Ensuring

happiness for
your family
with Health Suraksha
Top Up Plus Plan

Heatlh Suraksha Top Up Plus Plan

HDFC ERGO Health Suraksha Top-Up Plus 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.

Eligibility
 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

Heatlh Suraksha Top Up Plus Plan

 Product highlights
Supplementary coverage

No sub-limits on any disease, room rent, hospital

charges and doctor fees

No medical tests upto the age of 55 years**

Tax benefit under section 80D (subject to change in

tax laws)

Avail a family discount of 10%, if 3 or more members

of a family are covered under the same policy on
individual sum insured basis

Offers 1 year and 2 years policy coverage period

**If pre-policy check up would be conducted in our empanelled diagnostic centre,

50% of the standard medical tests charges would be reimbursed, subject to
acceptance of proposal and policy issuance

Heatlh Suraksha Top Up Plus Plan

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

In-patient treatment: Covers medical expenses for hospitalisation

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 pre-hospitalisation Medical expenses

incurred due to an illness in 60 days immediately before the
insured person was hospitalised

Post-hospitalisation: The post-hospitalisation medical expenses

incurred in 90 days immediately after the insured person was
discharged post hospitalisation

Day care procedures: The medical expenses for day care

procedures which do not require 24 hours hospitalisation 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 hospitalisation

Organ donor: The medical expenses on harvesting the organ from

the donor

Emergency ambulance: Expenses up to `2,000 per hospital for

utilizing ambulance service for transporting insured person to
hospital

Heatlh Suraksha Top Up Plus Plan

What is not covered
 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

 Waiting periods applicable

Initial waiting period 30 days
Specified disease/procedure 24 months
Pre-existing diseases 48 months

 War or any act of war, invasion, act of foreign enemy, civil war, public defence,
rebellion, revolution, insurrection, military or usurped acts, nuclear, chemical or
biological attack or weapons, radiation of any kind.

 Treatment for alcoholism, drug or substance abuse or any addictive condition and
consequences thereof

 Any insured person’s participation or involvement in naval, military or air force

operation

 Any insured person committing or attempting to commit intentional self-injury or

attempted suicide or suicide

 Congenital external diseases, defects or anomalies

 Treatment taken on outpatient basis

For in depth detail on benefits, waiting periods and exclusions kindly refer to prospectus
and policy wordings documents before concluding sale.
#
Deductible means a cost-sharing requirement under a health insurance policy that provides that we will not be liable for a
specified rupee amount in case of indemnity policies and for a specified number of days/hours in case of hospital cash
policies which will apply before any benefits are payable by the insurer. A deductible does not reduce the sum insured.

Heatlh Suraksha Top Up Plus Plan

Claim process
▪ In case of hospitalisation, 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

Terms and conditons

▪ Disclaimer: The above information is only indicative in nature. For details of the coverage
and exclusions please refer to the policy wordings.
▪ Liability of the company does not commence until the company has accepted the proposal
and full premium has been paid

Free look
The free look period shall be applicable on new individual health insurance policies and not
on renewals or at the time of porting/migrating the policy.

The insured person shall be allowed free look period of fifteen days from date of receipt of
the policy document to review the terms and conditions of the policy, and to return the same
if not acceptable.

If the insured has not made any claim during the free look period, the insured shall be
entitled to a refund of the premium paid less any expenses incurred by the company on
medical examination of the insured person and the stamp duty charges or where the risk has
already commenced and the option of return of the policy is exercised by the insured person,
a deduction towards the proportionate risk premium for period of cover or where only a part
of the insurance coverage has commenced, such proportionate premium commensurate with
the insurance coverage during such period.

my:health Medisure Super Top Up

Illustration
Top Up Plus Plan of sum insured `5 lakhs and deductible `2 lakhs. Furthermore, the customer
has an existing primary policy of `2 lakhs
At Inception Approved Available SI Benefit in Benefit in
SI 5L & Claim Deductible Balance in Top Up Existing
Amount Exhaustion Deductible Policy Top Up Plan
SI 2L Plan
Claim 1 70,000 70,000 130,000 500,000 70,000 0
Claim 2 50,000 50,000 80,000 500,000 50,000 0
Claim 3 80,000 80,000 0 500,000 80,000 0
Claim 4
Preventive
150,000 0
Health Check-Up
0
- Booster
350,000 0 150,000

Anti -rebating warning

Cumulative Bonus

As per Section 41 of the Insurance Act 1938, as amended, the practice of rebating is prohibited,
as follows: No person shall allow or offer to allow, either directly or indirectly, as an inducement
to any person to take out or renew or continue
my: Health Active## an insurance policy in respect of any kind of risk
relating to lives or property in India, any rebate of the whole or part of the commission payable
or any rebate of the premium shown on the policy, nor shall any person taking out or renewing
or continuing a policy accept any rebate, except such rebate as may be allowed in accordance
with the published prospectus or tables of the insurer. Violations of Section 41 of the Insurance
Act 1938, as amended, shall be punishable with a fine which may extend to `10 Lakhs.

