Health Insurance 144 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:

  1. Supplementary Coverage
  2. No Sub-Limits
  3. No Pre-Policy Health Checkup up to the age of 55 years
  4. Policy period of 1 and 2 years
  5. Family discount of 3% if more than three members of the family are covered

Read this page and learn more about the HDFC ERGO Health Suraksha Top-Up Plus plan benefits.

HDFC ERGO Health Suraksha Top-Up Plus Plan Coverage

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:

  1. Room rent, boarding and nursing expenses
  2. ICU charges
  3. Medical practitioner’s fees
  4. Cost of anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and consumables, prosthetic and other medical devices or equipment if implanted internally during a surgical procedure.
  5. Diagnostic procedures

Pre-Hospitalization 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.

Post-Hospitalization Medical Expenses

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.

Day Care Procedures

The insurer shall cover the daycare procedures as mentioned in the policy schedule, provided the in-patient hospitalization is for less than 24 hours.

Domiciliary Treatment

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.

Organ Donor

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.

Emergency Ambulance

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.

HDFC ERGO Health Suraksha Top-Up Plus Plan Renewal Incentives

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%.

Free Look Period

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.

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