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Health Insurance 401 views August 6, 2021
HDFC ERGO Health Suraksha Top-Up Plus Plan provides additional coverage to you in case of medical emergencies. The key benefits of HDFC ERGO Health Suraksha Top-Up Plus Plan are as follows:
Read this page and learn more about the HDFC ERGO Health Suraksha Top-Up Plus plan benefits.
Table of Contents
The insurer shall cover the following medical expenses under HDFC ERGO Health Suraksha Top-Up Plus Plan.
In-patient Medical Expenses: If you are admitted to the hospital due to an illness/injury, the insurer shall cover the following in-patient expenses:
The insurer shall cover the medical expenses incurred 60 days before the date of admission to the hospital, provided such expenses are for the same condition for which hospitalization is required. You can avail of this benefit if the insurer has accepted an in-patient hospitalization.
Any expenses incurred 90 days after the date of discharge from the hospital shall be covered under the policy, provided these are for the same condition for which you are hospitalized. This benefit is available if the insurer has accepted a claim under in-patient hospitalization.
The insurer shall cover the daycare procedures as mentioned in the policy schedule, provided the in-patient hospitalization is for less than 24 hours.
If you are taking any necessary medical treatment at home on the advice of the attending medical practitioner for at least 3 days, the insurer shall cover the same for the time the treatment lasts.
The insurer shall cover the medical expenses for an organ donor’s treatment for harvesting the organ, provided the donor is any person whose organ has been made available as per the Transplantation of Human Organs Act, 1994. The insurer shall not cover any other medical treatment for the donor after harvesting. You can avail of this benefit if the insurer has accepted a claim under in-patient hospitalization.
The insurer will reimburse the medical expenses incurred on an ambulance service to transfer the insured to the nearest hospital. The insurer’s maximum liability is restricted to INR 2,000 per hospitalization. The coverage under this benefit includes the cost of the transportation from a hospital to another hospital for advance medical service, provided the medical practitioner has prescribed such transportation.
If no claim is made under HDFC ERGO Health Suraksha Top-Up Plus Plan, you’ll receive a cumulative bonus in the next policy year. The cumulative bonus would increase your sum insured by 5%, subject to a maximum of 50%. In the case of a family floater plan, the cumulative bonus for every insured member will be computed from the year of addition of the member and the number of claim-free years. If you file a claim in the subsequent policy year, the cumulative bonus will automatically decrease by 5%.
You’ll get a free look period of fifteen days from the date of receipt of the policy document to review the terms and conditions. You can return the policy if the terms and conditions are not acceptable to you. On cancellation, the insurer shall refund the paid premium after deducting the medical examination and stamp duty charges, provided no claim has been made during the free look period. If the risk has already commenced and you have returned the policy, a deduction towards the proportionate risk premium for the period on the cover will be made. If only a part of the insurance coverage has commenced, such proportionate premium commensurates with the insurance coverage during the free look period.