{"uin":"HDFHLIP22021V042122","name":"my:health Medisure Super Top Up Insurance","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122","insurer":{"slug":"hdfc-ergo-general-insurance","name":"HDFC ERGO General Insurance Company Limited","url":"https://indiainsurances.com/insurer/hdfc-ergo-general-insurance"},"line":"health","category":"health-topup","category_name":"Top-up and super top-up","irdai_type":"Revision","kind":"product","status":"unknown","approved_on":"2021-05-19","withdrawn_on":null,"summary":"my:health Medisure Super Top Up Insurance is an HDFC ERGO indemnity super top-up health policy that pays hospitalisation expenses above an aggregate deductible of Rs 2, 3, 4 or 5 lakh per policy year, on an individual or floater sum insured. It has a 30-day initial waiting period, 24 months for listed illnesses, 36 months for pre-existing diseases, and a 10% co-pay for insured persons above age 80.","analysis":{"state":"extracted","analysed_at":"2026-10-16 04:48:12.283545+00","note":"Every stated fact carries a verbatim quote found in the cited clause."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"cross-checked","value":["Individual Sum Insured","Floater Sum Insured"],"display":"Individual Sum Insured or Floater Sum Insured","note":"Each plan is bought with an aggregate deductible of Rs 2, 3, 4 or 5 lakh and a policy tenure of 1, 2 or 3 years.","quote":"Individual Sum Insured -Where each member has a separate sum insured under the policy), or ... Floater Sum Insured-Where all members under the policy have a single sum insured limit which may be utilized by any or all members","sources":[{"clause":"Row 4","heading":"Sum Insured","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/11#c-row-4"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1, 2 or 3 years, renewable.","display":"1, 2 or 3 years","note":"Discount of 5% (2-year) or 10% (3-year) when the premium is paid in advance as a single premium.","quote":"Policy Tenure – 1/2/3 Years ... A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured ... A discount of 5% and 10% will be offered in case a policy is purchased for 2-year and 3-year tenure respectively with Single Premium option","sources":[{"clause":null,"heading":"ADDITIONAL BENEFITS","page":3,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-additional-benefits"}],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"cross-checked","value":"At least 72 hours before a planned hospitalisation and within 24 hours of an emergency hospitalisation.","display":"72 hours before planned; within 24 hours of emergency hospitalisation","note":"If expenses were not expected to exceed the deductible but later do, notify immediately with a copy of the intimation made to the other insurer.","quote":"Intimation of claim must be done at least 72 hours prior to Hospitalization in case of planned Hospitalization and within 24 hours of Hospitalization in case of an emergency Hospitalization.","sources":[{"clause":"1","heading":"Claim Notification","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-1-7"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"cross-checked","value":["Claim Form duly filled and signed by Insured & Hospital","Copy of the claim intimation","Original Hospital Main Bill","Original Hospital Bill break up","Original Hospital Bill Payment Receipt","Hospital Discharge Card/Summary","Original Pharmacy Bill with supporting prescriptions","Medical investigation reports","All Doctor's consultation notes","Original bills and receipts for Ambulance charges (if any)","Operation Theatre Notes in surgical cases","Bar code sticker & Invoice for implants and prosthesis (if used)","Medico Legal Certificate and/or First Information Report for accidental injuries","Indoor case papers"],"display":"Claim form, intimation copy, original hospital bills and receipts, discharge summary, pharmacy bills, investigation reports, doctor's notes and others","note":"Submit to the TPA within 30 days of discharge; post-hospitalisation documents within 15 days of the end of the post-hospitalisation period.","quote":"Claim Form Duly filled with requisite information and signed by Insured & Hospital ... Copy of the claim intimation ... Original Hospital Main Bill ... Original Hospital Bill break up (Where issued by the Hospital) ... Original Hospital Bill Payment Receipt ... Hospital Discharge Card/Summary ... Original Pharmacy Bill with supporting prescriptions ... Medical Investigation report ... All Doctor's consultation note ... Original bills and receipts for claiming Ambulance charges(if any) ... Operation Theatre Notes in surgical cases ... Bar code sticker & Invoice for implants and prosthesis (if used) ... In case of Accidental Injuries, Medico Legal Certificate and/ or First Information Report, where applicable ... Indoor case papers","sources":[{"clause":"3(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-3-i"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"cross-checked","value":"The company settles or rejects a claim within 15 days from receipt of intimation.","display":"Within 15 days from receipt of intimation","note":"Interest at 2% above bank rate for delay. Service assurance: reimbursement decision within 6 working days of complete documents (Rs 1,000 if late); cashless request response within 6 hours. CIS instead says cashless pre-authorisation within 1 hour and final bill within 3 hours.