SABSE BADA SACH
OPTIMA SECURE
DE BENEFITS SO MUCH!
Optima Secure is a testament to the years of trust 1.6+ crore customers
have bestowed upon us.
It’s great when you ask for something and get more in return, isn’t it? That’s
why, HDFC ERGO brings to you a health insurance plan that gives you
SO MUCH more benefits than you had asked for!
The new HDFC ERGO Optima Secure provides 4X coverage, at no additional
cost, thereby redefining the value you get from health insurance. It doesn’t
just secure your present, but safeguards your future as well.
So Much Coverage
So Much Choice
So Much Trust
So Much More...
A policy like no other.
Introduction
Get So Much Coverage*
Guaranteed^^
Secure Benefit is a first-of-its-kind benefit of Optima Secure
that doubles the insurance cover you buy, instantly and
automatically. This means that you get a 2X coverage from
day 1, without having the need to activate or claim it,
at no additional cost.
2X coverage from day 1
2X
Secure Benefit
Get So Much Coverage*
Guaranteed^^
Plus Benefit is another first-of-its-kind benefit of
Optima Secure. With this benefit, the base cover you choose
for yourself automatically increases by 50% after 1 year, and
100% after 2 years, irrespective of any claims made. With this
benefit, you do not have to worry about earning a full no
claim bonus or a reduced bonus in case of a claim.
100% increase in coverage after 2 years
Plus Benefit
Get So Much Coverage*
Guaranteed^^
With the Restore Benefit of Optima Secure, if any
claim, partial or total, is made any time during the
year, then 100% of the base cover gets restored in
the policy cover automatically,
at no additional cost!
100% restore coverage
Restore Benefit
Get So Much Coverage*
Guaranteed^^
In case of an unfortunate hospitalisation, Protect Benefit of
Optima Secure guarantees payment of consumables, which
include listed non-medical expenses like gloves, masks,
nebulizer kits and so on. It’s built-in, and automatically
available at no extra charge.
Zero deduction on non-medical expenses
Protect Benefit
All the above benefits of Optima Secure work together
to give 4X coverage than the chosen cover.
Mr. Sharma, a 35-year-old married businessman from Delhi buys an Optima
Secure policy of 10 lakhs base cover for his family. He pays a premium of INR
26,700
▲
for it.
▲
Rs.26,700/- premium is including tax and for a 2-member Family Floater policy with age 35 years and 30 years. Premium shown above is
for Optima Secure plan for Tier 1 (Delhi, NCR, Mumbai, ane, Mumbai Suburban and Navi Mumbai, Surat, Ahmedabad & Vadodara) which
includes tax. For calculating exact premium, please visit www.hdfcergo.com
Secure Benefit instantly makes his 10 lakhs
base cover to 20 lakhs, at no extra cost.
Secure Benefit
Any time Mr. Sharma claims partial or total
10 lakhs base cover, it gets 100% restored,
making it 30 + 10 = 40 lakhs.
Restore Benefit
40
lakhs
Covered
non-medical
expenses
During hospitalisation, his non-medical
expenses that add up to 10-20% of the total
bill amount also get covered by Protect Benefit.
Protect Benefit
When he renews the plan for 1 year, Plus
Benefit increases his base cover of 10 lakhs
by 50% and in 2nd year by 100%, making it
15 lakhs and 20 lakhs respectively. Plus
Benefit and Secure Benefit together take
the total coverage to 30 lakhs.
Plus Benefit
20L
5L
25L
5L
30L
Af ter
1 year
Af ter
2 years
10
+10
=20
Lakhs
1.
2.
3.
4.
Let’s see how Optima Secure works
With all of these, Mr. Sharma gets access
to 16,000+ network hospitals and
healthcare service providers**
With 10 lakhs base cover eventually becoming INR 40 lakhs,
Mr. Sharma gets 4X coverage after 2 years.
4X coverage
4X
4x coverage after 2 years
By opting to pay the first INR 25,000/-
of claim in a policy year, Mr. Sharma gets a
discount of 25% on his premium, bringing it
down to INR 20,025/-
25% discount
60 and 180 days pre and post
hospitalisation covered
Instead of 30 and 90 days availed normally, Optima Secure covers
medical expenses for 60 days pre and 180 days post hospitalisation.
These cover tests, medicine purchases and other medical expenses
that Mr. Sharma has incurred during these aforementioned days.
Home healthcare
This policy covers treatment availed from comfort of homes,
and as per everyone’s convenience on cashless basis.
So, during Mr. Sharma’s home treatment, which in normal course
would have required hospitalisation, all his medical expenses
including doctor visits, nursing charges, etc. get covered by it.
Daily cash for shared room
With this, daily cash of INR 800 per day up to a maximum of INR 4800
on hospitalisation is provided as out of pocket expenses when you
choose a shared accommodation in a network hospital, and the
hospitalisation period exceeds 48 hours.
