HDFC ERGO Optima Secure

All You Need To Know

Features

Product Details:

HDFC ERGO Optima Secure redefines the value you get from health insurance, with SO MUCH benefits
that give an incredible 4X coverage at no additional cost.

So Much Coverage ,
So Much Choice
So Much Trust
So Much Savings
So Much More...

Get So Much Coverage* Guaranteed^^

Secure Benefit - 2X coverage from day 1
The base cover you opt for gets doubled instantly upon purchase, without having the need to claim it.
Plus Benefit - 100% increase in coverage after 2 years
The base cover increases by 50% after 1 year and 100% after 2 years, irrespective of any claims made.
Restore Benefit - 100% restore coverage
If a claim is made, 100% of the base sum insured gets restored in the policy automatically.
Protect Benefit - Zero deduction on non-medical expenses
Zero deductions on listed non-medical expenses to maximise your claim during hospitalisation.

All the above benefits of Optima Secure work together to give 4X coverage than the chosen cover.

So Much Coverage

60 and 180 days pre and post hospitalisation covered
Instead of 30 and 90 days availed normally, get 60 and 180 days pre and post hospitalisation medical expenses covered.
Preventive health check-ups
Get health check-ups after completion of each year and irrespective of claims
Get up to 50% discount on premium
Choose to pay a small amount on claim and get up to 50% discount on premium year-on-year
Daily cash for shared room
Get daily cash of INR 800 per day, up to a maximum of INR 4,800 on hospitalisation, as out-of-pocket expenses
Room rent at actuals
Expenses on room rent covered without any capping
E-opinion on 51 illnesses
Avail e-opinion on 51 critical illnesses through network provider in India

So Much Choice

Coverage
From INR 5 lakhs to 2 crores
Policy options
Individual and Family Floater options
Tenure
Policy tenure from 1 to 3 years
Premium instalment options
Monthly/Quarterly/ Half Yearly
Age Limit
Minimum Age - The minimum entry age for a dependent child (who is, natural or legally adopted) is 91 days and maximum entry age is 25 years.
Maximum Age - The maximum entry age is 65 years. There is no maximum cover ceasing age in this policy.

So Much Savings

Online Discount: Get 5% premium discount on the base premium if you buy a health insurance policy online
Family Discount: Get 10% family discount if 2 or more members are covered in a single Optima Secure policy on an individual sum insured basis
Long Term Discount: If premium is paid in advance for 2 or 3 years policy tenure, then you get a premium discount of 7.5% and 10% respectively
Loyalty Discount: Get 2.5% premium discount on the base premium if you have an active retail insurance policy with us, with a premium above ₹2000

So Much Trust

Network of healthcare providers
13,000+ healthcare providers**
Customer service
24x7 call centre servicing in 10 languages
Family of millions
Family of 1.5+ Cr happy customers@
Quick turnaround time
Offers quick turnaround time, reducing pre-authorisation hurdles.
Quick claim payment
Get quick claim settlements, to honour every genuine claim.
Tax savings
Get income tax benefits under section 80D of the Income Tax Act°
Lifelong renewal
Renew your insurance cover for life
No claim-based loading
No loading of renewal premium just because you claimed it or fell ill after taking the policy
Claims Procedure
Initiate a claim or to know about the process visit HDFC ERGO Health Insurance Claim Process to initiate/Track a claim.
OR
Connect on HDFC ERGO’s Whatsapp no 8169500500
OR
Call on HDFC ERGO's toll free helpline no. 022 6234 6234 / 0120 6234 6234 and register your claim.

