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Health Insurance Brochure - HDFC ERGO General Insurance

HDFC ERGO brings to you Health Suraksha, a unique health insurance plan, providing optimum health
coverage at an affordable price. Health Suraksha covers not only hospitalisation in the event of an accident or
sickness but extends to cover pre and post-hospitalisation expenses, day care procedures, domiciliary
treatment, organ donor expenses. Moreover, you get a renewal bonus for each claim-free year.
Get Health Suraksha today and protect your tomorrow.
PRODUCT HIGHLIGHTS
Tax Benefit under section 80D*
No Medical Check-up upto 45 years
No sub-limits on any disease, room rent, hospital charges and doctor fees(Except for Ayurvedic
/Homeopathic Benefit)
Cashless Treatment at Network Hospital
5% bonus on Sum Insured for every claim-free year
Covers persons upto 65 years of age
Offers one year or two year policy coverage period
Option to cover on individual sum insured basis and on family floater basis
Avail a family discount of 10%, if 2 or more members of a family are covered under the same
policy on Individual sum insured basis
Life Long Renewability
(* Subject to the change in Tax Laws)

Children below 5 years would be covered provided both the parents are covered under our policy.
PREMIUM TABLE (Inclusive of Service Tax & Edu.
Sum Insured - 200,000
Age
1A
2A
0-17
2,384
18-35
3,217
4,825
36-45
4,037
6,056
46-50
7,171
11,473
51-55
7,529
12,047
56-60
8,771
14,033
61-65
12,308
19,693
66-70
17,712
25,506
71-75
19,538
34,433

Cess)
2A1C
6,256
7,486
12,904
13,477
15,464
21,123
28,056
37,015

2A2C
7,686
8,917
14,334
14,908
16,894
22,554
30,097
39,253

1A1C
4,242
4,899
7,838
8,188
9,291
12,298
17,590
23,746

76-80
>80

29,842
36,108

44,763
54,163

47,449
56,871

49,687
59,037

30,870
37,353

Age
0-17
18-35
36-45
46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

1A
4,292
5,790
7,267
13,625
14,306
17,542
24,616
35,425
39,077
53,715
64,994

2A
8,686
10,900
21,799
22,889
28,067
39,385
45,910
61,979
80,574
97,494

2A1C
11,261
13,475
24,517
25,607
30,928
42,246
50,501
66,627
85,4070
102,368

2A2C
13,836
16,050
27,235
28,325
33,789
45,108
54,174
70,655
89,436
106,267

1A1C
7,636
8,818
14,978
15,557
18,582
24,595
31,662
42,743
55,566
67,235

33,957
37,353
41,088
45,197
2 Year Policy
1A2C
1A3C
10,351
13,355
11,458
14,463
17,242
20,413
17,787
20,958
20,709
24,047
26,369
29,707
34,827
38,310
47,017
51,719
61,123
67,235
73,958
81,354

Sum Insured - 300,000

Age
0-17
18-35

1A
2,712
3,721

2A
5,582

2A1C
7,209

2A2C
8,837

1A1C
4,876

1 Year Policy
1A2C
1A3C
6,588
8,487

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1 Year Policy
1A2C
1A3C
5,751
7,420
6,366
8,035
9,075
10,744
9,361
11,030
10,355
12,024
13,184
14,853
19,348
21,283
26,120
28,733

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12/26/13

Health Insurance Brochure - HDFC ERGO General Insurance

36-45
46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

4,479
8,037
8,439
9,764
14,102
19,008
27,237
33,157
40,120

6,718
12,859
13,503
15,623
22,564
28,339
38,259
49,736
60,181

8,345
14,487
15,130
17,250
24,191
31,174
41,128
52,720
63,190

9,973
16,114
16,758
18,877
25,819
33,441
43,615
55,207
65,597

5,482
8,866
9,208
10,388
14,075
19,544
26,384
34,300
41,504

Age
0-17
18-35
36-45
46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

1A
4,882
6,698
8,026
15,271
16,035
19,528
28,205
38,016
54,474
59,683
72,217

2A
10,048
12,092
24,433
25,656
31,245
45,127
51,011
68,865
89,525
108,326

2A1C
12,977
15,022
27,525
28,748
34,500
48,382
56,114
74,031
94,897
113,742

2A2C
15,906
17,951
30,617
31,840
37,755
51,637
60,193
78,507
99,373
118,074

1A1C
8,776
9,867
16,845
17,495
20,776
28,151
35,179
47,492
61,740
74,706

7,156
9,055
10,227
11,724
10,549
12,025
11,609
13,019
15,079
16,273
21,499
23,648
29,024
31,926
37,730
41,504
45,653
50,219
2 Year Policy
1A2C
1A3C
11,859
15,277
12,881
16,299
19,431
22,275
20,043
22,848
23,217
26,038
30,158
32,545
38,698
42,567
52,243
57,467
67,915
74,706
82,175
90,395

