Stay safe and healthy with HDFC Group Health Insurance
Claims processing- fully online! Claim settlement promptly!
Cover yourself, your spouse and up to 4 dependent children
No medical test if you are between 18 and 55 years
Heal in a room you feel comfy in. No room rental caps.
Higher limit of 60 and 180 days of pre and post-hospitalisation expense, compared to the usual 30 and 60 days
No more unanswered questions, with 24X7 call centre support in 10 languages
100% sum assured restored on partial or complete utilisation, at no cost.
Exclusive for GIGA customers.
Cover age for those from 18 to 55 years of age
Straightforward process for individuals up to age 55 years with Good Health Declaration
Click here to buy the policy
Sr.No |
Coverage |
HDFC Group Health Insurance - Gold Plan |
HDFC Group Health Insurance - Platinum Plan |
|
1 |
Base sum insured (₹) lakh |
5, 10 and 15 |
5, 10 and 15 |
|
2 |
In-patient hospitalisation |
Covered up to the Sum Insured |
Covered up to the Sum Insured |
|
3 |
Room rent limit - (per day) |
up to 1% of SI, maximum ₹3,000 per day |
No restriction |
|
4 |
ICU limit - (per day) |
up to 2% of the sum insured per day |
No restriction |
|
5 |
Pre-hospitalisation medical expenses cover |
60 days |
60 days |
|
6 |
Post-hospitalisation medical expenses cover |
90 days |
180 days |
|
7 |
Day care procedures |
All day care |
All day care |
|
8 |
Domiciliary hospitalisation |
Covered |
Covered |
|
9 |
Road ambulance cover |
Up to ₹2,000 |
Up to ₹2,000 |
|
10 |
Organ donor expenses |
Covered |
Covered |
|
11 |
Alternative treatments (AYUSH) |
Covered up to Sum Insured |
Covered up to Sum Insured |
|
12 |
Hospital cash |
₹500 per day, max 30 days |
₹1000 per day, max 30 days |
|
13 |
Restore benefit |
Not available |
Restore 100% of the basic sum insured |
|
Renewal Benefits |
||||
1 |
Preventive health check-up |
1% of SI, maximum ₹2000/- at the end of each block of continuous 3 policy years |
1% of SI, maximum ₹7500, every claim free year |
|
2 |
Cumulative bonus |
10% of SI at each claim free year, max up to 50% |
10% of SI at each claim free year, max up to 50% |
|
Waiting Periods |
||||
1 |
Initial waiting period |
First 30 days |
First 30 days |
|
2 |
Specific illness waiting periods |
2 years |
2 years |
|
3 |
Pre-existing waiting period |
3 years |
3 years |
The Base Sum Insured, Cumulative Bonus and Restore Sum Insured are available to all Insured Persons for all claims under the Coverage during the current Policy Year, subject to condition that a single claim in a Policy Year cannot exceed the Base Sum Insured and Cumulative Bonus (if applicable).
In the event of complete or partial utilisation of the Base Sum Insured due to any claim admitted during the Policy Year, irrespective of the utilisation of the Cumulative Bonus, the Company shall restore the Sum Insured up to the Base Sum Insured (as applicable under the current Policy Year) for any subsequent claims admissible subject to the following conditions:
Number of Claim |
Claim Amount |
Available Benefit Limit |
Admissible claim amount |
Utilisation of Sum Insured |
||
Base Sum Insured |
Cumulative Bonus*(on first renewal) |
Restore Benefit |
||||
First claim |
₹3,00,000 |
₹5,00,000 |
₹50,000 |
0 |
₹3,00,000 |
Base (partial) |
Second claim |
₹7,00,000 |
₹2,00,000 |
₹50,000 |
₹3,00,000 |
₹5,50,000 |
Base (balance) + Cumulative Bonus + Restore Benefit (partial) |
Third claim |
₹3,00,000 |
- |
- |
₹2,00,000 |
₹2,00,000 |
Restore Benefit (partial) |
*If opted
Single claim in a Policy Year cannot exceed the Base Sum Insured and Cumulative Bonus (if applicable).
Internal Congenital Diseases |
Non-infective Arthritis |
Diseases of the gall bladder, including cholecystitis |
Calculus diseases of Urogenital system, for e.g., kidney stone or urinary bladder stone |
Pancreatitis |
Ulcer and erosion of stomach and duodenum |
All forms of cirrhosis |
Gastroesophageal Reflux Disorder (GERD) |
Perineal abscesses |
Perianal Abscesses |
Cataract |
Fissure/fistula in anus, haemorrhoids including gout and rheumatism |
Pilonidal sinus |
|
Benign tumours, cysts, nodules, polyps, including breast lumps |
Osteoarthritis and osteoporosis |
Polycystic ovarian diseases |
Fibroids (fibromyoma) |
Sinusitis, rhinitis |
Tonsillitis |
Skin tumours |
Benign hyperplasia of prostate |
Adenoidectomy, tonsillectomy |
Tympanoplasty, Mastoidectomy |
Hernia |
Dilatation and curettage (D&C) |
Nasal concha resection |
Surgery for prolapsed inter vertebral disc |
Myomectomy for fibroids |
Surgery of Genito urinary system |
Surgery for varicose veins and varicose ulcers |
Surgery on prostate |
Cholecystectomy |
Surgery for Perianal Abscesses |
Hydrocele/Rectocele |
Joint replacement surgeries |
Surgery for Nasal septum deviation |
Ligament, Tendon and Meniscal tear |
Hysterectomy |
Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries |
Endometriosis |
Prolapsed Uterus |
Rectal Prolapse |
Varicocele |
Retinal detachment |
Glaucoma |
Nasal polypectomy |
|
|
(Kindly refer to the policy wording for a complete detailed list)
Available on our website.
