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HDFC ERGO Health Suraksha Gold Insurance Plan is uniquely designed for who want to have never-ending benefits from their health insurance policy. HDFC ERGO is a General Insurance Company which was formed with the collaboration of famous Housing Finance Institution called HDFC and ERGO International AG insurance rooted in Germany.
The Health Suraksha Gold Insurance Plan caters to the needs of both individual and family. This HDFC ERGO Health Suraksha Gold is highly flexible and dynamic as it offers an extensive range of choices for different individuals as per their demands at highly affordable rates and unlimited benefits. Check more about the benefits and features of the plan to get a better understanding of the plan.
|Sum Assured||3 lac to 10 lac|
|Eligibility||Child – 91 days, Adult – No Limit|
|Renewability||Life Time Renewal|
|Daycare Procedure||144 Treatment|
|Plan tenure||1 – 2 Years|
1. In-patient Hospitalization
This feature covers hospitalization expenses that can arise due to medical issues like an accident or illness. It basically covers the nursing expense, medicines, doctor fees, intensive care expense, surgeon fee, operation theatre charges, single private room accommodation, etc.
It covers the expenses that happened before the hospitalization of the insured for inpatient treatment and provides coverage for 60 days prior to hospitalization. It may include medical tests, Medicines, vaccinations, Doctor’s practitioner fees etc
These are the medical expense to regain the lost stamina or capacity of the body after illness/injury has been treated in the hospital. This is also referred to as recuperation expenses and the time limit ranges from minimum 60 days to 90 days maximum after the hospitalization.
4. Room Rent
When you got hospitalized, you need room for which you have to pay some rent. In this plan, you can enjoy the benefit of no sub-limit on the room rent charges.
5. Emergency Ambulance
In certain medical emergencies, the insured may need the service of an ambulance which is covered by Health Suraksha Gold Insurance Plan as it pays as the ambulance charges up to 2000 (for a sum assured 3 Lac, 4 Lac, 5 Lac) and 3500 (for a sum assured 7.5 Lac, 10 Lac)
6. Domiciliary Hospitalisation
This kind of hospitalization is required when the insured is not in the condition to move to a hospital or nursing home due to extreme illness and want complete treatment at home. There are certain guidelines provided below under this feature-
7. Day Care Treatments
Day Care Treatments are also called short term hospitalization treatment that can be covered within 24 hours and does not require extended hospitalization. There are 144 different daycare treatments that are included by the plan.
8. Organ Donor
If the insured have to face any organ transplantation which will involve the expense for the treatment of organ donor. This expense is covered by the insurance company.
9. Maternity Expenses
The maternity coverage may include pre and post natal expenses which under abidance of 4 years of a waiting period.
10. Newborn Baby
Expenses covered for the newly born baby for up to 90 days after the birth of the baby. The expenses may include important vaccinations, treatment of baby etc
11. Convalescence Benefit
This benefit is to ensure extra financial safety to the insurer at the times of prolonged stay, let's say for 8 to 10 days. So, this feature helps in providing the lump sum payment to cover the income loss due to a long stay at hospitals.
12. Non-Allopathic Treatment
Under this insurance company pays the expenses under treatment done through Ayurveda, Unani and Homeopathy. This kind of treatment is also called AYUSH treatment.
13. No Claim Bonus
No claim bonus is offered every year on the renewal of the policy. The insured who hasn’t applied for any claim in a year or for cumulative years are beneficiaries of the bonus. The bonus amount depends upon the number of claim free years. The maximum percentage of bonus is determined as 50% of the sum insured. This bonus can give a jump in the amount of the sum insured.
The insured can receive the benefit of health checkups for which you become eligible after 4 years of claim free years. You may get reimbursement as 1% of the sum assured or Rs 5000 whichever is more.
This feature assists the insured to get the second opinion by a medical practitioner if he suffered from critical illness in the future within the policy period.
To illustrate how the plan works, here is a short example of a man named Dharmesh who wants to invest in HDFC ERGO Health Suraksha Gold Plan. Let us see how it works.
