesia now require less than 24-hour hospitalisation. They are called daycare treatments. The plan covers the cost of all such treatments fully.
Get unlimited restorations during a policy year
You do not have to worry about coverage for the next claim if you have already made a claim. Your insurer restores your sum insured multiple times during a policy year if your base cover is fully or partially exhausted. This feature comes in handy if you need to make multiple claims during any policy year.
Covers alternative treatment
Do you want to consider an alternative treatment for your ailment, such as Ayurveda or Homoeopathy? The plan covers the hospitalisation expenses of such alternative treatments.
Get cover for domiciliary hospitalisation
Are you forced to be hospitalised at home? Think of a situation when hospital beds are unavailable or the patient’s medical condition does not allow him to be moved to a nearby hospital. This is called domiciliary hospitalisation. The plan still covers the expenses related to hospitalisation if done under the supervision of a medical practitioner and exceeds 3 consecutive days.
Get coverage for road ambulance charges
You also get coverage for road ambulance charges if you need to be transported to the hospital by an ambulance.
Get cumulative bonus, irrespective of claims
You get a cumulative bonus equal to 10% of the base sum insured each year, irrespective of claims. The maximum bonus is capped at 100% of the base sum insured.
Organ donor expenses covered
Organ transplant surgeries are expensive. Moreover, the donor also requires surgery to harvest the organ. But you don’t have to worry anymore. The insurer covers the cost of harvesting an organ from a donor in case you are the organ recipient.
Get coverage for non-medical expenses
The plan also covers non-medical items, such as masks, syringes, gloves, etc. You don’t have to pay for them out-of-pocket.
Get annual preventive health check-up
All insured members are entitled to free preventive health check-up once in a policy year.
Doctor on call
You also get access to video or teleconsultations with medical practitioners at any time of the day. This facility is available only through the insurer’s empanelled service providers.
Policy Conditions
| Sum Insured Range | Rs. 10 Lakh, Rs. 25 Lakh, Rs. 50 Lakh, and Rs. 1 Crore |
| Entry Age | 3 Months – 25 Years for dependent children, 18 Years and above for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual and Family Floater |
| Family Coverage | Up to 10 members under the family floater option; self, spouse, 4 dependent children, parents, parents-in-law can be included. |
| Premium Payment | Monthly, Quarterly, Half-yearly, Annual |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months.
- Waiting Period on Pre-Existing Diseases: 36 months
Medical Exclusions
- Congenital external diseases
- Maternity / Sterility or Infertility treatments
- Obesity control
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven treatment
- Dental treatment
- Refractive error correction for less than 7.5 diopters
Non-Medical Exclusions
- Investigation and evaluation
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Expenses for treatment necessitated by committing breach of law with criminal intent
- Expenses for treatment taken by a medical practitioner outside his discipline.
- War, terrorism, nuclear events
- Injuries from hazardous sports
About the Insurer
Acko General Insurance Limited is a newer general insurance company. The company was founded in 2016 and started operations in 2018. It is India’s first fully digital insurance company, catering directly to retail clients online, thus eliminating intermediaries and commissions.
Initially, its major focus was on the motor insurance business. In 2023, it started offering retail health insurance plans. Currently, it offers plans covering motor, travel, and health insurance. The company’s high claim settlement ratio and moderate volume of claim complaints speak about its claim settlement efficiency. However, the company has a very limited overall business record.
Performance Highlights (FY24)
Turnover – Rs. 2,016 Crore
Claim Settlement Ratio – 98.13%
Incurred Claim Ratio – 69.57%
Volume of Claim Complaints – 27.33 per 10,000 claims
Network Hospitals – 11,500+
Get In Touch
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Related Variants
Frequently Asked Questions
What is the Acko Standard Health Insurance Plan?
Acko Standard Health Insurance is a comprehensive policy covering hospitalisation, daycare treatment, ambulance charges, pre‑ and post‑hospitalisation expenses, and more, with zero claim deductions and no room rent capping.
What is the maximum sum insured available under this plan?
You can opt for coverage up to Rs. 1 Crore under the Acko Standard Health Insurance plan.
Are pre‑hospitalisation expenses covered?
Yes, medical expenses incurred up to 60 days before hospitalisation are covered, if directly related to the same condition for which you made an inpatient claim.
Are post‑hospitalisation expenses covered?
Post‑hospitalisation costs, like tests and consultations, are covered up to 120 days post-discharge.
Is daycare treatment covered under Acko Standard Health Insurance Plan?
Yes, all daycare procedures are covered with no sub‑limits, up to the sum insured.
Does Acko Standard Health Insurance cover domiciliary treatment?
Yes, domiciliary hospitalisation expenses are covered up to the sum insured.
Are organ donation expenses covered?
Yes, expenses related to the hospitalisation of the donor during an organ transplant are covered up to the sum insured.
Are modern treatments like stem cell therapy or radiosurgery covered under Acko Standard Health Insurance Plan?
Yes, modern medical treatments are covered up to the sum insured, without restriction.
Are non‑medical expenses included?
Yes, items like gloves, oxygen masks, and nebuliser kits are covered without limit up to the sum insured.
Is there a copayment or deductible clause in Acko Standard Health Insurance Plan?
No, the plan includes no copay and no deductible. The entire approved claim amount is covered.
Is there any room rent cap under Acko Standard Health Insurance?
No, there is no room rent limit in the plan. Even ICU charges are fully covered up to the sum insured.
What is the waiting period for pre‑existing illnesses under Acko Standard Health Insurance?
Pre‑existing conditions are covered after a 36‑month waiting period.
What are the disease‑specific waiting periods?
Illnesses like cataract, ENT disorders or joint surgeries have a 24‑month waiting period.
Is there a No Claim Bonus (NCB)?
Yes, 10% of the sum insured is added every year, irrespective of claims, up to a maximum of 100%. The bonus remains intact even if a claim is made.
Is there a restoration benefit?
Yes, if the sum insured and NCB are used in the policy year, the sum insured can be restored multiple times within the same year for subsequent claims.
Can I add family members like spouse or parents?
Yes, you can add dependents, including spouse, up to 4 children (3 months to 25 years), parents, and parents-in‑law, subject to terms of the plan.
How is the claim process handled?
Claims are fully digital. For cashless claims at network hospitals, Acko pays directly to the hospital. For non‑network hospitals, you file for reimbursement through the insurer’s app.
Can I port my policy from another insurer?
Yes, portability is permitted as per IRDAI guidelines, allowing you to retain continuity benefits on switching.
What does the free look period allow?
You can cancel the policy within 30 days after receiving your policy and receive a refund if not satisfied with the policy terms.
Are AYUSH treatments covered under Acko Standard Health Insurance?
Yes, the plan covers alternate treatments like Ayurveda, Yoga, Unani, Siddha, and Homoeopathy on a hospitalisation basis.
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