HDFC ERGO Optima Secure+ - Policy Details

Quick Information

Basic Details

Entry Age 18 to 65 years

Coverage Amount ₹1,000,000 to ₹20,000,000

Claim Settlement 95.19% (FY 2024-2025)

Claim Repudiation 0.00%

Incurred Claim Ratio 87.04%

Claims Paid Amount 77.69%

Best For

Families

salaried professionals and metro users wanting high practical hospitalization cover

day-1 double cover

unlimited restore and consumables protection.

What Works Well

2X cover from Day 1 through Secure Benefit

100% base sum insured added every year with Infinite Benefit

without claim-based reduction

Automatic Restore Benefit available unlimited times in policy year

Room rent and ICU covered at actuals

Protect Benefit covers listed non-medical/consumable expenses

Watch Out For

Premium can be higher than basic health plans

Feature structure is complex and can be misunderstood

Some add-ons are optional and require extra premium

Home healthcare is cashless only and available in select cities

PED-related claims may face strict scrutiny

Aggregate deductible can remove or restrict some benefits if selected

Hidden Clauses - Read Very Carefully!

These clauses are often buried in fine print. MyInsureBuddy surfaces them so you're never surprised at claim time.

Automatic restore is used only for subsequent claims during the remaining policy year; unused restore amount is not carried forward.

Secure Benefit is applied only after exhaustion of Base Sum Insured and unutilized Secure Benefit is not carried forward.

Room rent is at actuals unless policy schedule says otherwise; if a higher-than-eligible room is chosen

proportionate deduction can apply.

Protect Benefit covers listed non-medical expenses

not every possible non-payable item.

⚡ At a Glance

Cashless Available No Room Rent Limit Maternity Cover Online Claim Tracking Domiciliary Cover Family Floater PED Reduction Modern Treatments Reset Benefit Organ Donor Teleconsultation Health Coaching Preventive Checkups Complex Exclusions Claim Restrictions

Air Ambulance

₹500,000

Cum. Bonus

100%/yr

Special Benefits

•Secure Benefit

•Restore Benefit

•Protect Benefit

Wellness Benefits

•Preventive health check-up after every policy year

•E-opinion for critical illness through network providers

•Optima Wellbeing add-on available as separate add-on

Modern Treatments

•Modern treatments covered as per policy terms and IRDAI standard list; no separate sub-limit highlighted in provided data.

Optional Add-ons

•Aggregate Deductible

•PED Waiting Period Modification

•Modification of Room Rent

•ABCD Chronic Care

•Parenthood

•Limitless

Domiciliary Exclusions

•Data Not Available

Key Benefits (Pros)

•High claims experience rating

•Large cashless hospital network

•Lower claim repudiation ratio mentioned in source text

•Strong claim settlement metrics in provided data

Policy Drawbacks

•Higher after-sales complaints mentioned in source text

•Toll-free response marked slow

•X/Twitter response marked average

Day 31 Covered Diseases

•Asthma

•Blood Pressure

•High Cholesterol

•Diabetes

User Testimonial

Abhinand Reddy★ 5.00/5

"Customer stated that expert guidance helped select a suitable family insurance plan."

Insurer Positives

•High claims experience rating

•Large cashless hospital network

•Lower claim repudiation ratio mentioned in source text

•Strong claim settlement metrics in provided data

Insurer Negatives

•Higher after-sales complaints mentioned in source text

•Toll-free response marked slow

•X/Twitter response marked average

Benefit Availability Notes

•Ambulance service is available in this policy: road ambulance up to Sum Insured and air ambulance up to ₹5,00,000. Therefore it is not placed under Not Available data.

Policy Schedule Dependency

•Final benefit limits depend on the selected plan, policy schedule, add-ons, deductible and underwriting approval.

Aggregate Deductible Impact

•If high aggregate deductible is selected, benefits like preventive health check-up, Secure Benefit, Infinite Benefit, Automatic Restore Benefit and daily cash may be unavailable as per wording notes.