Dharmesh is a 37-year-old married man who works in an MNC located in Noida. His income is between 5-7 Lacs per annum an. He wants to include his wife (who is 35 years) and 7-year child into his health insurance. He compared various insurance companies and selected HDFC ERGO to buy their Health Suraksha Gold Insurance Plan.
Also, he has no smoking habit neither any other infectious diseases but still he wants to secure his future from financial problems by taking insurance. The sum insured was 10Lac along with the payment of Rs 24,707 per year as premium. Dharmesh faced a medical urgency for which he needs immediate hospitalization and funds too. So, he simply claims the expenses from the insurer and get compensation for the inpatient expenses, pre and post hospitalization expenses.
The salary of Dharmesh is tax payable. As he is paying premiums for his health insurance, so he will get a tax deduction up to 25000 in total tax payable on salary. This will automatically enrich his saving per year.
*The amount of premium may vary according to the age of an individual in taking the plan.
HDFC ERGO General insurance company has been existing in the insurance sector for 17 years of establishment and has gained much momentum among the competitors. The company has the highest claim settlement ratio which is why customers display a remarkable amount of interest in buying the HDFC ERGO policies.
The company has been rated iAAA by the ICRA. Apart from health insurance services, the company also provide car insurance, bike insurance, travel insurance, personal accident insurance, crop insurance, weather insurance etc.
1. What is the eligibility criteria for entering into the Health Suraksha Gold plan?
In order to enter into the plan, an individual must be above 90 days or 3 months of age which is the minimum age. Whereas the maximum has no limitations.
2. What are the additional benefits offered by the plan?
The first thing you need to know is that you have to pay an extra premium to avail additional benefits or add-on covers offered. The add-on covers include-
3. What is the time period of Health Suraksha Gold Plan?
The usual time period of this policy plan is one to two years in accordance with the choice of an individual. If the policyholder wants to continue the policy, he/she can easily renew the policy by notifying the insurer.
4. Do this policy offer any tax benefit or tax exemptions?
Yes, this plan offers tax benefit up to Rs 25000 under Section 80D of Income. While if you pay a premium for your parents who come in the category of senior citizen, you can avail Rs 30,000 as a tax benefit.
5. What are the documents required for the plan?
To buy the policy, an individual to submit an application form or proposal form with complete information about your medical history along with address proof. Moreover, a medical examination can be required in case the policyholder is equal to 55 years or more.
6. What are the minimum and maximum sum insured options available in the plan?
In case of an individual, the sum insured is 3 Lac, 4 Lac, 5 Lac, 7.5 Lac, and 10 Lac. The premium may vary according to the age and medical conditions of the individual.
7. Can we cancel the policy in case we don’t like policy’s terms and conditions?
Yes, the policyholder is given the option of Free-Look Period in which he/she is given a time period of 15 to review all the mentioned terms and conditions. If the policyholder has any disagreement with any clause, he/she can terminate the policy. The premium paid towards the policy will be refunded to the policyholder’s bank account with a deduction of expenses incurred in medical checkups, stamp duty charges, and risk-adjusted premium.
8. What is the value of E-opinion in the plan?
As the storm comes without any notification, so do the illness which can take the life of an individual without any notice if not taken precaution. The E-opinion holds value when a policyholder suffers any Critical illness during the policy term and need second advise from a medical expert.
In E-Opinion, the insurer will take the responsibility of arranging the second opinion from a medical expert selected by the insured from the company’s panel. The second opinion will be formed on the basis of information and documentation submitted by the insured to the expert.
9. What is the process of claim settlement in HDFC ERGO Health Suraksha Gold Plan?
To settle your claims, follow the few easy steps:
10. How to file the claim under HDFC ERGO?
Generally, claims are of two types as listed below-
If you want a hassle-free settlement of the claim, submit the documents below.
11. If the primary applicant passes away, what happens to the policy?
If in any condition the policyholder is no longer, then the second member included in the policy can continue the existing policy.
12. What to do if the cashless hospitalization is rejected by the network hospitals?
For this, you have to check your policy whether your condition for which you are seeking cashless treatment is mentioned in the policy papers. It is recommended to pay the expenses first and then seek for the reimbursement of the claim.