HDFC ERGO General Insurance Company Limited Customer Information Sheet

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HDFC ERGO General Insurance Company LimitedCustomer Information SheetOptima RestoreDESCRIPTION IS ILLUSTRATIVE AND NOT EXHAUSTIVETITLEDESCRIPTIONREFER TO POLICYCLAUSE NUMBERa. In-patient Treatment– Covers hospitalisation expenses forperiod more than 24 hrs.b. Pre-Hospitalisation- Medical expenses incurred in 60days before the hospitalisation.c. Post-Hospitalisation- Medical expenses incurred in 180days after the hospitalisation.d. Day-Care procedures– Medical expenses for day careprocedures.e. Domiciliary Treatment- Medical expenses incurredfor availing medical treatment at home which wouldotherwise have required hospitalisation.f. Organ Donor- Medical expenses on harvesting the organfrom the donor for organ transplantation.g. Ambulance cover– Upto Rs. 2,000 per hospitalisationfor utilizing ambulance service for transporting insuredperson to hospital in case of an emergency.h. Daily Cash for choosing shared accommodation- Dailycash amount if hospitalised in shared accommodation innetwork hospital and hospitalisation exceeds 48 hrsi. E-Opinion in respect of a Critical Illness – Second opinionby a Medical Practitioner from Our panel, for a CriticalIllness suffered during the policy period.j. Emergency Air Ambulance Cover- covers, Expenses forambulance transportation in an airplane or helicopter foremergency life threatening health conditions.k. Restore Benefit- Instant addition of 100% Basic SumInsured on complete or partial utilization of Your existingPolicy Sum Insured and Multiplier Benefit (if applicable)during the Policy Year. The Restore Sum Insured can beused for all claims under Inpatient Benefit. If the RestoreSum Insured is not utilized in a Policy Year, it will expire.Section B-1.iProduct Name Optima RestoreSection B-1.iiSection B-1.iiiSection B-1.ivSection B-1.vSection B-1.viSectio B-1.viiSection B-1.viiiSection B-1.ixSection B-1.xAUG2021Section B-2CIS/Ver -1What am Icovered for: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 and ERGO International AGand used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620211

TITLEDESCRIPTIONWhat arethe majorexclusions inthe policy:Waiting Period Payout basisCost SharingRenewalConditions RenewalBenefits Following is a partial list of the policy exclusions. Pleaserefer to the policy wording for the complete list ofexclusions.War or any act of war, nuclear, chemical and biologicalweapons, radiation of any kind, breach of law withcriminal intent, intentional or attempted suicide,participation as a professional in hazardous or adventuresports, including but not limited to, para-jumping, rockclimbing, mountaineering, rafting, motor racing, horseracing or scuba diving, hand gliding, sky diving, deepsea diving, treatment for alcoholism, drug or substanceabuse or any addictive condition, treatment of obesityand any weight control program, sleep apnoea, externalcongenital illness, sterility, treatment to effect or totreat infertility, circumcisions, treatment for correctionof refractive error, plastic surgery or cosmetic surgeryunless required due to an Accident, Cancer or Burns, anynon-allopathic treatment.30 days for all illnesses (except accident) in the first yearand is not applicable in subsequent renewals24 months for specific illness and treatments in the firsttwo years and is not applicable in subsequent renewalsPre-existing Diseases will be covered after a waitingperiod 36 months.Payout on indemnity payment basis.Not ApplicablePolicy is ordinarily life-long renewable, subject toapplication for renewal and the renewal premium in fullhas been received by the due dates and realisation ofpremium.Grace period of 30 days for renewing the policy isprovided. To avoid any confusion any claim incurredduring break-in period will not be payable under thispolicy.Multiplier Benefit – 50% increase in your basic suminsured for every claim free year, subject to a maximumof 100%. In case a claim is made during a policy year,the limit under this benefit would be reduced by 50% ofthe basic sum insured in the following year. However thisreduction will not reduce the Sum Insured below the basicSum Insured of the policy.Preventive Health Check-up –we will reimburse upto thestated amount towards cost incurred in the preventivehealth check-up.Stay Active- Upto 8% discount on renewal premiumsubject to insured member achieving the average numberof steps in each time interval prescribed in the gridby either walking or running regularly to keep fit. Thediscount will be accrued by the customer at defined timeintervals and cumulated at the end of the policy periodand offered as a discount on renewal premium.REFER TO POLICYCLAUSE NUMBERSection CSection C-1.iSection C-1.iiSection C-1.iii.Section BSection D v.Section B-4Section B-3Section D-2-IIIHDFC 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 AGand used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620212