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of intimation.","sources":[{"clause":"13","heading":"Claim Settlement (Provision for Penal Interest)","page":20,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-13-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-existing diseases until 36 months of continuous coverage (Excl01)","Specified diseases/procedures until 24 months of continuous coverage (Excl02)","Any illness within 30 days of first policy commencement, except accidents (Excl03)","Claims falling within the Aggregate Deductible","Maternity (Excl18)","Cosmetic or plastic surgery (Excl08)","Alcoholism, drug or substance abuse (Excl12)","Hazardous or adventure sports as a professional (Excl09)","Sterility and infertility (Excl17)","War, nuclear, chemical and biological weapons","Intentional self-injury or suicide","Domiciliary hospitalization expenses","Treatment taken on Outpatient basis","Ambulance charges","Non-Medical expenses"],"display":"Pre-existing diseases (36 months), listed illnesses (24 months), first 30 days, amounts within the deductible, maternity, cosmetic surgery, OPD, ambulance and more","note":"Treatment outside India is not payable. 26 specific exclusions in all, plus the standard Excl01 to Excl18.","quote":"Pre-existing Diseases: Code – Excl01 ... excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer ... Specified Disease/Procedure waiting period: Code – Excl02 ... excluded until the expiry of 24 months of continuous coverage ... 30-day waiting period: Code – Excl03 ... Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident ... Aggregate Deductible: We are not liable for Claims/Claim amount falling within Aggregate Deductible limit ... Maternity: Code – Excl18 ... Cosmetic or plastic surgery: Code – Excl08 ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12 ... Hazardous or Adventure sports: Code – Excl09 ... participation as a professional in Hazardous or Adventure sports ... Sterility and Infertility: Code- Excl17 ... War or any act of war ... nuclear weapons/materials, chemical and biological weapons ... intentional self-injury or attempted suicide or suicide ... Domiciliary hospitalization expenses ... Treatment taken on Outpatient basis ... Ambulance charges. ... Non-Medical expenses","sources":[{"clause":"1","heading":"Pre-existing Diseases: Code – Excl01","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-1-5"},{"clause":"2","heading":"Specified Disease/Procedure waiting period: Code – Excl02","page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-2"},{"clause":"2(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-a"},{"clause":"2(e)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-e"},{"clause":"2(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-a-2"},{"clause":null,"heading":"II. Specific Exclusions","page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-ii-specific-exclusions"},{"clause":"18","heading":"Maternity: Code – Excl18","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-18"},{"clause":"8","heading":"Cosmetic or plastic surgery","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-8"},{"clause":"12","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-12"},{"clause":"9","heading":"Hazardous or Adventure sports: Code – Excl09: Expenses related to any treatment","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-9"},{"clause":"17","heading":"Sterility and Infertility","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-17"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"Contact HDFC ERGO first by phone or website; then write to the Complaints & Grievance Cell (grievance@hdfcergo.com); then the Chief Grievance Officer (cgo@hdfcergo.com); then the Council for Insurance Ombudsmen or Insurance Ombudsman.","display":"HDFC ERGO first (022 6158 2020 / 022 6234 6234), then the Complaints & Grievance Cell, then the Chief Grievance Officer","note":"Escalate to the Chief Grievance Officer if not satisfied or no response within 15 days. Dedicated senior citizen helpline seniorcitizen@hdfcergo.com.","quote":"First Point of Contact | Call us at 022 6158 2020 / 022 6234 6234/www.hdfcergo.com ... Write to The Complaints & Grievance Cell (C&G Cell) HDFC ERGO General Insurance Company Limited ... You can also write an email to grievance@hdfcergo.com ... Write to the Chief Grievance Officer HDFC ERGO General Insurance Company Limited ... You can also write an email to cgo@hdfcergo.com ... you can also lodge an online complaint through the website of Council for Insurance Ombudsmen (CIO) ... the Insured Person may also approach the office of Insurance Ombudsman","sources":[{"clause":"9","heading":"Grievance Redressal Procedure","page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-9-3"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"cross-checked","value":"Fixed by the deductible chosen: Rs 3 or 8 lakh with a 2 lakh deductible; 7 or 12 lakh with 3 lakh; 6, 11 or 16 lakh with 4 lakh; 5, 10, 15 or 20 lakh with 5 lakh.","display":"3 Lakh to 20 Lakh, depending on the deductible","note":"Prospectus table: first column is the aggregate deductible, the rest are the sum insured options for it.","quote":"2 Lakh | 3 Lakh | 8 Lakh ... 3 Lakh | 7 Lakh | 12 Lakh ... 4 Lakh | 6 Lakh | 11 Lakh | 16 Lakh ... 5 Lakh | 5 Lakh | 10 Lakh | 15 Lakh | 20 Lakh","sources":[{"clause":null,"heading":"SUM INSURED AND AGGREGATE DEDUCTIBLE","page":2,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-sum-insured-and-aggregate-deductible"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to accidents, or if the insured person has continuous coverage for more than twelve months.","quote":"Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident","sources":[{"clause":"2(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-a-2"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"cross-checked","value":{"unit":"months","amount":36},"display":"36 months","note":"Reduced to the extent of prior continuous coverage under portability. Applies afresh to any sum insured increase.","quote":"Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"1","heading":"Pre-existing Diseases: Code – Excl01","page":11,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-1-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"cross-checked","value":{"unit":"months","amount":24},"display":"24 months","note":"Not for accidents. If the condition is also pre-existing, the longer waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exclusion shall not be applicable for claims arising due to an Accident.","sources":[{"clause":"2(a)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"conflicting","value":["Cataract","Hysterectomy other than for malignancy","Uterine prolapse including any condition requiring Hysterectomy","Polycystic Ovarian Diseases","Myomectomy for Fibroids","Knee Replacement Surgery (other than caused by an accident)","Osteoarthritis and Osteoporosis","Arthritis","Arthroscopic Surgery","Rheumatism","Joint Replacement Surgery (other than caused by accident)","Prolapse of Intervertebral discs (other than caused by accident)","Varicose Veins and Varicose Ulcers","Hernia","Stones in the urinary, uro-genital and biliary systems","Benign Prostate Hypertrophy","Hydrocele","Fistula in anus","Piles","Fissures","Fibroids","Dilatation & Curettage for treatment purposes","Pilonidal sinus","Chronic Suppurative Otitis Media (CSOM)","Deviated Nasal Septum","Sinusitis and related disorders","Surgery on tonsils/Adenoids","Gastric and duodenal ulcer","Any type of Cysts/Nodules/Polyps","Any type of Breast lumps","Benign ear, Nose and Throat disorders and surgeries","Chronic Nephritis and Nephropathy (Kidney diseases)"],"display":"Cataract, hysterectomy, joint replacement, hernia, piles, stones, sinusitis, ENT disorders and others","note":"Policy wording list given here. Prospectus says: 'Congenital internal anomaly' is also on the 24-month list; the wording's list does not include it.","quote":"Cataract ... Hysterectomy other than for malignancy ... Uterine prolapse including any condition requiring Hysterectomy ... Polycystic Ovarian Diseases, Myomectomy for Fibroids ... Knee Replacement Surgery (other than caused by an accident) ... Osteoarthritis and Osteoporosis ... Arthritis, Arthroscopic Surgery, Rheumatism, Joint Replacement Surgery (other than caused by accident), Prolapse of Intervertebral discs (other than caused by accident) ... Varicose Veins and Varicose Ulcers, Hernia, Stones in the urinary, uro-genital and biliary systems, Benign Prostate Hypertrophy, Hydrocele ... Fistula in anus, Piles, Fissures ... Fibroids, Dilatation & Curettage for treatment purposes, Pilonidal sinus, Chronic Suppurative Otitis Media (CSOM) ... Deviated Nasal Septum, Sinusitis and related disorders ... Surgery on tonsils/Adenoids ... Gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps, and any type of Breast lumps, benign ear, Nose and Throat disorders and surgeries Chronic Nephritis and Nephropathy (Kidney diseases). ... Congenital internal anomaly","sources":[{"clause":"2(e)","heading":null,"page":12,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-e"},{"clause":"3(e)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-3-e"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"cross-checked","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For an enhanced sum insured, the sixty months run from the date of enhancement on the enhanced part only.