HDFC Ergo Health Suraksha Regain Plan

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Introduction

“Health is the soul that animates all the enjoyments of life, which fade and are tasteless without it”. Health Suraksha Regain plan covers you and your family against medical expenses. It covers your expenses at affordable rates.

Key Features

  • 4800+ network hospitals to avail cashless service.
  • It covers pre and post hospitalization expenses.
  • Ayush covers is provided without any sublimit.
  • There are two options available- Individual policy or Family floater policy.
  • No sub limits on room expenses, hospital charges and ICU expenses.

Benefits

  • Claims settlement is hassle free with less documents and turnaround time.
  • Cumulative bonus: sum insured is increased by 10 % on every claim free renewal and it can be increase up to 100% on continuous claim free renewals.
  • Income tax benefit can be availed under section 80D.
  • Cost of health checkup up to 1% of sum insured will be paid on 4 consecutive claim free renewals.
  • If two or more members are covered under this policy, then a discount of 10% can be availed.
  • 10% discount on premium if the policy period chosen is 2 years.

Regain benefits: Under regain benefits, health insurance sum insurance is regained in one policy period once it is exhausted.

  • Under regain benefits it will only be reinstated once in a policy period.
  • Regain benefit can’t be withdrawn on renewals.
  • Regain benefit is only available for other future diseases not for illnesses for which claim has already been paid in the present year.

Details about Premium

  • There are different sum insured available under this policy. Different sum insured options are: 3lacs, 4lacs, 5 lacs.7.5 lacs and 10 lacs.
  • Premium amount will depend on the age and sum insured chosen by the proposer.

 

Policy Details

Minimum sum insured: Rs 3, 00,000

Maximum sum insured: Rs 10, 00,000

Policy period: There are two policy periods available for this policy. Proposer can either choose one year or two year as policy period.

Free look period: If the policy holder is not happy with the terms and conditions of policy, he/she can cancel the policy giving the reason for cancellation of policy.

Grace period:If the payment is due on renewal of the policy, grace period of 30 days is given to the policyholder to make the payment.

Lifelong renewability: This policy can be renewed for lifelong.

Documents Required

A proposer has to fill up an ‘Application form/ proposal form’ with accurate medical history along with the address proof. In certain conditions, medical examination may be required in some cases, based on the sum assured and the age of the person. No medical checkup is required for a person of 45 years of age.

Eligibility Criteria

  • Children above 5 years can be covered provided their parents are also covered under this policy.
  • There is no limit at age of entry.

Inclusions

Treatments

Coverage

 

Emergency Ambulance (Limit per hospitalization)

Up to Rs. 2,000 for SI 300000, 400000 & 500000 AND Rs 3,500 for SI 750000 & 1000000 reimbursed as ambulance expense during an emergency

Ayush treatment

Inpatient treatment medical expenses under Homeopathy, Siddha, Ayurveda or Unani are reimbursed.

Medical checkup

Reimburses 1% of Sum Insured or Rs. 5000 whichever is less.

In-patient Treatment

Hospitalization costs due to illness or accident are covered up to the Policy Sum Insured

Pre and post hospitalization

Medical costs incurred during 60 days prior to hospitalization and 90 days post hospitalization are reimbursed

 

Exclusions

  • A waiting period of 30 days for claims, other than bodily injury.
  • Expenses incurred for tonsils, surgery are not covered for the first two years of policy period.
  • Pre-existing diseases are covered after 48 months of continuous coverage from the company.
  • Claims for diseases like sexually transmitted diseases and vaccination are not covered.