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Saral Suraksha Bima is HDFC ERGO's version of the standard personal accident policy that IRDAI designed to have common coverage and wording across insurers. It pays a fixed lump sum if an accident leads to death, permanent total disablement or permanent partial disablement. It is a benefit-based plan, not a health plan. The sum insured ranges from ₹2.5 lakh to ₹1 crore, the policy runs for one year, and you can add optional covers for temporary total disablement, hospitalisation expenses due to accident and an education grant for dependent children.
An IRDAI-mandated standardised personal accident policy — same core structure across all insurers, so you can compare HDFC ERGO's version directly against other companies. Not a hospitalization/health plan — pays a lump sum for accidental death or disability only.
Saral Suraksha Bima is useful as an income-protection layer, because the payout is a fixed amount tied to the sum insured and does not depend on medical bills. The three base covers share one sum insured, and a cumulative bonus of 5% of the base sum insured is added at each renewal irrespective of claims, up to 50%. The limits are in the nature of the product. Only accidents are covered, so illness and natural death are outside it. Death or disablement must happen within 12 months of the accident, partial disablement pays only the percentage set in the schedule, and the hospitalisation option is capped at 10% of the base sum insured and covers treatment in India only. Because every insurer sells the same standard wording, the differences between companies come down to price, service and the add-ons offered, so it is worth comparing the quote rather than the cover.
HDFC ERGO Health Insurance
Key Insights
Founded
2002
HDFC ERGO Health Insurance was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97.9% CSR, calculated as a 3-year average
HDFC ERGO Health Insurance settles 97.9% of all claims it receives, demonstrating strong credibility.
Network Hospitals
12,000–14,000
HDFC ERGO Health Insurance has a network of 12,000–14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
If the insured person dies because of an injury sustained in an accident during the policy period, 100% of the sum insured is paid, provided the death occurs within 12 months of the accident.
If a claim is paid for a missing person and the person is later found to have survived, the amount has to be refunded.
100% of the sum insured is paid if an accident causes permanent total disablement within 12 months. This includes total and irrecoverable loss of sight of both eyes, loss of use of both hands or both feet, loss of one hand and one foot, or loss of sight of one eye together with loss of a hand or foot. It also covers an injury that permanently and totally stops you from doing any work or occupation.
A fixed percentage of the sum insured is paid for the specific loss, within 12 months of the accident. For example: one entire hand, one entire foot or sight of one eye pays 50%; loss of use of both ears 50%; one ear 20%; four fingers and thumb of one hand 40%; a thumb with both phalanges 25%; an index finger with three phalanges 10%.
For any other permanent partial disablement, the percentage is assessed by an independent medical practitioner. The total paid across several disablements cannot exceed the sum insured.
Death, permanent total disablement and permanent partial disablement share a single sum insured, which you pick between ₹2.5 lakh and ₹1 crore in multiples of ₹50,000. The cumulative bonus also applies across all three.
The policy is offered on an individual basis. If you cover family members, the sum insured you choose applies to each member separately.
On renewal without a break, the sum insured goes up by 5% of the base sum insured each year irrespective of any claims, up to a maximum of 50%.
The bonus is available only if you renew or pay the premium within the grace period.
Optional. Pays a weekly benefit while an accident completely stops you from doing your work, for up to 100 weeks for one injury and never more than the sum insured. The disablement must last more than four consecutive weeks and be certified by the treating doctor as having begun within 30 days of the accident.
The proposal form lists the benefit as 0.2% of the base sum insured per week and states that only earning members are eligible. It is paid at quarterly intervals.
Optional. Reimburses hospital costs for an accident, up to 10% of the base sum insured. It covers room, boarding and nursing, doctor and surgeon fees, anaesthesia, blood, oxygen, operation theatre, medicines, diagnostics, ICU and internally implanted devices, plus dental treatment, plastic surgery, day care treatments and AYUSH treatment in an AYUSH hospital.
Conditions or treatments that the policy clearly says it will not cover.
Insurer
HDFC ERGO Health Insurance plans and claim process
Saral Suraksha Bima is a standard personal accident policy that IRDAI designed so that insurers offer common coverage and wording. HDFC ERGO's version pays a lump sum if an accident causes death, permanent total disablement or permanent partial disablement. It is benefit-based, which means it pays a fixed amount instead of reimbursing medical bills, except for the optional accident hospitalisation cover, which is indemnity-based.
The sum insured ranges from ₹2.5 lakh to ₹1 crore in multiples of ₹50,000. Adults can join from 18 to 70 years and dependent children from 3 months to 25 years. The family can include self, spouse, dependent children, parents and parents-in-law. The policy is individual only, so the sum insured you choose applies to each covered member separately.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official HDFC ERGO Health Insurance website before purchasing.
Contact Details
1800-2700-700
Headquarters: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059, Maharashtra, India
The aforementioned ratios have been averaged over three years (FY24-FY26)
Road ambulance is covered up to ₹2,000 per hospitalisation. A stay of at least 24 hours is needed, except for day care. Treatment must be taken in India.
Optional. After an admissible death or permanent total disablement claim, a one-time grant of 10% of the base sum insured is paid for each dependent child who is a full-time student and not older than 25.
The optional covers are independent of each other and are paid over and above the base sum insured.
A fixed percentage of the sum insured is paid for each listed loss. For example, one entire hand, one entire foot or sight of one eye pays 50% of the sum insured, loss of use of both ears pays 50%, and loss of one ear pays 20%. For any other permanent partial disablement, an independent medical practitioner assesses the percentage. The total paid cannot exceed the sum insured.
There are three. Temporary total disablement pays a weekly benefit while an accident stops you from working. Hospitalisation expenses due to accident reimburses hospital costs up to 10% of the base sum insured. Education grant pays 10% of the base sum insured for each dependent child after a death or permanent total disablement claim. These optional benefits are independent of each other and are paid over and above the base sum insured.
Yes. On renewal without a break, a cumulative bonus of 5% of the base sum insured is added each year irrespective of claims, up to a maximum of 50%. The bonus applies across death, permanent total disablement and permanent partial disablement, and it is available only if you renew or pay within the grace period.
No. The policy covers injury caused by an accident, which means harm that comes from external, violent and visible means. Death or disablement caused by illness or disease is outside the cover. If you also want cover for medical bills from illness, you need a separate health insurance policy.
The policy excludes war, intentional self-injury and suicide, injury under the influence of intoxicants, aviation other than as a passenger on a scheduled airline, breach of law, professional adventure sports, and nuclear or chemical and biological events. The optional hospitalisation cover additionally excludes treatment outside India, outpatient and domiciliary treatment, injuries that do not need hospitalisation, and the listed non-payable items.
Intimate the event within 30 days, or within 24 hours of admission if hospitalisation is an emergency, and submit claim documents within one month after treatment ends. Depending on the claim you may need an FIR or police report, a medico-legal certificate, a death certificate or a doctor's disability certificate. HDFC ERGO has to settle or reject the claim within 15 days from the date it receives the intimation, and pays interest at 2% above the bank rate if payment is delayed.