HDFC ERGO Medisure super top up

Features of HDFC ERGO Medisure super top up Insurance

• Room Rent :Payable at Actuals upto Sum Insured
• Co-pay : NIL for all treatment upto 80 yrs / 10% Co pay for insured > 80 yrs
• Restoration Benefit: NIL Rebound Benefit under this plan
• High Sum Insureds with range of Deductible options at extremely competitive premiums
• Entry age is 65 years with lifetime renewal option
• Hospitalisation cover limit upto Sum Insured – No Sublimits
• Coverage under the Family Option is provided for entire family that include parents, in-laws, niece, nephew, spouse and kids
• Constant premiums from Age 61 – this means that even in a plicy year in which there have been claims, the base premium (without GST) at the time of renewal will remain the same
• No health checkupsuptothe insured age of 55 years – ensure no time spent in unnecessary pre policy check ups. However proposed insureds above the age of 55 years and those with declared pre existing medical conditions irrespective of age will need to undergo medical tests
• Pay less, Get more - Opt for a long-term policy of 2 years and get a 5% discount on the premium. If one wishes to cover a family of more than 2 members on individual Sum Insured basis, they can avail 10% discount.
• HDFC Service Guarantee – 6 hour turn around time for cashless claims guarantee to Network hospitals, 6 day turn around time for reimbursement claims on submission of complete documents
• Free Look Period of 15 days

Sum Insured and Deductible Options

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

Illustration

(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

Exclusions of HDFC ERGO Medisure super top up Insurance

Some of the key exclusions under this plan are as follows; however please go through the policy wordings for the entire list:

• All pre-existing diseases / illness / injury / conditions as defined in the Policy, until 36 months of continuous covers have elapsed since inception of the first Policy with us.
• Any disease contracted and/or Medical Expenses incurred by You in respect of any illness during the first 30 days from the commencement date of the Policy except in case of accidental injuries. This Exclusion doesn't apply for those having any health insurance indemnity policy in India at least for 1 year prior to taking this Policy as well as for subsequent renewals with Us without a break.
• All expenses along with their complications on treatment towards following ailments/illness are excluded and will be covered after the first two years (24 months) of continuous operation of this insurance cover:
  • Cataract
  • Uterine prolapse including any condition requiring Hysterectomy
  • Polycystic Ovarian Diseases, Myomectomy for Fibroids
  • Osteoarthritis and Osteoporosis
  • Arthritis, Arthroscopic Surgery, Rheumatism, Joint Replacement Surgery (other than caused by accident), Prolapse of Intervertibral discs(other than caused by accident)
  • Congenital internal anomaly
  • Fistula in anus, Piles, Fissure
  • Gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps, and any type of Breast lumps, benign ear, Nose and Throat disorders and surgeries Chronic Nephritis and Nephropathy (Kidney diseases).
  • Fibroids, Dilatation & Curettage for treatment purposes, Pilonidal sinus, Chronic Suppurative Otitis Media (CSOM)
  • Hypertension, Diabetes and related complications
  • Deviated Nasal Septum, Sinusitis and related disorders
  • Surgery on tonsils/Adenoids