HDFC ERGO Critical Illness Plan

Critical illnesses are largely unpredictable. Moreover, due to the high healthcare cost in the country, it becomes difficult for people to meet the medical expenses incurred due to such illnesses. While most of the health insurance policies cover major illnesses, it is vital to have a separate critical illness cover as an assurance during the critical times. The HDFC ERGO Critical Illness Plan is a special health insurance policy developed by HDFC ERGO to provide optimum coverage against critical illnesses.

HDFC ERGO Critical Illness Plan Overview:

HDFC ERGO Critical Illness Silver Plan provides coverage against critical illnesses. It covers eight critical illnesses and provides a lump-sum payout on confirmed diagnosis of critical ailments listed under it following a survival period of 30 days. However, the policyholder can raise only one claim during the policy tenure as the cover ceases after a claim is made. This plan is suitable for individuals with a history of life-threatening ailments.

Critical Illnesses Covered:

HDFC ERGO Critical Illness Silver provides protection against 8 major illnesses. The list of illnesses covered by this medical insurance policy can be given as follows: The plan covers the following critical illnesses:

  • Heart Attack (Myocardial Infarction)
  • Stroke
  • Coronary Artery Bypass Surgery
  • Multiple Sclerosis
  • Cancer
  • Kidney Failure
  • Paralysis
  • Major Organ Transplantation

Features and Benefits:

HDFC Ergo Critical Illness Silver Plan comes with several exclusive features and benefits. Here are the details of the coverage under this policy:

  • This policy provides a lump-sum amount to the insured after the first diagnosis of the disease, provided he/she survives a period of 30 days from the date of the initial diagnosis.
  • The lump-sum amount not only covers the cost and care of the treatment and recuperation aids, but it also mitigates the loss of income caused due to the diagnosis. It also helps in paying off the debts, if any.
  • The policyholder gets the option of choosing between one year or two years of policy coverage period.
  • The insured needs to wait for a period of 90 days from the date of buying the policy before making a claim.
  • The policyholders are eligible to get tax deduction benefits on the premiums paid under this policy as per Section 80D of the Income Tax Act, 1961. Policyholders can claim up to Rs.15,000 as tax benefit while senior citizens can avail up to Rs.20,000.
  • Individuals who are up to 45 years of age need not undergo any kind of medical check-up while availing this policy. It depends on the assumption that the applicant is not suffering from any health issues.
  • If the policy owners undergo diagnostic tests at the empanelled diagnostic centre of the company, they are eligible to receive a 50% discount on the cost of the tests. Once the policy is accepted and issued, the amount spent on the tests is reimbursed.
  • In the event of diagnosis of a critical illness the insured can receive a minimum sum assured of Rs.5 lakh and a maximum of Rs.10 lakh.
  • The policy comes with the benefit of lifetime renewability.
  • Before the issuance and acceptance of the policy the insured will have a 15-day free-look period to cancel the policy.

Exclusions:

The company has outlined the following exclusions under the HDFC ERGO Critical Illness Silver Plan for which it is not liable to provide any compensation to the insured:

  • The policy takes a waiting period of 90 days to come into effect unless the insured was covered under this policy continuously during the previous policy year.
  • It does not cover HIV/ AIDS, STDs, venereal disease, tuberculosis, Kaposi’s sarcoma, brain lymphomas or any other related disease.
  • The policy doesn’t provide coverage for health adversities occurred due to war, revolution, public defence, invasion, radiation, nuclear and biological weapons, and military, air force, or naval operations.
  • No coverage would be provided for individuals who have committed or attempted to commit any criminal acts or involved in any unlawful activity
  • The policy does not cover individuals engaging in adventurous sports such as mountaineering, parachuting, racing, diving, and so forth.
  • It does not include consequences resulted from abuse of drugs, intoxicants, alcohol, or treatment of nicotine addiction, smoking cessation programs or any substance abuse treatments.
  • Pregnancy related issues, voluntary termination, miscarriage, maternity or birth, congenital diseases, and defects or anomalies are not covered under the policy.
  • No coverage is provided to the policyholder in cases of intentional self-injury and attempted suicide while being insane or sane.

Eligibility:

People who want to opt for HDFC ERGO Critical Illness Silver Plan must meet the following eligibility criteria:

  • Individuals who are in the age group of 5 to 65 years are only eligible to avail this critical illness plan.
  • Applicants up to the age of 45 years of can avail this policy without undergoing any kind of medical check-up. However, it is subject to no existing health issues.
  • The policyholders may have to undergo a pre-policy check depending on the age and sum insured at the empanelled diagnostic centres at their own cost.

Claim Procedure and Documentation:

The following documents need to be submitted to the company while raising a claim:

  • Claim form of the company
  • Consultation forms
  • Medical reports and invoices
  • Hospitalization bills (including break up)
  • Pharmacy bills and prescriptions
  • Discharge summary

The procedure of raising a claim under this policy is detailed below:

  • In the event of raising a claim the policyholder should immediately inform the company via call, mail, or by visiting the nearest branch.
  • The company may record all the conversation and evaluate it later as a part of the claim record.
  • Upon receiving the final documents, the company will consider the claim and if they are satisfied with the evidences, the claim will be settled.

