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    Day2day Care Brochure 2021

    Uploaded by

    hiteshmohakar15
    This document summarizes an outpatient health insurance plan from HDFC ERGO General Insurance Company. The plan provides unlimited general and specialist doctor consultations at network providers as well as coverage for pharmacy and diagnostics expenses. It offers two plan options - Silver and Gold - with different annual limits for pharmacy/diagnostics. Eligible individuals are those aged 91 days to 65 years. The plan provides lifelong renewal regardless of health status and has no waiting periods. Premium rates vary by plan option and number of family members covered.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Day2day Care Brochure 2021

    Uploaded by

    hiteshmohakar15
    33 views6 pages
    This document summarizes an outpatient health insurance plan from HDFC ERGO General Insurance Company. The plan provides unlimited general and specialist doctor consultations at network providers as well as coverage for pharmacy and diagnostics expenses. It offers two plan options - Silver and Gold - with different annual limits for pharmacy/diagnostics. Eligible individuals are those aged 91 days to 65 years. The plan provides lifelong renewal regardless of health status and has no waiting periods. Premium rates vary by plan option and number of family members covered.

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    Original Title

    Day2day Care Brochure 2021(1)

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    This document summarizes an outpatient health insurance plan from HDFC ERGO General Insurance Company. The plan provides unlimited general and specialist doctor consultations at network providers as well as coverage for pharmacy and diagnostics expenses. It offers two plan options - Silver and Gold - with different annual limits for pharmacy/diagnostics. Eligible individuals are those aged 91 days to 65 years. The plan provides lifelong renewal regardless of health status and has no waiting periods. Premium rates vary by plan option and number of family members covered.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    33 views6 pages

    Day2day Care Brochure 2021

    Uploaded by

    hiteshmohakar15
    This document summarizes an outpatient health insurance plan from HDFC ERGO General Insurance Company. The plan provides unlimited general and specialist doctor consultations at network providers as well as coverage for pharmacy and diagnostics expenses. It offers two plan options - Silver and Gold - with different annual limits for pharmacy/diagnostics. Eligible individuals are those aged 91 days to 65 years. The plan provides lifelong renewal regardless of health status and has no waiting periods. Premium rates vary by plan option and number of family members covered.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 6

    Don’t you worry

    about your day to day medical expenses!


    Presenting a unique Outpatient
    Health Insurance Plan
    from HDFC ERGO General Insurance Company Limited.
    Medical expenses don’t always come from
    major illnesses, in fact, it is the small but frequent
    expenses on pharmacy, medical tests and doctor
    visits that add up & before you realize you have put
    a dent in your savings.

    HDFC ERGO General Insurance Company Limited


    brings you a unique health insurance plan that
    helps you manage your daily medical expenses
    seamlessly through our integrated network of
    outpatient service providers.

    What Makes It Unique

    Covers all inevitable outpatient expenses from day one.

    Offers 100% cashless redemption for outpatient expenses at our


    network providers.

    Does not reject on the basis of current health status

    Offers unlimited general and specialist doctor consultation at our


    network providers
    Eligibility

    • All persons in the age group of 91 days to 65 years. The minimum entry age for an adult is 18 years and maximum
    entry age is 65 years. The maximum entryage for a child is 25 years
    • This policy can be issued to an individual and/or family. The family includes spouse, dependent children and
    dependent parents/parents-in law
    • A maximum of 4 members can be covered in a single family floater policy with a maximum of 2 Adults and 3
    children. The member combinations offered in a single family floater policy are: 1A+1C, 1A+2C, 1A+3C, 2A,
    2A+1C and 2A+2C only. The 2 adults can be self & spouse. Dependent Parents/Parents-in-law will have to be
    covered in a separate policy
    • A maximum of 6 members can be covered in a single individual policy on individual sum insured basis with a
    maximum of 4 adults and 5 children.
    The member combinations allowed in an individual policy are 1A, 1A+1C, 1A+2C,1A+3C, 1A+4C, 1A+5C, 2A,
    2A+1C, 2A+2C, 2A+3C, 2A+4C, 3A, 3A+1C, 3A+2C, 3A+3C, 4A, 4A+1C & 4A+2C only. The 4 adults can be a
    combination of Self, Spouse, either set of dependent parents/parents-in-law

    Policy Tenure

    The policy can be issued for a period of 1 or 2 year(s); the sum insured & benefits will be applicable on Policy Year
    basis.

    Know Your Plan Options

    Silver Plan

    Individual Family Floater (2, 3 or 4 members)

    Outpatient Consultation Unlimited for network & maximum upto 5 consultation


    (General & Specialist) after applying 20% co-pay in non-network.

