HDFC ERGO’s Health Suraksha Plan

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Highlights
  • Optimized health insurance plans at affordable rates
  • Option to choose Individual or Family Floater Health Insurance
  • Choose a health insurance plan from either an annual policy or a two year policy
  • Get a Cumulative Bonus on completion of every claimless year
  • Get Health Check-up expenses reimbursed on completion of 4 claimless years
  • A network of more than 4800+ hospitals to choose from to avail cashless services
  • Health check-up not mandatory for individuals below 45 years of age
  • Get benefits on Income Tax under Section 80D of the Income Tax Act
  • Enjoy hassle free claim procedures with least documentation and settlement times
  • No Sub-limits on hospital room rents, hospital expenses, specific diseases and doctor fees.
Features
Schedule of Benefits - Individual & Family Floater
Basic Sum Insured per Policy Year Rs. 200000, Rs. 300000, Rs. 400000, Rs. 500000
In-patient Treatment Hospitalization costs due to illness or accident are covered upto the Policy Sum Insured
Pre-hospitalization Medical costs incurred during 60 days prior to hospitalization are reimbursed
Post-hospitalization Medical costs incurred during 90 day period following discharge post hospitalization are reimbursed
Day Care Procedures Expenses for 144 listed day care procedures that does not need 24 hours hospitalization on account of technological advancements are reimbursed
Domiciliary Treatment The Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise have required Hospitalization on the advice of the attending Medical Practitioner, if the Insured Person could not be transferred to a Hospital or a Hospital bed was unavailable are reimbursed
Organ Donor Medical costs for harvesting an organ donated are reimbursed
Emergency Ambulance (Limit per hospitalisation) Upto Rs. 2,000 reimbursed as ambulance expenseduring an emergency
AYUSH Benefit Inpatient treatment medical expenses under Homeopathy, Siddha, Ayurveda or Unani are reimbursed.
Cumulative Bonus Every claim free year increases the Sum Insured by 5%(of the basic sum insured); upto a Max. 50%(of the basic sum insured) increase.
Medical checkups Reimburses 1% of Sum Insured or Rs. 5000 whichever is less.
Exclusions
  • A Waiting Period of 30 days for claims
  • A Waiting Period of 2 years for Particular Diseases and Treatments like surgery on tonsils and sinuses, internal tumors, cysts etc.
  • Pre-existing conditions not covered until covered for 48 months continuously
  • War or any sort of armed conflicts
  • Breach of any law with an intent of crime
  • Suicide attempts/ Suicide, injuries due to an act of self-destruction or self-inflicted injury
  • Terrorist activities, radioactivity or war
  • Claims for illnesses arising due to intoxication of Drugs and Alcohol
  • AIDS / HIV
  • Plastic or cosmetic surgeryunless carried out as a part of medically required treatment
  • Vaccinations including inoculation and immunizations taken as part of preventive measures
  • Refer to the Policy Wording document for a complete list of exclusions

 
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