HDFC Life Easy Health Plan

‘Health is Wealth’ is one of the oldest adages heard by every individual. This is because, without good health it is not possible to enjoy every other aspect of life. Individuals today give more importance to their health unlike the previous generation. This is also due to advances in terms of healthcare and technology. However, due to a number of lifestyle changes health issues are more common today than before. This in turn results in a greater financial burden on not just the individual but also his/her family. Therefore, health insurance policies are imperative today, so that the individual’s financial security is not compromised. HDFC Life offers a number of health insurance plans that cater to the needs of individuals.

One of the most prominent plans is the Easy Health Plan. This scheme provides a lump sum amount in case the individual is hospitalised or undergoes any Surgery or even when he/she is diagnosed with a Critical Illness. This comprehensive and fixed benefit health insurance policy that provides protection against Surgeries, Critical Illness and Hospitalization. Policyholders can choose between 1, 2 or all 3 benefit options. They also have the choice to customise their health plan based on their needs and choose any one of the 7 Plan Choices.

In case of diagnosis of any of the 18 Critical Illnesses, a lump sum payout will be provided. The same will also be given against any of the 138 Surgical Procedures covered under this plan. In case the policyholder has been hospitalised, a daily hospital cash benefit will be provided. However, the most appealing aspect of this plan is the fact that issuance process is very simple without the need for potential customers to undergo any medicals.

Eligibility - Who is the HDFC Life Easy Health Plan for?

Eligibility for this plan depends on a number of factors such as age and policy term chosen.

Minimum Age of Entry	18 years
Maximum Age of Entry	65 years
Minimum Age of Maturity	23 years
Maximum Age of Maturity	70 years
Policy Term	5 years

Customers should note that all ages mentioned are based on the last birthday of the applicant.

Sum Insured and Premium Range - What you Get and What it Costs?

Sum Insured will vary based on the type of plan and benefit option chosen by the individual.

Premium Payment Frequency	Single/Regular Premium
Premium Payment Mode	One Time/Annual
Premium	Single Pay	Minimum - Rs.2,184 Maximum - Rs.4,04,279
	Regular Pay	Minimum - Rs.676 Maximum - Rs.1,22,068
Sum Insured	Option 1 - Rs.25,000 Option 2 - Rs.50,000 Option 3 - Rs.75,000 Option 4 - Rs.1,00,000 Option 5 - Rs.1,50,000 Option 6 - Rs.2,00,000 Option 7 - Rs.2,50,000 Option 8 - Rs.3,00,000 Option 9 - Rs.4,00,000 Option 10 - Rs.5,00,000

Premium Amount is inclusive of Swachh Bharat Cess and Service Tax.

Policyholders can choose the Sum Insured based on their needs from the options mentioned above. Sum Insured amount can only be selected during policy commencement and not any other time during policy term. Benefits will paid based on the Sum Insured option chosen. Upon completion of policy term or exhaustion of all benefit payments under the selected plan, whichever is earlier, the policy will terminate. Premiums will have to paid for the benefits only as long as the benefits have not been used up.

Customers should note that premiums vary based on age, location, plan term and other factors.

Plan Coverage - What the HDFC Life Easy Health Plan Covers?

The Easy Health Plan by HDFC Life offers individuals the flexibility to choose any 1, 2 or all three benefits from the options provided below -

• Daily Hospital Cash Benefit Option
• Surgical Benefit Option
• Critical Illness Benefit Option

Additionally, customers can choose between any of the plan options provided below

Plan Option	Benefits that are covered
A	Daily Hospital Cash Benefit
B	Surgical Benefit
C	Critical Illness Benefit
D	Daily Hospital Cash Benefit along with Surgical Benefit
E	Surgical Benefit along with Critical Illness Benefit
F	Daily Hospital Cash Benefit along with Critical Illness Benefit
G	Daily Hospital Cash Benefit along with Surgical Benefit and Critical Illness Benefit

Benefit Structure:

