HDFC ERGO Women Critical Illness Comprehensive Plan
HDFC ERGO has been the pioneer in providing quality health insurance policies specifically for women. Women today are successfully juggling their family and professional responsibilities, but in so doing, have neglected their health and well-being. A large proportion of the women population has been inflicted with all kinds of diseases and sicknesses that have hampered their natural healthy way of life.
HDFC ERGO has come up with this Women Critical Illness Comprehensive policy to provide comprehensive insurance coverage for women-specific critical illness. It covers most of the issues that women may face in future. This plan is one variant of the plans under My: Health Women Suraksha Insurance.
What is HDFC ERGO Women Critical Illness Comprehensive Plan?
Most of the health insurance plans provide an insurance cover that is common for all policyholders, irrespective of their gender. Cardiovascular diseases, auto-immune diseases, heart ailments, osteoporosis, lifestyle disorders and even cancer are the common ailments suffered by women. Diseases can be cured if detection and diagnosis are made earlier.
However, the substantial cost of treatments can burn a hole in your pocket. In such a situation, HDFC ERGO Women Critical Illness Comprehensive Plan comes as a friendly aid to help you get through these tough times by covering expenses related to critical illnesses and ailments. This provides comprehensive coverage for women who are the backbone of a family and society. You can include your wife, daughter, or mother under this plan at every stage of their lives.
Features and Benefits of HDFC ERGO Women Critical Illness Comprehensive Plan
HDFC ERGO Women Critical Illness Comprehension plan comes with an array of attractive features and benefits that make it a beneficial policy for the women of today.
- Diverse Coverage amount- The plan offers a wide range of sum insured amount, ranging from Rs 3 Lakh to Rs 24 Lakh. You can opt for the sum insured according to your financial ability and health history with different plan options.
- Cancer Cover: There is provision for reimbursement of 100% sum insured if you are diagnosed suffering from Breast /Uterus /Ovary/Cervix/Fallopian Tubes/Vagina, or other significant cancers.
- Carcinoma in-situ: This policy provides cancer coverage in the earlier stages. In the early stages of cancer, it remains localized and does not spread to the other organs or tissues of the body. This stage is the Carcinoma in-situ stage, and it can be dealt with effectively with medication and treatment. HDFC ERGO offers 25% of the sum insured to a maximum of Rs 10 lakh for early-stage breast and cervix cancer.
- Major Illness Cover: This offers financial coverage for 100% sum insured for treatment of major illnesses that require prolonged treatment with long-term expenses - e.g., Systemic Lupus Erythematous, Lupus Nephritis, and Rheumatoid Arthritis.
- Surgical Procedures Covered:HDFC ERGO Women Critical Illness Comprehensive plan offers 25% of sum insured (or Rs 10 lakh, whichever is lesser) in case of surgeries like Mastectomy, Hysterectomy, Breast reconstructive surgery, Radical Total Pelvic Exenteration, Vulvectomy, and complicated vaginal fistula repair surgeries.
- Critical Illness Cover: This plan provides coverage for 41 listed life-threatening critical illnesses and diseases. Such diseases can not only ruin your health but can also put breaks on your jobs, leading to financial losses. With HDFC ERGO, you can make an efficient health plan to fight these diseases.
- Additional Covers: With this Women Critical Illness Comprehensive policy, you have the facility to opt for other covers for further medical protection and an enhanced safety shield
- Post Diagnostic Support: There is a provision for seeking a second medical opinion up to Rs 10,000.
- The policyholder can also opt for Molecular Gene Expression Profiling Test. This is an advanced examination to get treatment guidance in case of diagnosis of a major Cancer.
- The policy also covers expenses for counselling sessions post-diagnosis for taking measures for quick recovery, which is set to a maximum of 6 sessions, at around Rs 3000 per session.
- In case of vehicular damage in an accident, there is an add-on cover that arranges for your vehicle to be towed to the nearest garage. Assistance services from the insurer are available up to 100 km from your registered address.
- In case of loss of job in case of critical illnesses, this policy can also arrange for a payment of up to 50% of monthly salary for 6 months under appropriate additional financial cover.
- This policy ensures payment of a lump-sum amount that gets paid in one single transaction.
- You have the benefit to avail attractive rebate For example, you can save up to 5% for online policy for 1 year, 7.5% for a 2 years policy and 12.5% for 3 years tenure.
* All savings provided by the insurer are as per the IRDAI approval. Standard T&C apply.
- This policy also allows for lifetime renewability.
- There is a facility of free health check-ups as preventive measures with every policy renewal.
- You can also avail the facility of a wellness coach for healthy lifestyle development.
- This policy also offers tax benefits under Section 80 D of the Indian IT Act
- You also avail the free policy cancellation feature within 15 days from the date you receive the policy document if you do not agree with it.
- There is provision for a fitness rebate of up to 10% on every renewal.
Inclusion and Exclusions of HDFC ERGO Women Critical Illness Comprehensive Plan
This Women Critical Illness Comprehensive policy covers all possible ailments which women may face anytime in future and provides financial protection against them.
