HDFC Ergo Insurance Plans

HDFC ERGO Women's Critical Illness Essential Plan

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.

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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.

HDFC ERGO Health Insurance Review

HDFC ERGO Health Insurance
HDFC ERGO Health Insurance sum insured
3 lacs − 75 lacs options available
Incurred Claims Ratio *
62.00%
HDFC ERGO Insurance tenure options
2 years
Claims Settlement Ratio **
85.97%
List of network hospitals
10,000+ hospitals
Number of policies issued *
1,066,395
Maximum family floater coverage
Self, Spouse + dependent (children (upto 25 yrs) + parents)
Number of lives covered *
96,05,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

HDFC Ergo Women Critical Illness Essential insurance benefits

  • Entry Age
  • What the Policy covers
  • Exclusions
  • Claims

HDFC Ergo Entry Age for all the Cancer Covers:

  • Proposer
    • Minimum Entry Age – 18 Years
    • Maximum Entry Age – 65 Years
  • Adult Dependent
    • 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.

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

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!

Brochure

Review HDFC ERGO Women's Critical Illness Essential Plan brochure to understand coverage details.

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Proposal form

Fill the online HDFC ERGO Women's Critical Illness Essential Plan proposal form.


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Policy wordings

Review HDFC ERGO Women's Critical Illness Essential Plan policy wordings which explains the terms and conditions.

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025