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"12","heading":"Moratorium Period","page":20,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-12-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"cross-checked","value":"Yes. Apply to the new insurer at least 30 days but not earlier than 60 days before renewal; continuity benefits in waiting periods carry over as per IRDAI guidelines.","display":"Yes, with waiting-period credit; apply 30 to 60 days before renewal","note":"Migration to another HDFC ERGO product is also allowed, applying at least 30 days before renewal.","quote":"The Insured Person will have the option to port the Policy to other insurers by applying to such Insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date ... the proposed Insured Person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":"10","heading":"Portability","page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-10-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"cross-checked","value":true,"display":"Yes","note":"Lifetime renewal is stated in the prospectus; the wording says renewable except for fraud, non-disclosure or misrepresentation, provided the product is not withdrawn.","quote":"It can be renewed annually or for a period of 2 or 3 years throughout your lifetime. ... A health insurance policy shall be renewable except on grounds of established fraud or non-disclosure or misrepresentation by the insured, provided the policy is not withdrawn","sources":[{"clause":"2","heading":"Comprehensive coverage that","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-2"},{"clause":"9","heading":"Renewal of Policy","page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-9-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"cross-checked","value":"No. No loading applies on renewal based on individual claims experience.","display":"No loading on renewal for claims","note":"Medical underwriting loading of up to 100% of basic premium can be applied at proposal and continues at renewals.","quote":"No loading shall apply on renewals based on individual claims experience","sources":[{"clause":"9","heading":"Renewal of Policy","page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-9-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Excl04 Investigation & Evaluation","Excl05 Rest Cure, rehabilitation and respite care","Excl06 Obesity/Weight control","Excl07 Change-of-Gender treatments","Excl08 Cosmetic or plastic surgery","Excl09 Hazardous or Adventure sports","Excl10 Breach of Law","Excl11 Excluded Providers","Excl12 Alcoholism, drug or substance abuse or any addictive condition","Excl13 Health hydros, nature cure clinics, spas or similar establishments","Excl14 Dietary supplements and substances that can be purchased without prescription","Excl15 Refractive Error","Excl16 Unproven Treatments","Excl17 Sterility and Infertility","Excl18 Maternity","Domiciliary hospitalization expenses","War, invasion, nuclear, chemical and biological weapons, radiation","Intentional self-injury, attempted suicide or suicide","Naval, military or air force operations","Investigative treatment for sleep-apnoea, general debility or exhaustion","Congenital external diseases, defects or anomalies","Stem cell harvesting","Spinal subluxation and manipulation treatment","Circumcisions (unless necessitated by Illness or Injury)","Convalescence, sanatorium treatment, private duty or long-term nursing care","Preventive care and nutritional and electrolyte supplements","Vaccination, inoculation and immunisations (except post bite treatment)","Non-Medical expenses","Treatment outside a practitioner's discipline or by a family member","Treatment taken on Outpatient basis","Hearing aids, spectacles or contact lenses","Alopecia, baldness and hair replacement; optometric therapy","Treatment not Reasonable and Customary or not Medically Necessary","Artificial limbs, prosthesis, corrective devices and external durable medical equipment","Claims arising from non-disclosure of pre-existing illness or material fact","Ambulance charges","Costs of donor screening and organ","Alternative treatments except to the extent covered under In-patient Hospitalization expenses","Flying or aerial activities except as a passenger in a scheduled airline or air charter"],"display":"Standard