HDFC Ergo Optima Restore Health Insurance Features
- rohanjagtap
- Sep 24, 2023
- 3 min read
Policy : HDFC Ergo Optima Restore Health Insurance
Claim Settlement Ratio : 97.55
Hospitalization Period : 24 Hours
Room Rent Cap : No Cap
Age Limits
Maximum Age : The maximum entry age is 65 years. There is no maximum cover ceasing age in this Policy.
Minimum Age : The minimum entry age is 91 days. Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.
Exit Age : 25 years for dependent children
Renewal Age : Lifetime
Family Members
An individual and/or his family members namely spouse, dependent children and dependent parents/parents-in-law are eligible for buying this cover on an individual or floater basis.
Waiting Periods
Waiting Period : Any Case : 30 Days Except Accident
Waiting Period : Pre Existing Diseases : 3 Years (36 Months)
Waiting Period : Specified Diseases : 2 Years (24 Months)
Waiting Period : Personal Waiting Period : Not Defined
List of Specified Diseases
Pre & Post Hospitalization Cover
Pre-Hospitalization : 60 Days
Post-Hospitalization : 180 Days
Non-medical Expenses
Add On : Protector Rider : Claim Protector : If a claim has been accepted under the Base plan, then the items which are not payable under the Base Plan as per the List of Excluded items released by IRDA related to the particular claim will become payable. The maximum claim payout under this benefit shall be limited to Base Sum Insured under Base Plan.
Double Base Sum-Insured
Not Available
No-Claim Bonus
Multiplier Benefit : Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%.In case of claim, bonus will be reduced by 50% of the basic sum insured. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.
Add On : Protector Rider : Multiplier Benefit/Cumulative Bonus Protector : Multiplier Benefit/Cumulative Bonus will not be impacted or reduced at renewals if any one claim or multiple claims admissible in the previous policy year under the Base Plan does not exceed the overall amount of Rs. 50,000 Rs.
Restoration
Restoration Benefit : Equal to 100% of basic sum insured.Same person, same illness.
Add On : Unlimited Restoration
Single Claim Limit
Single claim in a policy Year cannot exceed the sum of Basic Sum Insured and Multiplier Benefit (if any).
Shared Accommodation Benefit
Up to 15 Lakh Sum Insured : Rs.800/day, Maximum Rs.4,800
Above 15 Lakh Sum Insured : Rs.1000/day, Maximum Rs.6,000
Preventive Health Checkup
For Floater Policy : for sum insured of 5 Lakh, total upto 2,500 Rs/year. For sum insured of 10 lakh, total upto 5,000 Rs/year. For sum insured of 15 lakh, total upto 8,000 Rs/year
Inflation Benefit
Add On : Protector Rider : Sum Insured Protector : The Sum Insured protector is designed to protect Your Sum Insured against rising inflation by linking the Basic Sum Insured under the Base Plan to the Consumer Price index (CPI). The Basic Sum Insured will be increased on cumulative basis at each renewal on the basis of inflation rate in previous year. Please Note that all the accumulated Sum Insured Protector benefit will lapse and your Sum Insured under Base Plan will roll back to the Basic Sum insured opted under the Base Plan if this rider Policy is not renewed.
Hospital Cash
Add On : Hospital Daily Cash Rider : If an Insured Person suffers an Illness or Injury during the Policy Period that requires Hospitalization as an inpatient, then
i. Inpatient Benefit - We will pay Daily Cash amount for maximum 30 days per Policy Year for each continuous and completed period of 24 hours the Insured Person is hospitalized;
ii. Intensive Care Unit Benefit - We will pay twice the Daily Cash amount for maximum 30 days per Policy Year for each continuous and completed period of 24 hours that the Insured Person is hospitalized and admitted in an Intensive Care Unit. Whenever Intensive Care Unit benefit is admissible under the policy, We will not pay for Daily Cash benefit in i. above for the period when the Insured Person is in Intensive Care Unit. Choices : 1,000 Rs/day, 2000 Rs/day, 3000 Rs/day
Critical Illness Cover
Add On : my:Health Critical Illness :Get comprehensive coverage for 51 critical illnesses with sum insured options of INR 100,000 to INR 200,00,000 and in multiples of INR 100,000. my: health Critical Illness add-on can be opted by adults (persons over 18 years of age) only.
Personal Accident Cover
Add On : Personal Accident Rider : Sum Insured under Individual Personal Accident rider will be 5 (five) times the Sum Insured of Optima Restore (Base Plan) up to a maximum of Rs. 1 Crore and this rider will be offered only to the Proposer.
Hypertension / Diabetes Cover : Not Available
AYUSH : Not Available
Discounts
Family Discount : 10% if 2 or more family members are covered under Optima Restore Individual Sum Insured Plan.
Long Term Discount : An additional 7.5% discount is offered on the premium if you choose a 2 year policy.
These are some features of the HDFC Ergo Optima Restore Health Insurance policy, to the best of our knowledge. Please ensure to read the brochure and policy wordings before purchasing health insurance.
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