In Patient Hospitalisation | If any Insured Person suffers an Illness or Accident during the Policy Period requiring Inpatient Hospitalization, the insurer will pay the MedicalExpenses (upto SI) incurred for
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Pre Hospitalisation Medical Expenses | The Medical Expenses incurred in the 30 days immediately before the insured was Hospitalized is payable under the policy upto SI, provided that:
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Post Hospitalisation Medical Expenses | The Medical Expenses incurred in the 60 days immediately after the insured is discharged is payable under the policy upto the SI, provided that:
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Day Care Treatment | The Medical Expenses for a day care treatment is covered where the procedure or surgery:
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Aggregate Deductible (₹) | Sum Insured (₹) | |||
2 lacs | 3 lacs | 8 lacs | ||
3 lacs | 7 lacs | 12 lacs | ||
4 lacs | 6 lacs | 11 lacs | 16 lacs | |
5 lacs | 5 lacs | 10 lacs | 15 lacs | 20 lacs |
(All figs in INR ₹) | Policy Deductible | Sum Insured for the Policy | Claim Amount | Paid by Policy Deductible | Claim Payable by Top Up Policy |
At Inception | 3,00,000 | 12, 00,000 | |||
Claim 1 | 3,00,000 | 12,00,000 | 2,00,000 | 2,00,000 | NIL |
Claim 2 | 3,00,000 | 12,00,000 | 5,00,000 | 1,00,000 | 4,00,000 |
Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.
HDFC Ergo has an extensive network of 10,000+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through theHDFC Ergo network hospital list
There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.
A pre - existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.
Review HDFC ERGO Medisure super top up insurance brochure to understand coverage details.
Know more »Review HDFC ERGO Medisure super top up insurance policy wordings which explains the terms and conditions.
Know more »You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque
Know more »HDFC ERGO Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 10,000+ Hospitals
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