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HDFC ERGO General Insurance Company LimitedCustomer Information SheetOptima Plus PolicyNote: The Information must be read in conjunction with the product brochures and policy document. In case of any conflict between the Key FeaturesDocument and the policy document the terms and conditions mentioned in the policy document shall prevail.TITLEDESCRIPTIONProductNameOptima PlusWhat am Icovered for:What arethe majorexclusions inthe policy:Benefits In-patient Treatment – Medical Expenses for Hospitalisation above 24 hrs. Pre-Hospitalisation - Medical Expenses incurred in 60 days before the admission in the Hospital. Post-Hospitalisation - Medical Expenses incurred in 90 days after the discharge from Hospital. Day-Care procedures – Medical Expenses for Day care procedures Organ Donor- Medical Expenses on harvesting the organ from the donor for organ transplantation. Emergency Ambulance– Upto Rs. 2,000 per Hospitalisation for utilizing ambulance service for transportingInsured Person to Hospital in case of an Emergency. Domiciliary Treatment - The Medical Expenses incurred by an Insured Person for availing medical treatmentat his home which would otherwise have required Hospitalisation.Following is a partial list of the policy exclusions. Please refer to the policy wording for the complete list ofexclusions. Hazardous or Adventure sports: Code – Excl09Expenses related to any treatment necessitated due to participation as a professional in hazardous oradventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motorracing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving. Breach of law: Code – Excl10Expenses for treatment directly arising from or consequent upon any Insured Person committing orattempting to commit a breach of law with criminal intent. Treatment for alcoholism, drug or substance abuse, or any addictive condition and consequences thereof.Code – Excl12 Obesity/Weight control: Code – Excl06Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions:A. Surgery to be conducted is upon the advice of the DoctorB. The surgery/Procedure conducted should be supported by clinical protocolsC. The member has to be 18 years of age or older andD. Body Mass Index (BMI);I. Greater than or equal to 40 orII. Greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure ofless invasive methods of weight loss:A. Obesity-related cardiomyopathyB. Coronary heart diseaseC. Severe Sleep ApnoeaD. Uncontrolled Type2 Diabetes Cosmetic or plastic surgery: Code – Excl08Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstructionfollowing an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct andimmediate health risk to the insured. For this to be considered a medical necessity, it must be certified bythe attending Medical Practitioner. Maternity: Code – Excl18o Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sectionsincurred during hospitalization) except ectopic pregnancy;o Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancyduring the policy period Sterility and infertility: Code – Excl17Expenses related to sterility and infertility. This includes:o Any type of contraception, sterilizationo Assisted Reproduction services including artificial insemination and advanced reproductive technologies suchas IVF, ZIFT, GIFT, ICSIo Gestational Surrogacyo Reversal of sterilizationREFER TOPOLICYCLAUSENUMBERSection 1 a)Section 1 b)Section 1 c)Section 1 d)Section 1 e)Section 1 f)Section 1 g)Section 2HDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg,Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd and ERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220211

HDFC ERGO General Insurance Company LimitedWaitingPeriod 30 days for all illnesses (except accident) in the first year and is not applicable in subsequent renewalsSection 2 b., i 24 months for specific illness and treatments in the first two years and is not applicable in subsequentrenewalsSection 2 b., ii Pre-existing Diseases will be covered after a waiting period 48 months.Payout basis Cost Sharing We will pay Medical Expenses exceeding the Deductible Deductible applicable mentioned in the Policy Schedule.Renewal ofPolicyIndemnity basisThe policy shall ordinarily be renewable except on grounds of fraud, misrepresentation by the insured person.i.Section 2 b., iiiSection 1Section 2 a.Section 3 lThe Company shall endeavor to give notice for renewal. However, the Company is not under obligation togive any notice for renewal.ii. Renewal shall not be denied on the ground that the insured person had made a claim or claims in thepreceding policy years.iii. Request for renewal along with requisite premium shall be received by the Company before the end of thepolicy period.iv. At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30days to maintain continuity of benefits without break in policy. Coverage is not available during the graceperiod.v. No loading shall apply on renewals based on individual claims experience.RenewalBenefits Not ApplicableCancellationThe policyholder may cancel this policy by giving 15days’ written notice and in such an event, the Company shallrefund premium for the unexpired policy period as detailed in the Policy WordingsSection 3 sNotwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect ofCancellation where, any claim has been admitted or has been lodged or any benefit has been availed by theinsured person under the policy.The Company may cancel the policy at any time on grounds of misrepresentation non-disclosure of materialfacts, fraud by the insured person by giving 15 days’ written notice. There would be no refund of premium oncancellation on grounds of misrepresentation, non-disclosure of material facts or fraud.How to ClaimIn case of any hospitalisation or an event which might give rise to a claim, please contact Our designated TPA.Section 5Note: Pre-Policy Checkup at Our network may be required based upon the Age. We will reimburse 50% of the expenses incurred onthe acceptance of the proposal. The medical reports are valid for a period of 90 days from the date of Pre-Policy Checkup.2HDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg,Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd and ERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V022021

