Health Insurance 285 views January 11, 2021

HDFC ERGO my:credit Comprehensive Suraksha is a health insurance plan for people who have taken loans. This policy offers coverage for Critical illnesses, Surgical Procedures, Assault and Burns, Hospital Cash Benefit, post-diagnosis cover, loss of job, cardiac arrest, preventive health checkup, etc.  The product also offers additional coverage for women like women-specific cancers, surgical procedures, pregnancy, and newborn-related complications, etc. HDFC ERGO my:credit Comprehensive Suraksha has multiple Sum insured options ranging from INR 1 lakh to 5 Crore. Read this page and let’s learn more about HDFC ERGO my:credit Comprehensive Suraksha coverage and exclusions.

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Covers Under HDFC ERGO my:credit Comprehensive Suraksha

HDFC ERGO my:credit Comprehensive Suraksha plan comes with the following covers.

Critical Illness (CI) Covers

When you suffer from a critical illness and need to undergo a surgical procedure, the policy comes into force and ensures payment of such medical expenses. You can choose your critical illness cover from the following options.

  1. Essential CI – Cancer of specified severity, Open Chest CABG, Kidney failure DE requiring regular dialysis, Myocardial Infarction (First Heart Attack of specified severity), Open Heart Replacement or Repair of Heart Valves, Major Organ/Bone Marrow Transplantation, Multiple Sclerosis with persisting symptoms, Permanent Paralysis of Limbs, Stroke resulting in permanent symptoms
  2. Essential CI plus – Benign Brain Tumour, Coma of specified severity and Parkinson’s Disease
  3. Silver CI – Benign Brain Tumour, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Surgery of Aorta and End-stage Liver Failure
  4. Silver CI Plus – Benign Brain Tumour, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Surgery of Aorta, End-stage Liver Failure, Deafness, Loss of Speech and Third Degree Burns.
  5. Gold CI – Benign Brain Tumour, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Surgery of Aorta, End Stage Liver Failure, Deafness, Loss of Speech, Third Degree Burns, Medullary Cystic Disease, Motor Neurone Disease with permanent symptoms, Muscular Dystrophy, Infective Endocarditis, Primary (Idiopathic) Pulmonary Hypertension, Dissecting Aortic Aneurysm, Systemic Lupus Erythematosus with Lupus Nephritis.
  6. Gold CI Plus – Benign Brain Tumour, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Surgery of Aorta, End-stage Liver Failure, Deafness, Loss of Speech, Third Degree Burns, Medullary Cystic Disease, Motor Neurone Disease with permanent symptoms, Muscular Dystrophy, Infective Endocarditis, Primary (Idiopathic) Pulmonary Hypertension, Dissecting Aortic Aneurysm, Systemic Lupus Erythematosus with Lupus Nephritis, Apallic Syndrome, Aplastic Anaemia, Bacterial Meningitis, Cardiomyopathy, other serious coronary artery diseases, Creutzfeldt-Jakob Disease (CJD), Encephalitis, End-stage Lung Failure, Fulminant Hepatitis, Eisenmenger’s Syndrome, Major Head Trauma, Chronic Adrenal, Insufficiency (Addison’s Disease), Progressive Scleroderma, Progressive Supranuclear Palsy, Blindness.
  7. Platinum CI – Benign Brain Tumour, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Surgery of Aorta, End-stage Liver Failure, Deafness, Loss of Speech, Third Degree Burns, Medullary Cystic Disease, Motor Neurone Disease with permanent symptoms, Muscular Dystrophy, Infective Endocarditis, Primary (Idiopathic) Pulmonary Hypertension, Dissecting Aortic Aneurysm, Systemic Lupus Erythematosus with Lupus Nephritis, Apallic Syndrome, Aplastic Anaemia, Bacterial Meningitis, Cardiomyopathy, Other serious coronary artery disease, Creutzfeldt-Jakob Disease (CJD), Encephalitis, End-stage Lung Failure, Fulminant Hepatitis, Eisenmenger’s Syndrome, Major Head Trauma, Chronic Adrenal, Insufficiency (Addison’s Disease), Progressive Scleroderma, Progressive Supranuclear Palsy, Blindness, Chronic Relapsing Pancreatitis, Elephantiasis, Brain Surgery, HIV due to blood transfusion and occupationally acquired HIV ü, Terminal Illness, Myelofibrosis, Pheochromocytoma, Crohn’s Disease, Severe Rheumatoid Arthritis, Severe Ulcerative Colitis, Angioplasty.

Women Suraksha Covers

If the insured person is a woman, these coverage benefits shall apply to your HDFC ERGO my:credit Comprehensive Suraksha plan.

