General Insurance

Health Suraksha Silver Plan

Eligibility Criteria

Minimum Entry Age 91 days
Maximum Entry Age No age bar
 
 

Benefits

AYUSH

Medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy.

 

Product Features

 

Key Features

Sum Insured

Sum Insured is the amount of cover provided by the insurance company.
The plan provides a cover of up to Rs. 1- 50 lakh
In-patient hospitalisation

This covers hospitalisation expenses due to an illness or accident.
The company pays for medical expenses for room rent, boarding expenses, Nursing, Intensive care unit, Medical Practitioner, Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, Medicines, drugs and consumables, Diagnostic procedures, Cost of prosthetic & other devices or equipments if implanted internally during a Surgical Procedure.
Pre-hospitalisation

It covers the medical expenses due to an illness before the insured is hospitalised.
The plan covers pre-hospitalisation expenses of up to 60 days.
Post-hospitalisation

It covers the medical expenses due to an illness after the insured is discharged from hospitalisation.
The plan covers post-hospitalisation expenses of up to 90 days.
Room Rent

Room rent specifies the sub-limit on room rent charges you can avail in case of hospitalisation.
There is no limit to room rent charges under this plan.
Health check-up

A free medical check-up is provided by the insurance companies to its policyholders.
This plan offers medical check-ups up to 1% of Sum Insured to a limit of maximum Rs. 5000 per person.
 

Other Features

Day Care Treatments

These are treatments that don’t require a 24-hr hospitalisation and conducted in a hospital or day-care center.
This plan allows 144 day care procedures.
Ambulance Cover

In case of an emergency, the ambulance charges are covered by the insurance company.
Ambulance expenses up to Rs. 2000-3500 are borne by the insurance company based on the amount of your sum insured.
Domicilliary Hospitalisation

If a patient is in a condition that he cannot be moved to the hospital or there is lack of accommodation in the hospital, he is been treated at home and this process is known as domicilliary hospitalisation.
The plan covers domicilliary hospitalisation.
Recharge of Sum Insured

Under this feature, the policyholder’s entire sum insured is automatically restored back to him upon exhaustion of the limit of the coverage during the policy period.
If the policyholder’s basic sum insured inclusive of the no-claim bonus is exhausted, he will be automatically provided with the basic sum insured
Cumulative Bonus

Avail Cumulative Bonus at the end of each claim-free year
Every claim-free year is subject to an increase in the Sum Insured amount by 5% (of the basic sum insured); up to a maximum of 50% increase of the sum insured.
Organ Donor Cover

The medical expenses for an organ donor's treatment in the event of organ transplantation.
This policy covers the expenses for organ donor’s treatment.
 
 

Other Plans in same category

NA

 

Add-on Covers/Riders

 

Newborn baby

Coverage for newborn from birth.

 

Maternity Expenses

Medical Expenses for maternity including pre-natal and post-natal expenses after a waiting period of 4 years.

 

Outpatient Dental Treatment

50% of the Medical expenses for X-rays, Extractions, Amalgam / Composite Fillings, Root Canal Treatments and prescribed Drugs from 4th year onwards.

 

Critical Illness Cover

The sum insured is paid as a lump sum amount to the insured if 11 critical illnesses are identified. Critical Illness covered are Cancer of specified severity, Coronary Artery (Bypass) Surgery, First Heart Attack (Myocardial Infarction), Kidney Failure requiring regular dialysis, Major Organ/Bone Marrow Transplant, Multiple Sclerosis with Persisting Symptoms, Permanent Paralysis of Limbs, Stroke resulting in Permanent Symptoms, Aorta Graft Surgery, Primary Pulmonary Arterial Hypertension and Heart Valve Replacement.

 

Hospital Daily cash

Daily allowance for the each and every continuous and consecutive 24 hours as an inpatient hospitalisation. Maximum upto 30/60 days. If mentioned in the policy schedule this benefit will be applicable to the eldest member of the family. This benefit will be provided with a life-long renewability

 

Regain benefit

Automatic availability of the basic sum insured, if the basic sum insured inclusive of the no claim bonus has been exhausted during the policy year.

 

Enhanced Cumulative Bonus

The cumulative bonus shall automatically increase to 10% and the maximum cumulative bonus shall not exceed 100% of Base Sum Insured. Cumulative bonus thus applied would automatically decrease by 10% of the Basic Sum Insured in that following Policy Year in case of a claim.

 

Exclusions

  • A 30-day waiting period for claims
  • 2 years waiting period for Particular Diseases and Treatment such as surgery on tonsils and sinuses, cysts, internal tumor etc.
  • Pre-existing conditions are not covered unless the insured is covered for 48 months
  • 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
 
 

FAQs

 

Are there any medical tests that I need to undergo to enroll myself?

No pre policy medical checkup is required for individuals’ up to 45 years.

 

Are there any special discounts available under the policy?

The policy provides a Family discount of 10%, if 3 or more family members are covered under a single policy on Individual Sum Insured basis.

 

What is Cumulative Bonus?

Cumulative Bonus is an increase in sum insured by a specified percentage for every claim free year subject to a certain maximum; provided that the policy should be renewed without any break. Under Health Suraksha, you can avail of 5% cumulative bonus for every claim free year.

 

How can I port my existing health insurance with HDFC ERGO's Health Suraksha?

If you own a health insurance plan issued by an Indian general insurer and you want to shift to HDFC ERGO on renewal, Health Suraksha policy offers portability of accrued benefits and make due allowances for waiting period etc. as per the regulation and guidelines on portability issued by IRDA. If the person insured transfers from any other insurer and enhances coverage, then the portability benefits will be offered on the previous sum insured.

 

What is meant by Organ Donor expenses?

Organ donor expenses includes all hospitalisation expenses incurred by the donor for donating an organ (excluding the cost of the organ) to the insured during the course of an organ transplant.

 

What is Family Floater and what are its advantages?

Family Floater is a policy wherein the entire family of the insured comprising of insured and his dependents are covered under single sum insured.


The advantages of such a policy are:

  • All members of the family can be covered under one policy.

  • Single Premium is payable for the entire family.

  • The amount of Sum Insured floats over the entire family i.e. the limit can be used by any member of the family and for any number of times.

  • One does not have to keep a track of renewals for different members; a single renewal date is to be remembered.