If you are between 18 and 55 years old, join the GIGA by HDFC Bank program, and you are in.
Get a health policy curated, keeping the needs of gig workers/freelancers like you in mind
Get up to ₹15 lakhs in coverage at an affordable premium
Annual coverage starts at ₹5 lakhs as the base sum assured
Better benefits, seamless online processes, instant policy issuance - it is in tune with your fast life
Buy with an online purchase process that is streamlined and customer-friendly.
No need if you are not 55 years old yet. A simple ‘Good Health Declaration’ is good enough.
No, unfortunately, that’s the bare minimum to buy the plan.
Yes, get your spouse and up to 4 dependent children covered along with you.
A year from the date you purchased it.
The certificate promptly reaches your registered email address.
Yes, there are 13,000+ network hospitals all around the country to choose from. To know more, click here.
HDFC ERGO's in-house team will process claims. For further details on the claims process, visit the HDFC ERGO website, www.hdfcergo.com.
Having a hospitalisation? Just file a claim on our website, www.hdfcergo.com or the app, or by sending claims paperwork to HDFC ERGO General Insurance Co. Ltd., Stellar IT Park, Tower-1, Fifth Floor, C - 25, Sector 62, Noida - 0120 398 8360.
Under the Platinum Plan, you can avail Sum Insured options of ₹5 lakh, ₹10 lakh, and ₹15 lakh.
The Platinum plan does not have any ICU or Room Rent restraints.
Under the Platinum Plan, pre-hospitalisation medical expenses are covered for 60 days before admission to the hospital, and post-hospitalisation medical expenses are covered for up to 180 days after discharge.
If prescribed by a medical practitioner, in-patient hospitalisation under Alternative Treatment for Ayurvedic, Unani, Siddha, and Homeopathy is covered up to Sum Insured.
Under Platinum plan hospital cash benefit of ₹1000/- per day for a maximum period of 30 days in a policy year is covered for each continuous and completed 24 hours of hospitalisation.
On complete or partial utilisation of the base Sum Insured by way of the first claim admitted under the Policy, 100% of the base Sum Insured will be restored to the Insured Person and will be accessible for subsequent claims in the Policy Year. Subject to the condition that single claim in a policy year cannot exceed the sum of Base Sum Insured and the cumulative bonus (if applicable).
For each claim-free year, you can get a preventive health check-up benefit of up to 1% of the sum covered (up to ₹7,500) under the Platinum Plan.
Each claim-free year results in a 10% increase in the Sum Insured Amount, up to a maximum of 50% in any policy year.
Medical Expenses for organ donor’s hospitalisation for harvesting a donated organ, where an Insured Person is a recipient in accordance and in compliance with
· The Transplantation of Human Organ (amendment) Act, 2011
· Transplantation of Human Organs and Tissues Rules, 2014
· And other applicable laws and/or regulations
Organ donor expenses are covered up to the Sum Insured limit.
You can avail a maximum of ₹2,000 per hospitalisation in ambulance expenses to transport an insured individual to the nearest hospital in the event of an emergency.
Under the Gold Plan, you can avail Sum Insured options of ₹5 lakh, ₹10 lakh, and ₹15 lakh.
The Gold Plan's Room Rent Limit is up to 1% of the Base Sum Insured, up to a maximum of ₹3,000 daily, and Intensive Care Unit (ICU) expenditures are covered up to 2% of the Sum Insured per day.
Under the Gold plan, pre-hospitalisation medical expenses are covered for 60 days before admission to the hospital, and post-hospitalisation medical expenses are covered for up to 90 days after discharge.
If prescribed by a medical practitioner, you can up to Sum Insured for in-patient hospitalisation for Ayurvedic, Unani, Siddha, and Homeopathy therapy.
Under Gold plan hospital cash benefit of ₹ 500/- per day for a maximum period of 30 days in a policy year is covered for each continuous and completed 24 hours of hospitalisation.
The Gold Plan does not offer Restore Benefit.
Under Gold plan, you can avail preventive health check-up benefit up to 1% of Base Sum Insured, maximum up to ₹ 2,000 at the end of each block of continuous 3 policy years.
Each claim-free year results in a 10% increase in the Sum Insured amount, up to a maximum of 50% in any policy year.
Medical Expenses for organ donor hospitalisation, for harvesting of a donated organ, where an Insured Person is a recipient in accordance and in compliance with
You can avail a maximum of ₹2,000 per hospitalisation in ambulance expenses to transport an insured individual to the nearest hospital in the event of an emergency.
Disclaimers
# Available under Platinum Plan
*Figure as on 30th June 2024.
**Data as on 31st March, 2024 (includes members of the group)
*** Data for FY24
^ Data till FY24
^^ Subject to no medical history
Terms & Conditions apply. 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. 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. UIN: HDFC Group Health Insurance -HDFHLGP21116V012021.