HDFC ERGO Arogya Sanjeevani policy

Expenses Covered under HDFC ERGO Arogya Sanjeevani Policy

• Pre & Post Hospitalization Expenses
  This policy will cover all the pre-hospitalization expenses (upto 30 days) and post-hospitalization expenses (upto 60 days) following an emergency illness or accidental injury.
• ICU Charges
  The Arogya Sanjeevani policy pays ICU/ICCU expenses be provided up to 5% of sum assured or a maximum of ₹10,000 per day.
• Room Rent
  It covers the room rent of the hospital to up to a maximum of ₹5,000 per day.
• Ambulance Services
  It covers the cost of ambulance services up to a maximum of ₹2000 per hospitalization.
• Cataract Surgery
  It also covers the cost of cataract surgery upto a maximum of ₹40,000 or 25% of the sum insured amount, whichever is less for each eye.
• Coronavirus (COID-19) Expenses
  It covers any expenses incurred on hospitalization/treatment due to contracting COVID-19 or coronavirus disease.
• AYUSH Treatment
  AYUSH treatments are covered at recognised medical centres. (AYUSH means all treatments related to Ayurvedic, Yoga, and Naturopathy, Unani, Siddha, Homeopathy).
• New Age/ Modern Treatment
  This policy also covers the cost of modern/ new age treatment up to a maximum of 50% of the sum insured amount. The list of illnesses are in the table above.

Terms and Conditions of HDFC ERGO Arogya Sanjeevani Policy

• Sum Assured
  This policy offers the multiple sum assured options from ₹1 lac to ₹5 lacs in the multiple of ₹50,000. The sum assured is available on both individual and family floater basis.
• Policy Duration
  This policy scheme offers policy term option of one year and is renewable on a lifetime basis.
• Co-payment
  For insureds of all age categories and sum insureds, this policy offers a standard co-payment option of 5% of the incurred claims amount payable at the time of settlement.
• Cumulative Bonus
  Arogya Sanjeevani policy also provides a bonus of 5% on the total sum insured amount for every claim-free year that is passed by the insured, and this is accumulated upto a maximum of 50% of the sum insured as a bonus.
• Frequency of Premium Payment
  The premium for this policy can be paid on a monthly, half-yearly, quarterly, and annual basis.
• Portability
  Arogya Sanjeevani policy is easily portable from one insurance company depending on the requirements of the insured.
• Grace Period
  For annual premium payment, 30 days grace period is allowed and for other modes (monthly, quarterly, half yearly) of premium payment 15 days grace period is allowed.
• Free Look Period
  The policy has a Free Look period of 15 days, within which the insure can cancel the policy and expect a full refund.

How can one buy the HDFC ERGO Arogya Sanjeevani Policy?

Perhaps the easiest way to purchase a Arogya Sanjeevani health insurance policy will be online because the IRDAI has allowed insurance companies to issue the Arogya Sanjeevani electronically to the policyholders. This means that the insurance company can only share a online pdf document as an insurance policy to the insured unlike all other insurance plans currently in the Indian market. The simple process to be followed is:

• Go online to a comparison website like eindiainsurance
• Compare the quotes across all the insurance companies – Importantly since all insurance companies, will be offering exactly the same set of benefits for this plan, the individual can compare the premiums and also review the financial parameters of the insurance company while making a final decision
• Fill up the Arogya Sanjeevani proposal form of the respective insurance company
• Make a payment directly online through the payment gateway and then the policy will get issued by the respective insurance company

Moreover, the IRDAI has also directed all health insurance companies to provide a certificate of insurance to each policyholder for the benefits, terms and conditions of their Arogya Sanjeevani policy.

Highlights of HDFC ERGO Arogya Sanjeevani Policy

• Affordable Policy: Highly beneficial and affordable health insurance policy
• Flexible Policy: Policy can be taken on Individual and Floater basis
• Day Care Procedures: All Day care Procedures covered
• Ayush Cover: AYUSH Treatment covered
• Modern Treatment Cover: Modern Treatments are covered – Upto 50% of the Sum Insured.
• Policy Term: One year

HDFC Ergo General Insurance Co Ltd

For Travel Claims

• Call: International Toll Free at +800 08250825 or India Toll Number 01204507250
• Email:processing@hdfcergo.com, with cc totravelclaims@hdfcergo.com
• Fax at: +91-120-6691600 within 30 days from date of loss.
• Postal Address: HDFC ERGO General Insurance Company Limited
  6th Floor, Leela Business Park,Andheri Kurla Road,Andheri – East,
  Mumbai- 400 059,India

For Health Claims (Cashless & Reimbursement)

• Email at:healthclaims@hdfcergo.com
• Postal Address:
  Send filled Claim Form to: HDFC ERGO General Insurance Company Ltd
  5th Floor, Tower 1, Stellar IT Park, C-25, Sector-62,
  Noida 201301 State, Uttar Pradesh

In case of additional Support, reach HDFC Ergo directly at:

• Call at: Toll Free 1800 2700 700
• Fax at: +91 22 66383699
• Email at:care@hdfcergo.com

Exclusions under the HDFC ERGO Arogya Sanjeevani Health Insurance Plan

The Arogya Sanjeevani health insurance policy excludes the following treatments:

• Maternity Expenses - Cost of treatment related to pregnancy and child birth
• Domiciliary hospitalization - Domiciliary hospitalization expenses
• Outpatient Treatment – Policy covers only expenses incurred during Inpatient treatment (atleast 24 hours hospitalisation)
• Adventure/ Hazardous Sports – Active Participation in a hazardous activities including scuba diving, rock climbing, sky diving, parasailing, deep-sea diving, mountaineering, etc, as a professional
• Cosmetic or Plastic Surgery – Unnecessary expenses for cosmetic/plastic surgery following an accident, burn injury, other medically necessary treatment
• Diagnostic or Investigative Tests - Diagnostic or Investigative tests done by the insured which are elective in nature
• Alcohol/ Drug addiction- Treatment following addiction of alcohol or drug/substance abuse
• Bed Rest or Rehabilitation Expenses
• Expenses for Treatment of Sterility or Infertility
• Claims due to a Nuclear Attack or War/ War-like situation
• Expenses incurred for Weight Control/ Obesity Treatment
• Any Treatment received by the insured outside the boundaries of India
• Expenses relating to surgery or treatment of Gender change

Please review the Terms & Conditions/Policy Wordings for the complete list of exclusions under the Arogya Sanjeevani policy.