FAQs:

1. What is the policy coverage period?

The policy comes with one year or two years of policy coverage period.

2. Can the policy be directly purchased online? 

Yes, this policy can be purchased online by visiting the official website of HDFC Ergo. 

3. What are the documents to be submitted when applying for the plan?

It does not require any documentation. The applicants just need to submit the proposal form and the premium payment cheque. In case of credit card payments, the proposal form should contain the details.

4. How many claims can be made during the policy tenure?

Only one claim can be made during the policy tenure as the cover will cease after that.

5. Within how many days of purchasing the policy it can be cancelled?

The policy can be cancelled within 15 days (free-look period) of purchasing the policy.

6. Will the company refund the premium in case of cancelation?

Yes, a certain percentage of premium would be refunded based on the policy term.

Read terms, conditions and exclusions mentioned in the policy document.

Find cashless network hospitals nearby: HDFC ERGO Cashless Network Hospitals

Other Health Insurance Plans from HDFC ERGO Health Insurance:

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

 4.5 / 5.0   by 23 users
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HDFC ERGO Critical Illness Plan Reviews

Page 1 of 2 1 2
  • HDFC Ergo Health Insurance
    "Good for health"
    0.5 5.0/5 "Blown Away!"
    The medical cover of HDFC ERGO is good, I got Rs. 3 lakhs medical cover however the premium is around Rs. 9000 its covers my entire family. They have critical illness like paralytic, the insurance company got tie up many hospitals. There is no claim benefits so far from Hdfc ergo.
    Was this review helpful? 0
    , kolkata
    Reviewed on Jun 12, 2019
  • HDFC Ergo
    HDFC Ergo Health Insurance
    "Good Experience"
    0.5 4.0/5 "Great!"
    My company provided Hdfc Ergo health policy for my entire family for the sum assured of Rs. 5 lakhs. They do have critical illness cover for the cancer and heart attack. They got tie up with many hospitals, I got the medical card from their end.
    Was this review helpful? 0
    , delhi
    Reviewed on Jun 08, 2019
  • HDFC Ergo Health Insurance
    "Good Insurance company"
    0.5 5.0/5 "Blown Away!"
    I pay the premium around RS. 20,00 for two years of health policy in HDFC Ergo, its for covers me and my kid and spouse. So far I didnâ??t use it, I got the medical card around Rs. 3 lakhs they have critical illness and one more thing upto 15 lakhs I can top up the health benefits.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Apr 24, 2019
  • HDFC Ergo Health Insurance
    "GOOD"
    0.5 3.0/5 "Satisfactory"
    I have been using the health insurance policy with the HDFC ERGO GENERAL INSURANCE since from last 4-5 years and i have no claim experience with this policy. The medical coverage is for self and the coverage is 5L for this policy. It covers the critical illness, accidental benefits.
    Was this review helpful? 0
    , bhubaneshwar
    Reviewed on Feb 12, 2019
  • HDFC Ergo Health Insurance
    "Good"
    0.5 3.0/5 "Satisfactory"
    I have taken health insurance from HDFC Ergo which was offered along my personal loan. I have received the insurance paper and its been couple of months. It covers critical illness and need to go through the policy benefits. Always the customer is good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 14, 2019
  • HDFC Ergo Health Insurance
    "Average"
    0.5 3.5/5 "Pretty good"
    HDFC ERGO, I had used the online portal after analyzing all the details online decided to invest in HDFC ergo. It provides coverage for critical illness . Premium what I pay is 12k per year. It is very much reasonable this one is closed now and no reason for closing this insurance. This was taken before one year. Lastly I make the payment through online.
    Was this review helpful? 0
    , bahadurgarh
    Reviewed on Nov 08, 2017
  • HDFC Ergo Health Insurance
    "Good heatlh plan"
    0.5 4.5/5 "Excellent!"
    I have got one claim experience with HDFC ERGO where I was able to reimburse 20k of the amount and I got it immediately the process was so simple where I had been asked to call a specific number and it was all done..HDFC ERGO health insurance is particular meant for critical illness and when we get hospitalized. One can avail the maximum benefits. I am supposed to pay about rs 1600 for a period of 4 years and I will continue to get that till the end .
    Was this review helpful? 1
    , hyderabad
    Reviewed on Oct 08, 2016
  • HDFC Ergo Health Insurance
    "Good for accidental cover"
    0.5 3.0/5 "Satisfactory"
    I have taken a health insurance policy from HDFC which has a cover of over 15 Lakhs. It has a good accidental cover and good payouts in case of severing of limbs, fractures etc. or any damage caused from accidents. I pay around 6-7k for a year which amounts to 200-300 a year. The death benefits as usual goes to the family members. It covers critical illness, hospital charges but not bed charges.
    Was this review helpful? 1
    , bangalore
    Reviewed on May 21, 2016
  • HDFC Ergo Health Insurance
    "Very good policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with HDFC Ergo since 2011. I pay a premium amount of Rs.12,000 on a yearly basis. I pay this amount to the office directly by cheque. It does offer tax exemption benefits and covers hospitalisation charges as well as critical illness cover. Its is recommendable.