  1. Cancer Cover – Malignant Cancer of specified sites such as Breast, Cervix, Uterus, Fallopian Tube, Ovary, Vagina/Vulva. Under this, other major cancers, Carcinoma in-situ of the Cervix Uteri and Breast will be covered as well.
  2. Major Illnesses – Systemic Lupus Erythematosus with Lupus Nephritis, Rheumatoid Arthritis and Severe Osteoporosis.
  3. Surgical Procedures – Breast Lumpectomy, Mastectomy, Breast Reconstructive Surgery, Hysterectomy, Wertheim’s Operation, Radical Vulvectomy, Total Pelvic Exenteration, Complicated Repair of Vaginal Fistula
  4. Cardiac Ailment and Procedures – Open Chest CABG, Heart Valve Repair, First Heart Attack of Specified Severity, Coma of Specified Severity, Stroke resulting in permanent symptoms, Balloon Valvotomy or Valvuloplasty, Insertion of Pacemaker, Angioplasty.
  5. Critical Illnesses – Surgery of Aorta, Kidney failure requiring regular dialysis, Infective Endocarditis, Major Organ/Bone Marrow Transplantation, Primary (Idiopathic) Pulmonary Hypertension, End-stage Liver Failure, Dissecting Aortic Aneurysm, Medullary Cystic Disease, Cardiomyopathy, Aplastic Anaemia, Other serious coronary artery disease, End Stage Lung Failure, Eisenmenger’s Syndrome, Fulminant Hepatitis, Multiple Sclerosis with persisting symptoms, Chronic Adrenal Insufficiency (Addison’s Disease), Permanent Paralysis of Limbs, Progressive Scleroderma, Benign Brain Tumour, Chronic Relapsing Pancreatitis, Parkinson’s Disease, Elephantiasis, Alzheimer’s Disease, HIV due to blood transfusion and occupationally acquired HIV,Motor Neurone Disease with permanent symptoms,Terminal Illness, Muscular Dystrophy, Myelofibrosis, Apallic Syndrome Major, Pheochromocytoma, Bacterial Meningitis, Crohn’s Disease, Creutzfeldt-Jakob Disease (CJD), Severe Ulcerative Colitis, Encephalitis, Deafness, Major Head Trauma, Loss of Speech, Progressive Supranuclear Palsy, Blindness, Brain Surgery.

Sachet Critical Illness Covers

  1. Cancer Cover – Malignant Cancer of specified Sites such as Breast, Cervix, Uterus, Fallopian Tube, Ovary, Vagina/Vulva for females. And Head and Neck, Lung, Stomach, Colorectum, Prostate for males. This also covers Cancer of specified severity, Aplastic Anemia, Early Stage Cancer, Carcinoma in situ and Major Organ Transplant.
  2. Heart Cover – Open Chest CABG, Open Heart Replacement or Heart Valve Repair, Myocardial Infarction (First Heart Attack of Specified Severity), Major Organ Transplant – Heart, Primary (Idiopathic) Pulmonary Hypertension, other serious coronary artery diseases, Dissecting Aortic Aneurysm, Cardiomyopathy, Eisenmenger’s Syndrome, Infective Endocarditis, Angioplasty, Balloon Valvotomy or Valvuloplasty, Insertion of Pacemaker.
  3. Nervous System Cover – Multiple Sclerosis with persisting symptoms, permanent paralysis of limbs, Stroke resulting in permanent symptoms, Benign Brain Tumor, Coma of specified severity, Parkinson’s Disease, Alzheimer’s Disease, Motor Neurone Disease with permanent symptoms, Muscular Dystrophy, Apallic Syndrome, Bacterial Meningitis, Creutzfeldt-Jakob Disease(CJD), Encephalitis, Major Head Trauma, Progressive Supranuclear Palsy, Brain Surgery, Loss of Speech.
  4. Other Major Organ Cover – Kidney failure requiring regular dialysis. Major Organ Transplant for Kidney, Lung, Liver and Pancreas, End-stage Liver Failure, Medullary Cystic Disease, Systemic Lupus Erythematosus with Lupus Nephritis, End-stage Lung Failure, Fulminant Hepatitis, Chronic Adrenal Insufficiency (Addison’s Disease), Progressive Scleroderma, Chronic Relapsing Pancreatitis, Elephantiasis, HIV due to blood transfusion and occupationally acquired HIV, Terminal Illness, Myelofibrosis, Pheochromocytoma, Crohn’s Disease, Severe Rheumatoid Arthritis and Ulcerative Colitis, Deafness, Blindness, third-degree burns, Severe Osteoporosis.