TITLECancellationHow to ClaimInsured’sRightsDESCRIPTIONThe Company may cancel the policy at any time ongrounds 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, nondisclosure of material facts or fraud.Kindly contact Us 48 hrs prior for planned hospitalisationor within 24 hours of hospitalisation in case of emergencyhospitalisation onToll Free (within India) :022-62346234 / 0120-62346234Outside IndiaToll Free No: 800 08250825Global Toll Free No: 800 08250825 (accessible fromlocations outside India only)Landline no (Chargeable) : 0120-4507250Email: healthclaims@hdfcergo.comYou must submit a duly filled claim form along withspecified documents under the policy within 30 days fromdate of discharge. Any additional information requestedmust be submitted within 15 days of Our requestFree Look: You have a period of 15 days from the dateof receipt of the Policy document to review the terms andconditions of this Policy. If You have any objections to any ofthe terms and conditions, You have the option of cancellingthe Policy stating the reasons for cancellation and Youwill be refunded the premium paid by You after adjustingthe amounts spent on any medical check-up, stamp dutycharges and proportionate risk premium.REFER TO POLICYCLAUSE NUMBERSection D-I.viSection ESection DThe policy shall ordinarily be renewable except on groundsof fraud, misrepresentation by the insured person.ClaimsFor Cashless Claims: We will check your coverage as perthe eligibility and send an authorization letter to the provider.In case there is any deficiency in the documents sent, thesame shall be communicated to the hospital within 6 hoursof receipt of documents.Insured’sObligationsFor Reimbursement Claims: On receipt of the completeset of claim documents, we will make the payment for theadmissible amount, along with a settlement statementwithin 30 days.Please disclose all pre-existing disease/s or condition/sbefore buying a policy. Non-disclosure may result in claimnot being paid.Disclosure of material facts sought to be declared on theproposal form.Section DHDFC 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 AGand used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620213

NotePre-Policy Check-up at our network may be required based upon the age and Basic Sum Insured. Wewill reimburse 100% of the expenses incurred on the acceptance of the proposal. The medical reportsare valid for a period of 90 days from the date of Pre-Policy Check-up.In order to be eligible for portability benefits you may apply 45 days in advance of the policy renewaldate.(LEGAL DISCLAIMER) NOTE: The information must be read in conjunction with the product brochureand policy document. In case of any conflict between the Key featured document and the policydocument the terms and conditions mentioned in the policy document shall prevail.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 and ERGO International AGand used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620214

HDFC ERGO General Insurance Company LimitedPremium illustration for Delhi, National Capital Region & Mumbai metropolitan regionTenure - 1 YearAgeof themembersinsured(in Years)Coverage optedon individual basis covering eachmember of thefamily separately(at a single pointin time)Coverage opted on individual basiscovering multiple members of thefamily under a single policy (SumInsured is available for each memberof the family)Coverage opted on family floater basiswith overall Sum Insured (only one SumInsured is available for the entire s.)FamilyDiscount .)Premium oronsolidatedpremiumfor allfamilymembersof the family (Rs.)FloaterDiscount 497,6405NA28,54925,69417,108Total premium forall members ofthe family is Rs.28,549 when eachmember is coveredseparately.Total premium for all members of the family is Rs.25,694 when they are coveredunder a single policy.Total premium when policy is opted onfloater basis is Rs.17,108Sum Insuredavailable for eachindividual is Rs. 5LakhsSum Insured available for each individualis Rs. 5 Lakhs.Sum Insured of Rs. 5 Lakhs is available forthe entire family.Premium as mentioned above are exclusive of taxes.Above premium examples are for Illustration purpose only, terms and conditions 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 and ERGO International AGand used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620215