Terms of renewal

Life-long renewal - Get access to life-long renewal regardless of your health status or previous claims made under your policy, except on grounds of fraud or misrepresentation by the insured person.
Waiting period – The waiting periods mentioned in the policy wording will get reduced by 1 year on every continuous renewal of your policy.
Renewal premium - These are subject to change with prior approval from IRDAI. Any change in benefits or premium (other than due to change in age) will be done with the approval of the Insurance Regulatory and Development Authority and will be intimated at least 3 months in advance.
Withdrawal of policy - In the likelihood of this policy being withdrawn in future, intimation will be sent to insured person about the same 3 months prior to expiry of the policy. Insured person will have the option to migrate to similar indemnity health insurance policy available at the time of renewal with all the accrued continuity benefits, waiver of waiting period etc; provided the policy has been maintained without a break as per portability/migration guidelines issued by IRDAI.
Migration - Any insured person in the policy has the option to migrate to similar indemnity health insurance policy available at the time of renewal subject to underwriting with all the accrued continuity benefits, waiver of waiting period etc; provided the policy has been maintained without a break as per portability/migration guidelines issued by IRDAI.
Portability - This plan offers you easy portability. So, if you are insured under another insurer's health insurance policy you can transfer to HDFC ERGO General Insurance Company Limited with all your accrued benefits at the time of renewal subject to underwriting guidelines, after due allowances for waiting periods and enjoy so much coverage.

So, get access to SO MUCH benefits with your Optima Secure, today!

Standard exclusions and waiting periods

Standard exclusions

Waiting periods

30 days initial waiting period | 24 months waiting period on specific illnesses & surgical procedures | 36 months waiting period on pre-existing diseases

For complete list please refer the policy wordings.

Section 41 of Insurance Act 1938 (Prohibition of Rebates):

1. No person shall allow or oer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance 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 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 prospectus or tables of the insurers. 2. Any person making default in complying with the provision of this section shall be punishable with fine which may extend to Ten Lakh Rupees.

Disclaimers:

Terms & Conditions Apply. ~~This is a one-time option which can only be availed if the eldest member is less than 50 years at the time of purchasing this Policy (with aggregate deductible) and is less than 61 years at the time of availing this option, subject to underwriting. *4X coverage means base Sum Insured + Plus Benefit (after 2 Policy Years) + Secure Benefit + Automatic Restore Benefit. Under Plus Benefit, irrespective of claims means sum insured gets increased by 50% of base sum insured per year maximum up to 100%. A single claim in a Policy Year cannot exceed the sum of Base Sum Insured, Plus Benefit (if applicable) and Secure Benefit. Please refer the list of Non-Medical Expenses specified in the policy wording. Home health care available only on cashless basis in select cities only. Daily cash in case of hospitalization for more than 48 hours in a Network Hospital's shared accommodation. Preventive health check-ups at each renewal of the Policy. E-opinion available through the Network Provider only. For additional covers, additional premium will be charged. For in-depth details on terms and conditions applicable to add-ons, please refer to the prospectus and policy wording documents of the respective add-ons available under the download section on our website. 25% premium discount is applicable for Sum Insured up to INR 20 lakhs. ^^Get Guaranteed Secure, Plus, Protect and Restore Benefits. Up to 50% discount available by choosing option of Aggregate deductible of Rs. 1 lakh up to Base Sum Insured of equal to or less than 20 lakhs. •Based on claims of FY 2020-2021. **Healthcare Providers include Network hospitals and Diagnostic centers. Data as on March 2022. Please refer to the website www.hdfcergo.com for an updated network list. @As on July, 2022. °Subject to change in tax laws. 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 Ltd and ERGO International AG and used by the Company under license. The above mentioned product is underwritten by HDFC ERGO General Insurance Company Limited. HDFC Bank Limited (Senapati Bapat Marg, Lower Parel, Mumbai - 400 013) is an authorized corporate agent of HDFC ERGO General Insurance Company Limited. IRDAI License No. CA0010.

FAQs

1. Is No Cost Installment*^ feature in optima secure applicable for all policy tenures?

The feature is available to one-year policy holders. It can also be availed by debit and credit card holders

2. What is the secure benefit of my Optima Secure?

2X Coverage from Day 1

Secure Benefit instantly makes his ₹10 lacs base cover to ₹20 lacs, at no extra cost.

3. If I am hospitalised, can I opt for AC Single room in the hospital?

Yes, you can opt for AC single room with Optima Secure plan. We let you choose AC single room for undergoing treatment/surgery at any hospital. You can avail this facility on a cashless basis if you are hospitalised at a network hospital. There is also no disease capping either. You can undergo treatment for any disease and make use of your sum insured. You need not worry about room rent at the time of hospitalisation as we want you to undergo quality treatment without any worry.