Heatlh Suraksha Top Up Plus Plan

 1 year (all premiums are excluding GST)
Sum insured - `10 Lakhs
Family Type 1A Family Type 1A + 1C
Age Band `2 Lakhs `3 Lakhs `4 Lakhs `5 Lakhs Age Band `2 Lakhs `3 Lakhs `4 Lakhs `5 Lakhs
0-17 4,635 4,320 3,985 3,725 0-17
18-35 6,410 5,955 5,460 5,135 18-35 8,950 8,320 7,635 7,175
36-45 7,570 7,140 6,575 6,190 36-45 10,110 9,505 8,750 8,230
46-50 13,645 12,810 11,795 11,110 46-50 16,185 15,175 3,970 13,150
51-55 14,330 13,455 12,390 11,660 51-55 16,870 15,820 14,565 13,700
56-60 15,325 14,635 13,735 12,310 56-60 17,865 17,000 15,910 14,350
61-65 22,130 20,220 16,780 13,485 61-65 24,670 22,585 18,955 15,525
66-70 29,825 27,255 22,620 18,185 66-70 32,365 29,620 24,795 20,225
>70 42,740 39,050 32,410 26,055 >70 45,280 41,415 34,585 28,095

Family Type 2A Family Type 2A + 1C

Age Band `2 Lakhs `3 Lakhs `4 Lakhs `5 Lakhs Age Band `2 Lakhs `3 Lakhs `4 Lakhs `5 Lakhs
0-17 0-17
18-35 9,615 8,930 8,190 7,705 18-35 12,155 11,295 10,365 9,745
36-45 11,350 10,710 9,860 9,285 36-45 13,890 13,075 12,035 11,325
46-50 21,835 20,495 18,870 17,780 46-50 24,375 22,860 21,045 19,820
51-55 22,930 21,530 19,825 18,655 51-55 25,470 23,895 22,000 20,695
56-60 24,515 23,415 21,975 19,695 56-60 27,055 25,780 24,150 21,735
61-65 35,410 32,350 26,850 21,580 61-65 37,950 34,715 29,025 23,620
66-70 47,720 43,605 36,195 29,095 66-70 50,260 45,970 38,370 31,135
>70 68,385 62,480 51,860 41,685 >70 70,925 64,845 54,035 43,725

Family Type 2A + 2C
Age Band `2 Lakhs `3 Lakhs `4 Lakhs `5 Lakhs
0-17
18-35 14,425 13,400 12,285 11,555
36-45 17,030 16,065 14,790 13,930
46-50 27,295 25,620 23,590 22,220
51-55 28,660 26,910 24,780 23,320
56-60 30,895 29,280 26,135 23,700
61-65 39,840 36,390 30,205 24,275
66-70 53,690 49,055 40,720 32,730
>70 76,935 70,290 58,340 46,895

Heatlh Suraksha Top Up Plus Plan

 Sum insured - `7.5 Lakhs
Family Type 1A Family Type 1A + 1C
Age Band `2 Lakhs `3 Lakhs `4 Lakhs Age Band `2 Lakhs `3 Lakhs `4 Lakhs
0-17 3,335 3,195 2,505 0-17
18-35 4,535 4,390 3,915 18-35 6,355 6,135 5,345
36-45 5,455 5,245 4,695 36-45 7,275 6,990 6,125
46-50 9,790 9,475 8,425 46-50 11,610 11,220 9,855
51-55 10,280 9,950 8,845 51-55 12,100 11,695 10,275
56-60 11,900 10,705 9,290 56-60 13,720 12,450 10,720
61-65 15,945 14,335 12,445 61-65 17,765 16,080 13,875
66-70 21,485 19,325 16,775 66-70 23,305 21,070 18,205
>70 30,790 27,690 24,035 >70 32,610 29,435 25,465

Family Type 2A Family Type 2A + 1C

Age Band `2 Lakhs `3 Lakhs `4 Lakhs Age Band `2 Lakhs `3 Lakhs `4 Lakhs
0-17 0-17
18-35 6,805 6,580 5,875 18-35 8,625 8,325 7,305
36-45 8,185 7,865 7,040 36-45 10,005 9,610 8,470
46-50 15,665 15,160 13,480 46-50 17,485 16,905 14,910
51-55 16,450 15,915 14,150 51-55 18,270 17,660 15,580
56-60 19,045 17,125 14,865 56-60 20,865 18,870 16,295
61-65 25,510 22,940 19,910 61-65 27,330 24,685 21,340
66-70 34,380 30,920 26,840 66-70 36,200 32,665 28,270
>70 49,260 44,300 38,460 >70 51,080 46,045 39,890

