Critical Illness

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CRITICAL ILLNESS
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About Us: HDFC ERGO
For India, HDFC has been synonymous with housing loans for almost
30 years. The market leader in home mortgages, HDFC is among
India's premier financial institutions with a distribution network of 250
branches and 90 outreach programme centres across the country.
Today, with assets worth more than Rs 80,000 crores, a customer
base of 32 lakhs and AAA rating for 13 consecutive years, the Group
has expanded into banking, insurance (Life and General), asset
management and property venture funds.
Ergo is the primary insurance entity of Munich Re Group, one of the
world's largest risk carriers and the leader in health and legal
protection insurance in Europe. Its investments total to over € 100
billion. Little wonder, 3.3crore clients in 25 countries place their trust
in the services, competence and security Ergo provides.
With the coming together of these two financial giants, we aim at
setting benchmarks in our path of innovating products and delivering
customer service.
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The Need for Critical Illness
According to a recent survey by Money Digest,
1 in 3 persons – will develop some life threatening Cancer…
1 in 4 persons – will develop heart disease before they retire…
1 in 20 persons – risk the chance of having stroke before the age of
seventy
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Why Purchase Critical Illness Insurance?
Medical Treatment is expensive!
Experts believe that medical bills are a factor in one out of five
bankruptcies (MSNMoney.com)
Shift to lifestyle-related diseases
Lifestyle-related diseases are typically more expensive to treat
viz. Cardiac Arrests, Hypertension, Stroke and the like.
Provides a lump sum benefit which can pay for:
Costs for the care and treatment;
Recuperation aids;
Debts pay off;
Any lost income due to a decreasing ability to earn;
Fund for a change in lifestyle.
Income Tax Benefit Under Section 80D of the Income Tax Act
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Key Coverage
Provides a Lump Sum Benefit on first diagnosis after a 30 Day
Survival period for any one of the Critical Illnesses covered under the
plan.
Critical Illness covered Silver
1.
Heart Attack (Myocardial Infarction)
2.
Coronary Artery Bypass Surgery
3.
Stroke

4.
Cancer

5.
Kidney Failure
6.
Major Organ Transplantation
7.
Multiple Sclerosis
8.
Paralysis

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Premium – Silver Plan
Age Bands 5-17 18-25 26-30 31-35 36-40 41-45
250,000 248 552 689 827 1,379 2,068
500,000 496 1,103 1,379 1,655 2,758 4,136
750,000 745 1,655 2,068 2,482 4,136 6,204
1,000,000 993 2,206 2,758 3,309 5,515 8,273
Premium inclusive of Service Tax
Premiums inclusive of Service Tax & Edu. Cess
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Description of Cover
Heart Attack (Myocardial Infarction): The death of a portion of the
heart muscle as a result of inadequate blood supply to the relevant
area. Diagnosis must be confirmed by a specialist Medical
Practitioner and evidenced by all of the following criteria:
new characteristic electrocardiogram changes
elevation of infarction specific enzymes, Troponins or other
biochemical markers
Coronary Artery (Bypass) Surgery:The actual undergoing of open
chest surgery for the correction of one or more coronary arteries,
which are narrowed or blocked, by coronary artery bypass graft
(CABG). The surgery must have been proven to be necessary by
means of coronary angiography and realisation of the surgery must
be confirmed by a specialist Medical Practitioner.
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Description of Cover
Stroke:Any cerebrovascular incident producing permanent
neurological sequelae and including infarction of brain tissue or
hemorrhage or embolisation from an extracranial source. Diagnosis
must be confirmed by a specialist Medical Practitioner and evidenced
by typical clinical symptoms as well as typical findings in CCT Scan or
MRI of the brain. Evidence of neurological deficit for at least 90 days
must be produced.
Cancer: A disease manifested by the presence of a malignant tumour
characterized by the uncontrolled growth and spread of malignant
cells, and the invasion of tissue. . Diagnosis must be confirmed by a
specialist Medical Practitioner and evidenced by definite histology.
Cancer also includes leukemia and malignant diseases of the
lymphatic system such as Hodgkin’s Disease.
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Description of Cover
Kidney Failure (End Stage Renal Disease): End stage renal
disease presented as chronic irreversible failure of both kidneys to
function, as a result of which either regular renal dialysis
(haemodialysis or peritoneal dialysis) is instituted or renal
transplantation is carried out. Diagnosis must be confirmed by a
specialist Medical Practitioner.
Major Organ Transplantation: The actual undergoing of
transplantation as the recipient of a heart, lung, liver, pancreas, small
bowel, kidney or bone marrow. Realization of the transplantation must
be confirmed by a specialist Medical Practitioner.
Multiple Sclerosis: Unequivocal diagnosis of Multiple Sclerosis by a
specialist Medical Practitioner evidenced by typical clinical symptoms
of demyelination and impairment of motor and sensory functions as
well as by typical MRI findings. The diagnosis must be confirmed by a
specialist Medical Practitioner and evidenced by all of the following
criteria:
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Description of Cover
Typical clinical symptoms (neurological abnormalities) of
demyelination manifested as an impairment of motor & sensory
functions.
The diagnosis must establish that the Insured Person has
exhibited these clinical symptoms (neurological abnormalities)
that have existed for a continuous period of at least 6 calendar
months or at least 2 clinically documented episodes at least 30
days apart.
Characteristic findings in the cerebrospinal fluid as well as
specific cerebral MRI lesions.
Paralysis: Total and irreversible loss of use of two or more limbs
through paralysis due to Accident or Illness of the spinal cord. These
conditions must be medically documented by a specialist Medical
Practitioner for at least 90 days.
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Key Exclusions
90 days Waiting Period
War or any act of war, invasion, act of foreign enemy, war like
operations
Criminal or unlawful act, or intentional self injury or attempted suicide
while sane or insane
Participation or involvement in naval, military or air force operation,
racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock
or mountain climbing
Intoxicating drugs and alcohol
Venereal disease," AIDS” (Acquired Immune Deficiency Syndrome)
and/or infection with HIV
Any treatment arising from pregnancy (including voluntary
termination), miscarriage, maternity or birth (including caesarean
section)
For a complete list of exclusions, kindly refer Policy Wordings
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Claims – Documents Required
Our claim form, duly completed and signed for on behalf of the
Insured Person.
All reports, including but not limited to all medical reports, case
histories, investigation reports, treatment papers, discharge
summaries.
A precise diagnosis for which a claim is made.
If any time period, is specifically mentioned against the Critical Illness
for which the claim is made, then the related documents/medical
reports to be submitted within 45 days of the completion of such
period.
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Thank You

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