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HDFC ERGO Health Suraksha Silver Plan

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.

Written By: PolicyBazaar - Updated: 10 June 2020

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