Health Suraksha Top Up Plus

Health Suraksha Brochure

HDFC ERGO Health Suraksha Top Up plan is designed to help you deal with different kinds of medical emergencies over a period of time. This plan is crafted to provide additional coverage in the event of prolonged illness or a major accident, thus keeping you protected under all circumstances. Under this plan risk initiates when the exhaustion of deductible* happens as multiple claims consuming the deductible amount in multiple hospitalizations/conditions/claims etc.


Policy covers persons in the age group of 5-65 years
There will be no exit-age for ceasing of the cover
Children covered from 91 days onwards if both parents are covered under same policy
The policy offers option of covering on individual / family floater basis
The family includes self, spouse, dependent children and dependent parents
Dependent parents have to be covered under separate family floater policy
Parents shall include your (policyholder) dependant parents


Supplementary Coverage
Avail a family discount of 10%, If 3 more members of a family are covered under the same policy
  on Individual sum insured basis
No Medical Check-Up upto 55 years
No Sub-limits on any disease, room rent, hospital charges & doctor fees
Tax Benefit under section 80D#
5% bonus on Sum Insured for every claim-free year
Offers one year or two year policy coverage period (* Subject to the change in Tax Laws)
Life Long Renewability


Claims under this policy shall be payable only if the aggregate of covered medical expenses in respect to hospitalizations) of insured person exceeds the deductible applicable on per policy year basis.

In Patient Treatment - Covers medical expenses for hospitalization due to an illness or accident.
We will pay for the medical expenses for room rent, boarding expenses, nursing, intensive care unit, medical practitioner(s), etc.
Pre-Hospitalisation - The medical expenses incurred due to an illness in 60 days immediately
  before the insured person was hospitalized
Post-Hospitalisation - The medical expenses incurred in 90 days immediately after the insured
  person was discharged post hospitalization
Day care procedures - The medical expenses for 140 day care procedures which do not require
  24 hours hospitalization due to technological advancement in medical science
Domiciliary Treatment -The medical expenses incurred by an Insured Person for availing
  medical treatment at his home which would otherwise have required hospitalization
Organ Donor - The medical expenses on harvesting the organ from the donor
Emergency Ambulance - Expenses up to `2000 per hospital for utilizing ambulance service
  for transporting insured person to hospital


The company will not be liable for any payment unless the medical expenses exceed the deductible*
The company will not be liable for any treatment which begins during waiting periods except if any
  insured person suffers an accident
A waiting period of 30 days will apply to all claims
Pre-existing Conditions will not be covered until 48 months of continuous coverage have elapsed,
  since inception
Expenses arising from HIV or AIDS and related diseases
Mental disorder or insanity, cosmetic surgery, weight control treatment
Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
Hospitalization due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
Pregnancy, dental and external aids and appliances unless covered under specific plans
2 Year exclusions for specific diseases
Experimental, investigational or unproven treatment, devices and pharmacological regimens
For a complete list, kindly refer the Policy Wordings


In case of hospitalization, intimation should be provided to the Company / TPA immediately and
  not later than 7 days
In all other cases, the Company / TPA must be informed of any event or occurrence that may give
  rise to a claim under this Policy at least 7 days
Prior to any consequent treatment, consultation or procedure being taken and the Company / TPA
  should pre-authorise such treatment, consultation or procedure
Any documentation and information requested to establish the circumstances of the claim, its
  quantum or the Company’s liability for the claim, should be submitted within 10 days of our request
  or discharge from Hospital or completion of treatment, whichever is earlier

*Deductible means a cost-sharing requirement under a health insurance policy that provides that we will not be liable for a specified rupee amount (as opted and mentioned in policy schedule. On individual basis in case of individual policy and on family floater basis in case of family floater policy) of the covered expenses, which will apply before any benefits are payable by us. A deductible does not reduce the sum insured.