HDFC ERGO General Insurance Company LimitedPolicy WordingsOptima Plus PolicyHDFC ERGO General Insurance Company Limited. will provide the insurance cover detailed in the Policy to the Insured Personup to the Sum Insured subject to the terms and conditions of this Policy, Your payment of premium, and Your statements in theProposal, which is incorporated into the Policy and is the basis of it.Section 1. BenefitsClaims made in respect of any of the benefits below will be subject to the Sum Insured.If any Insured Person suffers an Illness or Accident during the Policy Period that requires that Insured Person’s Hospitalisationas an Inpatient, then We will pay for the Medical Expenses for the benefits mentioned below, in excess of the Deductible statedin the Schedule.Our maximum liability for a continuous period of Illness, including relapses within 45 days from the last date of discharge fromthe Hospital or nursing home where treatment has been taken, shall be limited to the amount mentioned in the Schedule ofBenefits. Occurrence of the same Illness after a lapse of 45 days as stated above will be considered as fresh Illness for thepurpose of this Policy.a)In-patient TreatmentThe Medical Expenses for:i)Room rent, boarding expenses,ii)Nursing,iii)Intensive care unit,iv) Medical Practitioner(s),v)Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances,vi) Medicines, drugs and consumables,vii) Diagnostic procedures,viii) The Cost of prosthetic and other Medical devices or equipment if implanted internally during a Surgical Procedure.b)Pre-Hospitalisation Medical ExpensesThe Medical Expenses incurred in the 60 days immediately before the Insured Person was Hospitalised, provided that:i)Such Medical Expenses were in fact incurred for the same condition for which the Insured Person’s subsequentHospitalisation was required, andii)We have accepted an inpatient Hospitalisation claim under Benefit 1a).c)Post-hospitalisation Medical ExpensesThe Medical Expenses incurred in the 90 days immediately after the Insured Person was discharged post Hospitalisation providedthat:i)Such costs are incurred in respect of the same condition for which the Insured Person’s earlier Hospitalisation was required,andii)We have accepted an inpatient Hospitalisation claim under Benefit 1a).d)Day Care ProceduresThe Medical Expenses for a day care procedure where the procedure or surgery is under taken under General or LocalAnaesthesia in a Hospital/Day Care Centre in less than 24 hours because of technological advancement, and which wouldhave otherwise required Hospitalization of more than 24 hours. Treatment normally taken on an Out-patient basis is notincluded in the scope of this cover.HDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220211

