Optima Lite

You choose either ₹5 lakh or ₹7.5 lakh as the base sum insured. There is no higher option within this plan.

Pays medical expenses for hospitalisation due to illness or injury, up to the sum insured. This includes room rent, ICU, surgeon, anaesthetist and specialist fees, tests directly related to the stay, prescribed medicines, blood, surgical appliances, operation theatre charges and internally implanted prosthetics.

Room rent is covered up to 1% of the base sum insured per day and ICU/ICCU up to 2% per day. That works out to ₹5,000 for a room and ₹10,000 for ICU on a ₹5 lakh plan, and ₹7,500 and ₹15,000 on a ₹7.5 lakh plan.

As soon as a claim partly or fully uses up the sum insured, 100% of the base sum insured is added again. This can happen unlimited times in a policy year, and the restored amount can be used for the same illness or a different one, by the same person or by another member on the policy.

On renewal without a break, 10% of the base sum insured is added each year irrespective of claims, up to a maximum of 100%.

Medical expenses up to 30 days before admission and 60 days after discharge are covered, provided they relate to an admissible hospitalisation.

Treatments and surgeries under general or local anaesthesia that are completed within 24 hours are covered up to the sum insured. Modern treatments and robotic surgeries are also covered up to the sum insured, except cosmetic and experimental procedures.

Treatment taken at home is covered if the treating doctor prescribes it in writing and the treatment would otherwise need hospital admission. This includes doctor visits and nursing charges, up to the sum insured.

Medical expenses for treatment at home are covered, up to the sum insured, if the doctor prescribes it in writing and you cannot be moved to a hospital or no hospital room is available.

In-patient treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy is covered up to the sum insured when taken in an AYUSH hospital.

The organ donor's hospitalisation costs for harvesting the organ are covered up to the sum insured when an insured person is the recipient and the recipient's claim is admissible.

Road ambulance charges are covered up to the sum insured per hospitalisation. Air ambulance charges are covered up to ₹5 lakh per hospitalisation.

If you choose a shared room in a network hospital and stay for more than 48 hours, you get ₹800 for every completed 24 hours, up to a maximum of ₹4,800.

A second opinion from a network doctor for listed critical illnesses, available once in a policy year for each insured person.

After the first policy year, the plan pays for a preventive health check-up every year: up to ₹1,500 per person on an individual policy, or up to ₹2,500 per policy on a family floater.

Adults can join from 18 years with no upper age limit, and there is no cover-ceasing age on renewal. Dependent children are covered from 91 days up to 25 years.

You can take the plan on an individual or family floater basis. A floater can include up to 4 adults (self, spouse, parents and parents-in-law) and up to 6 dependent children. A multi-individual policy can include up to 6 adults and 6 children, each with their own sum insured.

You can buy a 1, 2 or 3 year policy. Paying a 2-year or 3-year premium upfront earns a 7.5% or 10% discount. Other discounts include 5% for buying online, 2.5% loyalty discount, 10% family discount on individual policies covering two or more members, and 5% for HDFC Group or Munich Re Group employees.

After 60 continuous months of coverage, including portability and migration, a claim cannot be contested for non-disclosure or misrepresentation, except for established fraud.