HDFC ERGO Critical Illness Insurance

Modern treatment methods may be effective, but the costs can burn a hole in your pocket, especially if it is a critical illness. Without proper planning, the treatment will drain away one's life savings. This is where health insurance plans such as HDFC ERGO Critical Insurance Plan can help. It is a smart move to invest in this plan well in advance to financially secure yourself and family in the event of an unexpected diagnosis of a critical illness.

What is the HDFC ERGO Critical Illness Insurance Plan?

HDFC ERGO Critical Insurance Policy offers wide coverage for most of the critical illnesses at reasonable premium amounts. There is an umbrella coverage for up to 15 illnesses (for the Platinum plan) from this single plan. To avoid the additional stress of dealing with the insurance company for claims, the sum insured is paid in a single transaction. There are 2 variants with this plan- Silver and Platinum with slight variations in coverage. The plan can be bought for one or two years with the option for easy renewals. 

Features of the HDFC ERGO Critical Illness Insurance plan

The features of the HDFC ERGO Critical Insurance Plan are:

• HDFC ERGO Critical Insurance Plan covers up to 15 critical illnesses (for the Platinum plan) listed in their document.
• The sum insured is paid a lump-sum amount on the first diagnosis of any of the 15 illnesses, provided the insured survives for 30 days post-diagnosis.
• The sum insured with this plan falls within the range of 100,000 - 50,00,000 depending on the plan variant chosen. This amount can be used for any of the following:
• Medical care and treatment
• Recuperation expenses
• Paying off debts
• Compensation for any loss of income
• Change to a healthy lifestyle
• In case of accidental death, the nominee will receive the sum insured as security.
• In case a critical illness makes the applicant completely disabled, the policy continues to exist without the insured having to pay any premiums.
• The waiting or survival period for this policy is 30 days. That is, the patient must survive for at least 30 days after he/she is diagnosed with any of the critical illnesses listed.
• Claims for this policy can be filed 90 days post-policy inception.
• There are 2 variants of this plan-Silver and Platinum. The Platinum option covers 15 critical illnesses, and the Silver option covers 8 critical illnesses.
• HDFC ERGO Critical Insurance Plan can be purchased for 1-year or 2-year periods.

Benefits of HDFC ERGO Critical Insurance Policy

The major benefits offered under HDFC ERGO Critical Insurance Policy are:

• Lifetime renewal is allowed under this policy.
• Tax benefits in Section 80D of the Income Tax for the premiums are paid under this policy. Tax savings can amount up to Rs 50,000.

The table given below gives the split-up of tax benefits:

*Tax Benefits are subject to changes in tax laws

• This policy helps to safeguard one’s finances. Treatment for life-threatening illnesses will have little or no impact on hard-earned savings as the insurance will take care of hospital bills.
• The policyholder need not worry about getting access to quality treatment at good hospitals. This insurance policy can help you get the best treatment possible.
• There is a free-look period of 15 days from the date of receipt of the policy. During this period, the insured can cancel the policy if wishes.
• There is no medical check-up required to purchase this policy if the individual is below 45 years of age. 

Inclusions of the HDFC ERGO Critical Illness Insurance plan

The HDFC ERGO Critical Insurance Plan coverage includes the critical illnesses listed below for the Silver and Platinum variants:

Exclusions of the HDFC ERGO Critical Insurance Policy

Given below are the exclusions under the HDFC ERGO Critical Insurance policy:

• The policy does not cover injuries inflicted from participation in adventure sports.
• The policy does not cover the treatment of self-inflicted injuries.
• The policy does not cover any claim that may arise due to the side-effects of wars.
• The policy does not cover accidents that cover while participating in defence operations in the army, navy or air-force.
• The policy does not cover treatment for venereal or sexually transmitted diseases.
• Treatments for cosmetic surgery, obesity or weight reduction are not covered under this plan.
• The policy will not honour any claim that is a result of abuse of intoxicants such as alcohol or drugs.
• Any injury inflicted through the act of breach of law or criminal act is not covered under this policy.
• Any treatment arising from pregnancy, miscarriage, childbirth, or maternity is not covered under this policy.

Eligibility Criteria to Buy the HDFC ERGO Critical Illness Insurance plan

Individuals under the age group of 5 years to 45 years are eligible for purchasing the policy. The plan also covers children between 5 years to 18 years, but only when both the parents are also insured under the policy.

No medical checkup is necessary for applicants who are below 45 years of age unless there is a serious health concern.

Claim Process of HDFC ERGO Critical Illness Insurance Plan

The insured can make only one claim throughout the policy period. In case the claim arises, he must immediately contact HDFC ERGO health insurance on their customer service number to speak to a customer service representative who can offer guidance on claims procedure and required documents. The claims must be filed within 7 days of discharge of the patient.

On receipt of intimation, they will register the claim and assign the insured a unique claim reference number that can be used for future correspondence.

Claim Documents

The policyholder must arrange for the following documents while filing a claim:

• Duly Completed and Signed Claim Form
• Copy of the ID card of the policyholder
• Original Discharge Summary.
• Medical certificate from a doctor which confirms the diagnosis of the critical illness.
• Consultation Note or relevant treatment papers.
• All relevant medical reports, along with supporting invoices and doctors requisition of the same.
• Pharmacy Bills with prescriptions
• Original hospitalization bills with a detailed breakup
• Other documents as required by the Insurance provider

On receipt of the claim request, it will be processed within a few days by the policy terms and conditions.

How to Buy the HDFC ERGO Critical Illness Insurance Plan?

The applicant can easily buy HDFC ERGO Critical Insurance plan online either with HDFC ERGO directly or through Paisawiki.com. He/she can compare online the various variants features and choose the one that best fits his needs in terms of coverage and budget.

Given below are the steps to complete the insurance policy buying process from the portal of Paisawiki:

• The applicant must visit the official website at paisawiki.com and choose the health insurance section. In that, he/she must choose the Critical Illness option.
• Once the policy to be purchased is chosen, he must click on the “Buy online” tab which will direct to a secured page.
• Then the premium calculator will calculate the premium amounts based on the type of coverage, the sum insured, and date of birth mentioned.
• The next form will ask for the applicant’s personal details such as name, contact information, and history of ailments.
• This will take him to the secure payment gateway where he must pay the premium and complete the policy purchase.
• The applicant will get the confirmation message on the registered email id and phone number. 

Documents Required to Buy the HDFC ERGO Critical Illness Insurance Plan

The required documents needed to apply for an HDFC ERGO Critical Illness Insurance plan are:

• Document showing ID proof such as Aadhar card, PAN card or passport
• Document showing age proof such as Aadhar card or birth certificate
• Document showing address proof such as drivers’ license or Aadhar card
• Passport size photos.

Renewal Process of the HDFC ERGO Critical Illness Insurance Plan

Given below are the steps to renew the HDFC ERGO Critical Illness Insurance plan online:

• Visit the official portal at paisawiki.com and click on Renewal under Health Insurance option
• The insured must enter the policy number and click on Proceed.
• The insured must then enter the policy details.
• He/she will see the premium to be paid for renewal.
• Once the premium amount is paid, the policy will be renewed, and the person will get a confirmation message. 

FAQs