HDFC Life: Easy Health Plan Review

By | May 1, 2017
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Health is the most important aspect of life. Due to the changing lifestyles, health issues have increased and has become complex in nature thus escalate extra financial burden on the family. Therefore it has become vitally important for everyone to have a health insurance.

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HDFC Life has introduced a health insurance plan and mediclaim policy for the family; parents as well as individuals which will provide a lump sum payout if you are hospitalized or undergo any Surgical Procedure or if you are diagnosed with Critical Illness.

About the health plan

HDFC Life easy health plan is a health insurance product with fixed benefits which provides coverage against:

  • Critical Illness and/ or
  • Surgeries and/or
  • Hospitalization

*depending upon the plan option you choose from.

HDFC Life Easy Health plan provides you the flexibility to choose any of the three or all the above mentioned benefits. The cover will be available for a period of 5 years. You can choose the option to pay single or regular premiums.

Key Features

Surgical Benefit: You will get a lump sum amount if you ever have to undergo any type of surgery (138 Surgeries Specified).

Daily Hospital Cash Benefit: It gives you lump sum if you ever need to be hospitalized for more than 24 hrs. Daily Hospital Cash Benefit available from ` 250 to` 5000 per day as per your requirement.

Critical Illness Benefit: You get a lump sum amount if you diagnosed with a major critical illness. (18 major critical illnesses specified)

Flexibility: you can choose to pay single or regular premium payment options as per your convenience.

Value for Money: It gives great value cover for your medical needs. You can avail multiple claims and double benefit in case if you are hospitalized in ICU.

Tax Benefit:  You can avail tax benefits under section 80D as per applicable tax laws.

Eligibility Criteria

Eligibility of this plan is mentioned below.

Particulars Minimum Limit Maximum Limit
Entry Age 18 years 65 years
Maturity Age 23 years 70 years
Policy Term 5 years
Premium Paying Term Regular /Single Premium
Premium Single Pay- Minimum :Rs. 2,184/-, Maximum: Rs.404,279/- Regular Pay- Minimum: Rs. 676/- , Maximum : Rs. 122,068/-

**This premium is exclusive of Service tax &Swach Bharat Cess

Different Plan options under this product

This plan offers seven options to choose from as mention below:

Plan Benefit covered
1 Daily Hospital cash benefit.
2 Surgical Benefits
3 Critical Illness Benefit
4 Daily Hospital cash Benefits+ Surgical Benefits
5 Surgical Benefits +Critical Illness Benefits
6 Daily Hospital Cash Benefit + Critical Illness Benefit
7 Daily Hospital Cash Benefit + Surgical Benefit + Critical Illness Benefit


Benefit Structure

Daily Hospital cash benefit.

  • In case of Hospitalization due to an injury, disease or sickness, you will get 1% of the sum insured as daily hospital cash benefit if admission into Non ICU room and 2% of sum insured in case of admission in ICU room.
  • The benefit will be payable as a lump sum payout at the end of stay in the Hospital for more than 24 hours.

Surgical Benefit: 

  • Surgical Benefit is payable if you undergo any of the 138 specified surgeries (as specified in annexure 2) based on the severity of the surgery.
  • You can make multiple claims up to maximum of 100 % of the sum insured during the policy term.
  • You are not allowed to claim for the same surgery more than once. However, you can make multiple claims from the same category.
  • In case 100% of the Sum Insured has been used up, the cover forSurgical Benefit will cease for the remaining policy term. However, other benefits (such as Daily Hospital Cash Benefit and Critical Illness Benefit, if applicable) can be availed.

Critical Illness Benefit

  • In case of critical illness benefit a lump-sum payment equal to 100% of the sum insured is made is case if the policy holder is diagnosed with any one of the 18 major Critical Illness as specified, only if you survive a period of 30 days from the date of diagnosis.
  • Listed below the Critical Illness:
  1. Cancer of specified severity
  2. Kidney Failure requiring regular dialysis
  3. First Heart Attack – of specified severity
  4. Stroke resulting in permanent symptoms
  5. Alzheimer’s Disease / Irreversible Organic Degenerative Brain Disorders
  6. Apallic Syndrome
  7. Benign Brain Tumour
  8. Coma of Specified Severity
  9. . End Stage Liver Disease.
  10. . End Stage Lung Disease
  11. Loss of Independent Existence
  12. . Loss of Sight
  13. Major Burns
  14. Major Head Trauma
  15. Parkinson’s Disease
  16. Motor Neurone Disease With Permanent Symptoms
  17. . Multiple Sclerosis with persisting symptoms
  18. . Permanent Paralysis of Limbs
  • Critical Illness Benefit will be payable only once during the entire policy term.
  • Once the Critical Illness Benefit is paid, the benefit will cease for the remaining policy term. However, other benefits such as Daily Hospital Cash Benefit and Surgical Benefit will be continue if applicable.
  • The waiting period will be 90 days for Critical Illness Benefit from the date of commencement or reinstatement of the cover, whichever occurs later except in cases where the Critical Illness occurs due to an Accident (e.g., Major Head Trauma)

Maturity Benefit:  There is no maturity benefit under this product. The policy will terminate at the end of policy term and no maturity benefit will be available.

Death Benefit:  There is no death benefit under the product.

Surrender Benefit:

  • No surrender value shall be payable if any claim has been made under thisproduct.
  • The policy can only be surrendered in full, partial surrender shall not be allowed.
  • In case of Regular Premium paying policies, no surrender benefit is payable.
  • In case of Single Premium paying policies, surrender value would be calculated as follows :

70% x Single Premium x (1- M/P)

Where,

M: policy month of surrender

P: policy term in months.

Claim Procedure

To claim under this policy must be submitted along with following documents in original:

  • Duly filled and signed claim form in original.
  • Copy of Policy document (self attested copy).
  • Claimant’s residence and identity proof (For all claims greater than ` 1 lakh).
  • Cancelled personalized cheque or copy of first page of passbook in case of non personalized cheque.
  • Discharge Summary (self attested copy)
  • Final Hospital Bill (self attested copy)
  • Medical records (self attested copies) • Consultation notes • Laboratory reports • X- Ray and MRI films.
  • Self declaration of 30 day survival.
  • Operating Theater Notes (for Surgical Cash benefit).

Please note the company may ask for additional documents for further requirements. You are required to intimate to the company for the claim along with all the necessary documents within 60 days from the date of diagnosis of the condition.

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