HDFC Ergo Health Suraksha Regain Plan

HDFC Ergo Health Suraksha Regain Plan Overview

HDFC Ergo Health Suraksha with Regain and ECB Health insurance plan provides coverage to your medical emergencies in a most comprehensive manner. All the expenses including pre and post hospitalization, in-patient hospitalization expenses, domiciliary hospitalization, organ donor expenses are taken care off. You can get all the benefits by paying an annual premium amount.  

If the sum insured is exhausted, the plan provides automatic reinstatement of the sum assured.  Moreover, there are no sub-limits applicable to the doctor fees, treatment of diseases; hospital room rent expenses and other in-patient treatment expenses.

HDFC ERGO Health Suraksha Regain & ECB Health Insurance Plan Features and Benefits

• Cashless treatment available in more than 6000 network hospitals
• No capping on entry age
• Sub-limits not applicable on AYUSH treatment
• 10% of cumulative bonus for every claim free year ( subjected to policy limitations)
• Both Individual and family floater plans
• REGAIN benefit - Automatic reinstatement of the sum insured when it’s exhausted
• Tax benefits under Sec 80/D of the Income Tax Act
• Quick claim settlement process
• No Sub-limits on any treatment of disease, hospital charges, doctor fees, room rent, expenses, etc.

Inclusions of HDFC ERGO Health Suraksha Regain & ECB Health Insurance Plan

• In-patient hospitalization expenses are covered. This includes room rent charges, boarding and nursing expenses, doctor fees, cost of prosthetic devices, implantations, surgical equipment’s, blood, oxygen, etc.
• 60 days Pre-hospitalization expenses and 90 days of post-hospitalization expenses
• 144 listed day care procedures are included. This includes treatments for which more than 24 hours of hospitalization is not required.
• Domiciliary hospitalization for health treatment taken at home. The treatment should be on the advice of the doctor. Only applicable to cases where hospitalization is required but cannot be availed due to the health condition of the patient, unavailability of beds in the hospital, etc.
• Coverage to organ donor expenses
• Coverage to emergency ambulance charges up to Rs. 2,000, if the sum insured amount is up to Rs. 5 lakhs. Up to Rs 3,500 coverage to ambulance expenses for sum insured ranging between Rs. 7.5 lakhs & 10 lakhs
• AYUSH cover that includes inpatient hospitalization expenses under Ayurveda, Homeopathy, Unani, Siddha up to the sum insured
• After 4 years of claim free years, up to Rs. 5000 of health check-up benefits or 1% of sum insured to be reimbursed
• Enhanced Cumulative Bonus of 10% for every claim-free year. For each claim, the bonus will decrease by 10%
• Regain benefits, which includes reinstatement of the sum insured with a cumulative bonus upon its exhaustion

Regain Benefits

• The basic sum insured is recovered once it is exhausted. This is included the cumulative bonus during the policy period
• Reinstatement of sum assured will take place only once during a policy period
• If not utilize this shall not be forwarded to the next policy year
• Regain Sum insured can be utilized only for future claims. It cannot be claimed against any disease or illness or any complication for which the premium was already paid during the policy period

Discount Benefits

• 10% discount on the purchase of a 2-year policy
• 10% of family discount if the individual sum assured opts for more than family members in the family plan

Exclusions of HDFC ERGO Health Suraksha Regain & ECB Health Insurance Plan

• Any disease diagnosed within the initial 30 days of policy purchase unless it is an accidental injury
• Pre-existing diseases to be covered after a waiting period of 2 years
• A waiting period of 2 years for treatment of specific diseases and surgeries like tonsils, cysts etc.
• Expenses incurred on treatment of HIV, AIDS and other related diseases
• Treatment for psychological disorders, depression, anxiety, cosmetic surgeries etc.
• Overconsumption of alcohol, drugs, and any other intoxicant
• Hospitalization required due to war conditions, nuclear radiations, war conditions etc.
• Pregnancy-related disorders, dental surgeries or treatment
• Expenses incurred on the purchase of any external aids, spectacles, and appliances if not covered in the plan

Sum Assured (Rs.)

Sum Insured Rs. 3 lakhs, 4 lakhs, 5 lakhs, 7.5 lakhs & 10 lakhs

Pre-policy Check-up Procedure

It is mandatory to go through a pre-policy medical check-up if you are above 45 years of age. On the basis of this your application will be accepted or rejected and the cost of premium will be decided.

Benefits of Pre-Policy Check-Up Process

• People above 45 years of age or with a pre-existing disease can submit their application online.
• You can submit the proposal online and make the payment online
• HSFC Ergo health insurance team will contact you once you submit your application
• The application will be accepted and premium will be decided on the basis of the pre-existing disease and results of the medical check-up
• The application status can all check However, the insurer will update you the status on email and SMS

*The cost of pre-policy medical check-up will be borne by HDFC Ergo health insurance once the proposal is accepted

Procedure to Make Changes in HDFC Ergo Health Suraksha with Regain and ECB Plan

If Changes are Required in the Salutation/Gender/ Address/Beneficiary name

• File your request online
• Dial their emergency assistance number to speak to them on their helpline number
• Write an email to their claim to request changes

If Changes are Required in the Name and Date of Birth of the Insured Members

• Request for it online
• Additional premium to be paid if changed in date of birth is required
• Provide Identity proof - PAN Card, Voter ID, Passport (any)