HDFC ERGO General Insurance Company LimitedPolicy WordingsOPTIMA RESTORESectionSection ACONTENTSDescriptionPage No.Preamble3Definitions31Standard Definitions32Standard Definition: Critical illness73Specific Definitions10Benefits111In-patient Benefits11iIn-patient Treatment11Section vDay Care Procedures12vDomiciliary Treatment12viOrgan Donor:13viiAmbulance Cover13viiiDaily Cash14ixE-Opinion in respect of a Critical Illness14xEmergency Air Ambulance Cover152Restore Benefit163Preventive Health Check-up164Multiplier Benefit17Waiting Period & Exclusions171Standard Waiting Period172Standard Exclusions19Non-Medical Exclusions21Medical Exclusions21Specific Exclusions22Medical Exclusions23Specific Exclusions23Terms & Clauses241Standard Terms and Conditions242Specific General Conditions24Other Terms & Conditions36Contact Us36Ombudsman details36Section C3Section DSection EHDFC 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 toHDFC Ltd and ERGO International AG and used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620211

HDFC ERGO General Insurance Company Limited will coverall the Insured Persons under this Policy upto the Sum Insured.The insurance cover is governed by, and subject to, the terms,conditions and exclusions of this Policy.Section A. DefinitionsThe terms defined below and at other junctures in the PolicyWording have the meanings ascribed to them wherever theyappear in this Policy and, where appropriate, references tothe singular include references to the plural; references tothe male include the female and references to any statutoryenactment include subsequent changes to the same:1.2Standard DefinitionsDef. 1.Accident means a sudden, unforeseen andinvoluntary event caused by external, visible andviolent means.Def. 2.Any one illness means continuous Period of illnessand it includes relapse within 45 days from thedate of last consultation with the Hospital/NursingHome where treatment was been taken.Def. 3.Cashless facility means a facility extended by theinsurer to the insured where the payments, of thecosts of treatment undergone by the insured inaccordance with the policy terms and conditions,are directly made to the network provider by theinsurer to the extent pre-authorization approved.Def. 4.Condition Precedent means a policy term orcondition upon which the Insurer’s liability under thepolicy is conditional upon.Def. 5.Congenital Anomaly refers to a condition(s) whichis present since birth, and which is abnormal withreference to form, structure or position(a)Internal Congenital Anomaly - CongenitalAnomaly which is not in the visible andaccessible parts of the body(b)External Congenital Anomaly- CongenitalAnomaly which is in the visible and accessibleparts of the bodyDef. 6.Co-payment means a cost-sharing requirementunder a health insurance policy that provides thatthe policyholder/insured will bear a specifiedpercentage of the admissible claim amount. Aco-payment does not reduce the Sum Insured.Def. 7.Cumulative Bonus (Multiplier Benefit) means anyincrease in the Sum Insured granted by the insurerwithout an associated increase in premium.Def. 8.Day Care centre means any institution establishedfor day care treatment of illness and/or injuries or amedical setup within a hospital and which has beenregistered with the local authorities, whereverapplicable, and is under the supervision of aregistered and qualified medical practitioner ANDmust comply with all minimum criteria as under-has qualified nursing staff under itsemployment;-has qualified medical practitioner/s in charge;has a fully equipped operation theatre of itsown where surgical procedures are carriedout;maintains daily records of patients and willmake these accessible to the insurancecompany’s authorized personnelDef. 