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hdfc student travel insurance HDFC ERGO Women's Critical Illness Essential Plan

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Critical Illnesses

If Insured Person suffers from Critical illness Condition/Surgical Procedureas listed below, whose diagnosis and/or manifestation first commence/occurs after 90 days from the commencement of first Policy with Us, Wewill pay Sum Insured as specified on the Schedule of Coverage.

HDFC ERGO health insurance review

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Sum Insured

2 lac − 50 lacs

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Claims settlement ratio **

62.00%

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List of network hospitals

10,000+ hospitals

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Number of policies issued *

1,066,395

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Number of lives covered *

96,05,000

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Number of policies issued *

1,066,395

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Tenure options

2 years

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Maximum family floater coverage

Self, Spouse + dependent (children (upto 25 yrs) + parents)

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Brochure

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Policy Wordings

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HDFC Ergo Women Critical Illness Essential insurance benefits

  • HDFC Ergo Entry Age for all the Cancer Covers:

    • Proposer
      • Minimum Entry Age – 18 Years
      • Maximum Entry Age – 65 Years
  • Coverages for Critical Illnesses Include

    Critical Illness/Surgical Procedure Stage
    Surgery of Aorta Major
    Kidney failure requiring regular dialysis Major
    Infective Endocarditis Major
    Major Organ/Bone Marrow Transplantation Major
    Primary (Idiopathic) Pulmonary Hypertension Major
    End Stage Liver Failure Major
    Dissecting Aortic Aneurysm Major
    Medullary Cystic Disease Major
    Cardiomyopathy Major
    Aplastic Anaemia Major
    Other serious coronary artery disease Major
    End Stage Lung Failure Major
    Eisenmenger’s Syndrome Major
    Fulminant Hepatitis Major
    Multiple Sclerosis with persisting symptoms Major
    Chronic Adrenal Insufficiency (Addison’s Disease) Major
    Permanent Paralysis of Limbs Major
    Progressive Scleroderma Major
    Benign Brain Tumour Major
    Chronic Relapsing Pancreatitis Major
    Parkinson’s Disease Major
    Elephantiasis Major
    Alzheimer’s Disease Major
    HIV due to blood transfusion and occupationally acquired HIV Major
    Motor Neurone Disease with permanent symptoms Major
    Terminal Illness Major
    Muscular Dystrophy Major
    Myelofibrosis Major
    Apallic Syndrome Major
    Pheochromocytoma Major
    Bacterial Meningitis Major
    Crohn’s Disease Major
    Creutzfeldt-Jakob Disease (CJD) Major
    Severe Ulcerative Colitis Major
    Encephalitis Major
    Deafness Major
    Major Head Trauma Major
    Loss of Speech Major
    Progressive Supranuclear Palsy Major
    Blindness Major
    Brain Surgery Major

    Survival Period

    Claim under this Section is payable only if Insured Person survives 7days from the diagnosis and fulfilment of the definition of the Critical Illnesscovered.The Claim is payable only with confirmatory diagnosis of theconditions covered while the Insured Person is alive (A claim wouldnot be admitted if the diagnosis is made post mortem)

    No of Claims and Benefits payable

    Only one Claim is payable under each of the stages given belowduring lifetime of the Policy under this Section.
    • Minor Stage - On the admissibility of Claim under Minor Stagecondition under the Policy, coverage for all other Minor stageConditions shall cease to exist. The Policy shall continue to CoverMajor Stage condition for Balance Sum Insured.
    • Major Stage – On the admissibility of Claim under Major Stagecondition, coverage shall cease to exist.
  • Key Features of the my: health Women Suraksha Policy (including Critical Illness)

    • Policy exclusively designed for today’s Women, which looks beyond her health insurance needs and ensures her well being
    • Multiple sum insured options ranging from Rs. 1 Lac to Rs. 5 Crs available under this policy.
    • Coverage for all the women in the family under the single policy
    • Comprehensive policy with coverage for all women specific major illnesses and surgeries
    • Wellness features like Fitness discount@ renewal, Health Coachetc for maintenance of good health
    • Various discount offered like family discount, long term policy discount, loyalty discount
    • Long term policy options 0f 1 year / 2 years / 3 years
    • Option to pay premium in yearly, half yearly, quarterly and monthly instalments.
  • General Exclusions applicable to Critical Illness Cover

    • 48 months waiting period shall apply for all Pre-existingConditions declared and/or accepted at the time of applyingfirst policy with us
    • Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, revolution, insurrection, military or usurpedacts, nuclear weapons/materials, chemical and biologicalweapons, radiation of any kind.
    • Any Insured Person committing or attempting to commit a breach of law with criminal intent, or intentional self-injury orattempted suicide while sane or insane.
    • Participation or involvement of an Insured Person in naval,military or air force operation, racing, in a professional or semiprofessional nature
    • From engaging in or participation in adventure sports including but not limited to winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters, participation in any Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which the Insuredis untrained, unless specifically covered under the Policy;
    • Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs andalcohol including smoking cessation programs and thetreatment of nicotine addiction or any other substance abusetreatment or services, or supplies
    Disclaimer: “For the detailed list of exclusions under the policy, kindly refer to the same provided in your policy kit”

  • Claims documents for Critical Illness Cover

    • Claim Form duly signed by the Insured Person
    • Copy of Discharge Summary / Discharge Certificate
    • First consultation letter from treating Medical Practitioner
    • Medical certificate confirming diagnosis, and the treatment from Medical Practitioner
    • Certificate from treating Medical Practitioner, specifying the duration and etiology
    • OT Notes in case of Surgery
    • Medical certificate from treating Medical Practitioner specifying the diagnosis and need for the surgery
    • MLC/FIR copy/ certificate regarding abuse of Alcohol/intoxicating agent if applicable
    • All pathological and radiological Investigation Reports We may require the Insured Person to undergomedical examination by Medical Practitioner authorized by Us to obtain an independent medical opinion forthe processing of the claim. Any cost towards such a medical examination will be borne by Us.
    • NEFT details & cancelled cheque

HDFC Ergo Health Insurance FAQ’s

Individual plan has to be separate for every individual. Floater covers all in family (max. 2 Adults and Children upto 25 years and Dependent parents) and provides one sum insured to all, hence there is saving of premium.

There is No maximum exit age for HDFC Ergo medical insurance.

Sub limit defines the capping of insurance amount, for specific surgeries and medical procedures, which reduces the premium of the plan. You can also opt for an add on cover by paying extra premium to remove the sub- limits under the policy.

The duration only after which a claim can be made is called the waiting period.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

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