HDFC ERGO Critical Illness Platinum Policy

• Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
• 10,000+ hospitals for cashless treatment
• Claim up to Rs. 55,000 deduction under section 80D**

HDFC ERGO Critical Illness Policy is a fixed-benefit health insurance policy offered by the company. As the name implies, this is a critical illness cover that provides a lump-sum payment against the diagnosis of any of the named critical illness. This policy provides coverage against 15 major illnesses and ensures that policyholders are protected against medical expenses and recuperation costs if they ever get diagnosed with a life-threatening disease. This health insurance plan ensures peace of mind for policyholders by taking care of the financial instability arising out of critical illness treatment. This policy is available in two different variants – Silver and Platinum – depending upon the number of critical illnesses covered.

Eligibility for HDFC ERGO Critical Illness Platinum

People who wish to take HDFC ERGO Critical Illness Platinum must meet the following eligibility criteria:

• Anyone between the age of 5 years and 65 years can take this policy.
• Pre-insurance medical examination is required for people entering this cover after 45 years of age.
• Once entered, this policy can be renewed till one’s lifetime.

Critical Illnesses Covered

As noted earlier, there are two different variants in the policy based on the number of critical illnesses covered. The list of critical illnesses covered under the silver plan of the policy are listed as follows: 

• Cancer 
• Stroke 
• Multiple Sclerosis 
• Kidney failure 
• Major organ transplantation 
• Heart attack 
• Paralysis 
• Coronary Artery Bypass Surgery 

• Cancer 
• Stroke 
• Myocardial infarction (heart attack) 
• Coronary artery bypass 
• Kidney failure 
• Paralysis 
• Alzheimer’s disease 
• Multiple sclerosis 
• Major organ transplant 
• Aorta graft surgery 
• End stage liver disease 
• Heart valve replacement 
• Parkinson’s disease 
• Benign brain tumour 
• Primary pulmonary arterial hypertension 

Features of HDFC ERGO Critical Illness Platinum

Some of the notable features of HDFC ERGO Critical Illness Platinum can be listed as follows:

• This policy is available in three different sum insured variants – Rs.5 lakh, Rs.7.5 lakh, and Rs.10 lakh. 
• An initial waiting period of 90 days is applicable after purchasing this policy. However, this waiting period is not applicable for subsequent renewals. 
• If the pre-insurance medical examination is taken in the company’s empanelled diagnostic centre, 50% of the cost will be reimbursed to the insured person. 
• There is an initial waiting period of 90 days before any claims can be made under this policy cover. 
• This policy comes with a survival period of 30 days. In other words, the insured must live for at least 30 days after the first diagnosis of the disease before any claim can be made. 
• This policy comes with a free look period of 15 days. This means that policyholders have 15 days to review the policy terms and cancel it if they are not satisfied. 
• The premium amount paid for this policy is eligible for tax relief as per Section 80D of the Income Tax Act. 

Benefits of HDFC ERGO Critical Illness Platinum

Exclusions of HDFC ERGO Critical Illness Platinum

The company has outlined certain exclusions for which it is not liable to provide any compensation to the insured. Some of these exclusions can be given in the following list:

• Illnesses caused by acts of war, invasion, revolution, riots, etc.
• Illnesses arising out of nuclear weapons, chemical weapons, biological weapons, etc.
• Any kinds of self-inflicted injury or attempted suicide
• Illnesses arising out of intoxication and hallucinogenic substances
• AIDS, HIV, and sexually transmitted diseases
• Treatments related to maternity, childbirth, pregnancy, miscarriage, etc.
• Any kinds of congenital diseases, birth defects, or anomalies
• Injuries caused while participation in extreme sports, racing, etc.

Claim Procedure

Upon the diagnosis of an illness that may give rise to a claim, the insurer must be notified immediately to initiate the claim proceedings. The insured must submit certain documents along with the claim form. Some of these documents include diagnostic reports, physician certificate, etc. Once the documents are submitted, the company will verify the submitted documents. Following the verification process, the lump sum compensation amount will be provided to the insured person at the end of the survival period.