9.Day Care Procedures means those medicaltreatment, and/or surgical procedurei.which is undertaken under General or LocalAnaesthesia in a Hospital/day care centre inless than 24 hours because of technologicaladvancement,ii.which would have otherwise required aHospitalisation of more than 24 hours.Treatment normally taken on an Out-patientbasis is not included in the scope of thisdefinitionDef.10.Deductible means a cost-sharing requirement undera health insurance policy that provides that theinsurer will not be liable for a specified rupee amountin case of indemnity policies and for a specifiednumber of days/hours in case of hospital cashpolicies which will apply before any benefits arepayable by the insurer. A deductible does not reducethe Sum Insured.Def.11.Dental treatment means a treatment related toteeth or structures supporting teeth includingexaminations, filings (where appropriate), crowns,extractions and surgery.Def.12.Domiciliary Hospitalisation medical treatment for anillness/disease/injury which in the normal coursewould require a care and treatment at a Hospitalbut is actually taken while confined at home underany of the following circumstances: The condition of the patient is such that he/she is not in a condition to be removed to ahospital, or The patient takes treatment at home onaccount of non-availability of a room in ahospitalDef.13.Emergency Care means management for a severeillness or injury which results in symptoms whichoccur suddenly and unexpectedly, and requiresimmediate care by a medical practitioner to preventdeath or serious long term impairment of the insuredperson’s health.Def.14.Grace Period means the specified period of timeimmediately following the premium due date duringwhich a payment can be made to renew or continuea Policy in force without loss of continuity benefitsHDFC 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 toHDFC Ltd and ERGO International AG and used by the Company under license. UIN:Optima Restore - HDHHLIP21322V062021PWW/Ver - 1 AUG2021Preamble

such as waiting periods and coverage of Pre-ExistingDiseases. Coverage is not available for the periodfor which no premium is received.it requires rehabilitation for the patient or forthe patient to be specially trained to cope withitDef.15.Disclosure of information norm means the policyshall be void and all premiums paid hereon shall beforfeited to the Company, in the event ofmisrepresentation, mis-description or non-disclosureof any material fact.-it continues indefinitely-it recurs or is likely to recurDef.16.Hospital means any institution established for inpatient care and day care treatment of illnessand/or injuries and which has been registeredas a hospital with the local authorities under theClinical Establishments (Registration andRegulation) Act, 2010 or under the enactmentsspecified under the Schedule of Section 56(1) of thesaid Act OR complies with all minimum criteria asunder:Def.19.Injury means accidental physical bodily harmexcluding illness or disease solely and directlycaused by external, violent and visible and evidentmeans which is verified and certified by a MedicalPractitioner.Def.20.In-patient Care means treatment for which theInsured Person has to stay in a Hospital for morethan 24 hours for a covered event.Def.21.Intensive Care Unit means an identified section,ward or wing of a Hospital which is under theconstant supervision of a dedicated MedicalPractitioner(s), and which is specially equippedfor the continuous monitoring and treatment ofpatients who are in a critical condition, or require lifesupport facilities and where the level of care andsupervision is considerably more sophisticated andintensive than in the ordinary and other wards.Def.22.ICU (Intensive Care Unit) Charges means theamount charged by a Hospital towards ICUexpenses which shall include the coverage forbed, general medical support services provided toany ICU patient including monitoring devices, criticalcare nursing and intensive charges.Def.23.Maternity expenses means has qualified nursing staff under its employmentround the clock, has at least 10 in-patient beds, in those townshaving a population of less than 10,00,000and 15 in-patient beds in all other places has qualified Medical Practitioner(s) in chargeround the clock, has a fully equipped operation theatre of itsown where surgical procedures are carriedout, maintains daily records of patients and willmake these accessible to the insurancecompany’s authorized personnel.Def.17.Hospitalisation means admission in a Hospital fora minimum of 24 consecutive ‘In-patient Care’ hoursexcept for specified procedures / treatments,where such admission could be for a period of lessthan 24 consecutive hours.Def.18. Illness means a sickness or a disease orpathological condition leading to the impairment ofnormal physiological function and requires medicaltreatmenta)Acute Condition- Acute condition is a disease,illness or injury that is likely to respond quicklyto treatment which