Insurance Plans 677 views November 14, 2019

HDFC Ergo Health Suraksha Silver Insurance Plan

About Health Suraksha Silver Insurance Plan

HDFC Ergo gives great precedence to health, which is why it has established an extraordinary health plan. This health plan is called the HDFC Ergo Health Suraksha Silver Insurance Plan. What makes this health plan different than the other ordinary health plans is that it safely secures you against high-end medical costs through comprehensive coverage. The strong and clear intention of this health plan successfully protects families, individuals, and senior citizens who seek health plans between the range of 3 lakhs INR to 5 lakhs INR. This distinct health plan also offers renewal bonuses as rewards, if claims aren’t made for one complete year.

Let’s have a look at the various beneficial features of HDFC Ergo Health Suraksha Silver Insurance Plan:

  1. The Suraksha Silver Insurance Plan provides its customers with free health check-ups for every renewal. They do their best to ensure that their customers are healthy.
  2. Staying true to its name, the policy strives to protect you in all ways. It provides you with a cashless home health care service. This means that if the customer is advised by the doctor in-home treatment, then the customer can easily avail of this service without spending any money. For instance for the treatments towards chemotherapy, dengue, hepatitis, gastroenteritis, fever management, etc.
  3. No claim bonus: Here, for every year that is claim free, you receive a cumulative bonus wherein the sum insured is increased by a particular percentage each year.
  4. Co-pay: Some percent of the permitted claim is undertaken by the insured. (10% discount on base premium if the insured chooses a 10% co-pay option; likewise, a 25% discount if he or she chooses a 20% co-pay option).
  5. No room rent capping as you can avail of all healthcare facilities and comforts under this plan.
  6. With the sum insured rebound facility, customers can receive an additional amount equal to the permitted amount of the claim up to the sum insured.
  7. It offers pre-hospitalisation as well as post-hospitalization covers. Full coverage is provided on doctor consultations, check-ups, rehabilitations, medical prescriptions, etc. However, pre-hospitalization covers are given 60 days before hospitalization. Whereas, post-hospitalization covers are provided until 180 days of discharge from the hospital.
  8. Daycare hospitalization expenses are also covered. 586-day care procedures are covered under this incredible health plan.
  9. All hospitalization costs like nursing costs, bed charges, ICU, blood test costs, along with complete consultation fees are covered completely.
  10. The above also includes mental health care costs, which means hospitalization expenses are covered if the insured customer suffers from any mental illness.
  11. If the insured has been hospitalized for 10 consecutive days, he or she is liable to receive a lump sum amount of 5000 INR as a recovery benefit. This is given with respect to cover daily household expenses so that the insured does not get stressed or worried.
  12. In case the insured customer faces a life-threatening medical emergency, a road ambulance cover is provided for travel from hospital to home within the same city.
  13. Since nothing is nobler than a person donating his or her organs, HDFC Ergo Health Suraksha Silver Insurance Plan provides coverage for organ harvesting costs undertaken by the donor, in a situation wherein the insured needs to undergo an organ transplant.
  14. Indeed offering full coverage, this Plan provides coverage for treatments such as Unani, Ayurveda, Sidha, and Homeopathy as well. Its main motto is the insured’s well being.

Benefits not offered by HDFC Ergo Health Suraksha Silver Insurance Plan:

  1. The HDFC Ergo Health Suraksha Silver Insurance Plan does not provide coverage for injuries caused due to adventure sports. Hence, if the insured suffers any kind of injury due to adventure sports, none of the hospital expenses will be covered by the company.
  2. Although wars are extremely dangerous, devastating and life-threatening, this policy does not cover accidents caused due to war-like situations.
  3. With its utmost intention of wanting a happier and healthier life for its customers, the plan does not provide coverage for self-inflicted injuries done to oneself as it does not want you to harm or hurt yourself in any way.
  4. This Health Suraksha Silver Plan does not offer coverage for any accidents caused due to participation in defense operations. (Navy, Army or Air Force)
  5. Empathizing with the severity of such situations one may face, this plan does not provide coverage for venereal or sexually transmitted diseases.
  6. HDFC Ergo Health Suraksha Silver Insurance Plan also does not provide coverage for cosmetic surgery and obesity treatment charges.
  7. Expenditures incurred from unproved or investigational treatment.

Documents required for claims:

  1. Appropriately filled and signed claims form, along with HDFC Ergo policy number claim form
  2. Original documents: Discharge summary, a bill with appropriate breakups, receipts and medical invoices along with prescriptions, investigation reports like blood tests, X-ray, etc.
  3. Any documents of treatments done in the past
  4. Medico-Legal Certificate (MLC) or FIR, in case of an accident
  5. NEFT details for payment: canceled cheque or passbook copy attested by the bank
  6. For claim up to 1 lakh INR and above: KYC form as well as a photocopy of anyone KYC document i.e. passports, Aadhaar card, driver’s license, voters ID, etc.
  7. On receiving all the documents correctly, the claim is processed within 7 days of receiving the last document.

Claim procedure of HDFC Ergo Health Suraksha Insurance Plan:

  1. The insurance company needs to be informed within 7 days from the ate of hospitalization.
  2. The insurance company needs to be intimated before the beginning of any treatment, process or consultation.
  3. It is important for the insurance company to provide authorization for these procedures.
  4. The necessary documents and reimbursement claims need to be submitted to the insurance company within 15 days from the discharge date or treatment completion date, whichever is earlier.
  5. Following this, the insurance company will pay the reimbursed amount to the person concerned.

Summary

HDFC Ergo Health Suraksha Silver Plan strives to comprehensively protect you and your family against hospitalization costs and provides you with valuable advantages. Although it is an all-inclusive health insurance plan, it is available at affordable rates. However, it is to be noted that the medical treatment must be availed in India only.

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