    Was this review helpful? 0
    , ranchi
    Reviewed on Apr 07, 2016
  • HDFC Ergo Health Insurance
    "Satisfied.."
    0.5 5.0/5 "Blown Away!"
    More or less all the kinds of critical illness are covered, I guess. Coverage amount is average for the health insurance. No claim is there in HDFC Ergo but never noticed about the percentage. Myself and my daughter are the dependents and overall coverage is 2 lakhs.
    Was this review helpful? 0
    , mumbai
    Reviewed on Nov 05, 2015
  • HDFC Ergo Health Insurance
    "Good plan.."
    0.5 4.0/5 "Great!"
    Overall medical coverage is 3lakhs and network hospitals are satisfactory. Premium is very low in HDFC Ergo for health insurance. I think no claim bonus option is not present in HDFC. To cover some diseases HDFC is taking one year of time and since second year all the critical illness are covered.
    Was this review helpful? 0
    , secunderabad
    Reviewed on Sep 03, 2015
  • HDFC Ergo Health Insurance
    "Very good"
    0.5 5.0/5 "Blown Away!"
    HDFC ERGO Health insurance is very good. Annual fee charged on this is very less when compared with others which was rs 6000. It provides a coverage against critical illness and all diseases. I am holding this health insurance for a period of 2montsh and this policy was taken based ob my credit card and I make the payment on an installment basis.
    Was this review helpful? 0
    , bangalore
    Reviewed on Sep 02, 2015
  • HDFC Ergo Health Insurance
    "Beneficial One..."
    0.5 4.5/5 "Excellent!"
    I have a health insurance policy from hdfc ergo. They cover hospitalizations, accidental benefits, critical illness. I directly approached them to take this policy. So far I donâ??t have any claim experience. I used to get notifications from them if any new policy is introduced.
    Was this review helpful? 0
    , bangalore
    Reviewed on Aug 24, 2015
  • HDFC Ergo Health Insurance
    "Try To Help The Customers..."
    0.5 1.0/5 "Really Bad"
    I had a policy from hdfc ergo which covers critical illness. When I had such issue I contacted them. They did not support me to claim the money. I wrote a mail and called several times, after a long discussion they came and checked the medical records, they also took a copy of the same. Then they denied. Earlier they said I can claim up to 5 lakhs, but I was very much disappointed. So I switched to ICICI Lombard.
    Was this review helpful? 0
    , bhubaneshwar
    Reviewed on Aug 24, 2015
  • HDFC Ergo Health Insurance
    "Wonderful..."
    0.5 4.5/5 "Excellent!"
    HDFC Ergo had issued the papers related with health insurance details and complete details were mentioned over there. Network hospitals are plenty and they are covering all critical illness. Claim is being offered in pre and post hospitalization.
    Was this review helpful? 0
    , chennai
    Reviewed on Jul 31, 2015
  • HDFC Ergo Health Insurance
    "Good "
    0.5 4.5/5 "Excellent!"
    I do have a health Insurance with HDFC Ergo and I do have two different plan,one for critical illness and other for general medical coverage.They do provide a total coverage amount around 10Lakh and they do cover all disease.I pay a premium around 3000 in this insurance and I prefer online payments.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jun 30, 2015
  • HDFC Ergo Health Insurance
    "Good ..."
    0.5 4.0/5 "Great!"
    Till now no claim experience and they are covering almost all kinds of critical illness except few. Also they have cashless features with good benefits on health insurance. I think maternity is covered in HDFC Ergo but term and conditions apply. Pre hospitalization and post hospitalization charges are being covered.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jun 13, 2015
  • HDFC Ergo Health Insurance
    "Thumbs up!!!"
    0.5 4.0/5 "Great!"
    Not used the benefits of HDFC Ergo so far but I am renewing it once in a year. Health insurance is good to have as it helps in critical illness and here in HDFC, the existing diseases are being covered since start of the insurance. At the start, I undergone for medical check ups. Premium is high and coverage is also high as it is 10lakhs per individual where three of them are covered. They do have tie up with all the hospitals and for the same I have booklets as well.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 29, 2015
  • HDFC Ergo Health Insurance
    "Really good"
    0.5 5.0/5 "Blown Away!"
    HDFC ERGO medi claim insurance is really good. It is provided by my company. The coverage amount is 3 lakh and on top of that they have provided one lakh for critical illness. More than all ,they have provided cash less card which provides a coverage for pre existing diseases up to the age of 85 years. I have been holding this policy for 2 years.
    Was this review helpful? 1
    , new delhi
    Reviewed on Apr 14, 2015
  • HDFC Ergo Health Insurance
    "Its fine"
    0.5 5.0/5 "Blown Away!"
    I have got a medi claim insurance with HDFC Ergo. Till now it is good, I cannot comment much about that. On a general note I would say it is very much beneficial for me. As it provides coverage for critical illness and its over a year now since I am holding this insurance. This was taken for a period of 2 years and once in every 2 years I have to renew this policy.
    Was this review helpful? 2
    , mumbai
    Reviewed on Apr 13, 2015
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