aims to return the personto his or her state of health immediately beforesuffering the disease/illness/injury which leadsto full recovery.b)Chronic Condition- A chronic condition isdefined as disease, illness, or injury that hasone or more of the following characteristics:it needs ongoing or long-term monitoringthrough consultations, examinations, checkups, and / or testsit needs ongoing or long-term control or reliefof symptomsi.medical treatment expenses traceable tochildbirth (including complicated deliveries andcaesarean sections during hospitalization);expenses towards lawful medical terminationii.of pregnancy during the Policy Period.Def.24.Medical Advice means any consultation or advisefrom a Medical Practitioner including the issue ofany prescription or repeat prescription.Def.25.Medical Expenses means those expenses thatan Insured Person has necessarily and actuallyincurred for medical treatment on account of illnessor Accident on the advice of a Medical Practitioner,as long as these are no more than would have beenpayable if the Insured Person had not been insuredand no more than other Hospitals or doctors inthe same locality would have charged for the samemedical treatment.Def.26.Medically Necessary Treatment means anytreatment, test, medication, or stay in Hospital orpart of stay in Hospital which Is required for the medical management of theIllness or injury suffered by the Insured ; Must not exceed the level of care necessaryto provide safe, adequate and appropriatemedical care in scope, duration or intensity.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 toHDFC Ltd and ERGO International AG and used by the Company under license. UIN: Optima Restore - HDHHLIP21322V0620213

Must have been prescribed by a MedicalPractitioner. Must conform to the professional standardswidely accepted in international medicalpractice or by the medical community in India.Def.27.Medical Practitioner means a person who holdsa valid registration from the medical council of anystate or medical council of India or council for Indianmedicine or for homeopathy set up by thegovernment of India or a state government and isthereby entitled to practice medicine within itsjurisdiction; and is acting within the scope andjurisdiction of license.Def.28.Migration means the right accorded to individualhealth insurance policyholders (including allmembers under family cover and members of grouphealth insurance policy) to transfer the credits gainedfor pre-existing conditions and time-boundexclusions, with the same insurer.Def.29.Network Provider means Hospital enlisted by aninsurer or a TPA or jointly by an insurer and a TPA toprovide medical services to an insured by a cashlessfacilityDef.30.New Born Baby means baby born during the PolicyPeriod and is aged up to 90 days.Def.31.Non Network Provider means any Hospital, day carecentre or other provider that is not part of the NetworkDef.32.Notification of Claim means the process of intimatinga claim to the insurer or TPA through any of therecognized modes of communication.Def.33.OPD treatment means the one in which the Insuredvisits a clinic / hospital or associated facility like aconsultation room for diagnosis and treatment basedon the advice of a Medical Practitioner. The Insuredis not admitted as a day care or in-patientDef.34.Def.35.Portability means the right accorded to individualhealth insurance policyholders (including allmembers under family cover) to transfer the creditsgained for pre-existing conditions and time-boundexclusions, from one insurer to another insurer.Pre-existing Disease means any condition, ailment,injury or disease:a)That is/are diagnosed by a physician within48 months prior to the effective date of thepolicy issued by the insurer or its reinstatementb)For which medical advice or treatment wasrecommended by, or received from, aphysician within 48 months prior to theeffective date of the policy issued by theinsurer or its reinstatement.Def.36.Pre- Hospitalisation Medical Expenses means themedical expenses incurred during predefinednumber of days preceding the hospitalization of theInsured Person, provided that:i.4Hospitalisation was required, andii.The In-patient Hospitalization claim for suchHospitalization is admissible by the InsuranceCompanyDef.37.Post- Hospitalisation Medical Expenses meansmedical expenses incurred during predefinednumber of days immediately after the insured personis discharged from the hospital provided that:i.Such Medical Expenses are for the samecondition for which the