HDFC ERGO Health Suraksha Top Up Plan

These are the features and benefits of the plan:

1. Coverage for pre-hospitalization and post-hospitalization expenses without sub-limits
2. Coverage for daycare procedures without sub-limits
3. Quick response time of 6 hours for cashless claims or the company pays a penalty to the insured
4. Lower premiums but with higher sum insured
5. A wide range of deductibles to choose from
6. Tax benefits under Section 80D
7. Discount of 5% on the total premium if taken for a continuous period of 2 years
8. Cancellation of the policy can be done within 15 days from date of receipt of the policy's documents. The premium will be refunded after adjusting the cost of stamp duty charges, proportionate premium, and medical examination (wherever applicable). However, please note that if any claim has been made within this 15-day period, refund will not be applicable.
9. You can renew the policy throughout your lifetime, if the renewal premium (in full) and application is received before the due date or within 30 days of the due date.
10. There is no increase in premium at the time of renewal if a claim has been made during the policy year
11. Spouse, two dependent children, parents, and parent in-laws can be covered in the same policy on an individual sum insured basis and in a separate policy on a floater sum insured basis

Eligibility Criteria

The following is the eligibility criteria for this plan:

1. The insured must be between 18 years and 65 years of age
2. Children can be insured if they are between the age of 91 days to 23 years
3. No medical examination up to the age of 55 years except in the case of pre-existing diseases at the time of application for the policy

Exclusions

These are some of the exclusions of the policy:

1. Pre-existing diseases, injuries, or illnesses as defined in the policy, until 36 months of continuous coverage has elapsed. Some of the pre-existing diseases are the following:

1. Diabetes and related complications (diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, diabetic angiopathy, hyperglycemic or hypoglycemic shocks, diabetic foot or diabetic wounds)
2. Hypertension and related complications (cerebrovascular accident, internal bleeds or hemorrhages, coronary artery disease, hypertensive nephropathy)

1. The following ailments or diseases are covered (expenses along with complications for treatment) only after the first two years of continuous coverage of the policy:
   1. Hysterectomy (other than for malignancy)
   2. Uterine prolapse including any condition that requires hysterectomy
   3. Cataract
   4. Polycystic ovarian disease
   5. Myomectomy for fibroids
   6. Osteoarthritis
   7. Osteoporosis
   8. Knee replacement surgery (other than caused by accidents)
   9. Joint replacement surgery (other than caused by accidents)
   10. Prolapse of intervertebral discs (other than caused by accidents)
   11. Arthroscopic surgery
   12. Arthritis
   13. Rheumatism
   14. Congenital internal anomaly
   15. Fistula in anus, piles, or fissures
   16. Varicose veins and varicose ulcers
   17. Stones in the urinary, uro-genital, and binary systems
   18. Hypertension and diabetes related complications
   19. Surgery on tonsils or adenoids
   20. Fibroids
   21. Dilatation and curettage for treatment purposes
   22. Pilonidal sinus
   23. Chronic Suppurative Otitis Media (CSOM)
   24. Deviated nasal septum, sinusitis, and related disorders

1. Domiciliary hospitalization expenses
2. Ambulance charges
3. Dental treatment or surgery of any kind other than due to an accident and necessitating 24 hours of hospitalization
4. Routine medical eye, and ear examinations
5. Cost of spectacles or contact lenses
6. Hearing aids
7. Laser surgery for cosmetic purposes or corrective surgeries for eyes
8. Genetic disorder and stem cell implantation/surgeries
9. Birth control procedures
10. Hormone replacement therapy
11. Voluntary termination of pregnancy within 12 weeks of conception
12. Any treatment that arises from or is traceable to pregnancy or childbirth including Caesarean section.
13. Aggregate deductibles
14. Co-payment: For people named in the schedule above the age of 80, a co-pay of 10% for each and every claim has to be borne.

Please refer the company brochure for a more extensive list of the exclusions.

Read terms, conditions and exclusions mentioned in the policy document.

GST rate of 18% applicable for all financial services effective July 1, 2017.