exclusions Excl04 to Excl18, plus 24 specific exclusions such as domiciliary hospitalisation, war, self-injury, outpatient treatment and ambulance charges","note":"Excl01 to Excl03 are waiting periods (36 months, 24 months, 30 days), not permanent. The wording's 26 specific exclusions also include the 10% co-pay above age 80 and the aggregate deductible, which are cost-sharing rather than exclusions and are left out here.","quote":"Investigation & Evaluation: Code – Excl04 ... Rest Cure, rehabilitation and respite care: Code – Excl05 ... Obesity/Weight control: Code – Excl06 ... Change-of-Gender treatments: Code – Excl07 ... Cosmetic or plastic surgery: Code – Excl08 ... Hazardous or Adventure sports: Code – Excl09 ... Breach of Law: Code – Excl10 ... Excluded Providers: Code - Excl11 ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12 ... Treatments received in health hydros, nature cure clinics, spas or similar establishments ... Code – Excl13 ... Dietary supplements and substances that can be purchased without prescription ... Code – Excl14 ... Refractive Error: Code - Excl15 ... Unproven Treatments: Code – Excl16 ... Sterility and Infertility: Code- Excl17 ... Maternity: Code – Excl18 ... 1. Domiciliary hospitalization expenses ... 4. War or any act of war ... invasion ... nuclear weapons/materials, chemical and biological weapons, radiation of any kind ... intentional self-injury or attempted suicide or suicide ... participation or involvement in naval, military or air force operation ... 7. Investigative treatment for Sleep-apnoea, general debility or exhaustion ... 8. Congenital external diseases, defects or anomalies ... 9. Stem cell harvesting. ... Investigative treatment for analysis and adjustments of spinal subluxation ... 11. Circumcisions (unless necessitated by Illness or Injury ... 12. Any Convalescence, sanatorium treatment, private duty nursing or long-term nursing care. ... 13. Preventive care, and other nutritional and electrolyte supplements ... 14. Vaccination including inoculation and immunisations (Except post bite treatment) ... 15. Non-Medical expenses ... Treatment rendered by a Medical Practitioner which is outside his discipline ... treatments rendered by a Medical Practitioner who is a member of an Insured Person's family ... 17. Treatment taken on Outpatient basis ... 18. The provision or fitting of hearing aids, spectacles or contact lenses. ... treatment and associated expenses for alopecia, baldness ... any non-surgical hair replacement method. Optometric therapy. ... 20. Any treatment or part of a treatment that is not of a Reasonable and Customary charge, not Medically Necessary ... 21. Expenses for Artificial limbs ... prosthesis, corrective devices external durable medical equipment of any kind ... 22. Any Claim arising due to Non-disclosure of Pre-existing Illness or Material fact ... 23. Ambulance charges. ... 24. Costs of donor screening and organ. ... 25. Expenses incurred on Alternative treatments except to the extent of coverage provided for under 'In-patient Hospitalization expenses' cover ... 26. Whilst You are flying or taking part in aerial activities ... except as a bona fide passenger (fare paying or otherwise) in a regular Scheduled airline or air Charter Company","sources":[{"clause":"4","heading":"Investigation & Evaluation: Code – Excl04","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-4-2"},{"clause":"5","heading":"Rest Cure, rehabilitation and respite care: Code – Excl05: Expenses related to any","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-5"},{"clause":"6","heading":"Obesity/Weight control","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-6"},{"clause":"7","heading":"Change-of-Gender treatments: Code – Excl07: Expenses related to any treatment, including","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-7"},{"clause":"8","heading":"Cosmetic or plastic surgery","page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-8"},{"clause":"9","heading":"Hazardous or Adventure sports: Code – Excl09: Expenses related to any treatment","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-9"},{"clause":"10","heading":"Breach of Law: Code – Excl10: Expenses for treatment directly arising from or consequent","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-10"},{"clause":"11","heading":"Excluded Providers: Code - Excl11: Expenses incurred towards treatment in any hospital or","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-11"},{"clause":"12","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-12"},{"clause":"13","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-13"},{"clause":"14","heading":null,"page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-14"},{"clause":"15","heading":"Refractive