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 |
| Sum Insured (Rs) | |
| Maximum | 5 lakh |
| Minimum | 2 lakh |
| Policy Term (years) | 1 or 2 years |
| 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 | [email protected] |
| Call to | 1800 2 700 700 |
Additions to the Plan
| 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. |
| Annual Premium Option for Sum Insured Rs 200,000 | |||||
| Age (in years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 2384 | NA | NA | NA | |
| 18-35 | 3217 | 4825 | 6256 | 7686 | |
| 36-45 | 4037 | 6056 | 7486 | 8917 | |
| 46-50 | 7171 | 11473 | 12904 | 14334 | |
| 51-55 | 7529 | 12047 | 13477 | 14908 | |
| 56-60 | 8771 | 14033 | 15464 | 16894 | |
| 61-65 | 12308 | 19693 | 21123 | 22554 | |
| Premiums are inclusive of taxes | |||||
| Annual Premium Option for Sum Insured Rs 300,000 | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 2712 | NA | NA | NA | |
| 18-35 | 3721 | 5582 | 7209 | 8837 | |
| 36-45 | 4479 | 6718 | 8345 | 9973 | |
| 46-50 | 8037 | 12859 | 14487 | 16114 | |
| 51-55 | 8439 | 13503 | 15130 | 16758 | |
| 56-60 | 9764 | 15623 | 17250 | 18877 | |
| 61-65 | 14102 | 22564 | 24191 | 25819 | |
| Premiums are inclusive of taxes | |||||
| Annual Premium Option for Sum Insured Rs 400,000 | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 4357 | NA | NA | NA | |
| 18-35 | 5587 | 8380 | 10994 | 13609 | |
| 36-45 | 6233 | 9349 | 11963 | 14578 | |
| 46-50 | 11058 | 17694 | 20308 | 22922 | |
| 51-55 | 11611 | 18578 | 21192 | 23807 | |
| 56-60 | 13925 | 22280 | 24894 | 27508 | |
| 61-65 | 22085 | 35337 | 37951 | 40566 | |
| Premiums are inclusive of taxes | |||||
| Annual Premium Option for Sum Insured Rs 500,000 | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 5306 | NA | NA | NA | |
| 18-35 | 7254 | 10881 | 14064 | 17248 | |
| 36-45 | 8137 | 12206 | 15389 | 18572 | |
| 46-50 | 14641 | 23425 | 26608 | 29792 | |
| 51-55 | 15212 | 24340 | 27523 | 30707 | |
| 56-60 | 17712 | 28340 | 31523 | 34707 | |
| 61-65 | 25341 | 40545 | 43728 | 46912 | |
| Premiums are inclusive of taxes | |||||
| Premium Option for 2 years policy term for Sum Insured of Rs 2 lakh | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 4292 | NA | NA | NA | |
| 18-35 | 5790 | 8686 | 11261 | 13836 | |
| 36-45 | 7267 | 10900 | 13475 | 16050 | |
| 46-50 | 13625 | 21799 | 24517 | 27235 | |
| 51-55 | 14306 | 22889 | 25607 | 28325 | |
| 56-60 | 17542 | 28067 | 30928 | 33789 | |
| 61-65 | 24616 | 39385 | 42246 | 45108 | |
| Premiums are inclusive of taxes | |||||
| Premium Option for 2 years policy term for Sum Insured of Rs 3 lakh | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 4882 | NA | NA | NA | |
| 18-35 | 6698 | 10048 | 12977 | 15906 | |
| 36-45 | 8062 | 12092 | 15022 | 17951 | |
| 46-50 | 15271 | 24433 | 27525 | 30617 | |
| 51-55 | 16035 | 25656 | 28748 | 31840 | |
| 56-60 | 19528 | 31245 | 34500 | 37755 | |
| 61-65 | 28205 | 45127 | 48382 | 51637 | |
| Premiums are inclusive of taxes | |||||
| Premium Option for 2 years policy term for Sum Insured of Rs 5 lakh | |||||
| Age(years) | 1Adult | 2Adults | 2Adults+1Child | 2Adults+2Children | |
| 0-17 | 9550 | NA | NA | NA | |
| 18-35 | 13057 | 19586 | 25316 | 31046 | |
| 36-45 | 14647 | 21970 | 27700 | 33430 | |
| 46-50 | 27817 | 44507 | 50556 | 56604 | |
| 51-55 | 28904 | 46246 | 52294 | 58343 | |
| 56-60 | 35425 | 56680 | 63047 | 69413 | |
| 61-65 | 50681 | 81090 | 87457 | 93823 | |
| Premiums are inclusive of taxes | |||||
