HDFC ERGO Health Suraksha Silver Plan

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Health Suraksha health insurance offered by HDFC ERGO has been designed keeping the soaring medical costs in mind. The sum insured options offered under the plan suit the needs of people from every walk of life. Some of the key features that make the policy a 360-degree insurance plan are- no sub-limits, no cap on room rent. Let’s take a detailed look at the policy:

What Makes HDFC ERGO Health Suraksha Silver Plan Unique

The plan comes with certain benefits that make the policy unique. The reason for you to consider this policy are:

  • Say yes to a swanky hospital room with no cap on room rent
  • The plan comes with AYUSH benefit
  • You are covered for 144 day-care treatment
  • You can avail long term discount if more than two members are covered
  • The policy offers a wide range of sum insured options ranging from Rs. 3 lakh to 10 lakh
  • There is no entry age restriction to avail this plan
  • No sub-limits on diseases
  • Integrated wellness services to promote a healthy lifestyle

HDFC ERGO Health Suraksha Silver Plan Features

The salient features of HDFC ERGO Health Suraksha Silver Plan include:

  • Tax Benefit under section 80D
  • No Medical Check-up up to the age 45 years
  • Cumulative bonus of 5% for every claim-free year up to a maximum of 50%
  • Pays up to 1% of Sum Insured, maximum up to Rs. 5000 for a Health Check-up after 4 consecutive claim-free years
  • Free-look period of 15 days to return the policy
  • No Sub-limit applicable to any illness, room rent, hospital charges and doctor fees
  • Cashless treatment at Network Hospitals across the country
  • No limit for age at entry
  • Offers one year or two years policy coverage period
  • The policy can be availed both as individual and floater sum insured basis
  • Avail a family discount of 10%, if 2 or more members of a family are covered under
  • It offers lifelong renewability
  • Children below 5 years can be added as well

HDFC ERGO Health Suraksha Silver Plan Coverage

 The coverage under HDFC ERGO Health Suraksha Silver plan includes:

Category

Nature of Coverage

In-patient Treatment

Hospitalisation expenses including boarding, nursing expenses, room rent, medicine and drugs costs, OT charges, ICU rent, doctor’s fee, surgeon’s fee etc.

Pre-Hospitalisation

The policy pays for the medical expenses for availing treatment for 60 days prior to the hospitalisation

Post-Hospitalisation

The policy pays for the medical expenses for availing treatment for 90 days prior to the hospitalisation

Day care Procedures

It pays for medical expenses for 144-day care procedures

Domiciliary Treatment

Covers you for the incurred expenses on treatment availing at home, which would have required hospitalisation

Organ Donor Cover

Expenses are covered for an organ donor's treatment in the

event of organ transplantation

 

Emergency Ambulance Cover

The transportation cost of an ambulance is covered in case of emergency

AYUSH Treatment Cover

It also pays or the expenses incurred in availing treatment under Ayurveda, Unani, Siddha or Homeopathy

 

HDFC ERGO Health Suraksha Silver Plan Exclusions

When the insurer tries or covers you for almost every possible way, certain things are just not feasible. The policy becomes null and void under the below conditions:

  • Any claim arising during the first 30 days of the policy
  • Claim arising out of a pre-existing medical condition up to 48 months
  • Expenses incurred for treating HIV/AIDS or related diseases
  • Mental disorder, self-inflicted injuries etc. are excluded
  • Abuse of drugs, alcohol or intoxicated substances
  • Injury or illness due to war, war-like situation, nuclear weapon, foreign invasion etc. are not covered
  • Maternity, childbirth-related expenses are excluded
  • Dental treatment, external hearing aids, unless covered under a specific sum insured2-year exclusions for specific diseases
  • Expenses incurred towards cosmetic surgery. Experimental, investigational or unproven treatment

*For the complete list of exclusions, consider the policy document

Waiting Period Clause

  • Initial Waiting Period: No claims will be entertained during the first 30 days of the policy period, except accidental claims.
  • 24 Months Waiting Period: Some specific illnesses will be covered after a waiting period of 2 years from the policy inception day
  • 48 Months Waiting Period: This waiting period is applied in case of pre-existing illnesses, except accidental claims.

HDFC ERGO Health Suraksha Plan Claim Process

In order to claim your health insurance in case of an emergency:

  • Immediately inform the insurer. You should register your claim within a 7 days window.
  • In case of a cashless claim, you’ll require to submit a cashless claim request to the Insurer. The designated TPA in the hospital will help you with the process
  • The documents supporting your claim have to be submitted as well. Upon receiving the application and documents, the insurance provider will convey its decision to the TPA or hospital authority
  • If your request gets approved, you can get the cashless treatment there. If not pay the bills initially at the time of discharge and register a reimbursement claim with the insurer.

HDFC ERGO Health Suraksha Renewal Process

 Policy renewal is essential. You can’t remain covered without renewing the policy. Hence, you can renew HDFC ERGO Health Suraksha Silver plan online or offline. When you renew it online, you can pay the premiums online by using debit/credit cards or net banking. You can also download the renewed policy online.

When you do it offline, you need the visit the branch office of the insurer, or you may approach an agent to do the formalities for you. You can pay the premiums through cheque and get the policy renewed.