Error","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-15"},{"clause":"16","heading":"Unproven Treatments: Code – Excl16: Expenses related to any unproven treatment, services","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-16"},{"clause":"17","heading":"Sterility and Infertility","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-17"},{"clause":"18","heading":"Maternity: Code – Excl18","page":14,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-18"},{"clause":null,"heading":"II. Specific Exclusions","page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-ii-specific-exclusions"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"cross-checked","value":"On 7 days' written notice, a pro-rata premium refund for the unexpired policy period; no refund if any claim has been admitted or benefit availed.","display":"Pro-rata refund for the unexpired period, on 7 days' written notice","note":"No refund if a claim has been admitted or a benefit availed. For instalment policies with an admissible claim, future instalments for the year are adjusted in the claim.","quote":"The Policyholder may cancel this Policy by giving 7 days' written notice and in such an event, the Company shall refund to the Insured a pro-rata premium for the unexpired Policy Period. ... no refunds of premium shall be made in respect of Cancellation where any claim has been admitted or any benefit has been availed","sources":[{"clause":"6(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-6-a"},{"clause":"6(d)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-6-d"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"cross-checked","value":"India only: no claim is payable for treatment or expenses incurred outside India.","display":"India only","note":null,"quote":"No claim shall be payable under this Policy for any treatment or expenses incurred outside India. All claims shall be payable in India and in Indian Rupees only.","sources":[{"clause":"16(a)","heading":"Place/Currency","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-16-a-2"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"thirty days from receipt of the policy document","note":"New individual policies only, not renewals or ported/migrated policies. Refund less medical examination and stamp duty costs, or less proportionate risk premium if cover has started. CIS also says 'within 30 days from the beginning of the policy'.","quote":"free look period of thirty days from date of receipt of the policy document ... within 30 days from the beginning of the policy","sources":[{"clause":"8","heading":"Free look Period","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-8-2"},{"clause":"D.3.2(ii)","heading":null,"page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/11#c-d-3-2-ii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"cross-checked","value":{"unit":"days","amount":30},"display":"30 days","note":"15 days for monthly instalments. Illness contracted during the renewal grace period is not covered; with instalment premiums, cover continues during the grace period.","quote":"A Grace Period of 30 days is available for Renewal of the Policy. ... Option 4 | Monthly | 15 days","sources":[{"clause":"16(a)","heading":"Place/Currency","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-16-a-2"},{"clause":"7","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-7-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"cross-checked","value":"Adults from 18 to 65 years; children from 91 days to 23 years.","display":"18 to 65 years; children 91 days to 23 years","note":"Age as on last birthday at policy inception. Prospectus figures; the wording defines dependent children as aged between 3 months and 23 years. Proposers above 55 years undergo medical underwriting.","quote":"With this Policy, one can be insured from the age of 18 years to 65 years. You can insure your children from the age of 91 days to the age of 23 years.","sources":[{"clause":null,"heading":"ELIGIBILITY","page":6,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-eligibility"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"cross-checked","value":["Single premium for the entire policy period","Yearly","Half Yearly","Quarterly","Monthly"],"display":"Single premium, or instalments: yearly, half-yearly, quarterly or monthly","note":null,"quote":"on an installment basis i.e. Yearly, Half Yearly, Quarterly or Monthly ... payment of premium for the entire policy period made in advance as a single premium","sources":[{"clause":"7","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-7-2"},{"clause":"Def. 5","heading":"Non-instalment Premium Payment","page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-def-5-2"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["My: health Critical Illness Add On","My: