HDFC ERGO Health Suraksha Platinum Plan

Product Overview

Hdfc Ergo Health Suraksha Platinum Insurance Plan is a hospitalization policy, which covers inpatient treatment for a minimum period of 24hrs, along with other benefits like day care treatments, Ayurvedic treatment, etc.

Unique Features of HDFC ERGO - Health Suraksha Platinum Plan

• Regain benefits up to Sum Insured (Optional by paying extra premium)
• This plan covers Pre-hospitalisation expenses upto 60 days and Post-hospitalisation expenses upto 90 days
• Out Patients benefits (Optional by paying extra premium)
• Ayurveda, Unani, Sidha and Homeopathy treatment are Covered
• Maternity Benefit Covered (Silver plan Optional)
• No Claim bonus 10% up to maximum 100%(Optional by paying extra premium)

Critical features of HDFC ERGO Health Suraksha Platinum Plan

• Room rent:
  Limits imposed towards room and ICU rent expenses
  No Sub limits on room rent and ICU
• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured

1. 10% discount on base premium if the Insured opts for 10% Co-pay option
2. 25% discount on base premium if the Insured opts for 20% Co-pay option

• No Claim Bonus:
  Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal

1. 5 % of Basic Sum Insured per year upto a maximum of 50% for each unclaimed year in case opted for .(5 % will be reduced on claim)
2. This plan has an options to increase the cumulative bonus to 10% up to maximum 100%(By paying extra premium)

• 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

1. This plans has a waiting period of 4 years is case of pre-existing diseases
2. Maternity has waiting period of 4 years

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)

Add-ons

Additional discounts

• Family Discount of 10 % if 2 members or more family members are covered under the same policy on Individual sum insured basis.
• Discount for multi-year polices-10% discount for opting 2yr policy tenure
• (25% discount on base premium if the Insured opts for 20% Co-pay)(10% discount on base premium if the Insured opts for 10% Co-pay)

Waiting Period

• Covered from Day 1:
  Accidental Injuries
• Covered after 30 Days:
  All incidences apart from specified surgeries, Permanent exclusion & Pre-existing diseases (if any)
• Covered after 2 Years:
  Internal Congenital diseases, non infective arthritis; calculus diseases of gall bladder including cholecystitis and urogenital system e,g, Kidney stone, Urinary Bladder Stone; Pancreatitis, Ulcer and erosion of stomach and duodenum;Gastro Esophageal Re?ux Disorder (GERD); All forms of Cirrhosis (Pls note: all forms of cirrhosis due to alcohol Will be excluded);Perineal Abscesses; Perianal Abscesses; cataract; ?ssurel fistula in anus. hemorrhoids, pilonidal sinus,: gout and rheumatism; internal tumors, cysts, nodules, polyps including breast lumps (each oi any kind unless malignant); osteoarthritis and osteoporosis; polycystic ovarian diseases; Fibroids (?bromyoma) ; sinusitis; Rhinitis; Tonsillitis and skin turnorsunless malignant: Benign Hyperpiasia of Prostate.adenoidectomy, mastoidectomy, tonsillectomy and tympanoplasty); dilatation and curettage (D&C);joint replacement: myorriectomy for ?broids; surgery of genito urinary system unless necessitated by malignancy; surgery on prostate; cholecystectomy; surgery of hernia; surgery of hydrocele/ Rectocele; surgery for prolapsed inter vertebral disk; Joint replacement surgeries surgery of varicose veins and varicose ulcers; Surgery for Nasal septum deviation, nasal concha resection

Exclusions

• In case of war or any sort of armed conflicts
• Violation of any law with an intent of crime
• Injuries caused due to an act of self-destruction, suicide or suicide attempts
• Radioactivity or war, terrorist activities
• HIV/AIDS
• Claims for illness that may arise due to intoxication of alcohol and drugs
• Plastic or cosmetic surgery unless performed as an internal part of the treatment
• Vaccinations including inoculation and immunizations taken for preventive measures
• Mental disorder or insanity, cosmetic surgery, weight control treatment
• Experimental, investigational or unproven treatment, devices and pharmacological regimens
• Pregnancy, dental and external aids and appliances unless covered under specific plans
• Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations

 

Note: Any claims arising out of or attributable to any of the following is not covered. Please refer policy T & C for detailed list of exclusions.

Tax Benefits

The premium paid for health insurance policy is liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below.

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