    Pharmacy & Diagnostics


    Upto Rs 5,000/year Upto Rs 6,000 for 2, Rs 7,000 for 3,
    (including pathology;
    (with 20% co pay for & Rs. 8,000 for 4 members/year
    radiology; vaccination;
    non-network) (with 20% co pay for non-network)
    physiotherapy)
    Gold Plan

    Individual Family Floater (2, 3 or 4 members)

    Outpatient Consultation Unlimited for network & maximum upto 5 consultation


    (General & Specialist) after applying 20% co-pay in non-network.

    Pharmacy & Diagnostics


    Upto Rs 5,000/year Upto Rs 6,000 for 2, Rs 7,000 for 3,
    (including Pathology;
    (with 20% co pay for & Rs. 8,000 for 4 members/year
    radiology; vaccination;
    non-network) (with 20% copay for non-network)
    physiotherapy)

    Annual health check


    2 Annual Health Check Up per policy at network
    Health Checkup up per person (Upto a
    centres ((Upto a maximum of Rs 4,000 per policy for
    maximum of Rs 2,000
    non-network)
    for non-network)

    Exclusions

    • Any Insured Person committing or attempting to commit a breach of law with criminal intent
    • Intentional self-injury or attempted suicide while sane or insane
    • Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences there of
    • Inpatient treatment & day care procedures

    Please refer to the Policy Wording for the complete list of exclusions.

    Other Conditions

    Life-long Renewal: We offer life-long renewal regardless of your health status or previous claims made under your
    policy, unless the insured person or any one acting on behalf of an Insured Person acts in a dishonest or fraudulent
    manner or if there is any misrepresentation under or in relation to this policy or it poses a moral hazard
    Waiting Period: There are no waiting periods in this policy
    Maximum Age: There is no maximum cover ceasing age in this policy
    Grace Period: 30 days for renewing the Policy is provided under this Policy
    Renewal premiums: are subject to change with prior approval from IRDAI. Any change in benefits or premium will be
    done with the approval of the Insurance Regulatory and Development Authority of India and will be intimated atleast 3
    months in advance.
    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 with us at the time of renewal with all the accrued continuity benefits provided the policy has been
    maintained without a break as per portability guidelines issued by IRDAI
    Portability: Any Insured Person in the policy has the option to migrate to similar indemnity health insurance policy
    available with us at the time of renewal subject to underwriting with all the accrued continuity benefits provided the
    policy has been maintained without a break as per portability guidelines issued by IRDAI
    Midterm addition is not allowed in the plan
    Free look cancellation: We offer a period of 15 days from the date of receipt of the Policy document to review the terms
    and conditions of this Policy. If case of any objections, you have the option of cancel the Policy and you shall be
    refunded the premium paid by you after adjusting the amounts spent on any stamp duty charges and proportionate risk
    premium

    Tax Benefit

    The premium amount paid under this policy qualifies for deduction under Section 80D of the Income Tax Act, subject
    to applicable tax laws.

    Premium - Day2Day Care - Silver*

    Plan Type Individual Family Floater (2, 3 or 4 members)

    Premium (in Rs.) 6,903 8,493 10,906 13,436

    Premium - Day2Day Care - Gold*

    Plan Type Individual Family Floater (2, 3 or 4 members)

    Premium (in Rs.) 10,877 15,557 17,971 20,500

    The premium mentioned is annual premium.


    All premium rates are exclusive of Goods & Services Tax & Cess (if any).
    *Premium rates are subject to change with prior approval from IRDAI.

    2 year Premium Discount

    7.5% Discount on premium if insured person is paying premium of 2 years in advance


    For example: Proposed insured opting for Day2Day Care-Gold Plan Individual 2 year policy.
    Calculation - 10,877 X 2 X 92.5% = Rs. 20,122/- plus taxes.

    Other Discount

    Discount of 5% on published tariff, if customer buys Day2Day Care plan through our direct channels.
    Disclaimer

    This is only a summary of the product features. The actual benefits available are as described in the policy, and will be
    subject to the policy terms, conditions and exclusions. Please seek the advice of your insurance advisor if you require
    any further information or clarification.

    Section 41 of Insurance Act 1938 as amended by


    Insurance Laws Amendment Act, 2015 (Prohibition of Rebates):

    1. 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 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 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 prospectuses or tables of the insurers.

    2. Any person making default in complying with the provision of this section shall be liable for a penalty which may
    extend to ten lakh rupees.

    Reach US

    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 policy document carefully before concluding a sale. Trade Logo
    displayed above belongs to HDFC Ltd and ERGO International AG and used by the Company under license.
    • UIN: Day2Day Care – HDHHLIP21318V022021 • UID: 9161.

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