• Daily Hospital Cash Benefit
  • In case of hospitalisation due to an injury, disease or sickness, policyholder will receive 1% of the Sum Insured as the Daily Hospital Cash Benefit in case he/she has been admitted in a Non ICU room. If the policyholder is admitted in an ICU room then 2% of the Sum Insured will be payable.
  • This benefit will be paid as a lump sum amount at end of the stay in the Hospital for every completed as well as continuous hospitalisation for over 24 hours due to injury, disease or sickness. The benefit amount will be calculated as - Daily Hospital Cash Benefit * (Number of Days admitted - 1)
  • The Daily Hospital Cash Benefit will be payable for a maximum of 20 days for a year in case the policyholder has been admitted in a Non ICU room and 10 days for a year in case it is an ICU room.
  • Daily Hospital Cash Benefit will be paid subject to a maximum of 60 days if the individual has been admitted in a Non ICU room and 30 days if the individual has been admitted in an ICU room for the entire term of the policy.
  • The Non ICU and ICU benefits are independent and subject to their limits as mentioned above.
  • In case the maximum benefit per policy term has been used up, the cover for Daily Hospital, the cover for Daily Hospital Cash Benefit would cease for the remaining term of the policy. However, other benefits, if chosen would continue.
  • A waiting period of 60 days from policy inception or reinstatement (whichever is later) would be applicable, except when such expenses are incurred for treatment of conditions caused due to accident.
• Surgical Benefit
  • This benefit will be payable only if individuals have undergone any of the 138 surgeries that are covered by this plan, as long as surgery has been done by -
    • A qualified surgeon and
    • Performed at a hospital due to sickness or an injury for surgical procedures that have been advised by an independent medical practitioner and the policy is in force during the policy term.
  • In case the policyholder has to undergo a surgery during the tenure of the policy, the benefit that is payable will be decided based on the category of surgery as shown below-
    • For Category 1, the percentage of Sum Insured will be 100%
    • For Category 2, the percentage of Sum Insured will be 60%
    • For Category 3, the percentage of Sum Insured will be 40%
    • For Category 4, the percentage of Sum Insured will be 20%
  • Policyholders are allowed to make multiple claims up to a maximum of 100% of Sum Insured during the tenure of the policy. Multiple claims for the same surgery cannot be made more than once, but multiple claims from the same category can be made.
  • In case the complete Sum Insured has been used up, cover for Surgical Benefit will cease for the remaining term of the policy. Other benefits, however, will continue to exist.
  • A waiting period of 60 days will be applicable from the date of policy inception or policy reinstatement, whichever is later, except when expenses are incurred for treatment of conditions due to an accident.
• Critical Illness Benefit
  • In case the policyholder has been diagnosed with any of the 18 critical illnesses mentioned below, a lump sum benefit which is equal to 100% of the Sum Insured will be paid, as long as the policyholder survives a period of 30 days following the diagnosis.
    • Cancer of specified severity
    • First Heart Attack of specified severity
    • Alzheimer’s Disease/Irreversible Organic Degenerative Brain Disorders
    • Benign Brain Tumour
    • End Stage Liver Disease
    • Loss of Independent Existence
    • Major Burns
    • Motor Neurone Disease With Permanent Symptoms
    • Permanent Paralysis of Limbs
    • Kidney Failure requiring regular dialysis
    • Stroke resulting in permanent symptoms
    • Apallic Syndrome
    • Coma of a specified severity
    • End Stage Lung Disease
    • Loss of sight
    • Major Head Trauma
    • Multiple Sclerosis with persisting symptoms
    • Parkinson’s Disease
  • 100% of the Sum Insured will be paid to the policyholder as long as he/she survives a period of 30 days from the date on which diagnosis was made. Once the benefit has been paid out, the Critical Illness Benefit will cease for the remainder of the tenure of the policy.
  • Critical Illness Benefit will be paid only once during the entire tenure of the policy.
  • In case diagnosis has been made within the policy tenure and the survival period exceeds beyond end of policy term, only valid claims arising due to such a diagnosis will be considered.
  • A waiting period of 90 days for Critical Illness Benefit is applicable calculated from the date of policy inception or reinstatement of the cover, whichever occurs later, except when Critical Illness occurs due to an accident.
• Maturity Benefit
  • There is no maturity benefit applicable under this policy and it will terminate at the end of the policy tenure and no further benefits will be payable.
• Death Benefit
  • This product does not come with a death benefit.
• Surrender Benefit
  • There is no surrender benefit applicable under this policy.
  • Policy can only be surrender completely, partial surrender is not allowed.
  • In case of policy wherein regular premium is being paid, no surrender benefit is applicable.
  • In case it is a single premium paying policy, surrender benefit that is payable is calculated as follows -
    • 70% x Single Premium x [1- (M/P)] wherein ‘M’ refers to policy month of surrender and ‘P’ is policy term in months.

Riders / Add-On Plans – Additional Coverage under the HDFC Life Easy Health Plan:

There are no add-on plans or riders available under the HDFC Life Easy Health Plan.

