HDFC Health Suraksha Top Up Insurance

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If you think your current medical insurance policy is not sufficient, then you can buy HDFC Ergo Health Suraksha Top up Plus Health Insurance Plan. With this top-up plan, you get an additional sum insured to pay for any prolonged medical emergencies, when the present health insurance policy may not suffice.

Advantages of HDFC Ergo Health Suraksha Top up Plus Health Insurance Plan

  • If your sum insured get exhausted in the existing medical insurance policy, then you can buy this plan to enjoy your peace of mind and financial security as you have coverage for the remaining policy term
  • Option to enhance the policy coverage at the time of renewal. This is subjected to policy terms and conditions.
  • It is not necessary to have a basic health plan to buy HDFC Ergo Health Suraksha Top up Plan.

However, it is recommended that you buy a health insurance plan with a sum assured equivalent to the deductibles.

Features and Benefits of HDFC Ergo Health Suraksha Top up Plus

  • The minimum age is 5 years and the maximum is 65 years
  • Children after 91 days can also be covered if both the parents are covered in this plan
  • No sub-limits and restrictions are applicable to hospitalization expenses including doctor fees, room rent charges etc.
  • Avail 5% of cumulative bonus on the sum insured not filing a claim ( maximum up to 50% )
  • 10% of family discount if more than 3 members are insured in the same plan. It covers the policyholder, dependent parents, spouse and children up to 21 years. Parents will be covered in a separate family floater plan
  • The insurer provides 15 days of free-look period
  • No medical check-up is required for people below 55 years
  • The policy term can be 1 or 2 years
  • Lifelong renewability
  • Tax exemption on the insurance premium paid under section 80/D of the Income Tax Act

Inclusions of HDFC Ergo Health Suraksha Top up Plus

  • 60 days of pre-hospitalization cover
  • In-patient hospitalization expenses such as boarding and nursing expense, operation theatre charges, room rent cost, cost of oxygen, doctor’s fees, implantation of any other equipment during surgery, prosthetic devices, blood, diagnostic procedures and so on
  • Organ donor expenses cover
  • 140 daycare procedures are inlcuded
  • 90 days of post-hospitalization cover
  • Emergency ambulance expenses up to a maximum of Rs. 2000 per hospitalization
  • Domiciliary treatment, as suggested by 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.
  • Earn a cumulative bonus at the time of policy renewal. The incentive is earned on every claim free year. Once a claim is made, the deductible shall be reduced by 5%.

Exclusions of HDFC Ergo Health Suraksha Top up Plus

  • Any claim lodged within 30 days of policy commencement date ( except for accidental cases)
  • Pre-existing diseases to be covered after4 years of policy purchase date
  • Treatment for depression, anxiety, and physiological disorders
  • Hospitalization required for AIDS, HIV and other related diseases
  • Pregnancy and its complications
  • Expenses incurred on any treatment other than allopathy
  • Cosmetic and plastic surgeries ( if not required as part of the treatment)
  • Health issues arising due to overdose of alcohol and drugs
  • Dental cover
  • Amount of deductibles
  • Experimental treatments
  • Any health issue arising due to civil war, rebellion, radiations etc.

Sum Assured (Rs.)

  • Up to Rs. 5 Lakhs ( the amount is over and above the deductibles)
  • Deductibles are applicable. Check policy wordings for the same

Claim Process for HDFC Health Suraksha Top-up Plan

  • Intimation should be given to the HDFC Ergo in-house claim services or Third Party Administrator (TPA) within 7 days of hospitalization.
  • For any other claim under the plan, inform the insurance company or TP within a week of the event or occurrence.
  • Any consultation, treatment or medical procedure taken prior to the following treatment should be pre-authorized by the TPA or HDFC ERGO in-house claims team.
  • All the documents and information related to the claim should be provided within 10 days of the completion of the treatment, hospitalization or discharge or as requested by the insurer.

Amount to be Refunded in Case of Policy Termination -

Policy Period - 1 year Percentage of Amount Refunded
1 month 75
3 months 50
6 months 25

 

Policy Period - 2 years Percentage of Amount Refunded
1 month 87.50
3 months 75
6 months 62.50


Procedure to Make Changes in HDFC ERGO Health Insurance Plan -

  1. To request Correction in Gender/ Salutation /Address/Beneficiary name
  • Submit your request online
  • Write an email to their customer care team
  • Call on their helpline number
  1. To request Correction in the name and date of birth of policyholder/ insured members
  • Submit the request online
  • Provide Identity proof - Voter ID, PAN, Passport (any)
  • Pay additional premium ( if required)
Written By: PolicyBazaar - Updated: 09 April 2019