HDFC ERGO My:Health Suraksha

• Wide coverage: You can choose an individual Health Suraksha scheme or a Family Floater health insurance policy according to your requirements. The coverage is optimal and comes at an affordable price.
• Time Period: You can opt for a HDFC ERGO Health Suraksha policy that runs for a time period of one or two years (With Life time renewability) .
• Bonus: If your policy is claim-free you are entitled to a cumulative bonus.
• Included Health check up: HDFC ERGO Health Suraksha will provide for at the cost of a health check up if you have completed 4 years without making a claim.
• Service Points: You can make cashless claims across more than 10,000+ network hospitals in India.
• Tax Benefits: You can avail of the Income Tax benefits under Section 80D of the Income Tax Act.                                                       * Subject to change in Tax laws
• Quick processing: Once you decide to purchase the HDFC ERGO Health Suraksha, the turnaround time of delivering your policy will be quick. Even the claims procedure is very straightforward.

        

Here are the details regarding the coverage that the Health Suraksha policy offers:

Health Suraksha - Individual & Family Floater Sum Insured

Product	Health Suraksha Silver
Product Benefit	Coverage-  (Sum Insured : 200000,300000,400000,500000)
In-patient Treatment	Hospitalization costs due to illness or accident are covered upto the Policy Sum Insured.
Pre-hospitalization	The Medical Expenses incurred due to an Illness in 60 days immediately before the Insured Person was hospitalized.
Post-hospitalization	The Medical Expenses incurred in 90 days immediately after the Insured Person was discharged post Hospitalization,
Day Care Procedures	Expenses for 144 listed day care procedures that does not need 24 hours hospitalization on account of technological advancements are reimbursed
Domiciliary Treatment	The Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise have required Hospitalization and on the advice of the attending Medical Practitioner, if the Insured Person could not be transferred to a Hospital or a Hospital bed was unavailable are reimbursed upto the policy sum insured
Organ Donor	The Medical Expenses for an organ donor’s treatment in the event of organ transplantation for harvesting an organ donated are reimbursed Upto the policy Sum Insured
Emergency Ambulance (Limit per hospitalisation)	Upto Rs. 2,000 reimbursed as ambulance expenses during an emergency
AYUSH	Covers inpatient hospitalization expenses under Ayurvedic ,Unani ,Sidha & Homeopathy Upto the policy Sum Insured
Cumulative Bonus (CB)	5% of the Basic Sum Insured every claim free year subject to a maximum of 50% of the basic sum insured. CB will be reduced by 5% of the basic sum insured in case of a claim.
Health check Up	We will offer health checkup only once at the end of continuous four claim free years during which You have been insured with Us. Our maximum liability will be subject to 1% of the Sum Insured for this Policy Year or the subsequent Policy Years upto a maximum of Rs 5,000. Incase of a family floater, if any of the members make a claim under this policy, the health checkup benefit will not be offered to the whole family.

 

Click Here to read the policy wording.

You must renew your HDFC ERGO Health Suraksha policy to take advantage of the cumulative bonus and continue the benefits you receive for any pre-existing illness from your previous policy with us.

The following are the exclusions on the policy that you should note.

• 30 day waiting period
• 2 year waiting period for Specific Illnesses and Treatments like internal tumours, cysts, surgery on tonsils and sinuses etc.
• Pre-existing conditions ( until 48 months of continuous coverage)
• War or any act of war
• Any breach of any law with criminal intent
• Self-destruction or self inflicted injury, attempted suicide or suicide
• Any claim arising out of the use of drugs and alcohol
• Plastic surgery or cosmetic surgery, unless necessary as a part of medically necessary treatment
• All preventive care, vaccination including inoculation and immunizations

Claim process

The first step towards making a claim should be to call us on our toll free number of our TPA, Health Claim Servics on 1800 2 700 700 / 1800 200 1 999 .Our claims service personnel will guide through the claim procedure and documents required. Apart from that, you should follow the procedure as outlined below:

Claims Procedure for hospitalization in Network Hospitals If your case is eligible under the insurance policy, the HCS will authorize our "Cashless Service" at any empanelled hospital.

• As soon as possible, you must inform HCS and co-ordinate with the hospital to have the details sent to the HCS to authorize the cashless service.
• On discharge, verify and sign hospital bills and pay for what is not covered under your health policy.
• The original discharge summary and other investigation reports should be handed over to the hospital. Please retain a photocopy for your records.
• In case hospitalization dates are known, kindly co-ordinate with the hospital and send in all the details of your hospitalization to the HCS at least 3 days prior to your admission, including the plan of treatment, cost estimates etc. You also need to indicate the contact details of the hospital to where the authorization has to be sent.

Claims Procedure for hospitalization in Non-Network Hospitals

In case of hospitalization in non-network hospitals, you must follow the procedure as outlined below:

• Inform the HCS as soon as possible.
• At the time of discharge, settle all hospital bills in full and collect the bills, documents and reports.
• Register your claim with the HCS for processing and reimbursement

To register your claim, send the following documents to the HCS :

• Duly signed claim form
• Identity proof
• Copy of Policy Document
• All hospital bills in original with detailed breakup for consolidated amounts
• Bills for medicines purchased from outside, should be accompanied by a doctor's prescription
• On discharge, verify and sign hospital bills and pay for what is not covered under your health policy.
• Discharge summary / Discharge card in original
• All investigation reports in original

To make sure you get the complete benefits of the claim, kindly make a note of the following:

• Please register your claim with HCS within 7 days of your discharge from hospital.
• Documents, in addition to those mentioned above, may be asked for, depending on the nature of claim lodged. Please retain a copy of the documents sent for your records.
• Any delay in claim intimation may lead to rejection of the claim.
• Issuance of the claim form should not be taken as admission of liability under the policy on the part of the insurer.

Please note that HDFC Bank is a corporate agent of HDFC ERGO. The Contract of insurance is between HDFC ERGO and the Insured only and HDFC Bank is not a party to the said contract. Participation by customer to buy insurance policy is purely voluntary. Insurance is the subject matter of the solicitation. For more details on coverage, terms and conditions, please read the policy document carefully before conducting a sale.

Certified Corporate Agent's License No. CA0010

Get started with your Health Suraksha Plan

Got your Welcome Kit? Inside it you will find:

• A Policy Document:
• Policy Wordings : to help you understand what is covered under the policy

Renew your Health Suraksha Plan

Don't forget to renew your Health Suraksha policy to continue availing the benefits against pre-existing illness from your previous policy.

Click Here to renew your Health Suraksha policy online.

Did you know?

• You can get financial security to meet immediate health contingencies through the policy instead of making a dent in your long term savings.
• You should take into consideration the high and rising cost of medical expenses.

You can also benefit from

• A  Critical Illness Insurance Policy and get a lump sum amount required to treat critical illnesses and pay for associated treatment.
• A  Private Car Insurance Policy that ensures your vehicle is safeguarded no matter what the mishap.
• A Personal Accident Policy that protects you when you get sick in India and offers you Personal Accident Cover worldwide.