e)Organ DonorThe Medical Expenses for an organ donor’s treatment for the harvesting of the organ donated, provided that:i)The organ donor is any person whose organ has been made available in accordance and compliance with TheTransplantation of Human Organs Act, 1994 (amended) andii)The organ donated is for the use of the Insured Person, andiii)We will not pay the donor’s pre and post-Medical Expenses or any other medical treatment for the donor consequent on theharvesting, andiv) We have accepted an inpatient Hospitalisation claim under Benefit 1a).f)Emergency AmbulanceWe will reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider used totransfer the Insured Person to the nearest Hospital with adequate Emergency facilities for the provision of health servicesfollowing an Emergency, provided that:i)Our maximum liability shall be restricted to the amount mentioned in the Schedule of Benefits, andii)We have accepted an inpatient Hospitalisation claim under Benefit 1a).iii)The coverage includes the cost of the transportation of the Insured Person from a Hospital to the nearest Hospital whichis prepared to admit the Insured Person and provide the necessary medical services if such medical services cannotsatisfactorily be provided at a Hospital where the Insured Person is situated, provided that transportation has beenprescribed by a Medical Practitioner and is medically necessary.g)Domiciliary TreatmentThe Medical Expenses incurred by an Insured Person for medical treatment taken at his home which would otherwise haverequired Hospitalisation because, on the advice of the attending Medical Practitioner, the Insured Person could not betransferred to a Hospital or a Hospital bed was unavailable, and provided that:i)The condition for which the medical treatment is required continues for at least 3 days, in which case We will pay thereasonable charge of any necessary medical treatment for the entire period, andSection 2. Exclusionsa. DeductibleWe are not liable for any payment unless the Medical Expenses exceed the Deductible. Deductible shall be applicable foreach and every Hospitalisation except claims made for Any One Illness.b. Waiting PeriodsIllnesses and treatments shall be covered subject to the waiting periods specified below:i.30-day Waiting Period: Code – Excl03I.Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excludedexcept claims arising due to an accident, provided the same are covered.II.This exclusion shall not, however, apply if the insured person has continuous coverage for more than twelve months.III. The within referred waiting period is made applicable to the enhanced sum insured in the event of granting higher suminsured subsequently.ii.Specified disease/procedure waiting period: Code – Excl02I.Expenses related to the treatment of the listed Conditions, surgeries/treatments as mentioned in the table below shall beexcluded until the expiry of 24 months of continuous coverage after the date of inception of the first Policy with us. This exclusionshall not be applicable for claims arising due to an Accident.II.In case of enhancement of sum insured the exclusion shall apply afresh to the extent of Sum Insured increase.III. If any of the specified disease/procedure falls under the waiting period specified for Pre-existing diseases, then the longerof the two waiting periods shall apply.HDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220212

IV. The waiting period for listed conditions shall apply even if contracted after the Policy or declared and accepted without aspecific exclusion.V.If the Insured Person is continuously covered without any break as defined under the applicable norms on portabilitystipulated by IRDAI, then waiting period for the same would be reduced to the extent of prior coverage.VI. List of specific diseases/procedure:.(1)Illnesses: arthritis if non infective; calculus diseases of gall bladder and urogenital system; cataract; fissure/fistulain anus, hemorrhoids, pilonidal sinus, gastric and duodenal ulcers; gout and rheumatism; internal tumors, cysts,nodules, polyps including breast lumps (each of any kind unless malignant); osteoarthritis and osteoporosis if Agerelated; polycystic ovarian diseases; sinusitis, Rhinitis, Tonsillitis and skin tumors unless malignant.(2)Treatments: benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to adenoidectomy,mastoidectomy, tonsillectomy and tympanoplasty); dilatation and curettage (D&C); hysterectomy for menorrhagia orfibromyoma or prolapse of uterus unless necessitated by malignancy; joint replacement; myomectomy for fibroids;surgery of gallbladder and bile duct unless necessitated by malignancy; surgery of genito urinary system unlessnecessitated by malignancy; surgery of benign prostatic hypertrophy; surgery of hernia; surgery of hydrocele; surgeryfor prolapsed inter vertebral disk; surgery of varicose veins and varicose ulcers; surgery on tonsils and sinuses;surgery for nasal septum deviation.c.Pre- Existing Diseases: Code- Excl01i.Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded untilii.In case of enhancement of Sum Insured the exclusion shall apply afresh to the extent of sum of Sum Insurediii.If the Insured Person is continuously covered without any break as defined under the portability norms of the extantthe expiry of 48 months of continuous coverage after the date of inception of the first policy with insurer.increase.IRDAI (Health Insurance) Regulations, then waiting period for the same would be reduced to the extent of priorcoverage.iv.Coverage under the Policy after the expiry of 48 months for any pre-existing disease is subject to the same beingdeclared at the time of application and accepted by Insurer.d.Permanent ExclusionsWe will not make any payment for any claim in respect of any Insured Person caused by, arising from or attributable to any ofthe following unless expressly stated to the contrary in this Policy:i.Investigation & Evaluation: Code – Excl04a.Expenses related to any admission primarily for diagnostic and evaluation purposes only are excluded.b.Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.ii.Rest Cure, rehabilitation and respite care: Code – Excl05 – Expenses related to any admission primarily for enforceda.Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living suchb.Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.iii.Obesity/Weight control: Code – Excl06 – Expenses related to the surgical treatment of obesity that does not fulfil allbed rest and not for receiving treatment. This also includes:as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.the below conditions:a.Surgery to be conducted is upon the advice of the doctorb.The surgery/procedure conducted should be supported by clinical protocolsc.The member has to be 18 years of age or older andd.Body Mass Index (BMI)HDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220213

