Due to the ever-rising healthcare costs, people often fail to avail high-quality medical facilities available around them. This compromise with the quality of treatment not only affects their health but at times, costs them their lives. Hence, having an all-inclusive health insurance policy in one’s investment basket is the ultimate need of the hour. HDFC Ergo General Insurance has one such extensive health insurance plan on offer which will enable people to access the top healthcare facilities without exhausting their lifetime savings.
Health Suraksha Silver Regain and ECB Plan Overview:
Health Suraksha Silver Plan Regain & ECB is an optimised health insurance policy that provides extensive coverage to the policy owner at an affordable premium. Under this scheme, the company pays for the pre and post hospitalisation charges in event of accident or sickness, day care procedures and domiciliary treatment costs, costs incurred due to organ donor’s treatment, etc. The expenses for using emergency ambulance service are also covered under it. Moreover, the insured enjoys a regain benefit and cumulative bonus as well. It comes with a hassle-free claim procedure and limited documentation.
Medical Expenses Covered:
HDFC ERGO Health Suraksha Silver Plan Regain & ECB offers comprehensive coverage to the policyholders by covering the medical expenses incurred in the following cases:
- Hospitalisation in event of illness or accident - Hospitalisation expenses resulted from accident or illness are covered. The policy also pays for room rent, boarding, nursing, intensive care unit, doctor fees, medicines, and other related expenses.
- Pre and post hospitalisation - It covers medical costs incurred due to an illness 60 days immediately before the date of hospitalisation and 90 days immediately after the discharge post hospitalisation.
- Ayurveda and other alternative medicines - The company pays for the in-patient treatments taken under Ayurveda and other alternative medicines like Homeopathy, Unani, Sidha etc.
- Domiciliary treatment - In cases where the insured takes medical treatments at home on the advice of a physician, the expenses will be paid by the company.
- Day care procedures - Medical costs for 144-day care procedures which don’t require 24-hour of hospitalisation due to advanced facilities are covered under it.
- Treatment of an organ donor - If the insured undergoes an organ transplantation, the medical expenses resulted due to the organ donor's treatment are borne by the insurer.
- Usage of emergency ambulance service - Costs incurred for utilising the ambulance services during emergency also come under the policy coverage.
Features and Benefits:
The most striking attributes of the HDFC ERGO Health Suraksha Silver Plan Regain & ECB are given below:
- The policy offers the option to choose a policy coverage period of one year or two years as per the policyholder’s convenience.
- It comes with a waiting period of initial 30 days from the date of policy purchase before making a claim, unless there is any accidental case.
- The policyholders can get tax benefits on the premiums paid for this policy under section 80D of the Income Tax Act, 1961. From Rs.15,000 to Rs.20,000 (senior citizens) can be availed as tax benefit.
- Individuals up to 45 years of age are not required to undergo any kind of medical check-up for buying this policy.
- 50% of standard medical test charges will be reimbursed after policy issuance in cases where the insured conducts pre-policy check at the company’s empanelled diagnostic centre.
- The insured will receive sum assured of Rs.3 lakh to Rs.10 lakh in event of hospitalisation and other medical treatments that are listed under the policy.
- Policyholders enjoy lifetime renewability benefits under this plan.
- The coverage includes no sub-limits on any disease, room rent, hospital charges, and doctor fees.
- The policy can be taken by the insured under both individual sum insured basis and on family floater basis.
- Family discount of 10% is available if 2 or more family members are covered under the plan on Individual Sum Insured basis.
- It features an additional benefit of automatic availability of basic sum insured upon its exhaustion during the policy year. Extra 5% premium will be charged on the base premium unless the sum insured is Rs.2 lakh.
- There is an optional cumulative bonus which will automatically increase to 10% with the maximum amount not exceeding 100% of Base Sum Insured. Extra 2.5% premium will be charged on the base premium unless the sum insured is Rs.2 lakh.
- Cumulative bonus of 5% of the Basic Sum Insured subject to a maximum of 50% will be given to the insured every claim-free year.
- At the end of 4 consecutive claim-free years the insured gets up to 1% of Sum Insured and maximum up to Rs.5000 for a health check-up.
- 10% discount on the premium for a 2-year policy if the policyholder is paying premium of 2 years in advance.
- It features a free-look period of 15 days from the date of receipt of the policy document before its issuance and acceptance.
The policyholder will not receive any compensation from the company under Health Suraksha Silver Plan Regain & ECB in the following cases:
- Pre-existing illnesses for a period of first 48 months from the date of policy purchase.
- Cost of any treatment conducted within first 30 days of purchasing the plan except any accidental injuries.
- Treatment of HIV, AIDS, and other related diseases.
- Costs of treatments such as cosmetic surgery, weight control therapy, and mental disorder/insanity.
- In cases of abuse of intoxicants, alcohol, drugs, and other addictions there is no coverage.
- Hospitalisation expenses occurred as a result of war or acts of war, radiation, and chemical/nuclear/biological weapon.
- Costs of dental and external aids and appliances along with pregnancy unless these are a part of any specific plan.
- Investigational, experimental, or unproven treatment, pharmacological regimens, and devices.
- There are 2-year exclusions for specific diseases.
- Any individual can avail the Health Suraksha Silver Plan Regain & ECB by providing all the requested documents.
- New born babies since their birth are eligible to be covered under it as there is no age restriction at entry.
- Children who are below 5 years can be covered if both the parents are covered under the policy.
- Individuals up to 45 years are eligible to avail the plan without any kind of medical test.
Claim Procedure and Documentation:
- Whenever there is a hospitalisation the company should be immediately informed before 7 days.
- In case of incidents that can result in a policy claim, the company must be informed at least 7 days before taking any consultation and treatment as these should be pre-authorised by the company.
- The required information and documents should be provided within 15 days of request or completion of treatment or discharge of the insured from hospital, whichever is earlier.
Frequently Asked Questions:
1. Can the policy be purchased online? ?
Yes, the HDFC ERGO Health Suraksha Silver Plan Regain & ECB can be purchased online by logging in to the registered website of HDFC ERGO.
2. What are the documents to be submitted when applying for the plan? ?
No documents are required to buy this plan. The policy can be availed just by submitting the proposal form and the premium payment receipt.
3. How many claims can be made during the policy tenure?
Only one claim can be requested during the policy period as the policy will get exhausted after that.
4. Within how many days from the policy purchase date can it be cancelled?
The policy can be cancelled within 15 days from the date of receipt of the policy document. However, it can be cancelled only if no claims are made under it.
5. Will the policy owner get refund of the premiums paid after cancelation?
Yes, the company will give refunds of the paid premiums after adjusting the medical check-up cost, stamp duty charges, and proportionate risk premium.
Read terms, conditions and exclusions mentioned in the policy document.
Find cashless network hospitals nearby: HDFC ERGO Cashless Network Hospitals
Also Read: Best Health Insurance Plans
Also Read: How to File a Claim with HDFC ERGO?
Other Health Insurance Plans from HDFC ERGO Health Insurance:
- HDFC ERGO Health Suraksha Silver
- HDFC ERGO Health Suraksha Gold
- HDFC ERGO Health Suraksha Silver Regain and ECB
- HDFC ERGO Critical Illness
- HDFC ERGO Critical Illness Platinum
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.