4. What is the meaning of aggregate deductible? How does it work?

This option allows you to enhance your sum insured as per your need at a lower cost. HDFC ERGO will bear any claim over and above the chosen deductible amount in a policy year and you can cut your premium by 50%. Can’t ignore right? Following discount will be applicable on the Policy premium:

Deductible Amount	Base Sum Insured up to 20 Lakhs	Base Sum Insured above 20 Lakhs
25,000	25%	15%
50,000	40%	30%
100,000	50%	40%

5. I have a car insurance with HDFC ERGO for the past 3 years. Am I eligible for any discount?

3 years is a long term association, and it's natural to expect a reward. Optima Secure will not disappoint you; you are a loyal customer; hence, you are eligible for a loyalty discount. You will be eligible to get a discount of 2.5% on the base premium if you have an active retail insurance policy with premium above ₹ 2,000 with us. That means if you are an existing retail policy holder (2 Wheeler, motor, travel, home, health, Cyber security insurance) with HDFC ERGO, you will be eligible for a 2.5% loyalty discount on Optima Secure premium. The best part is your claim history won't impact this benefit

6. What is protect benefit with my:Optima Secure?

In these pandemic times, ortho kits, gloves, masks etc., are very widely used items during hospitalization. These are considered disposable items and included as non-medical expenses of the hospitalization bill. But, under most health insurance policies, disposable items are not covered. With Optima Secure plan, you can easily pay for 68 listed non-medical items commonly used during a hospitalisation at no extra premium.

7. If I meet with an accident just 10 days after buying health insurance, am I eligible to claim under health insurance?

Absolutely. There is no waiting period for claims due to accidents. Under any health insurance policy, there is a clause of a waiting period. This means you are eligible to file a claim only after completing a certain number of days mentioned in the policy wording. With Optima Secure, there is a waiting period of 30 days before making a claim except for accidental claims, 24 months waiting period on specific & listed illnesses & surgical procedures and 36 months waiting period on pre-existing diseases. This means accidental claims are covered immediately from the policy start date.

8. My wife delivered a baby 6 months ago, Can I include the child under my health insurance?

Yes, you can include your child under your health insurance plan. In fact, you can include your child post 90 days of birth up to 25 years of age. It's a good thing to add the child to the policy at an early age.

9. What is the automatic restore benefit?

Optima Secure Health Insurance plan restores up to 100% of your base sum insured for subsequent claims, for any illness, or any insured person. Your base sum insured is the actual sum insured that you had chosen when buying the policy. This helps you in case you exhaust your existing sum insured for any claim or number of claims. Suppose today you have bought an Optima Secure Health Insurance plan with a health cover or sum insured of ₹5 lacs, and, you register a claim of ₹8 lacs in year one. In such a scenario, you will be able to settle hospital bills worth ₹5 lacs from your base sum insured and the remaining ₹3 lacs from your secure benefit. If there is a subsequent claim in the same policy year, you will have automatic restore benefit up to your base sum insured for your immediate usage. Automatic restore benefit kicks from your 2nd claim onwards once you exhaust Base Sum Insured, Plus Benefit (after 1st year), Secure Benefit (in this order) and is available every policy year. Unutilised automatic restore benefit is not carried forward to the next policy year.

10. What is the maximum sum insured available?

Optima Secure plan is available for the sum insured up to ₹2 Cr. Various sum insured options are available such as ₹5, ₹10, ₹15, ₹20, ₹25, ₹50 lacs and ₹1Cr. You can buy the best health insurance policy of a sum insured that best suits your needs.

11. Are Covid-19 expenses covered under my Optima Secure plan

Yes, all COVID- 19 expenses are covered under Optima Secure plan. You need not buy a separate health insurance policy when you get it all under one policy.

12. I have a critical illness, and I require an expert's opinion on the same. Is there any way I can get an E- Opinion?

We will pay for the expenses incurred by you towards E-Opinion for defined Critical Illness availed from a Medical Practitioner through the Network Provider. We understand that digital opinion is the future, and we believe in making your life simple.

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Optima Secure