- Hospitalization expenses including OPD, OT charges, doctor’s and surgeon’s fees, nurse and specialist charges
- Blood transfusion, radiotherapy, and chemotherapy charges
- Pregnancy and new-born baby coverage
- Malignant cancer covers for Breast, Cervix, Uterus, Fallopian Tube, Ovary, and Vagina/Vulva:
- Other Major Cancer, Carcinoma in situ of Cervix and the Breast
- Coverage for Systemic Lupus Erythematosus, Lupus Nephritis, Rheumatoid Arthritis, and Osteoporosis, as per the percentage of sum insured limit
- Cover for Breast Lumpectomy, Mastectomy, Breast Reconstructive Surgery, Vulvectomy, complicated repair of a vaginal fistula, Hysterectomy, as per the percentage of the sum insured
- Open Chest CABG, first heart attack or coma of specified severity, Stroke, heart valve repair, Balloon Valvotomy, Pacemaker insertion, Angioplasty, etc.
Any illness or injuries resulting on account of the following are not included in the insurance coverage under this plan:
- Loss of job due to voluntary or involuntary retirement, due to non-confirmation of employment
- Injuries due to adventure or extreme sports
- Suicide attempts or self-inflicted injuries
- Injuries due to wars, war-like operations, terrorist activities, etc
- Injuries due to participation in any defence activities
- Obesity treatment or related surgeries
- Cosmetic or aesthetic surgery
- Any illness or injury due to consumption of alcohol, drugs or other intoxicants
Eligibility Criteria to Buy the HDFC ERGO Women Critical Illness Comprehensive Plan
HDFC ERGO Women Critical Illness Comprehensive plan does not have complex criteria for enrolment to it.
For basic covers:
- The minimum age of entry to the plan is 18 years.
- The maximum age of entry to this plan is 45 years.
For optional covers like Pregnancy and New-Born Complications:
- The minimum age of entry to the plan is 18 years.
- The maximum age of entry to this plan is 40 years.
Claim Process of the HDFC ERGO Women Critical Illness Comprehensive Plan
HDFC ERGO provides for two ways of insurance claims:
- Cashless claims
- Reimbursement Claims
Cashless Claims Procedure
Under this method, in case of planned hospitalization or emergency in a network hospital, you should show your HDFC ERGO Health Insurance card at the Insurance desk in the hospital.
- You first need to get a Pre-authorisation for which, you need to notify your insurance authorities. This intimation should be within 24 hours in case of emergency hospitalization, and 48 hours before admission in case of planned hospitalization in a network hospital.
- Once you get an approval from the HDFC ERGO Claims team, you can go ahead with the hospitalization procedures and your expenses will be taken care of based on your insurance coverage amount.
Reimbursement Claims Procedure
This method is used in case of hospitalization in a non-network hospital or when your pre-authorisation request for hospitalization in a network hospital is rejected due to some reasons.
Here you need to go ahead with the hospitalization process as directed by your doctor and the hospital. Just keep a record of all medical bills, receipts, hospital expenses, investigation reports and the hospital discharge summary.
You need to file for a reimbursement claim within 30 days of your discharge from the hospital.
You can visit HDFC ERGO’s official website and click on Help> Claim registration for this Women Critical Illness Comprehensive policy.
You need to send the necessary documents on time to the branch office at Noida.
How to Buy the HDFC ERGO Women Critical Illness Comprehensive Plan?
You can easily compare plans online and finalize your purchase. You can buy this plan directly from the official website of HDFC ERGO or can also access www.paisawiki.com to buy the plan. You just need to provide your name, mobile number and gender. You will get an option to view various listed plans online from which you can make your choice.
You can continue to purchase the plan online by providing your payment mode and details.
Once the transaction is completed successfully, you will receive a softcopy of the policy document at your registered email address.
You can also get in touch directly with the Paisawiki customer care.
Documents Required to Buy the HDFC ERGO Women Critical Illness Comprehensive Plan
You can easily apply for this Women Critical Illness Comprehensive policy by submitting copies of the following documents.
- Identity proof- Copy of valid Passport/ Voter Id card/driving license or PAN Card
- Address Proof- AADHAAR Card copy/Voter Id/ DL / Utility bill, etc.
- Passport size photographs of the person insured.
Renewal Process of the Women Critical Illness Comprehensive policy
The plan can be easily renewed online at by visiting paisawiki.com. All one needs to fill a renewal form
Ans: This Loss of Job cover is an optional cover that comes along with this Women Critical Illness Comprehensive policy. This cover provides a safety financial shield in case the insured woman policyholder suffers a job loss or career break on account of accident or medical issues. This cover will help her take care of her monthly financial responsibilities like EMI payments and other expenses while she undergoes medical treatment.
Ans: Yes, you can change your current plan with HDFC ERGO at the time of renewals, if there has not been any claim made in the previous policy year. You can change both the sum insured amount or the type of plan under the prescribed underwriting guidelines.
Ans: Yes, you can take a second opinion from a seasoned medical practitioner in case of a diagnosis of a significant or critical illness listed in the policy. The expenses incurred in this case should not be more than Rs 10,000 as listed in the policy document for this HDFC ERGO Women Critical Illness Comprehensive policy.
Written By: Paisawiki - Updated: 18 November 2020