Exclusions - What the HDFC Life Easy Health Plan doesn’t Cover?

Daily Hospital Cash Benefit, Critical Illness Benefit and Surgical Benefits do not apply during the waiting period except in cases wherein the above occurs due to an accident. There are other permanent exclusions as well, these include -

• Treatment for congenital deformity or disease, including physical defects that are present from birth.
• Elective treatment or surgery that is not necessary medically.
• Weigh improvement or reduction regardless of whether it is a result of medical condition.
• Outpatient treatment
• Routine eye tests, dental treatments, cosmetic surgeries, extraction of tooth, orthodontic surgery, tempero-mandibular joint disorder except as necessary due to an accident.
• Mental or psychiatric conditions including but not limited to mental or nervous breakdown, insanity, depression, dementia, psychosomatic disorders, Alzheimer’s disease will also not be included.
• Sexually transmitted diseases or any treatment in the presence of HIV infection.
• Plastic or cosmetic surgery except when necessary for repair of damage caused by burns, cancer or accidental injuries.
• Nuclear disaster, radioactive contamination and release of atomic energy.
• Illness or injury as a result of intentionally self-inflicted injuries or attempts of suicide while sane or insane or deliberate exposure to danger.
• Hospitalisation where Life Assured is a donor for an organ transplant.
• Injury and sickness due to aviation, gliding or other aerial flights other than a scheduled commercial airline as a passenger/pilot/member of the crew.
• Artificial life maintenance such as life support machine wherein treatment will not result in restoration or recovery of previous state of health.
• Treatment of deformities, abnormalities or illnesses that are present as a result of having been passed down through generations of family.
• Treatment for or those related to developmental problems such as dyslexia, behavioral problems and so on.

Additionally, Critical Illness Benefit will not be payable for the following -

• Date of diagnosis within 90 days from policy inception or cover reinstatement.
• In case death occurs within a period of 30 days from date of diagnosis.
• Policy in lapsed condition as on date of diagnosis.
• Over one claim with respect to Critical Illness Benefit.
• Non-fulfilment of eligibility criteria for Critical Illness Benefits covered under this policy.

Other Key Features – Freelook Period, Surrender Values, Grace Period etc

Other key features include -

Premium Review	The HDFC Life Easy Health Plan is a health insurance product that provides fixed benefit. In case premium has been modified, the policyholder will be notified of the change 3 months prior to change and a period of 30 days from date of premium due will be given in order to continue policy. In case due premium has not been paid within this period, policy will lapse.
Grace Period	Premiums will have to be paid on or prior to premium due date and in case they miss paying their premium before due date, a 30 day grace period will be provided within which the premium can be paid.
Lapsation	In case regular premium has not been prior to expiry of grace period, policy will lapse and all benefits under the policy will cease.
Revival	In case policy has lapsed, policyholder can send a request to HDFC Life to revive the policy within a period of 2 continuous years from date of first unpaid premium. All premium will have to be paid along with interest applicable, which is currently 10.5% per annum. Satisfactory evidence of good health is required. If policy has been revived within a period of 60 days, only remaining part of waiting periods will apply and in case policy is revived after 60 days, waiting period will be reapplied.
Cancellation	In case policyholders do not agree with the terms and conditions or are not satisfied with the same, the policy can be returned with valid reasons within 15 days from date of receipt of policy documents.

Tax Benefits - How you can save with the HDFC Life Easy Health Plan?

Customers would be eligible for tax benefits under Section 80D of the Income Tax Act of 1961. The most deduction that can be claimed is Rs.55,000 currently and this is inclusive of additional deduction of Rs.30,000 in case of insurance on the health of parents who are senior citizens. The tax benefits mentioned above are subject to changes in tax laws and hence policyholders are advised to consult their tax advisors regarding the same.

Other Benefits - How can you save with the HDFC Life Easy Health Plan?

HDFC Life is one of the foremost insurance providers in the country. Customers can choose between a variety of products based on their necessities.

Online Applications	HDFC Life Easy Health Plan can be availed online by logging in to the HDFC Life website. This method is convenient for those who are unable to visit one of the HDFC branches to purchase the plan or stay in far-off places.
Customer Care	In case individuals have any queries, they can contact the customer care centre. They can contact the customer service department via SMS,email, toll free number, letter, etc.
Calculator	Before purchasing the HDFC Life Easy Health Plan, customers can identify their insurance needs on the basis of income, liabilities and expenses by using the HLV or Human Life Value Calculator, available on the HDFC Life website. Similarly, customers can also use the tax calculator by HDFC Life and find the amount of tax that they’ll have to pay.