These include all the peripheral costs incurred by Mr. Sharma or his
caregiver on travelling, food, lodging and so on, which is incurred at
the time of claim.
So Much More Coverage
E-opinion
So, if Mr. Sharma chooses to take teleconsultations, or online
consultations for any of the listed diseases in the policy, the
expense incurred gets covered by the policy.
Get e-opinion on 51 critical illnesses through network provider in India.
AYUSH treatment
Optima Secure covers In-patient care treatment expenses even for
alternate treatment methods viz. Ayurveda, Yoga and Naturopathy,
Unani, Siddha and Homeopathy.
Hospitalisation expenses
Covers medical expenses incurred at the time of hospitalisation that
include room rent at actuals, ICU expenses, nursing expenses,
surgeon’s fee, road ambulance charges and so on. It also covers all
day care treatments that require hospitalisation for less than 24 hours.
Preventive health check-up
You will be provided preventive health check-up benefits post
completion of every policy year, irrespective of claim status.
Mr. Sharma can choose tests of his choice up to a sub-limit as
mentioned below for any insured person (including children).
So Much More Coverage
Sum Insured (in INR) 5 L 10 L 15 L
1,500 2,000 4,000 5,000
15,000
2,500 5,000 8,000 10,000
8,000
20 L, 25 L
& 50 L
100 L
& 200 L
Individual policy
(per insured)
Floater policy
(per policy)
So Much More Coverage
Domiciliary hospitalisation
Secures all medical expenses during Domiciliary
hospitalisation.
Organ donor expenses
Get reimbursements for medical expenses incurred for organ
donor’s in-patient treatment for harvesting of the organ donated.
Emergency air ambulance
The policy pays for air ambulance transportation services
during your emergency needs.
Aggregate deductible
Value buy
A deductible is an amount you agree to pay at the time of claim once
in a policy year, post which our coverage kicks in. You can choose
from the below deductible options and enjoy up to 65% discount on
your premium.
So Much Choice
25,000 25%
40%
15%
30%50,000
50% 40%1,00,000
55% 45%2,00,000
65% 55%3,00,000
Deductible
Amount
Optima Suraksha, Optima Secure & Optima Super Secure
5,00,000
Base SI <25 Lakhs
Base SI = 25 Lakhs
Base SI >= 50 Lakhs
NA
15%
30%
40%
45%
55%
62%
62%
So, if Mr. Sharma agrees to pay the first INR 25,000 on his claims in the policy year, he
gets a discount of 25% on his insurance premium. Which means, his premium of INR
26,700 reduces to just INR 20,025!
So Much Choice
my:Health Critical Illness
Get comprehensive coverage for 51 critical illnesses with sum insured
options of INR 100,000 to INR 200,00,000 and in multiples of INR 100,000.
my:Health Hospital Cash Benefit (Add-on)
Get sum insured options of INR 500/ INR 1000/ INR 1500 / INR 2000 /
INR 2500 / INR 3000 / INR 5000 / INR 7500/ INR 10,000 to cover your
out-of-pocket expenses.
Unlimited Restore (Add-on)
Provides Unlimited Restorations in a policy year.
Add-on covers
lndividual Personal Accident Rider
Provides Lumpsum pay out in case of Accidental Death, Permanent Total
Disablement and Permanent Partial Disablement
Optima Wellbeing (Add on)
Covers expenses for various outpatient benefits.
Discounts
Loyalty discount
With it, 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 INR 2000.
Mr. Sharma also has the super power to waive his opted deductible at
renewal post completion of 5 years under this policy~~
Easy Switch
So Much Choice
Coverage
Choose between wide range of base coverage from INR 10 lakh,
25 lakh 50 lakh, 1 crore and 2 crore
Wide coverage choice
Policy Options
Individual policy - A maximum of 6 adults and a maximum of 6 children
can be included in a single policy having separate sum insured
individually.
Family Floater - A maximum of 4 adults and a maximum of 6 children
can be included in a single policy having a common sum insured.
Tenure
You can select policy tenure from 1 to 3 years according to your
convenience.
Premium payment in instalments
Options for payment of premium on an instalment basis i.e. monthly,
quarterly, half yearly
Note: Adults can be a combination of self, spouse, parents and parents-in-law.
If the policy period is more than one year, you will be entitled to
receive a discount of 7.5% and 10% if the policy is purchased for
a 2-year and 3-year tenure respectively.
Family discount
Get discount of 10% if two or more family members are covered
under the same policy under the individual policy option.
