HDFC ERGO Health Suraksha Plan

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HDFC ERGO Health Suraksha

Objective		This is an online health insurance policy which will provide for hospitalisation and other related expenses.
Suited for		This policy is more suitable for those who utilize homeopathic or ayurvedic treatment.
What does it do?		This health insurance policy covers expenses of treatment taken as an inpatient. It pays for pre and post hospitalisation cost, day care procedures, organ donor expenses, and domiciliary treatment. It provides for allopathic medicine expenses, as well as unani, siddha and homeopathy treatments. If a policyholder does not make any claim for four consecutive years, he will be entitled to a free health check-up.
Pros		There is no capping on room rent, nursing fees or doctor's charges. It covers non-allopathic treatment as well. It can be bought online through company's website. Family discount is available if two or more members are covered under the same policy. Premium paid under this policy qualifies for deduction under section 80D of Income Tax Act.
Cons		Cumulative bonus will reduce by 10 per cent on acceptance of claim during any policy year.
Our View		Cover for homeopathic and ayurvedic treatment is a unique feature of this policy. Other benefits under this policy are similar to what other insurers offer.
Eligibility
Entry Age (years)
Minimum	18; 3 Months for Children
Maximum	65; 21 for Children
Maximum Policy Renewal Age (years)	65
Coverage Type	Individual/Family Floater
Policy Term (years)	1 or 2 years
Sum Insured (Rs)
Maximum	5 lakh
Minimum	2 lakh
Tax Benefit	Section 80D of the Income Tax Act are applicable
Discount	Family discount of 10% if 2 or more members are covered
No Claim Bonus	5% for each claim free year upto maximum of 50% of initial Sum insured. On acceptance of claim during any policy year, cumulative bonus will be reduced by 10% in subsequent policy year.
Pre Policy Medical Check Up	Not required upto 45 years of age
Grace Period for Policy Renewal	15 days
Policy Termination	Insurer may cancel the policy by giving a 30 days written notice to policyholder. Policyholder may also cancel the policy at any time by giving a written notice to insurer. In case policyholder cancelling the policy, a certain percentage of premium would be refunded based on policy term elapsed till date.
Customer Service
Address	HDFC ERGO General Insurance Company Limited 6th floor, Leela Business Park, Andheri-KurlaRoad Andheri East, Mumbai 400 059; Registered Office: Ramon House, HT Parekh Marg 169, Backbay Reclamation, Mumbai 400 020
Mail to	care@hdfcergo.com
Call to	1800 2 700 700

 

Scope Of Cover
Cashless facility	available at empanelled network of hospitals
Re-imbursement	available at non network hospitals
Pre-hospitalisation	medical expenses incurred during 60 days immediately prior to hospitalisation are covered
Post-hospitalisation	medical expenses incurred during 90 days after discharge from hospital are covered
Inpatient hospitalisation	Covered
Day care procedures	141 day care procedures are covered
Emergency ambulance	Covered upto maximum of Rs 2000 per event
Domiciliary Treatment (for a minimum of 3 days continuous treatment)	covered
Organ Donor Expenses during Transplant	covered
Health Check Up	allowed after every 4 claim free years upto 1% of Sum Insured upto maximum of Rs 5000
Ayurvedic/ Homeopathic treatment	Inpatient treatment under Unani/ Siddha/Homeopathy is covered upto 20% for Policy Sum Insured of Rs 2 lakh and 3 lakh and Rs 25000 for policy sum insured of Rs 4 lakh. Once a claim for such treatment is admitted, any claim under allopathic treatment for same person and same illness willnot be accepted

 

Exclusions and Waiting Period
Pre-existing diseases	covered after a period of 48 months
No claim period	Any disease contracted during the first 30 days of commencement of the policy unless there is a case of accidental injury
Waiting Period	Certain diseases and illnesses such as cataract, arthritis, cysts, nodules etc. shall be covered after a waiting period of 24 months from inception of the policy
General Exclusions	Dental/ oral treatment, Cosmetic, beauty, weight reduction and other likely treatments.War, participation in any criminal activity or adventurous activities such as mountaineering etc or any other related condition.

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