Health Suraksha Gold - Individual Sum Insured | |||||||||
Plan | Silver | Gold | Platinum | ||||||
Basic Sum Insured per Insured Person per Policy Year [All figures in INR] | 1,00,000 2,00,000 3,00,000 | 4,00,000 5,00,000 | 7,50,000 10,00,000 15,00,000 20,00,000 25,00,000 50,00,000 | 1,00,000 2,00,000 3,00,000 | 4,00,000 5,00,000 | 7,50,000 10,00,000 15,00,000 20,00,000 25,00,000 50,00,000 | 1,00,000 2,00,000 3,00,000 | 4,00,000 5,00,000 | 7,50,000 10,00,000 15,00,000 20,00,000 25,00,000 50,00,000 |
Health Suraksha Gold - Individual Sum Insured | |||||||||
In Patient Treatment | Covered | Covered | Covered | ||||||
Pre Hospitalisation | 60 days | 60 days | 60 days | ||||||
Post Hospitalisation | 90 days | 90 days | 90 days | ||||||
Day Care Procedures | Covered | Covered | Covered | ||||||
Domiciliary Treatment | Covered | Covered | Covered | ||||||
Organ Donor | Covered | Covered | Covered | ||||||
Emergency Ambulance Limit per Hospitalisation | 2,000 | 2,000 | 35,000 | 2,000 | 2,000 | 35,000 | 2,000 | 2,000 | 35,000 |
AYUSH Benefit | Covered | Covered | Covered | ||||||
New Born Baby | Covered | Covered | Covered | ||||||
Section 2: Benefits not related to Basic Sum Insured & any claim under them will NOT affect entitlement to Renewal Incentive | |||||||||
Maternity Waiting Period 4 Years | Optional | Normal Delivery Rs. 15,000 Caesarean Delivery Rs. 25,000 Termination Rs. 15,000 (The maternity sum insured above Includes Pre/Post Natal limit of Rs. 1,500 and New Born limit of Rs. 2,000) | Normal Delivery Rs. 25,000 Caesarean Delivery Rs. 40,000 Termination Rs. 25,000 (The maternity sum insured above Includes Pre/Post Natal limit of Rs. 2,500 and New Born limit of Rs. 3,500) | ||||||
Dental Waiting Period of 3 years Co payment 50% | Optional | Optional | Upto 1 % of Sum insured subject to a Maximum of 5000 | ||||||
Spectacles / Contact Lenses and/or Hearing Aid Every Third Year Co payment 50% | Optional | Optional | upto 5,000 | ||||||
E-Opinion for Critical Illness | Optional | Covered | Covered | ||||||
Convalescence Benefit Minimum Hospitalisation of 10 continuous and consecutive days | Optional | Upto 1 % of Sum insured subject to a Maximum of 10,000 | Upto 1 % of Sum insured subject to a Maximum of 10,000 | ||||||
Section 3: Optional Benefit; not related to Basic Sum Insured & any claim under them will NOT affect entitlement to Renewal Incentive | |||||||||
Critical Illness Lumpsum | 50% or 100% of Basic Sum Insured or 10 Lacs whichever is lower | 50% or 100% of Basic Sum Insured or 10 Lacs whichever is lower | 50% or 100% of Basic Sum Insured or 10 Lacs whichever is lower | ||||||
Section 4: Optional Benefit; not related to Basic Sum Insured & any claim under them will NOT affect entitlement to Renewal Incentive | |||||||||
Hospital Daily Cash | 500/1000/1500/2000/ 2500 per day; Maximum 30/60 days as per plan opted | 500/1000/1500/2000/ 2500 per day; Maximum 30/60 days as per plan opted | 500/1000/1500/2000/ 2500 per day; Maximum 30/60 days as per plan opted | ||||||
Section 5: Optional Benefit will be subject to Basic Sum Insured and any claim under them will affect entitlement to Renewal Incentive | |||||||||
Regain Benefit | 100% of basic sum insured (applicable for 3 Lac and above Sum Insured) | 100% of basic sum insured | 100% of basic sum insured | ||||||
Section 6: Optional Benefit will be subject to Basic Sum Insured and any claim under them will affect entitlement to Renewal Incentive | |||||||||
Enhanced Cumulative Bonus | 10% of Sum Insured; Maximum 100% [Reduced by 10% in the event of claim] | ||||||||
Section 7: Optional Co-Pay | |||||||||
Co Pay | 10% or 20% of the admissible claim amount subject to the sum insured specified in the schedule | ||||||||
Section 8: Renewal Incentive | |||||||||
Cumulative Bonus | 5% of Sum Insured; Maximum 50% [Reduced by 5%% in the event of claim] | ||||||||
Health Check Up | Upto 1% of Sum Insured; Max 5,000 per person |
A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.
A deductible is a cost-sharing requirement. It states that the insurer will not be liable for a specified amount in case of indemnity policies. This is applicable for a specified number of days/hours in case of hospital cash policies which apply before any benefits are payable by the insurer. Remember that a deductible does not reduce your sum insured.
Review HDFC ERGO Health Suraksha Gold insurance brochure to understand coverage details.
Review HDFC ERGO Health Suraksha Gold insurance policy wordings which explains the terms and conditions.
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