📌 Other Custom Details

•Is Editors Choice: 1

•F Infinite Benefit: 1

•Base Product Name In Wording: my: Optima Secure

•Plan Variant: Optima Secure+

•Verification Status: Prepared from uploaded brochure, policy wording and supplied comparison text. Re-check latest insurer quote and policy schedule before production DB upload.

•Created At: 2026-06-13

•Founded Year: 2002

•Gross Written Premium Crore: 8463.22

•Number Of Policies: 33844746

•Number Of Claims: 3247926

•Financial Year: 2024-2025

•Claims Settled 30 Days Percent: 96.63

Coverage & Benefits

In-patient Hospitalization

Covered up to Sum Insured

Room Rent

At Actuals unless otherwise specified in policy schedule

ICU/ICCU

At Actuals unless otherwise specified in policy schedule

Pre-Hospitalization

60 days for same condition if hospitalization claim is admissible

Post-Hospitalization

180 days for same condition if hospitalization claim is admissible

Day Care Treatments

All day care treatments covered

Home Health Care

Covered on cashless basis only, select cities/conditions

Domiciliary Hospitalization

Covered as per policy conditions

AYUSH Treatment

Covered for inpatient care in AYUSH Hospital

Organ Donor Expenses

Covered for in-patient organ harvesting expenses

Emergency Road Ambulance

Covered up to Sum Insured

Emergency Air Ambulance

Covered up to ₹5,00,000

Preventive Health Check-up

Available every policy year, limit varies by base SI and policy type

E-Opinion for Critical Illness

Once per insured person for 51 defined major illnesses

Protect Benefit

Listed non-medical expenses covered up to Sum Insured

Infinite Benefit

100% of Base Sum Insured added after every policy year, unlimited accumulation

Automatic Restore Benefit

100% of Base SI restored unlimited times for same/different illness

What's Not Covered

Standard and specific exclusions under this policy.

Specific Exclusions

Stem cell harvesting expenses

alopecia/baldness treatment

prosthesis and external durable equipment unless needed for accidental injury

sleep apnea/general weakness/run-down investigation procedures.

Organ Donor Conditions

Any other organ donor expenses not incurred during transplant hospitalization are excluded; organ donor pre/post hospitalization expenses are excluded.

Disclosure / Non-disclosure Risk

Misrepresentation or non-disclosure of material facts may lead to voiding of policy and forfeiture of premium.

Standard Exclusions

Standard IRDAI health exclusions apply as per policy wording.

Official Policy PDF

Download the official IRDAI-filed brochure from HDFC ERGO General Insurance Company Limited.

📄 Official PDF brochure not yet available for this policy.

MyInsureBuddy Score

Recommended

Among top 20% in category

Claim Settlement 95%

Coverage Quality 98%

Policy Terms 90%

Value for Money 88%

Network & Features 92%

Product Benefits 98%

Hidden Risk Safety 84%

Rider Strength NULL

Flexibility NULL

Risk Level Medium Risk (3/10)

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HDFC ERGO Optima Secure+ ⭐ Editor's Choice

Quick Information

What Works Well

Watch Out For

Hidden Clauses - Read Very Carefully!

⚡ At a Glance

Special Benefits

Wellness Benefits

Modern Treatments

Optional Add-ons

Domiciliary Exclusions

Key Benefits (Pros)

Policy Drawbacks

Day 31 Covered Diseases

User Testimonial

Insurer Positives

Insurer Negatives

Benefit Availability Notes

Policy Schedule Dependency

Aggregate Deductible Impact

📌 Other Custom Details

Coverage & Benefits

Terms & Conditions (Simplified)

Pre-existing Disease Waiting

Specific Disease Waiting

Initial Waiting Period

Co-payment

Aggregate Deductible

Grace Period

Renewability

Home Healthcare

What's Not Covered

Official Policy PDF

MyInsureBuddy Score

Quick Actions

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