Objective

This is an online health insurance policy which will provide for hospitalisation and other related expenses.

Suited for

This policy is more suitable for those who utilize homeopathic or ayurvedic treatment.

What does it do?

This health insurance policy covers expenses of treatment taken as an inpatient. It pays for pre and post hospitalisation cost, day care procedures, organ donor expenses, and domiciliary treatment. It provides for allopathic medicine expenses, as well as unani, siddha and homeopathy treatments. If a policyholder does not make any claim for four consecutive years, he will be entitled to a free health check-up.

Pros

There is no capping on room rent, nursing fees or doctor's charges.
It covers non-allopathic treatment as well.
It can be bought online through company's website.
Family discount is available if two or more members are covered under the same policy.
Premium paid under this policy qualifies for deduction under section 80D of Income Tax Act.

Cons

Cumulative bonus will reduce by 10 per cent on acceptance of claim during any policy year.

Our View

Cover for homeopathic and ayurvedic treatment is a unique feature of this policy. Other benefits under this policy are similar to what other insurers offer.

Eligibility

Entry Age (years)

Minimum

18; 3 Months for Children

Maximum

65; 21 for Children

Maximum Policy Renewal Age (years)

65

Coverage Type

Individual/Family Floater

Policy Term (years)

1 or 2 years

Sum Insured (Rs)

Maximum

5 lakh

Minimum

2 lakh

Tax Benefit

Section 80D of the Income Tax Act are applicable

Discount

Family discount of 10% if 2 or more members are covered

No Claim Bonus

5% for each claim free year upto maximum of 50% of initial Sum insured. On acceptance of claim during any policy year, cumulative bonus will be reduced by 10% in subsequent policy year.

Pre Policy Medical Check Up

Not required upto 45 years of age

Grace Period for Policy Renewal

15 days

Policy Termination

Insurer may cancel the policy by giving a 30 days written notice to policyholder. Policyholder may also cancel the policy at any time by giving a written notice to insurer. In case policyholder cancelling the policy, a certain percentage of premium would be refunded based on policy term elapsed till date.

Customer Service

Address

HDFC ERGO General Insurance Company Limited 6th floor, Leela Business Park, Andheri-KurlaRoad Andheri East, Mumbai 400 059; Registered Office: Ramon House, HT Parekh Marg 169, Backbay Reclamation, Mumbai 400 020

Mail to

care@hdfcergo.com

Call to

1800 2 700 700

Scope Of Cover

Cashless facility

available at empanelled network of hospitals

Re-imbursement

available at non network hospitals

Pre-hospitalisation

medical expenses incurred during 60 days immediately prior to hospitalisation are covered

Post-hospitalisation

medical expenses incurred during 90 days after discharge from hospital are covered

Inpatient hospitalisation

Covered

Day care procedures

141 day care procedures are covered

Emergency ambulance

Covered upto maximum of Rs 2000 per event

Domiciliary Treatment (for a minimum of 3 days continuous treatment)

covered

Organ Donor Expenses during Transplant

covered

Health Check Up

allowed after every 4 claim free years upto 1% of Sum Insured upto maximum of Rs 5000

Ayurvedic/ Homeopathic treatment

Inpatient treatment under Unani/ Siddha/Homeopathy is covered upto 20% for Policy Sum Insured of Rs 2 lakh and 3 lakh and Rs 25000 for policy sum insured of Rs 4 lakh. Once a claim for such treatment is admitted, any claim under allopathic treatment for same person and same illness willnot be accepted

Exclusions and Waiting Period

Pre-existing diseases

covered after a period of 48 months

No claim period

Any disease contracted during the first 30 days of commencement of the policy unless there is a case of accidental injury

Waiting Period

Certain diseases and illnesses such as cataract, arthritis, cysts, nodules etc. shall be covered after a waiting period of 24 months from inception of the policy

General Exclusions

Dental/ oral treatment, Cosmetic, beauty, weight reduction and other likely treatments.War, participation in any criminal activity or adventurous activities such as mountaineering etc or any other related condition.