Sum Insured - 400,000

Age
0-17
18-35
36-45

1A
4,357
5,587
6,233

2A
8,380
9,349

2A1C
10,994
11,963

2A2C
13,609
14,578

1A1C
7,519
8,036

1 Year Policy
1A2C
1A3C
10,290
13,340
10,775
13,825

46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

11,058
11,611
13,925
22,085
29,447
40,848
41,447
50,151

17,694
18,578
22,280
35,337
35,425
47,824
62,170
75,226

20,308
21,192
24,894
37,951
38,968
51,410
65,900
78,988

22,922
23,807
27,508
40,566
41,801
54,518
69,009
81,997

12,668
13,138
15,191
22,128
24,430
32,981
42,875
51,879

Age
0-17
18-35
36-45
46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

1A
7,843
10,056
11,219
21,011
22,061
27,850
44,171
58,895
81,697
74,605
90,271

2A
15,084
16,828
33,618
35,298
44,559
70,674
63,765
86,083
111,906
135,407

2A1C
19,790
21,534
38,585
40,266
49,788
75,902
70,142
92,539
118,620
142,178

2A2C
24,495
26,240
43,552
45,233
55,017
81,131
75,242
98,133
124,217
147,595

1A1C
13,535
14,465
24,069
24,961
30,382
44,256
43,975
59,366
77,176
93,382

Sum Insured - 500,000

Age
0-17
18-35
36-45
46-50
51-55
56-60
61-65
66-70
71-75
76-80
>80

1A
5,306
7,254
8,137
14,641
15,212
17,712
25,341
38,281
53,104
49,736
60,181

2A
10,881
12,206
23,425
24,340
28,340
40,545
42,509
57,388
74,605
90,271

2A1C
14,064
15,389
26,608
27,523
31,523
43,728
46,761
61,692
79,081
94,785

2A2C
17248
18572
29792
30707
34707
46912
50161
65423
82810
98396

1A1C
9,517
10,224
16,424
16,910
19,141
25,625
29,316
39,577
51,450
62,254

Age
0-17
18-35
36-45
46-50
51-55

1A
9,550
13,057
14,647
27,817
28,904

2A
19,586
21,970
44,507
46,246

2A1C
25,316
27,700
50,556
52,294

2A2C
31,046
33,430
56,604
58,343

1A1C
17,131
18,403
31,205
32,129

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14,947
17,444
15,389
17,859
17,240
19,594
23,769
25,714
26,873
29,561
36,279
39,907
47,163
51,879
57,067
62,773
2 Year Policy
1A2C
1A3C
18,522
24,013
19,394
24,885
28,399
33,144
29,240
33,932
34,480
39,188
47,537
51,429
48,372
53,209
65,302
71,832
84,894
93,382
102,720 112,992

1 Year Policy
1A2C
1A3C
11,807
16,582
12,470
17,245
18,079
22,122
18,537
22,551
20,537
24,426
26,639
30,147
32,248
35,473
43,535
47,888
56,596
62,254
68,480
75,328
2 Year Policy
1A2C
1A3C
21,253
29,848
22,445
31,040
34,350
42,032
35,220
42,847

