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HDFC ERGO Health Suraksha with Regain & ECB

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HDFC ERGO Health Suraksha with Regain & ECB

HDFC ERGO Health Suraksha with Regain & ECB is a comprehensive health insurance plan with superior inbuilt benefits and coverage. In addition to the basic covers of hospitalisation and medical expenses, the plan offers Sum Insured Regain Benefit and Enhanced Cumulative Bonus (ECB). This plan does not offer maternity cover and new born benefits.


Key features HDFC ERGO Health Suraksha with Regain & ECB

  • Regain benefit – Automatic availability of Sum Insured upon its exhaustion during the policy year
  • No Medical Check – up to 45 years
  • AYUSH cover without any sublimit 
  • Enhanced Cumulative Bonus @ 10% per claim free year up to 100% of Sum insured
  • No Sub-limits on any disease, room rent, hospital charges and doctor fees
  • Life Time Renewability


 


What is covered in HDFC ERGO Health Suraksha with Regain & ECB?

  • In-patient Treatment - Covers medical expenses for hospitalization due to an illness or accident. The medical expenses for room rent, boarding expenses, nursing, intensive care unit, medical practitioner(s), medicines or drugs and other related expenses will be paid.
  • 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 - The medical expenses for 144 day care procedures which do not require 24 hours hospitalization.
  • Domiciliary Treatment - The medical expenses incurred by an Insured Person for availing medical treatment at his home which would otherwise have required hospitalization.
  • Organ Donor - The medical expenses for an organ donor's treatment in the event of organ transplantation
  • Emergency Ambulance - Expenses covered for utilizing ambulance service for transporting insured person to hospital
  • Ayush - medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy mode of treatment up to the limit of Sum Insured
  • 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.


Regain Benefits

Regain benefit means the policy will automatically provide you with the basic sum insured upon its exhaustion (inclusive of any cumulative bonus) during the health insurance policy year. 
Example – 
Policyholder makes a claim of 5 lacs and exhausts the entire sum insured amount for Illness 01. Now within the same year the policyholder is admitted for Illness 02. Under HDFC Ergo Health Suraksha Gold with Regain & NCB the sum insured with automatically go back to 5 lacs and the policyholder can make a claim again. 
Notes –
  • Basic sum insured will be re-instated only once in health insurance policy year
  • If the Regain SI is not utilized in a policy year, it shall not be carried forward to any subsequent insurance policy year.
  • Regain benefit cannot be withdrawn at subsequent renewals
  • Regain SI can be used for only future claims and not against any claim for an illness/disease (including its complications) for which a claim has been paid in the current policy year
 




Additional Benefits/Features of HDFC ERGO Health Suraksha with Regain & ECB

  • Discount on Health checkup – up to 1% of Sum Insured, maximum up to Rs. 5000 for a Health Checkup after 4 consecutive claim-free year.
  • Cashless Treatment at Network Hospital
  • Individual and Family Floater option
  • No entry age limit
  • Coverage period - one year or two years 
  • Maximum cover up to– 10 lacs
  • Tax Benefit under section 80D
  • Free look – If the policy holder is not convinced with the Terms and Conditions of the policy, then h/she can cancel the policy within 15 days of receipt of policy document.


Eligibility criteria in HDFC ERGO Health Suraksha with Regain & ECB

  Minimum Maximum
Sum Insured 3,00,000 10,00,000
Entry Age 91 days No Limit
Maximum Renewal Age - Lifetime
Policy Term 1 year 2 years
 

Exclusions - What is not covered in HDFC ERGO Health Suraksha with Regain & ECB?

  • Any treatment within first 30 days of cover except any accidental injury
  • 2 years waiting period for Particular Diseases and Treatment such as surgery on tonsils and sinuses, cysts, internal tumor etc.
  • Pre-existing conditions will not be covered for first 48 months
  • Expenses arising from HIV or AIDS and related diseases. 
  • Mental disorder or insanity, cosmetic surgery, weight control treatment
  • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
  • Hospitalization due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
  • Pregnancy, dental and external aids and appliances unless covered under specific plans 
  • 2 year exclusions for specific diseases
  • Experimental, investigational or unproven treatment, devices and pharmacological regimens

 
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