HDFC ERGO Energy for Diabetes Health Insurance Policy

Living with lifestyle diseases like Diabetes can be difficult at times. But you shouldn’t put your life at hold for this. Apart from following a strict diet and active lifestyle, apt HDFC ERGO Health Health Insurance helps you fit diabetes around your lifestyle. HDFC ERGO Health Energy Plan is one such option that partners you in living with diabetes successfully. Here’s how you can deal diabetes with HDFC ERGO Health Energy Plan.

Key Features of HDFC ERGO Health Energy Plan

The policy comes with the following features:

  • Avail cashless access to over 4500+ network hospitals in over 800 cities
  • The plan comes with a personalised wellness programme
  • Avail no claim bonus for every claim-free year up to a maximum of 100%
  • Tax benefit for the premiums paid towards HDFC ERGO Health Energy Plan
  • Free health check-ups
  • Coverage extended from day 1, no waiting period to serve
  • Stay healthy and avail policy discount up to 25%
  • Multiple sum insured options to choose from 2,3,5, 10, 15, 20,25,50 (lakhs)
  • The policy comes with restoration benefit
  • The policy comes with a co-payment of 20% on the total claim

HDFC ERGO Health Energy Plan Benefits

The policy benefits can be categorised into:

Category Coverage
Sum insured Offered 2,3,5, 10, 15, 20,25,50 (lakhs)
In-patient Expense up to sum insured Nursing expenses, ICU cost, expenses of Anaesthesia, OT, medicines, diagnostic procedures, X-ray, Oxygen etc.
Restore benefit Covered
Day Care Procedures Covered 182-day care procedures including for Cancer Chemotherapy, Haemodialysis, biopsy, Coronary angiography, Nasal sinus aspiration, cataract etc.
Pre-hospitalisation Expenses incurred due to treatment 30 days prior to the hospitalisation
Post-hospitalisation Expenses incurred due to treatment 60 days prior to the hospitalisation
Organ Donor Expenses on harvesting an organ including surgery from a donor in case of organ transplantation
Wellness Programme Health coach, routine medical monitoring, diet and fitness plan
HbA1C Check-up Benefit Rs. 750 reimbursement paid twice a year
Emergency Ambulance Rs. 2000 per hospitalisation in case of transporting the insured form the point of occurrence of the event or availing better treatment from another hospital

Additional Benefits under HDFC ERGO Health Energy Plan

  • E-opinion - The insurer arranges for the second opinion from a medical expert from their panel if the insured requests. This benefit can be availed once in a policy tenure
  • Portability Benefit: The insurer ensures a smooth portability option in case you are not satisfied with the existing health insurance provider and want to shift to HDFC ERGO Health . You can browse over the plan according to your comfort and switch without losing the accumulated policy benefits such as NCB bonus or waiting period.
  • Cashless Service - You can avail cashless services at more than 4500 network hospitals of the insurance provider. In order to avail so, a pre-authorisation letter and health card will be required. The process of applying for cashless services is mentioned in the policy document.
  • Tax Benefits - With HDFC ERGO Health Optima Vital plan, you can save on tax under Section 80D of Income Tax Act. The premiums paid towards the policy are exempted from the tax deduction.
  • Sum Insured Enhancement - The basic policy sum insured can be enhanced at the time of renewal if insured feels the existing SI insufficient. It may be subjected to a medical test or the waiting period will be applied afresh depending on the amount up to which the sum insured is enhanced.
  • Restore Benefit Feature: Avail 100% restore benefit of your basic policy sum insured, in case of exhaustion. Let’s say you have a cover with basic sum insured Rs. 10 lakhs and make a claim of Rs. 3 lakhs. With this cover, you’ll have 7+10 =17 lakhs, which is available at the same price you paid for 10 lakhs cover.

