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Optima Lite Health Insurance Plan
HDFC ERGO Optima Lite Health Insurance Plan is an affordable health insurance policy that provides necessary health insurance coverage to i…
- Affordable premiums
- Unlimited restore benefit
- No disease-wise sub-limits
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HDFC ERGO Health Insurance
HDFC ERGO Arogya Sanjeevani Policy
The Arogya Sanjeevani Policy from HDFC ERGO is designed for individual ...Read More
Up to 2 Cr
Sum insured
1
No. of plans
200+
Pan India presence
95.30%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,716 reviews
🏥 15,000+ hospitals
📊 2.00 solvency ratio
✅ 95.30% claim settlement
About HDFC ERGO Arogya Sanjeevani Policy
A quick read on what this HDFC ERGO Health Insurance plan covers and why it might be a fit for you.
The Arogya Sanjeevani Policy from HDFC ERGO is a basic plan designed for individual or family floater coverage. It provides essential medical support including hospitalization, pre and post-hospitalization, doctor’s consultation, AYUSH treatment, and preventive health check-ups.
With a sum insured of up to 10 Lakhs, the plan is sufficient for your medical requirements. As a policyholder, you can benefit from its affordable premiums and seamless customer support.
Read further to understand the benefits and specifications of this plan.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
18 - 65 Years
Plan type
Individual and Family Health Insurance
Sum insured options
₹50 L, ₹10 L
Waiting period
30 days
Renewability
Lifelong
Policy term
1 year
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- Pre and post-hospitalization
- Doctor consultation
- AYUSH treatment
- Preventive health check-ups
Cons
- Maternity expenses
- Daily hospital cash
- Modern treatment
- Organ donor cover
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Covered
- ICU charges Covered
- Pre-hospitalization Covered
- Post-hospitalization Covered
- Domiciliary hospitalization Not covered
- Day-care treatment Covered
- OPD charges Not covered
- Covid-19 treatment Covered
- Cataract Covered
Bonuses & restoration
- No-claim bonus Covered
- Automatic restoration of SI Not covered
- Daily hospital cash Not covered
Family & special care
- Maternity cover Not covered
- New-born baby cover Not covered
- IVF treatment Not covered
- AYUSH treatment Covered
- Organ donor expenses Not covered
Modern & preventive care
- Modern treatment Not covered
- Road ambulance Covered
- Air ambulance Not covered
- E-consultation Not covered
- Health check-up Covered
- Second medical opinion Not covered
- Vaccination Not covered
Conditions & global
- Co-payment Covered
- Sub-limits Covered
- Compassionate travel Not covered
- Global coverage Not covered
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
HDFC ERGO Health Insurance
HDFC ERGO video starts with an overview of HDFC ERGO, detailing its history, mission, and market position.
Benefits of Arogya Sanjeevani Policy by HDFC ERGO
- Here are some notable benefits of the Arogya Sanjeevani Policy by HDFC ERGO:
Easy policy buying process
- The online policy-buying process allows you to secure the mental, physical, and financial well-being of you and your family from the comfort of your home.
Dental treatment & plastic surgery
- This plan provides the additional benefit of cashless and hassle-free treatment for dental problems and plastic surgery. The only condition is that the injury must be caused due to a disease or an accidental mishap.
Good customer support
- The insurer provides its customers with an easy and hassle-free policy-buying and claim procedure. The 24/7 customer support is an impressive feature that ensures you enjoy the maximum benefits of your policy.
Tax benefits
- All premiums paid towards HDFC ERGO Arogya Sanjeevani Policy are eligible for tax benefits under Section 80D of the Income Tax Act.
HDFC ERGO Health Insurance Network Hospital List
HDFC ERGO Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, HDFC ERGO Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
Exclusions
- This policy schedule has some exclusions that are mentioned below:
- Any kind of external congenital diseases or voluntary treatments like cosmetic/beautification/plastic surgery, etc.
- Investigation and evaluation purposes.
- Obesity/weight control/liposuction.
- Hazardous/adventure sports/nuclear wars, acts of defense, etc.
- Breach of the law, alcoholism, drug or substance abuse.
- Unproven treatments, rest cure, rehabilitation, etc.
- Sterility and infertility, birth control, gender change treatments, etc.
- Hypertension, diabetes, cardiac arrests, organ transplants, donor expenses, etc.
- Maternity expenses like childbirth (complicated deliveries and cesarean sections, except ectopic pregnancy), miscarriage (except an accident), and lawful medical termination of pregnancy during the policy period.
- Certain diseases and treatments are covered under this plan after a specific waiting period. Read the details below:
- Pre-existing conditions: 48 Months
- Daycare procedures: 24 Months
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Min. Entry Age: 18 Years
- Max. Entry Age: 65 Years
- Sum Insured: Up to 10 Lakhs
- Initial Waiting Period: 30 Days
Other features & benefits
How to claim HDFC ERGO Arogya Sanjeevani Policy?
To avail of claim settlement services, the insured individual must follow the process below:
- Visit the official website of HDFC ERGO General Insurance.
- Click on the ‘Claim’ button on the header of the official website and navigate to the claim process > Health insurance.
- For claim intimation, the official website has a pre-authorized form that you can fill in with your contact number/policy number/email and ‘Proceed’.
- Individuals can call the toll-free number 022 6234 6234 or email their details to [email protected] to get information on their claim settlement procedure.
- Reach out to PolicyX.com for further assistance.
For Reimbursement of the Arogya Sanjeevani Policy:
- Get treatment at a network hospital with pre-authorization from the concerned HDFC ERGO executives.
- After receiving the authorization form, the company will verify and issue the authorized letter to the hospital.
- On the discharge day, you must verify and sign the form for the claim of your medical or non-medical expenses.
- You need to pay the medical expenses upfront and attach all necessary medical details to the claim submission form.
- Later, submit all required documents to your insurer for claiming reimbursement of your total medical bills, which will be settled upon verification.
Documents to be submitted while raising a claim:
- Completed claim form with the policyholder’s photographs.
- Doctor’s prescription for admission and treatment.
- All original medical bills and payment receipts.
- Discharge summary and all related details of the policyholder.
- KYC documents along with the bank’s cancelled cheque or NEFT details.
- Other documents the company asks to submit at the time of claim settlement.
Wrapping it up
Not having health insurance can sometimes drain all your emergency savings and even impact your financial stability. We often get skeptical about paying hefty premiums for a health insurance policy. This plan is the solution to your worries related to an affordable and specific health insurance policy. The Arogya Sanjeevani Policy of HDFC ERGO ensures basic health support at a pocket-friendly premium. Additionally, it provides coverage for you and your family, including daycare procedures and financial support against 12 listed treatment expenses.
HDFC ERGO Arogya Sanjeevani Policy: FAQs
The 5 most-asked questions about HDFC ERGO Arogya Sanjeevani Policy, answered.
The maximum sum insured under this plan is up to INR 10 Lakhs in the multiple of INR 50,000.
Seniors till the age of 65 years can buy this plan and the benefits of coverage work almost the same way as an adult. However, this plan is not specifically designed for senior citizens.
Yes, this plan is designed for all. Either you want an individual policy for you and your family separately. Or all the family members can be covered under the same family floater plan.
It also offers a family floater plan benefit so your spouse, parents/ in-laws/ children (3 months-25 years) or all can be covered under a separate or the same policy.
No, there is no variant of Arogya Sanjeevani’s policy of HDFC ERGO.
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