HDFC ERGO Health Suraksha Super Top up

Product Overview

Hdfc Ergo- Super Top-up Plan is an affordable option of upgrading your policy. A super top-up Policy takes into consideration the sum total of all the bills in a year and not just the single instance during a claim and its is an inpatient hospitalization policy, admission as an inpatient for a minimum period of 24hrs is required.

Unique Features of HDFC ERGO Health Suraksha Super Top-up

• Pre and Post hospitalisation 60 days and 90 days
• No Medical Check-Up upto 55 years
• No Sub-limits on any disease, room rent, hospital charges & doctor fees
• No Co-payment

Critical features of HDFC ERGO Health Suraksha Super Top-up

• Room rent:
  Limits imposed towards room and ICU rent expenses
  No Room rent Limit
• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured
  This plan does not have co-payment clause
• No Claim Bonus:
  5 % NCB on Sum Insured for every claim free year.
• Pre- Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
  This plans has a waiting period of 4 years is case of pre-existing diseases

Eligibility Criteria

• Minimum Age of Entry:- 91 days
• Maximum age of Entry:- No Limit
• Renewal Age:- Life Long Renewal
• Sum Insured:- 2 lakhs to 50 lakhs
• Policy Tenure:- 1 & 2 years
• Family Definition:-
  Individual Plan - spouse, dependent children, dependent parents.
  Family Floater - Self, Spouse,dependent children,Father, Mother
• Premium Calculated on Basis of:- Age, (i.e. Location & sum Insured Chosen)

 

Deductible Amount	Sum insured
1 lakh	2 lakhs
2 lakhs	3 lakhs
3 lakhs	4 lakhs
4 lakhs	5 lakhs
5 lakhs	7.5 lakhs
5 lakhs	10 lakhs

Additional discounts

• Family discount of 10 % if 3 or more members of a family are covered under the same policy on Individual sum insured basis.

Waiting Period

• Covered from Day 1:
  Accidental Injuries.
• Covered after 30 Days:
  All incidences apart from specified surgeries & Pre existing diseases (if any)
• Covered after 2 Years:

1. Illnesses : Arthritis if non infective; calculus diseases of gall bladder and urogenital system; cataract; fissure/fistula in anus, hemorrhoids, pilonidal sinus, gastric and duodenal ulcers; gout and rheumatism; internal tumors, cysts, nodules, polyps including breast lumps (each of any kind unless malignant); osteoarthritis and osteoporosis if Age related; polycystic ovarian diseases; sinusitis and related disorders and skin tumors unless malignant. 
2. Treatments: Benign ear, nose and throat disorders and surgeries , dilatation and curettage, hysterectomy for menorrhagia or fibromyoma or prolapse of uterus unless necessitated by malignancy, joint replacement, myomectomy for fibroids, surgery of gallbladder and bite duct unless necessitated by malignancy, surgery of benign prostatic hypertrophy, surgery of hernia, surgery of hydrocele, surgery for prolapsed inter vertebral disk, surgery of varicose veins and varicose ulcers, surgery on tonsils and sinuses, surgery for nasal septum deviation.

Exclusions

• War or any act of war, invasion.
• Any Insured Person committing or attempting to commit a breach of law with criminal intent, or intentional self injury or attempted suicide while sane or insane.
• Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hanggliding, rock or mountain climbing.
• Treatment of Obesity and any weight control program, Any non allopathic treatment.
• Venereal disease, sexually transmitted disease or Illness; Psychiatric, mental disorders, Pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness) .
• Dental treatment and surgery of any kind, unless requiring Hospitalisation.
• Experimental, investigational or unproven treatment, devices and pharmacological regimens

Tax Benefits

• You can claim tax deduction benefit u/s 80D as per IT Act 1961 for premium paid towards this policy.
• Self, Spouse, Childrens- Up to Rs 20,000/-
• Parents-Up to Rs 25,000/-
• Parents (Senior Citizens)-Up to Rs 30,000/-

Claim Process

Insurer has to be intimated 72 hrs before hospitalization in a planned event and within 24 hrs in case of an emergency hospitalization. For reimbursement claims the final claim documents have to reach the insurers office within 15 days of discharge from the hospital.

Claims Intimate at toll free-1800-102-0333 & Email Id-customerservice@apollomunichinsurance.com

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