HDFC ERGO Health Energy Plan: Policy Exclusions

HDFC ERGO Health Optima Plan cannot be claimed under below conditions:

  • No claim will be entertained within the first 90 days of the policy period
  • Claim arising due to a pre-existing condition will be covered after 2 years of the waiting period
  • Any critical illness in the presence of HIV /AIDS or other related illness
  • 2 years of the waiting period for covering specific illnesses
  • Congenital internal and external diseases, mental disorder
  • Use of alcoholic or intoxicating substances leading to an adverse health condition
  • Health condition arising due to war or act of war, use of a nuclear weapon, chemical weapon or radiation of any kind
  • Any expenses arising from pregnancy, miscarriage, maternity or birth are excluded
  • If the insured person is involved in any illegal activity, breach of law or injury arising due to suicide or attempts the suicide
  • Participation in navy, military or air force operations, adventurous activities leading to injury or serious health conditions are not covered

(For the complete list of exclusion, please refer to the policy document)

HDFC ERGO Health Energy Plan-Know the Basics

Feature Age
Minimum entry age 18 years-25 years 
Maximum entry age 65 years
Renewal age lifelong
Family Definition Individual Plan - A maximum of 4 adults and a maximum of 5 children can be included
Calculation of premium Basis of age and the sum insured chosen
Policy Tenure 1 & 2 years
Sum Insured 2,00,000-50,00,000

Waiting Period to be Served Under HDFC ERGO Health Energy Plan

  • Day 1 coverage for any health complication arising out of Diabetes
  • 2 years waiting period for pre-existing illness (other than diabetes or Blood Sugar)
  • 2 years waiting period to cover the specific illnesses

Discount to be Availed under HDFC ERGO Health Energy Plan

A 7.5% discount in case the policyholder pays 2 years premium in advance as a single premium.

HDFC ERGO Health Energy Plan Renewal Process

HDFC ERGO Health Optima Vital Plan can be renewed either online or offline. Online renewal offers the comfort of renewing your policy even sitting at the office or lying on the bed. To renew your policy online, the insured has to follow certain steps.

Below are the steps of renewing the policy online:

  • Visit the official website of HDFC ERGO Health and navigate through the ‘Renew Your Policy’ option
  • Mention the policy number. If you have renewed the policy earlier, mention the 12-digit policy number. If you are renewing for the first time, mention the 10-digit policy number and proceed
  • Calculate the premiums online and pay it using a credit/debit card or net banking
  • You’ll receive an instant renewal message with an acknowledgement. The renewed policy will be sent to the registered email Id. You can download the policy instantly.

The premiums are subject to change as per the prior approval from IRDA. However, the insurance company is obliged to intimate the insured about any change 3 months prior to the renewal date. The waiting period will reduce by 1 year with every renewal. Any change in sum insured can be initiated at the time of renewal only. Moreover, the portability benefit can be availed at the time of renewal.

HDFC ERGO Health Energy Plan Claim Process

  • In order to claim the HDFC ERGO Health Energy plan, immediately intimate the insurer by registering your claim. You can call the helpline number or write to them. The claim assistance officer will guide you through the claim process.
  • A claim form will be submitted along with the required documents supporting the claim
  • Upon receiving and verification of claim documents, the insurer will settle the claim either cashless or reimbursement mode.

Documents Required for Claiming HDFC ERGO Health Energy Plan

  • The duly filled and signed claim form by the insured person
  • Original medical bills including chemist bill, diagnostic bill, consultation fee etc. along with the receipts, prescription supporting the amount
  • Original payment receipts
  • Medical reports signed by the attending doctor, stating about the nature of the illness, occurrence and treatment suggested
  • Discharge letter with the date of admission and discharge
  • Invoice of implants, if any
  • An exact diagnosis of the treatment for which a claim is made
  • Previous treatment record, if any
  • Treating doctor’s certificate

How to Buy HDFC ERGO Health Energy Plan

HDFC ERGO Health Energy plan can be bought either online or offline. To buy online, you can visit the official website of the insurer and fill the online application form:

  • Visit the official website of HDFC ERGO Health and Navigate through the Energy Plan
  • Fill the online application by providing personal information and medical history. Make sure the information given is true
  • Submit the completed application form and proceed to the premium option
  • You will get premium options along with the mode. Select your preferred mode of payment and pay it accordingly.
  • In case of a pre-medical check-up, you can opt for any of the network hospitals to avail cashless service, where the expenses incurred due to test will be reimbursed on the proposal of the policy. In case your proposal is declined, the cost of the pre-policy check will be deducted from the refundable premium.

You can buy the plan by approaching an authorised broker who will help you in the formalities. Make sure you are provided with the correct information and double check the policy terms and conditions before paying or handing over the premium cheque.

Written By: PolicyBazaar - Updated: 08 January 2021
Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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