HDFC Life Health Assure Plan Complete Guide

1. Overview

The HDFC Life Health Assure Plan is a comprehensive health insurance solution designed for individuals and families who want protection against medical expenses arising from hospitalization, surgery, or critical illness. Launched by HDFC Life, a leading life insurer in India, the plan blends the simplicity of a traditional health cover with the flexibility of optional addons, making it suitable for a wide range of policyholders.

2. Who Should Buy?

• Professionals and salaried employees looking for a reliable basic health cover.
• Selfemployed individuals who prefer a single premium payment schedule.
• Families wanting an affordable way to secure medical expenses for spouse and children.
• People with existing health policies seeking additional coverage for specific diseases or hospitalization costs.

3. Key Features

• Hospitalization Cash Benefit Fixed sum paid on each day of hospitalization up to the policy limit.
• DayCare Procedure Cover Covers surgeries that do not require an overnight stay, up to a predefined limit.
• PreExisting Disease Waiting Period 24 months for diseases not covered under the policy.
• No Claim Bonus (NCB) Increase in sum insured for every claimfree year, up to 25%.
• Renewal up to 100years of age Lifetime coverage as long as premiums are paid.
• Portability Ability to switch from another insurer without restarting the waiting period.

4. Benefits at a Glance

Benefit	Description
Cash Benefit per Day	500 5,000 per day depending on sum insured.
Room Rent Reimbursement	Up to 10% of sum insured per day.
ICU Charges	Covered up to 25% of sum insured.
Preand PostHospital Consultation	Up to 10% of sum insured.
Ambulance Charges	Up to 5,000 per hospitalization.

5. How the Plan Works

When a policyholder is admitted to a hospital, the following steps apply:

1. Inform HDFC Lifes 24hour claim helpline within 24hours of admission.
2. Submit the required documents admission note, discharge summary, medical bills, and the claim form.
3. HDFC Life reviews the claim and either approves cash reimbursement (hospitalization cash benefit) or directly settles the hospitals bills (up to the sum insured).
4. If a claim is settled, the policyholder receives the balance amount (if any) after deduction of copay or deductible, as specified in the policy.

6. Premium & Payment Options

Premiums are calculated based on age, sum insured, policy term, and optional riders. The plan offers flexible payment frequencies:

• Annual
• HalfYearly
• Quarterly
• Monthly (subject to additional charge)

Premiums increase with age, but the increase is capped for policyholders who renew continuously after the age of 60, ensuring affordability in later years.

7. Optional AddOn Riders

To enhance coverage, policyholders can attach the following riders (subject to additional premium):

• Critical Illness Rider Lumpsum payout on diagnosis of covered critical illnesses.
• Accidental Death & Disability Rider Additional sum assured in event of accidental death or permanent disability.
• Hospital Cash Rider Extra daily cash benefit beyond the base plan.

8. Claim Process

The claim process is designed to be quick and transparent:

1. Notification: Call the tollfree number 18002677777 within 24hours of admission.
2. Document Collection: Gather admission note, discharge summary, itemised medical bills, prescription, and completed claim form.
3. Submission: Upload documents through the HDFC Life mobile app/website or email them to claims@hdfclife.com.
4. Assessment: Claims team reviews and may request additional information.
5. Settlement: Cash benefit transferred to the bank account or paid directly to the hospital.

Most straightforward claims are settled within 57 working days.

9. Pros & Cons

Pros

• Simple, easytounderstand cash benefit structure.
• Lifetime renewability without a medical test.
• No claim bonus encourages healthy behaviour.
• Portability from other insurers.
• Optional riders allow customization.

Cons

• Cash benefit is a fixed amount per day, not a percentage of actual expenses.
• Preexisting disease waiting period may be longer than some competitors.
• Maximum sum insured capped at 10lakh for individuals (higher for family plans).

10. Frequently Asked Questions

Q: Is the cash benefit taxable?

A: No. The hospitalization cash benefit paid under Health Assure is taxfree under Section10(10D) of the Income Tax Act, provided the premium does not exceed the overall taxbenefit ceiling.

Q: Can I increase my sum insured after buying the policy?

A: Yes. During the policy term, you can opt for a suminsured increase at the time of renewal, subject to underwriting.

Q: What happens if I miss a premium payment?

A: The policy will lapse after a grace period of 30days. Reinstatement is possible by paying the due premium along with interest, subject to health underwriting.

Q: Does the plan cover maternity expenses?

A: No. Maternity expenses are excluded. However, a separate maternity rider is available with HDFC Life.

Q: How is the No Claim Bonus calculated?

A: For each claimfree year, the sum insured increases by 5% of the original insured amount, up to a maximum of 25%.