i.Greater than or equal to 40 or,ii.Greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of lessinvasive methods of weight loss:1.Obesity related cardiomyopathy2.coronary heart disease3.severe sleep apnoea4.uncontrolled type2 diabetesiv.Change-of-Gender treatments: Code – Excl07 – Expenses related to any treatment, including surgical management,v.Cosmetic or plastic surgery: Code – Excl08 – Expenses for cosmetic or plastic surgery or any treatment to changeto change characteristics of the body to those of the opposite sex.appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of Medically NecessaryTreatment to removea direct and immediate health risk to the insured. For this to be considered a medical necessity,it must be certified by the attending Medical Practitioner.vi.Hazardous or Adventure sports: Code – Excl09 – Expenses related to any treatment necessitated due to participationas a professional in Hazardous or Adventure sports, including but not limited to, para-jumping, rock climbing,mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep sea diving.vii.Breach of Law: Code – Excl10 - Expenses for treatment directly arising from or consequent upon any Insured Personviii.Excluded Providers: Code11 - Expenses incurred towards treatment in any hospital or by any Medical Practitioner orcommitting or attempting to commit a breach of law with criminal intent.any other provider specifically excluded by the Insurer and disclosed in its website/notified to the policyholders arenot admissible. However, in case of life threatening situations or following an Accident, expenses up to the stage ofstabilization are payable but not the complete claim.ix.Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code –x.Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registeredExcl12as a nursing home attached to such establishments or where admission is arranged wholly or partly for domesticreasons. Code – Excl13xi.Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins,minerals and organic substances unless prescribed by a Medical Practitioner as part of Hospitalization claim or daycare procedure. Code – Excl14xii.Refractive Error: Code - Excl15 – Expenses related to the treatment for correction of eye sight due to refractive errorxiii.Unproven Treatments: Code – Excl16 – Expenses related to any unproven treatment, services and supplies for orless than 7.5 dioptres.in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significantmedical documentation to support their effectiveness.xiv.Sterility and Infertility: Code- Excl17 – Expenses related to sterility and infertility. This includes:a.Any type of contraception, sterilizationb.Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF,c.Gestational Surrogacyd.Reversal of sterilizationxv.Maternity: Code – Excl18a.Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurredZIFT, GIFT, ICSIHDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220214

during hospitalization) except ectopic pregnancy;b.Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during thexvi.War or any act of war(whether war be declared or not or caused during service in the armed forces of any country),Policy period.invasion, act of foreign enemy, civil war, public defence, rebellion, revolution, insurrection, military or usurped acts,nuclear weapons/materials, chemical and biological weapons, radiation of any kind.xvii. Any Insured Person committing or attempting to commit intentional self-injury or attempted suicide or suicide whilementally sound or unsound.xviii. Any Insured Person’s participation or involvement in naval, military or air force operation.xix.Investigative treatment for Sleep-apnoea, general debility or exhaustion (“run-down condition”).xx.Congenital external diseases, defects or anomalies,xxi.Stem cell harvesting.xxii. Investigative treatment for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulationof the skeletal structure or for muscle stimulation by any means except treatment of fractures (excluding hairlinefractures) and dislocations of the mandible and extremities).xxiii. Circumcisions (unless necessitated by Illness or Injury and forming part of treatment).xxiv. Any Convalescence, sanatorium treatment, private duty nursing or long-term nursing care.xxv.Preventive care, and other nutritional and electrolyte supplements, unless certified to be required by the attendingMedical Practitioner as a direct consequence of an otherwise covered claim.xxvi. Vaccination including inoculation and immunisations (Except post bite treatment),xxvii. Non-Medical expenses such as Food charges (other than patient’s diet provided by hospital), laundry charges,attendant charges, ambulance collar, ambulance equipment, baby food, baby utility charges etc. Full list of NonMedical expenses attached and is attached and also available at www.hdfcergo.com.xxviii. Treatment rendered by a Medical Practitioner which is outside his discipline or the discipline for which he is licensed;treatments rendered by a Medical Practitioner who is a member of an Insured Person’s family, or stays with him,xxix. Treatment taken on Outpatient basisxxx. The provision or fitting of hearing aids, spectacles or contact lenses.xxxi. Any treatment and associated expenses for alopecia, baldness including corticosteroids and topical immunotherapywigs, toupees, hair pieces, any non-surgical hair replacement method. Optometric therapy.xxxii. Any treatment or part of a treatment that is not of a Reasonable and Customary charge, not Medically Necessary;treatments or drugs not supported by a prescription.xxxiii. Expenses for Artificial limbs and/or device used for diagnosis or treatment (except when used intra-operatively).prosthesis, corrective devices external durable medical equipment of any kind, wheelchairs crutches and oxygenconcentrator for bronchial asthma/ COPD conditions, cost of cochlear implant(s) unless necessitated by an Accident.Exhaustive list of Non-Medical Expenses attached and also available on www.hdfcergo.com.xxxiv. Any Claim arising due to Non-disclosure of Pre-existing Illness or Material fact as sought to be declared on theProposal form.Section 3. General Conditionsa.Condition Precedent to Admission of LiabilityThe terms and conditions of the policy must be fulfilled by the insured person for the Company to make any payment for claim(s)arising under the policy.b.Insured PersonOnly those persons named as an Insured Person in the Schedule shall be covered under this Policy. Any person may be addedHDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220215