health Hospital Cash Benefit Add On"],"display":"Critical Illness Add On; Hospital Cash Benefit Add On","note":"Critical Illness Add On: lump sum on diagnosis of a listed critical illness, sum insured Rs. 100,000 to Rs. 500,00,000. Hospital Cash Benefit Add On: cash for each completed 24 hours in hospital, Rs. 500 to Rs. 10,000 per day. From the prospectus; each add-on has its own prospectus.","quote":"my:health Medisure Super Top Up product offers following Add on Covers: ... My: health Critical Illness Add On with Sum Insured options of Rs. 100,000 to Rs. 500,00,000 ... My: health Hospital Cash Benefit Add On with Sum Insured options of Rs. 500/ Rs. 1000/ Rs. 1500 / Rs. 2000/ Rs. 2500 / Rs. 3000 / Rs. 5000/ Rs. 7500/ Rs. 10,000 ... Per day hospital cash benefit for each continuous and completed 24 hours of hospitalization ... Provides comprehensive coverage by offering a Lumpsum payout on diagnosis of any of the listed 51 critical Illnesses","sources":[{"clause":null,"heading":"Add on – Cover","page":3,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-add-on-cover"},{"clause":"43(d)","heading":null,"page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-43-d-3"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"No cover for illness contracted during the 30-day renewal grace period (treated as pre-existing). If the premium is paid in instalments, cover continues during the grace period.","display":"Not covered in the renewal grace period; covered in an instalment grace period","note":"Prospectus also says on renewal: 'Coverage is not available during the Grace Period.'","quote":"A Grace Period of 30 days is available for Renewal of the Policy. Any Illness, disease or condition contracted during Grace Period will not be covered and will be treated as Pre-existing diseases. ... If premium is paid in instalments then coverage will be available during the grace period also. ... In case of non-instalment premium payment, coverage shall not be available for the period for which no premium is received ... Coverage is not available during the Grace Period","sources":[{"clause":"16(a)","heading":"Place/Currency","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-16-a-2"},{"clause":"7","heading":"Premium Payment in Instalments","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-7-2"},{"clause":"43(iii)","heading":null,"page":13,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-43-iii"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"The amount (per claim or per year) that must be crossed before this policy pays. Your base policy or you pay this part.","status":"cross-checked","value":"An aggregate deductible of Rs 2, 3, 4 or 5 lakh as opted, applied to the total admissible expenses in a policy year before the policy pays.","display":"2/3/4/5 lakh aggregate deductible, as opted","note":"Applies per insured person (individual) or per family (floater) in each policy year; it can be paid by another policy or by the insured.","quote":"Deductible options : - 2/3/4/5L ... We are not liable for Claims/Claim amount falling within Aggregate Deductible limit as opted and mentioned on the Schedule","sources":[{"clause":"D.3.2","heading":null,"page":5,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/11#c-d-3-2"},{"clause":null,"heading":"II. Specific Exclusions","page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-ii-specific-exclusions"}],"law":[]},{"key":"deductible_basis","label":"Per claim or aggregate","section":"Limits and co-pay","meaning":"Top-up: deductible applies to each claim. Super top-up: to the total of all claims in the year.","status":"cross-checked","value":"aggregate","display":"Aggregate (total of all claims in the policy year)","note":null,"quote":"The deductible is applicable in aggregate towards hospitalization expenses incurred which are admissible under this Policy (and not excluded) during the Policy Year period by Insured Person (individual policy) or insured family (in case of floater policy)","sources":[{"clause":"Def. 3","heading":"Aggregate Deductible","page":9,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-def-3-2"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"cross-checked","value":"No room rent limit; room rent is covered with no sub-limits.","display":"No limit (no sub-limits)","note":"From the prospectus; the wording covers room rent without stating any limit, and the CIS shows sub-limit 'NA'.","quote":"we cover the medical expenses incurred by you towards your hospitalisation on room rent /ICU/ Therapeutic Unit, Medical Practitioner fees, Anaesthetist fees, nurse fees, blood, oxygen and anaesthesia. There are no sub-limits under this cover.","sources":[{"clause":null,"heading":"POLICY