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12/26/13

Health Insurance Brochure - HDFC ERGO General Insurance

51-55
56-60
61-65
66-70
71-75
76-80
>80
WHAT IS COVERED

28,904
35,425
50,681
77,423
107,401
89,525
108,326

46,246
56,680
81,090
76,516
103,298
134,289
162,488

52,294
63,047
87,457
84,170
111,046
142,346
170,612

58,343
69,413
93,823
90,290
117,761
149,059
177,113

32,129
38,282
51,250
52,769
71,238
92,609
112,058

35,220
41,073
53,278
58,047
78,363
101,872
123,264

42,847
48,852
60,295
63,852
86,198
112,058
135,591

In Patient Treatment - Covers hospitalisation expenses due to an illness or accident. Pays for
medical expenses incurred for room rent, boarding expenses, nursing, intensive care unit, medical
practitioner, medicines or drugs and other related expenses
Pre-Hospitalisation - Pays for medical expenses incurred due to an illness 60 days immediately
before hospitalisation
Post-Hospitalisation - Pays for medical expenses incurred 90 days immediately after the
discharge post hospitalisation
Day care procedures - Pays for medical expenses for 141 day care procedures which do not
require 24 hours hospitalisation due to technological advancement
Domiciliary Treatment - Pays for expenses incurred for medical treatment taken at home, on the
advice of a physician
Organ Donor - Pays for medical expenses for an organ donor's treatment in the event of
organ transplantation
Emergency Ambulance - Pays for expenses for utilizing ambulance services in an emergency
Ayush - Pays for medical expenses for in-patient treatment taken under Ayurveda, Unani,
Sidha or Homeopathy
WHAT IS NOT COVERED:
Any treatment within first 30 days of cover except any accidental injury
Pre-existing conditions will not be covered for first 48 months
Expenses arising from HIV or AIDS and related diseases
Mental disorder or insanity, cosmetic surgery, weight control treatment
Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
Hospitalisation due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
Pregnancy, dental and external aids and appliances unless covered under specific plans
2 year exclusions for specific diseases
Experimental, investigational or unproven treatment, devices and pharmacological regimens
No Sub-limits on any disease, room rent, hospital charges and doctor fees(Except for
Ayurvedic /Homeopathic Benefit).
CLAIMS PROCESS
Incase of hospitalization, intimation should be provided to the Company / TPA immediately and
not less than 7 days
In all other cases, the Company / TPA must be informed of any event or occurrence that may give
rise to a claim under this Policy at least 7 days prior to any consequent treatment, consultation or
procedure being taken and the Company / TPA should pre-authorise such treatment, consultation or
procedure
Any documentation and information requested to establish the circumstances of the claim, its
quantum or the Companys liability for the claim, should be submitted within 10 days of our request or
discharge from Hospital or completion of treatment, whichever is earlier
RENEWALS
Cumulative bonus of 5% for every claim-free year upto a maximum of 50%
Pays upto 1% of Sum Insured, maximum upto Rs. 5000 for a Health Checkup after 4 consecutive
claim-free years
TERMS & CONDITIONS
Disclaimer: The above information is only indicative in nature. For details of the coverage
and exclusions please refer to the policy wordings.
Liability of the Company does not commence until the Company has accepted the proposal and
full premium has been paid.
The proposer has the option to choose his policy with or without coinsurance. Under the
coinsurance option, we will coinsure the risk with Apollo Munich Health Insurance Company Limited, a
registered and prominent stand-alone health insurance company which has expertise in underwriting
and selling health insurance products. Furthermore, Apollo Munich is a joint venture between Asias
largest integrated healthcare provider, The Apollo Hospitals Group, and Germany based Munich Res
newest business segment, Munich Health.
Anti-Rebating Warning: As per Section 41 of the Insurance Act 1938, as amended, the practice of
rebating is prohibited, as follows: No person shall allow or offer to allow, either directly or indirectly, as
an inducement to any person to take out or renew or continue an insurance policy in respect of any
kind of risk relating to lives or property in India, any rebate of the whole or part of the commission
payable or any rebate of the premium shown on the policy, nor shall any person taking out or
renewing or continuing a policy accept any rebate, except such rebate as may be allowed in
accordance with the published prospectus or tables of the insurer. Violation of Section 41 of the
Insurance Act 1938, as amended, shall be punishable with a fine which may extend to five hundred
(500) Rupees.

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12/26/13

Health Insurance Brochure - HDFC ERGO General Insurance

(500) Rupees.
FREELOOK
You have a period of 15 days from the date of receipt of the Policy document to review the terms and
conditions of this Policy. If You have any objections to any of the terms and conditions, You have the option of
cancelling the Policy stating the reasons for cancellation and You will be refunded the premium paid by You
after adjusting the amounts spent on any medical check-up, stamp duty charges and proportionate risk
premium. You can cancel Your Policy only if You have not made any claims under the Policy. All Your rights
under this Policy will immediately stand extinguished on the free look cancellation of the Policy. Free look
provision is not applicable and available at the time of renewal of the Policy.
For details, kindly refer to Policy Wordings .
HDFC ERGO General Insurance Company Limited
6th Floor, Leela Business Park, Andheri-Kurla Road Andheri East, Mumbai 400 059.
Registered Office: Ramon House, H T Parekh Marg 169, Backbay Reclamation, Mumbai 400 020.
Toll-free No. 1800 2 700 700 Fax: 91-22-6638 3699
E-mail care@hdfcergo.com Website www.hdfcergo.com
Disclaimer: Please read the Terms & conditions before concluding the sale.Insurance is the subject matter of the solicitation.
IRDA Reg No. 125 Form No./UID No. 704

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