The Suraksha Gold with Regain and Enhanced Cumulative Bonus (ECB) is an affordable health insurance plan that offers special features so that policyholders and their families can avail complete health protection along with added benefits. With the help of the regain benefit, a policyholder can enjoy a re-instated sum insured amount in case the original sum insured amount is exhausted before the end of the term. Further, an Enhanced Cumulative Bonus is offered at 10% for every year that no claim is made under this plan type.
Given below are the major highlights of the Health Suraksha Gold with Regain and ECB:
The key benefits offered under this special health insurance policy are explained in the table below:
|Hospitalisation||In-patient treatment for certain health conditions, along with injuries caused by accidents, is provided during hospitalisation|
|Pre-hospitalisation||The pre-hospitalisation benefit offers coverage for treatment expenses up to 60 days before hospitalisation|
|Post-hospitalisation||The post-hospitalisation benefit offers coverage for treatment expenses up to 90 days post hospitalisation|
|Domiciliary treatment||Treatments undertaken at home, on the advice of a medical professional, will be covered under the domiciliary treatment benefit|
|Day care treatment||Medical procedures that do not require 24 hours of hospitalisation due to the advancement in technology is covered under this benefit|
|Organ donor expenses||Expenses incurred by an organ donor while transplanting his/her organ to the insured member is covered under the policy|
|Convalescence benefit||If an insured member has been hospitalised for more than 10 continuous days, a lump-sum benefit is provided as the convalescence benefit|
|Ayush benefit||In-patient procedures conducted under Ayurveda, Unani, Sidha, or Homeopathy are covered under this benefit|
|Ambulance Charges||Emergency ambulance charges incurred by the policyholder will be paid for by the insurance company|
|Maternity expenses||Maternity-related expenses, including pre and post-natal procedures are covered|
|Newborn baby cover||Coverage for a newborn baby, starting from the time of its birth, is available|
A few of the discounts and additional benefits offered under the policies are given below:
Not all treatments and procedures are covered. A few of the instances when the insurance policy will not offer coverage are:
HDFC Ergo offers two claim options – Cashless claim and Reimbursement claim. Both procedures are explained in detail here:
Claims for cashless treatments can be raised in network hospitals only. The policyholder is required to present his/her health card and photo ID at the hospital. The hospital will then send a request to HDFC Ergo for pre-authorisation. Once HDFC Ergo scrutinises all details and documents submitted, it will provide an update as to whether the request has been accepted or not. After authorisation, the insured person can enjoy the cashless treatment. Any deductions, co-payment, or expenses that are excluded under the policy, have to be borne by the insured individual.
To get a reimbursement of the claims incurred on hospitalisation, the policyholder can submit the claim form along with the necessary documents to the insurance company. The company will verify the details and documents, and request for additional information if required. After complete verification, the company will transfer the amount through NEFT if the claim request is accepted.
Here is a list of the claim documents that need to be submitted to process a claim:
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