Long term discount
So Much Trust
Quick turnaround time
Oers quick turnaround time, reducing pre-authorisation hurdles
Quick claim payment
Get quick claim settlements, to honour every genuine claim
Family of millions
Family of 1.6 Cr+ happy customers
@
Network of hospitals and healthcare providers
16,000+ network hospitals and healthcare service providers**
Customer service
24x7 call centre servicing in 10 languages
Illustration of Sum Insured utilisation
Illustration for Unlimited Restore (Add-on)
Number of
Claim
1
st
claim
3,00,000
3,00,000
Base(partial)
Base(balance)+Plus+
Secure+ Automatic
Restore(partial)
Automatic Restore
(partial)
5,00,000
2,00,000
2,50,000
2,50,000
5,00,000 0
5,00,000 3,00,000
12,50,000
2,00,000
2,00,000
14,00,000
3,00,000
2
nd
claim
3
rd
claim
Claim Amount
Base Sum
Insured
Plus
Benefit
Secure
Benefit
Restore
Benefit
Admissible
claim amount
Utilisation of Sum
Insured
- - -
Optima Secure plan with second policy year in progress
1
st
claim
Number of
Claim (all in
same Policy
Year)
5,00,000
Base Sum
Insured
2,50,000 5,00,000 0 10,00,000 10,00,000
Available Benefit Limit
0
Plus
Benefit
Secure
Benefit
Automatic
Restore
Benefit
Unlimited
Restore Add
on Benefit
Claim
amount
Admissible
claim
amount
Base Sum
Insured +Plus +
Secure (Partial)
4
th
claim
- - - - 7,50,000 5,00,0005,00,000 Unlimited Restore
5
th
claim
- - - - 5,00,000 5,00,0005,00,000 Unlimited Restore
2
nd
claim
- - 2,50,000 5,00,000 5,50,000 5,50,0000
Secure (balance)
+ Automatic
Restore Benefit
(partial)
3
rd
claim
- - - 2,00,000 7,00,000 5,00,0005,00,000
Automatic Restore
Benefit (balance)
+ Unlimited
Restore
Utilization
of Sum Insured
Note: A single claim in a Policy Year cannot exceed the sum of Base Sum Insured, Plus Benefit
(if remaining), Secure Benefit (if remaining).
Schedule of benefits (all limits are
in INR)
100% of Base Sum Insured
Up to Sum Insured
Irrespective of claim status, increase of 50% of
Base Sum Insured in a policy year, maximum up to 100%
Up to 100% of Base Sum Insured for any illness
any insured person
Road: Up to Sum Insured Air: Up to 500,000
800 per day (max up to 4,800)
Once per insured person (for 51 defined major illnesses)
5/10/15/20/25/50/100/200
At Actuals
Up to Sum Insured
Optima Secure
Secure Benefit
Protect Benefit
Plus Benefit
Restore Benefit
Emergency Ambulance
Daily Cash for Choosing
Shared Accommodation
E-Opinion for Critical Illness
Base Sum Insured (in Lakhs)
Room Rent
Hospitalisation Expenses
AYUSH Treatment
Home Healthcare
Organ Donor Expenses
Pre-Hospitalisation (60 days)
Post-Hospitalisation (180 days)
Plan Name
Lifelong renewal
Renew your insurance cover for life
No geography-based co-payment
With this, get treated in any city across India without any
co-payment, and irrespective of where you bought the
policy from.
No claim-based loading
No loading of renewal premium just because you
claimed it or fell ill after taking the policy
Tax savings
Get income tax benefits under section 80D of the
Income Tax Act°
Cashless transactions
Get treatment on a cashless basis across 16,000+ network
hospitals and healthcare service providers**
So Much More
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 oers 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.
Standard exclusions and
waiting periods
Standard exclusions
Investigation and evaluation purposes | Obesity control | Cosmetic surgery | Hazardous
sports | Breach of Law | Alcoholism, drug or substance abuse | Unproven treatments |
Sterility and infertility | Maternity
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.
So, get access to SO MUCH benefits
with your Optima Secure, today!
For more details, log on to www.hdfcergo.com or call us on 022 6242 6242
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 65% discount available by choosing option of Aggregate deductible of Rs. 3 lakhs up
to Base Sum Insured of equal to or less than 20 lakhs. **Data as on 30th June 2024. @Data as on 31st March, 2024 (includes members of the group. °Subject to change in tax laws. HDFC
ERGO General Insurance Company Limited. IRDAI Reg. No. 146. CIN: U66030MH2007PLC177117. Registered & Corporate Oce: 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 before concluding the sale. UIN: my: Optima Secure
- HDFHLIP25011V042425 | my: health Critical Illness - HDFHLIA22141V032122 | my:Health Hospital Cash Benefit (Add-on) - HDFHLIA21271V022021 | Unlimited Restore (Add On)
HDFHLIA22188V012122 | IPA Rider – APOPAIP19004V011920 | Optima Wellbeing (Add-on) -HDFHLIA24099V012324. UID: 15698.
Printing code: OPTIMASECURE/BR/DELHI/309/JUL2024
