HDFC ERGO General Optima Cash Plan

What is the Plan all About?

HDFC ERGO General Optima Cash is a top-up health plan that provides daily hospital cash in the event of hospitalization arising out of accidents/illness. It also provides coverage for parent’s hospitalization, day care procedures, convalescence benefit, etc. This health plan pays a lump sum amount that can be used towards additional expenses that are not covered under a traditional health insurance plan.

2 plan variants are applicable under this plan:

Gold Plan
Platinum Plan

Key Features

Cover for non-medical expenses
Daily cash benefit in case of hospitalization
Get the premium discount on covering family members
Get Tax Benefits

Policy Benefits

Hospital cash is payable in case of hospitalization due to sickness. This benefit is applicable for each completed and continuous period of 24 hours and is payable up to 90 days (Platinum Plan) & 90/180 days (Gold Plan).
A fixed daily hospital cash is payable in case of ICU hospitalization due to sickness. It is payable for a maximum of 15 days in a policy year.
Daily cash amount is payable in case of hospitalization due to accident. This benefit is payable for a maximum of 90 days (Platinum Plan) & 90/180 days (Gold Plan).
A fixed daily hospital cash is payable in case of ICU hospitalization due to accident. This benefit is payable up to 15 days per policy year.
A fixed daily hospital cash amount is payable for day care procedures. This benefit is payable for a maximum of 6 day care procedures in a policy year.
Twice the daily cash amount is payable, when two or more insured persons are hospitalized at the same time due to an accident. This benefit is applicable for a maximum of 10 days per policy year.
Convalescence benefit is paid when hospitalization exceeds 7 continuous days. This benefit can be availed once per policy year.
A lump sum amount equivalent to twice the daily cash amount is paid to the female insured, in case of childbirth. It is payable two times throughout the lifetime of the insured.
Parent accommodation benefit equal to the daily cash amount is payable, if the insured child is aged 12 years or less and hospitalization exceeds 3 continuous days. It is payable for a maximum of 30 days in a policy year.

Value Added Benefits

Sum insured enhancement is available at the time of policy renewal.
Avail Health Line services & discounts at listed partner’s network.
No pre-policy medical check-up is required under this plan.
Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

Daily hospital cash of Rs 1000 to Rs 3000 can be opted for normal hospitalization due to sickness.
ICU Hospital cash due to accident/sickness is paid up to twice the daily cash amount.
50% of the daily cash amount is payable for one of the 10 identified day care procedures.
A lump sum amount equal to daily hospital cash is paid as convalescence benefit.

Waiting Period Clause

Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
Specific Waiting Period: Specific illnesses are covered after 24 months from the commencement date of the policy.
Pre existing Disease Waiting Period: Any pre-existing ailment/injury is covered after a waiting period of 48 months.
Maternity Waiting period: There is a waiting period of 2 years to avail daily cash benefit for child birth.

Who can Buy the Plan?

Factor	Minimum	Maximum
Age (as on last birthday)	Adult: 18 Years, Children: 91 Days	65 Years
Daily Cash	Rs 1000	Rs 3000
Sum Assured	-	-
Cover Type	Individual/Family Floater	-
Policy Tenure	1 Year	2 Years
Grace Period	30 Days	-
Free Look Period	15 Days	-
Riders	Nil	-