COVERAGE","page":2,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-policy-coverage"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"Share of each admissible claim you pay.","status":"cross-checked","value":"10% of each claim for insured persons above 80 years of age (age last birthday); none stated for others.","display":"10% for insured persons above age 80","note":"Prospectus renewal section says 'after you have attained the age of 80 years'; CIS says 'after age 80 years'.","quote":"Co-payment: All person(s) named in the Schedule to this Policy above the age of 80 years (age last birthday) shall bear a co-pay of 10% for each and every claim.","sources":[{"clause":null,"heading":"II. Specific Exclusions","page":15,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-ii-specific-exclusions"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"cross-checked","value":"Yes, at Network Hospitals, through HDFC ERGO directly or the TPA after pre-authorisation; not available at non-network hospitals.","display":"Yes, at Network Hospitals with pre-authorisation","note":"Limited to in-patient and day care cover. Wording promises a response to a cashless request within 6 hours; the CIS says pre-authorisation decision within 1 hour.","quote":"We may provide Cashless facility for Hospitalization expenses either directly or through the Third Party Administrator (TPA) if treatment is undergone at a Network Hospital by issue of pre-authorization by Us or the TPA. ... Cashless facility for Hospitalization will not be available for treatment in Non-Network Hospital","sources":[{"clause":"2(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-i"},{"clause":"2(iv)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-iv"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"cross-checked","value":"HDFC ERGO directly or through a Third Party Administrator (TPA); all decisions remain the insurer's responsibility.","display":"HDFC ERGO directly or through a TPA","note":"Reimbursement documents are submitted to the TPA.","quote":"We may provide Cashless facility for Hospitalization expenses either directly or through the Third Party Administrator (TPA) ... The TPA where appointed, shall process and communicate rejection, if a claim is found to be not admissible under this Policy as authorized by Us. However, all decisions shall be Our responsibility.","sources":[{"clause":"2(i)","heading":null,"page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-2-i"},{"clause":"4","heading":"TPA to Pay or Reject","page":25,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10#c-4-4"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"cross-checked","value":true,"display":"Yes","note":"Floater covers you, your spouse and 2 dependent children. Parents and parents-in-law can be in the same policy on an individual sum insured basis, or on a floater basis only in a separate policy; other listed relatives only on an individual sum insured basis.","quote":"Floater Sum Insured-Where all members under the policy have a single sum insured limit which may be utilized by any or all members ... This Policy gives you an option of covering your spouse and 2 dependent children. Your parents and parents in-law can also be ... covered in the same Policy if it is on an Individual Sum Insured basis and in a separate Policy on floater Sum Insured basis","sources":[{"clause":"Row 4","heading":"Sum Insured","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/11#c-row-4"},{"clause":"2(e)","heading":null,"page":4,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12#c-2-e"}],"law":[]}],"documents":[{"kind":"wording","label":"my:health Medisure Super Top Up Insurance","pages":35,"fetched_at":"2026-10-16 04:47:29.445077+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/myhealth-medisure-super-top-up-insurance-569138917326.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/10"},{"kind":"prospectus","label":"my:health Medisure Super Top Up Insurance","pages":24,"fetched_at":"2026-10-16 04:47:32.135187+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/myhealthMedisureSuperTopUp-263217038830.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/12"},{"kind":"cis","label":"myhealth Medisure Super Top Up Insurance","pages":13,"fetched_at":"2026-10-16 04:47:30.211787+00","source_url":"https://customer-portal-assets.hdfcergo.com/assets/v2/docs/default-source/downloads/cis/cis---myhealth-medisure-super-top-up-insurance/pdf180-872857238027.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122/document/11"}],"versions":[],"where_to_buy":[],"claims_and_complaints":[],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"my:health Medisure Super Top Up Insurance (UIN HDFHLIP22021V042122), IndiaInsurances, https://indiainsurances.com/policy/hdfc-ergo-general-insurance/my-health-medisure-super-top-up-insurance-hdfhlip22021v042122"}