Optional Covers Under HDFC ERGO my:credit Comprehensive Suraksha

By paying an additional premium, you can opt for any of the following covers

Cardiac Arrest – The cover comes into play if the insured suffers from cardiac arrest after 90 days from the first commencement of critical illness cover.

Molecular Gene Expression Profiling Test – Under this, HDFC ERGO General Insurance will pay the expenses incurred towards Molecular Gene Expression Profiling Test for Treatment Guidance on the diagnosis of Cancer of specified severity (available only once during lifetime).

Pregnancy Complication – Cover medical expenses arising from pregnancy complications such as Disseminated Intravascular Coagulation (DIC), Ectopic Pregnancy, Molar Pregnancy and Eclampsia. Under this, 25% of the Sum Insured will be payable to the insured person, subject to the maximum limit mentioned on your policy schedule.

Newborn Complication – When the insured person’s baby is born during the coverage period, HDFC ERGO my:credit Comprehensive Suraksha plan will cover the following under this optional cover

  1. Down’s Syndrome
  2. Spina Bifida
  3. Tetralogy of Fallot
  4. Cleft Palate
  5. Ventricular Septal Defect
  6. Patent Ductus Arteriosus
  7. Surgical Separation of Conjoined Twins

Preventive Health Checkup – After each policy year, you will be entitled to Preventive Health Checkup at HDFC ERGO network hospitals.

Post Diagnosis Assistance – Outpatient counselling upon the diagnosis of Critical Illnesses or undergoing Surgical Procedures. The cover will be up to the sum insured.

Second Medical Opinion – Any medical consultation expenses towards a second medical opinion related to the critical illness and surgical procedure.

Loss of Job – Get the Sum Insured if you suffer from Loss of Job due to the Voluntary Resignation or Termination from employment within 6 months of diagnosis of any of the Major stage critical illnesses or undergoing any of the major stage surgical procedures.

Note – Under this optional cover, loss of job due to retirement or resignation after or during such probation will not be considered admissible for the claim.

Pre Diagnosis Cover – Coverage for Renal/Cardiac Angiogram, Intravenous Pyelogram, Ultrasonography, Ultrasound Guided FNAC, Colour Doppler, Mammography, CT Scan, MRI Scan, Treadmill Test ECHO, Cardiogram, Electrophysiology, Endoscopic Procedures, Special Radiological Procedures such as barium meal investigations, Arthrogram, ERCP, Intravenous Urogram, Cystourethrogram, Nephrostogram, Special Blood Investigations such as assay of various blood factors, Virology Markers, Complete Coagulation Work up

Note – HDFC ERGO my:credit Comprehensive Suraksha will have a waiting period of 90 days for critical illnesses, and if any of the illness is diagnosed to you during the policy period, 100% of the sum insured will be paid, except for Angioplasty. As per the HDFC ERGO terms and conditions, only 25% of the sum insured, subject to a maximum of INR 10 lakh, can be used for Angioplasty-related claims.

General Exclusions from HDFC ERGO my:credit Comprehensive Suraksha

  1. War or any act of war, invasion, an act of a foreign enemy, war like operations
  2. Breach of law with criminal intent
  3. Intentional self-injury, attempted suicide or suicide
  4. Servicing in naval, military or air force operation
  5. Participation in racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing of a professional or semi-professional nature
  6. Use of tobacco, intoxicants such as drugs and alcohol
  7. Treatment of obesity and any weight control
  8. Sleep-apnoea, Parkinson and Alzheimer’s disease, general debility or exhaustion
  9. Congenital external diseases, defects or anomalies
  10. Stem cell harvesting
  11. Growth hormone therapy
  12. Venereal disease
  13. Sexually transmitted diseases or Illnesses
  14. Pregnancy
  15. Treatment to treat infertility, fertility, sub-fertility or assisted conception procedure
  16. Sterility treatment whether to affect infertility, surrogate or vicarious pregnancy
  17. Birth control
  18. Contraceptive supplies or services
  19. Treatment and supplies for spinal subluxation
  20. Diagnosis and treatment by manipulation of the skeletal structure or for muscle stimulation, except treatment of fractures and dislocations of the mandible and extremities.
  21. Circumcisions
  22. Sex transformation operations
  23. Plastic surgery or cosmetic surgery
  24. Experimental, investigational or Unproven treatments
  25. Investigation & Evaluation;
  26. Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long term nursing care or custodial care.
  27. Preventive care
  28. Any physical, psychiatric or psychological examinations or testing
  29. Vaccination, inoculation and immunisations

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