Insurance Plans March 2, 2020

HDFC Ergo Health Suraksha Plan

HDFC ERGO General Insurance Company Ltd. is a joint enterprise between HDFC Ltd, India’s foremost Housing Finance Institution and ERGO International AG, the topmost insurance company of the Munich Re Group. The Company offers an assortment of numerous general insurance products which starts from Health, Home, Motor, Travel and Personal Accident plans for the retail customers with custom-made products. And Health Insurance is the most common and crucial insurance for all, as we need to ready for any untoward incident that may have a huge financial requirement. Health insurance plans with low premium will come as a saviour in those situations.

Health Insurance

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Presenting, HDFC Ergo Health Suraksha health plan will take care of yourself and your family in all possible ways with its extensive range of benefits.

HDFC Ergo Health Suraksha plan has been categorized into three plans mentioned below that suit the requirements of individuals at different levels and you can choose the best one that will take care of your financial needs.

  1. HDFC Ergo Health Suraksha- Silver Smart
  2. HDFC Ergo Health Suraksha- Gold Smart
  3. HDFC Ergo Health Suraksha- Platinum Smart

Let us see the main features HDFC Ergo Health Suraksha as a whole:

Multiple Sum Insured: You can choose between a wide range of sum insured starting from INR 3 lakhs till INR 75 lakhs

  1. No limit in the Entry Age: There is no limit in the entry age under the plan
  2. Coverage of certain selected expenses: You can get a cover for recovery, infertility and air ambulance
  3. Flexible Benefits: Option to choose the limit of the room rent or co-pay to avail the premium discount
  4. Basket of Discounts: Several discounts prevail like long term plan discount, family discount as well as a discount for your loyalty
  5. 3 years term option: You can get to choose a 3-year term and pay a lucrative premium
  6. The facility of Instalments: The yearly premiums can be paid in 3, 6 and 12 parts
  7. Incentives for good health: You are entitled to get discounts for maintaining good health at the time of renewal
  8. Pre-hospitalization expenses: Expenses are covered until 60 days before the admission in hospital
  9. Post-hospitalization expenses: Expenditures are covered until 180 days after release from the hospital
  10. Domiciliary Hospitalization: Coverage of domiciliary expenditures
  11. Road and Air Ambulance: Coverage for availing the road ambulance as per the plan chosen
  12. Day Care Coverage: Coverage for daycare treatments
  13. Cover for Organ Donor Costs: The benefit gives the coverage for expenses incurred for organ donation for hospitalization
  14. Alternate Treatment: You can go for alternative treatments under Ayus, Sidha, Unani, Homeopathy and Naturopathy treatments and the same will be covered as well
  15. Recovery benefit: For 10 successive and continuous days of hospitalization the expenses of hospitalization will be compensated
  16. Wellness discount: You can avail Wellness Discount towards the renewal premium and the table is as follows:
    Healthy Weeks AccruedPremium Discount (%)
    1-40.50
    5-81
    9-122
    13-163
    17-266
    27-367.50
    > 3610%
  17. Several Optional Covers: Many coverages like Child Care, Parent and Child Care Cover, Parent Care, non-medical cost cover, etc
  18. The benefit of Tax: Tax exemption under section 80D of the Income Tax Act

Eligibility under HDFC Ergo Health Suraksha

Entry age Proposer -Minimum 18 years, Maximum- No limit
Dependant Adult- Minimum 18 years, Maximum- No limit
Child- Minimum 91 days, Maximum- 25 years
Term of the Policy (in years)1, 2, 3
RenewalLifelong
Type of PlanIndividual or Family Floater
Sum InsuredSilver Smart: INR 3 lakhs till INR 5 lakhs
Gold Smart: INR 7.5 lakhs, INR 10 lakhs, and INR 15 lakhs
Platinum Smart: INR 20 lakhs, INR 25, INR 50 lakhs and INR 75 lakhs
Premium Depends on the age, the sum assured or the plan chosen and family size

Exclusions under HDFC Ergo Health Suraksha

The main exclusions are listed as below under the plan: For further details, you can visit HDFC Ergo official site https://www.hdfcergo.com/health-insurance

  1. Pre-existing diseases under HDFC Ergo Health Suraksha will be covered only after 3 years waiting
  2. HIV or AIDS-related diseases
  3. Illegal activity
  4. Plastic or Cosmetic Surgery
  5. Any expenses arising due to dangerous sports like racing, diving, scuba diving, etc.
  6. Expenses under the influence of alcohol and drugs
  7. Dental treatment, external aids, pregnancy and appliances
  8. Hospitalization due to any chemical or biological weapon, war or an act of war, nuclear war and any radiation
  9. Hereditary outside illnesses, mental disease, non-allopathic treatment, weight control treatments, etc.
  10. New treatments
  11. Sleeping disorders, Parkinson and Alzheimer

Claims under HDFC Ergo Health Suraksha

The claim process for HDFC Ergo Health Suraksha is hassle-free and user-friendly. You would need to submit the essential documents together with the KYC and NEFT details of the insured person and write to healthclaims@hdfcergo.com for cashless as well as reimbursement process. HDFC Ergo will keep you informed on the position of your claim and the same will be sent to either at your registered mobile number or email id.

Documents required under HDFC Ergo Health Suraksha

Below is the list of documents needed for the claim:

  1. Completed and signed Claim Form with HDFC Ergo policy number
  2. Summary of Discharge in original
  3. The final bill in original with the breakups, payment invoices and pharmacy invoices with prescriptions
  4. Reports of all Investigations in original like any X-Ray, blood report or any other reports
  5. Implant sticker or the invoice, if needed, the lens for cataract, etc
  6. Documents after the treatment, if needed
  7. Medico-Legal Certificate or MLC or FIR in case of an accident
  8. Other appropriate and valid documents, if required
  9. Details of NEFT of the insured person
  10. Claims greater than INR 1 lakh: KYC form with a duplicate of anyone KYC document of the insured person like an Aadhaar card, driving license, passport, voter ID and the KYC Form

Stay healthy with HDFC Ergo Health Suraksha and lead a tension free life with your family members as HDFC Ergo Health Suraksha, you need not worry anymore about the uncertainties. Analyze your needs, compare the benefits and choose HDFC Ergo Health Suraksha.

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