HDFC ERGO Health Optima Cash plan offers comprehensive coverage in the hour of need. It offers a daily cash benefit during a hospitalisation. This amount can be utilised to pay off the non-medical expenses while hospitalised.
This policy pays a lump sum that can be used for either medical expenses or other related expenses incurred during hospitalisation such as attendant’s food, travel and accommodation and so on. Usually, these expenses are not covered by a health insurance policy but can be equally daunting. Therefore, by purchasing HDFC ERGO Health Optima Cash plan, you can cover the additional expenses incurred during hospitalisation. In addition, the biggest USP of this plan is no pre-medical health test and less paperwork. You can earn tax benefit for the premiums paid towards this plan.
The policy comes with the following features:
Benefit |
Coverage |
Duration |
Sickness Hospital Daily Cash |
Daily hospital cash allowance in case of hospitalisation for the period of 24 hours or more due to any illness
|
Maximum up to 90 days. 180 days per policy tenure |
Sickness ICU Cash |
Double the Daily cash amount for a period of 24 hours of hospitalisation where the policyholder is admitted in ICU due to a sickness |
Maximum up to 15 days per policy year. |
Accident Hospital Cash |
Daily hospital cash allowance in case of hospitalisation for the period of 24 hours or more in case the policyholder is hospitalised due to an accident
|
Maximum up to 90 days. 180 days per policy tenure |
Accident ICU Cash |
Double the Daily cash amount for a period of 24 hours of accidental hospitalisation where the policyholder is admitted in ICU |
Maximum up to 15 days per policy tenure |
Day Care Procedure Cash |
50% of cash allowance is offered for 10-day care procedures where 24 hours of hospitalisation is not required
|
The benefit can be availed for a maximum 6 daycare procedures in a policy tenure |
Joint Hospitalisation due to an Accident |
If more than one insured person is hospitalised, double daily cash amount for each (24 hours hospitalisation is required) |
Maximum up to 10 days per policy year |
Convalescence Cash |
Lump sum amount is paid as daily cash if the person is hospitalised for more than 7 continuous days |
Payable once per policy year |
Parent Accommodation |
In case the insured child age is 12 or less than 12 year and is hospitalised for more than 72 hours, a cash amount supporting parent’s accommodation during hospitalisation is offered
|
Maximum up to 30 days per policy year |
Child Birth |
Lump sum amount equivalent to twice the Daily Cash amount for female insured in case of pregnancy or during childbirth |
Can be availed twice in the policy tenure |
The additional benefits offered under the HDFC ERGO Health Optima Cash Plan are:
The applicable waiting period under which the policy can’t be claimed are:
The common exclusions of HDFC ERGO Health Optima Cash Plan are:
For the complete list of exclusions, please refer to the Policy Fine Print
Minimum Entry Age |
5 years |
Dependent Children |
91 days |
Maximum Entry Age |
65 years |
Policy Ceasing Age |
No bar |
Policy Tenure |
1 or 2 years |
HDFC ERGO Health Optima Cash offers lifelong renewability where is no policy ceasing age. The insured needs to renew the policy once in a year to get the policy benefits. One can either do it online or offline. Online renewal of Optima Cash policy requires the insured to visit the official website and follow the renewal instructions:
The insurer offers a grace period of 30 days in case the insured forgets the renewal due date. He/she has to renew the policy without a fail to avoid policy lapse.
The policy premiums are subjected to change with approval from IRDA only. Although policy terms regarding the premiums remain the same throughout the tenure, in case of any change with due permission from IRDA, the same has to be intimated to the customers as well. The insurer informs the policyholder regarding any change in the premiums 3 months prior to the policy renewal due date.
HDFC ERGO Health ensures smooth and fast claim settlement in a hassle-free manner. You can register your claim online by approaching the online claim option. Or you can approach the customer care executive who guides you through the claim process.
The foremost thing is to inform the insurer without a delay. If it is a planned hospitalisation, inform them 48 hours prior to the hospitalisation, while in case of emergency hospitalisation, it has to be informed within 24 hours of hospitalisation. A pre-authorisation letter has to be filled and submit by requesting for the approval from the insurer. the cashless services can be availed once the insurer approves the request.
While registering your claim, the following information will be required. You can inform the insurer by calling on the too-free number and register along with the below details:
Under cashless service, you can avail the treatment free of cost, while the insured expenses are settled directly with the hospital authority.
When healthcare services are taken from a non-network hospital, you can claim your policy under the reimbursement clause. Here the medical expenses are borne by you initially and can be reimbursed by filing a claim after getting discharged from the hospital. The original hospital bills are to be attached with the claim form, along with the other supporting documents. The claim is settled upon verification of documents and the approved amount is transferred to the insured’s savings account.
The following documents are to be furnished to claim HDFC ERGO Health Optima Cash Plan:
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