HDFC ERGO my: Health Benefit Group Package Policy

HDFC ERGO my: Health Benefit Group Package Policy is a group plan that protects the finances of the insured members during critical illness treatment. This policy also provides coverage in case an insured member meets with an accident during the coverage period.

Please check the key features of this plan mentioned below to have a brief overview of the same.

1. Critical Illness Cover
2. Surgery Care
3. Personal Accident Cover
4. Payment Suraksha (In case of Resignation or Termination)
5. Health Coach Services
6. Wellness Services
7. A Grace Period of 15 or 30 days
8. Option to Pay Premiums in Installments

On this page, we will talk about these features and benefits extensively. Read through it to make a better decision.

Features and Benefits of the HDFC ERGO my: Health Benefit Group Package Policy in Detail

We have discussed the features and benefits of the HDFC ERGO my: Health Benefit Group Package Policy below so that you can understand better. Please check.

Critical Illness Cover

Health Benefit Group Package Policy from HDFC ERGO will provide the sum insured amount to the insured member if he/she suffers from any of the following critical illnesses. The diagnosis and/or first commencement of the disease should occur after 90 days from the date of the start of the policy.

1. Cancer of Specified Severity
2. Kidney failure requiring regular dialysis
3. Myocardial Infarction (First Heart Attack of specified severity)
4. Multiple Sclerosis with persisting symptoms
5. Permanent Paralysis of Limbs
6. Stroke resulting in permanent symptoms
7. Benign Brain Tumour
8. Coma of specified severity
9. Parkinson’s Disease
10. Alzheimer’s Disease
11. End-Stage Liver Failure
12. Deafness
13. Loss of Speech
14. Third Degree Burns
15. Systemic Lupus Erythematosus with Lupus Nephritis
16. Apallic Syndrome
17. Aplastic Anaemia
18. Cardiomyopathy
19. Creutzfeldt-Jakob Disease (CJD)
20. End-Stage Lung Failure
21. Major Head Trauma
22. Progressive Scleroderma
23. Medullary Cystic Disease
24. Motor Neurone Disease with permanent symptoms
25. Muscular Dystrophy
26. Primary (Idiopathic) Pulmonary Hypertension
27. Blindness
28. Refractory heart failure
29. Poliomyelitis
30. Myasthenia gravis
31. Goodpasture’s syndrome with lung or renal involvement
32. Loss of limbs
33. Loss of independent existence

Note: An insured member needs to survive for at least 30 days after the date of occurrence of the insured event to get covered.

Surgery Care

Insured members will get coverage against the expenses incurred on undergoing one of the listed surgeries in the policy. The coverage amount on medically necessary hospitalization will be up to the sum insured. Also, the illness or injury should have been contracted or sustained by an insured member during the policy term.

Some of the listed surgeries under this benefit are Replantation of Limb, Amputation of Arm/Foot/Hand/Leg, Closed Heart Valvotomy, Aortic Valve Repair, Surgery on Prostate, Hernia, etc.

Personal Accident Cover

The policy will pay the sum insured if an insured member faces an accidental injury (happened during the policy term), which results in the following within 12 months of the occurrence of an accident.

1. Death
2. Permanent Total Disability
3. Permanent Partial Disablement

Payment Suraksha

Under this feature, insured members will get coverage in case of termination or resignation from employment. We have discussed each of them below. Please check.

Termination from Employment

This policy from HDFC ERGO will pay the sum insured if an insured person faces the loss of income due to his/ her termination, dismissal, suspension or retrenchment from employment, imposed on him/her by the employer during the coverage term.

Note: The period of termination, dismissal, temporary suspension from employment should not be less than 30 consecutive days.

Resignation from Employment

If an insured member faces a loss of income due to his/her voluntary resignation from the employment due to the injury from an accident (during the coverage period) and the same results in the following, the policy will pay the sum insured.

1. Permanent Total Disablement
2. Permanent Partial Disablement
3. Temporary Total Disablement

Additional Services

HDFC ERGO Health Benefit Group Package Policy offers the following additional services to the insured members through mobile application only.

Health Coach

An insured member under the group will enjoy access to the following health coaching services.

1. Disease management
2. Activity and fitness
3. Nutrition
4. Weight management

Wellness Services

Through wellness services, insured members under the group will get discounts on OPD, Pharmacy and Diagnostic Centres. HDFC ERGO will also provide customer engagement services such as monthly newsletters, diet consultations and health tips. This group policy also provides the following specialized programs.

1. Stress Management
2. Pregnancy Care
3. Work-Life Balance Management

Note: You can also enjoy these services through the HDFC ERGO Mobile App.

Premium Payment in Installments

Insured members can also make the premium payment in installments from the different options – Yearly, Half-yearly, Quarterly or Monthly.

Grace Period

This policy from HDFC ERGO offers a grace period of 30 days from the due date within which the policyholders can pay the renewal premium. For policies on the installment basis, the grace period is according to the below table.

Note: During the grace period, the coverage will not be available from the due date of installment premium until the date of receipt of the premium amount. Also, the policy will get cancelled in case the insured member doesn’t pay the premium within the grace period.

What is Not Covered Under the Policy?

The group policy will not provide coverage in the following situations.

1. War or any act of war, invasion, the act of foreign enemy
2. A breach of law with criminal intent
3. Intentional self-injury or attempted suicide
4. Participation or involvement in naval, military or air force operation
5. If an insured member is under the influence of alcohol or drugs (unless prescribed by a medical practitioner)