Why should you Buy the Easy Health Plan from HDFC Life?

HDFC Life is one of the foremost providers of life insurance policies within the country. Through this provider, customers can avail insurance plans that come with a number of unique benefits and services. HDFC Life has a network of about 39 offices that are spread across 9,000 touch points in India for easy access. HDFC Life also has one of the highest Claims Track Record in the company with 95% of claims being honoured. This company has a fantastic financial consultancy wing in India and abroad while providing some of the most successful insurance plans for a wide variety of clientele. Cutting edge technology is employed by HDFC Life resulting in the company having one of the best claim settlement records in the company as compared to certain other insurance providers.

HDFC Life Easy Health Plan FAQs:

Q. How can customers find out the status of their policy application?

A. Customers can find out the status of their policy application by either calling HDFC Life on the toll free customer care number or by sending them an e-mail.

Q. Are Service Taxes applicable while purchasing this of the HDFC Life Easy Health Plan?

A. Yes, service taxes and charge will be applicable while purchasing this plan.

Q. What is the procedure for claims?

A. Claims will have to submitted along with the documents mentioned below (originals)-

• Duly filled and signed original claim form
• Self attested copy of policy document
• Claimant’s residence and identity proof for all claims that are above Rs.1 lakh
• Cancelled personalised cheque or a copy of the first page of passbook in case of a non personalised cheque
• Self attested copy of discharge summary
• Self attested copy of final hospital bill
• Self attested copies of medical records such as lab reports, MRI films and consultation notes
• Self declaration of 30 day survival
• Operating theatre notes for surgical cash benefit

Additional documents may be required and claim should be intimated to HDFC Life along with documents within a period of 60 days from date of diagnosis of the condition.

Q. Is nomination allowed for the HDFC Life Easy Health Plan?

A. The member of the policyholder of a life insurance will be able to nominate an individual or individuals who will receive the death benefit.

• In case the nominee is a minor, member of policyholder will be allowed to appoint a person to receive the benefit in case of member’s death during minority of the nominee.
• Nomination can be made prior to policy maturity.
• Nomination can be incorporated in the policy text itself.
• Nomination can be changed or cancelled at any time prior to policy maturity by an endorsement.
• Fee to be paid for registering change will be specified by the authority via regulations.
• A notice in writing of cancellation or change of nomination will have to be delivered to the insurer for the insurer to be liable, to the nominee.

Q. Can individuals avail loans through this policy?

A. Loan is not available under the HDFC Life Easy Health Plan.

Q. Are alterations allowed in the HDFC Life Easy Health Plan?

A. Customers do not have the option to switch between plan options and Sum Insured during the tenure of the policy.

Q. What is the waiting list period applicable on Cataract surgeries and other injuries?

A.

One Year Waiting List	Two Year Waiting List
Tonsillitis/Adenoiditis	Cataract
Hernia (Ventral/Inguinal/Umbilical/Incisional)	Menstrual irregularities
Hydrocoele/Spermatocele/Varicocele	Hysterectomy or Myomectomy for benign conditions
Piles/Fistula/Fissure/Rectal prolapse	Deviated Nasal Septum/Sinusitis
Benign Enlargement of Prostrate	Thyroid Nodule/Multinodular Goitre
Degenerative joint conditions	Cholecystitis or stones of the gall bladder/pancreatic system
Lumps/cysts/nodules/polyps	Stones of the urinary tract
	Treatment of prolapsed inter vertebral disc
	Diabetes and it’s complications

Q. Is assignment allowed with respect to the HDFC Life Easy Health Plan?

A. Assignment will be subject to Section 38 of the Insurance Act of 1938, and as amended from time to time.

Q. What are the Direct and Indirect Taxes applicable on the HDFC Life Easy Health Plan?

A. The direct taxes, if applicable will be deducted at the applicable rate from payments made under the policy, as determined by provisions of the Income Tax Act of 1961. Indirect taxes applicable are Service Tax, Swachh Bharat Cess.

Q. Is Mitral Valve Repair surgery covered under this policy?

A. Yes, Mitral Valve Repair surgery is covered under this policy.

Q. Is Total Glossectomy covered under this policy?

A. Yes, Total Glossectomy is covered under this policy.

Q. Is Partial Resection of Liver covered under the HDFC Life Easy Health Plan?

A. Yes, Partial Resection of Liver is covered under the HDFC Life Easy Health Plan.