Family Type 2A + 2C
Age Band `2 Lakhs `3 Lakhs `4 Lakhs
0-17
18-35 10,205 9,870 8,810
36-45 12,275 11,795 10,560
46-50 19,580 18,950 16,850
51-55 20,560 19,895 17,690
56-60 23,815 22,260 19,575
61-65 28,695 25,805 22,400
66-70 38,675 34,785 30,195
>70 55,420 49,840 43,265

Heatlh Suraksha Top Up Plus Plan

 Sum insured - `5 Lakhs
Family Type 1A Family Type 1A + 1C Family Type 2A
Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs
0-17 1,970 1,790 0-17 0-17
18-35 2,705 2,460 18-35 3,780 3,440 18-35 4,060 3,690
36-45 3,255 2,915 36-45 4,330 3,895 36-45 4,885 4,375
46-50 5,845 5,300 46-50 6,920 6,280 46-50 8,770 7,950
51-55 6,510 6,010 51-55 7,585 6,990 51-55 9,765 9,015
56-60 7,530 6,975 56-60 8,605 7,955 56-60 11,295 10,465
61-65 12,005 11,405 61-65 13,080 12,385 61-65 18,005 17,105
66-70 16,510 15,685 66-70 17,585 16,665 66-70 24,765 23,525
>70 19,060 18,110 >70 20,135 19,090 >70 28,590 27,165

Family Type 2A + 1C Family Type 2A + 2C

Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs
0-17 0-17
18-35 5,135 4,670 18-35 6,090 5,535
36-45 5,960 5,355 36-45 7,325 6,565
46-50 9,845 8,930 46-50 11,690 0,600
51-55 10,840 9,995 51-55 13,020 12,020
56-60 12,370 11,445 56-60 13,555 12,555
61-65 19,080 18,085 61-65 21,610 20,530
66-70 25,840 24,505 66-70 29,720 28,230
>70 29,665 28,145 >70 34,310 32,600

Heatlh Suraksha Top Up Plus Plan

 `4 Lakhs
Sum insured - `5
Family Type 1A Family Type 1A + 1C Family Type 2A
Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs
0-17 1,530 1,315 0-17 0-17
18-35 2,100 1,805 18-35 2,935 2,525 18-35 3,145 2,705
36-45 2,525 2,170 36-45 3,360 2,890 36-45 4,420 3,795
46-50 4,795 4,530 46-50 5,630 5,250 46-50 7,670 7,250
51-55 5,610 5,395 51-55 6,445 6,115 51-55 8,975 8,630
56-60 6,520 6,290 56-60 7,355 7,010 56-60 10,430 10,065
61-65 10,655 10,290 61-65 11,490 11,010 61-65 17,050 16,465
66-70 14,655 14,155 66-70 15,490 14,875 66-70 23,450 22,650
>70 17,255 16,665 >70 18,090 17,385 >70 27,610 26,665
Family Type 2A + 1C Family Type 2A + 2C
Age Band `2 Lakhs `3 Lakhs Age Band `2 Lakhs `3 Lakhs
0-17 0-17
18-35 3,980 3,425 18-35 4,720 4,060
36-45 5,255 4,515 36-45 5,680 4,880
46-50 8,505 7,970 46-50 9,590 9,060
51-55 9,810 9,350 51-55 11,220 10,790
56-60 11,265 10,785 56-60 11,735 11,320
61-65 17,885 17,185 61-65 19,180 18,520
66-70 24,285 23,370 66-70 26,380 25,480
>70 28,445 27,385 >70 31,060 29,995

`3 Lakhs
Sum insured - `5
Family Type 1A 1A + 1C 2A 2A + 2C 2A + 2C
Age Band `2 Lakhs `2 Lakhs `2 Lakhs `2 Lakhs `2 Lakhs
0-17 1,100
18-35 1,625 2,240 2,845 3,460 3,655
36-45 2,075 2,690 3,630 4,245 4,670
46-50 3,690 4,305 5,905 6,520 7,380
51-55 4,770 5,385 7,630 8,245 9,540
56-60 5,540 6,155 8,865 9,480 9,970
61-65 9,060 9,675 4,495 15,110 16,310
66-70 12,460 13,075 19,935 20,550 22,430
>70 15,170 15,785 24,270 24,885 27,305

Heatlh Suraksha Top Up Plus Plan

 Printing Code: HST/BR/0020/DEC2022

For more details, log on to www.hdfcergo.com or call us on 022 6242 6242

Terms & Conditions Apply. **Subject to no medical history. HDFC ERGO General Insurance Company Limited. IRDAI Reg. No. 146.
CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, 165-166 Backbay Reclamation, H. T. Parekh
Marg, Churchgate, Mumbai – 400 020. For more details on the risk factors, terms and conditions, please read the
sales brochure/prospectus before concluding the sale. Trade Logo displayed above belongs to HDFC Bank Ltd and ERGO
International AG and used by the Company under license. UIN: Health Suraksha Top - Up - HDFHLIP21467V022021. UID: 11683.