during the Policy Period after his application has been accepted by Us, additional premium has been paid and We have issued anendorsement confirming the addition of such person as an Insured Person.There is no maximum cover ceasing age under this Policy.We may apply a risk loading on the premium payable (based upon the declarations made in the proposal form and the healthstatus of the persons proposed for insurance). The maximum risk loading applicable for an individual shall not exceed above100% per diagnosis / medical condition and an overall risk loading of over 150% per person. These loadings are applied fromCommencement Date of the Policy including subsequent renewal(s) with Us.We will inform You about the applicable risk loading through a counter offer letter. You need to revert to Us with consent andadditional premium (if any), within 15 days of the issuance of such counter offer letter. In case, you neither accept the counter offernor revert to Us within 15 days, we shall cancel your application and refund the premium paid within next 7 days.Please note that We will issue Policy only after getting Your consent.c.Notification of ClaimTreatment, Consultation or Procedure:We must be informed:I.If any treatment for which a claim may be made is to betaken and that treatment requires Hospitalisation.Immediately and in any event at least 48 hours prior to theInsured Person’s admission.2.If any treatment for which a claim may be made is to betaken and that treatment requires Hospitalisation in anEmergency:Within 24 hours of the Insured Person’s admission toHospital.3.For all benefits which are contingent on Our prioracceptance of a claim under Section 1)a):Within 7 days of the Insured Person’s discharge posthospitalisation.4.If any treatment, consultation or procedure for which aclaim may be made is required in an Emergency:Within 7 days of completion of such treatment,consultation or procedure.5.In all other cases:Of any event or occurrence that may give rise to a claimunder this Policy at least 7 days prior to any consequenttreatment, consultation or procedure and We or OurTPA must pre-authorise such treatment, consultation orprocedure.Note: In the case of a covered Hospitalisation, the costs of which were not initially estimated to exceed the Deductible but weresubsequently found likely to exceed the Deductible, the intimation should be submitted along with a copy of intimation made tothe other insurer /Reimbursement Provider immediately on knowing that the Deductible is likely to be exceeded.Cashless Service:I.Treatment,Consultation orProcedure:Treatment, Consultationor Procedure Taken at:Cashless Service isAvailable:We must be given notice that theInsured Person wishes to takeadvantage of the cashless serviceaccompanied by full particulars:If any plannedtreatment,consultation orprocedure for which aclaim may be madeNetwork HospitalWe will providecashless service bymaking payment tothe extent of Ourliability directly to theNetwork Hospital.At least 48 hours before the plannedtreatment or HospitalisationHDFC ERGO General Insurance Company Limited. IRDAI Reg. No.146. CIN: U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor,HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd andERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336V0220216

2.If any treatment,consultation orprocedure for whicha claim may be madeis to be taken in anEmergency:d.Network HospitalWe will providecashless service bymaking payment tothe extent of Ourliability directly to theNetwork Hospital.Within 24 hours after the treatment orHospitalisationSupporting Documentation & ExaminationThe Insured Person or someone claiming on Your behalf shall provide Us with any documentation, medical records and informationWe or Our TPA may request to establish the circumstances of the claim, its quantum or Our liability for the claim within 15 days ofthe earlier of our request or the Insured Person’s discharge from Hospitalisation or completion of treatment. Suc

HDFC House, 165-166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. Trade Logo displayed above belongs to HDFC Ltd and ERGO International AG and used by the Company under license. UIN: Optima Plus - HDHHLIP21336022021 HDFC ERGO General Insurance Company Limited Policy Wordings Optima Plus Policy

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