insured person’shospitalization was required, andii.The inpatient hospitalization claim for suchhospitalization is admissible by the insurancecompanyDef.38.Qualified Nurse is a person who holds a validregistration from the nursing council of India or thenursing council of any state in IndiaDef.39.Reasonable & Customary Charges means thecharges for services or supplies, which are thestandard charges for a specific provider andconsistent with the prevailing charges in thegeographical area for identical or similar services,taking into account the nature of illness/ injuryinvolved.Def.40.Room Rent means the amount charged by a hospitaltowards room and boarding expenses and shallinclude associated medical expenses.Def.41.Renewal means the terms on which the contract ofinsurance can be renewed on mutual consent with aprovision of grace period for treating the renewalcontinuous for the purpose of gaining credit for preexisting diseases, time bound exclusions and for allwaiting periods.Def.42.Surgery or Surgical Procedure means manual and/or operative procedure(s) required for treatmentof an Illness or injury, correction of deformities anddefects, diagnosis and cure of diseases, relief fromsuffering or prolongation of life, performed in aHospital or day care centre by a Medical Practitioner.Def.43.Unproven/Experimental treatment means treatmentincluding drug experimental therapy which is notbased on established medical practice in India, istreatment experimental or unproven.2.Standard Definition: Critical illnessDef.1.Critical Illness means Cancer of specified severity,Open Chest CABG, First Heart Attack of specifiedseverity, Kidney Failure requiring regular dialysis,Major Organ/Bone Marrow Transplant, MultipleSclerosis with Persisting Symptoms, PermanentParalysis of Limbs, Stroke resulting in PermanentSymptoms as defined below only:Such Medical Expenses are incurred for thesame condition for which the Insured Person’sHDFC 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 toHDFC Ltd and ERGO International AG and used by the Company under license. UIN:Optima Restore - HDHHLIP21322V062021

Def.2.Cancer of specified severity:A malignant tumour characterised by the uncontrolledgrowth & spread of malignant cells with invasion& destruction of normal tissues. This diagnosismust be supported by histological evidence ofmalignancy & confirmed by a pathologist.The term cancer includes leukemia, lymphoma andsarcoma.The following are excluded: Tumours showing the malignant changes ofcarcinoma in situ & tumours which arehistologically described as pre-malignant ornon-invasive, including but not limited to:Carcinoma in situ of breasts, Cervicaldysplasia CIN-1, CIN -2 & CIN-3. Any skin cancer other than invasive malignantmelanoma All tumours of the prostate unless histologicallyclassified as having a Gleason scoregreater than 6 or having progressed to at leastclinical TNM classification T2N0M0. Papillary micro - carcinoma of the thyroid lessthan 1 cm in diameter Chronic lymphocytic leukemia less than RAIstage 3Def.3. Micro carcinoma of the bladder All tumours in the presence of HIV infection.Open Chest CABG:The actual undergoing of open chest surgery forthe correction of one or more coronary arteries,which is/are narrowed or blocked, by coronary arterybypass graft (CABG). The Diagnosis must besupported by coronary angiography and realisationof the surgery has to be confirmed by a specialistMedical PractitionerThe following are excluded: Angioplasty and / or Any other intra-arterialproceduresAny Key-hole surgery or laser surgeryDef.4.First Heart Attack of Specified Severity:The first occurrence of myocardial infarction whichmeans the death of a portion of the heart muscle asa result of inadequate blood supply to the relevantarea.The diagnosis for this will be evidenced by all of thefollowing criteria: A history of typical clinical symptomsconsistent with the diagnosis of AcuteMyocardial Infarction (for e.g. typical chestpain). New characteristic electrocardiogramchanges. Elevation of infarction specific enzymes,Troponins or other specific biochemicalmarkers.The following are excluded: Non-ST-segment elevation myocardialinfarction (NSTEMI) with elevation of TroponinI or T. Other acute Coronary Syndromes. Any type of angina pectorisDef.5.Kidney Failure requiring Regular Dialysis:End stage renal disease presented as chronicirreversible failure of both kidneys to function, asa result of which either regular renal dialysis(haemodialysis or peritoneal dialysis) is institutedor renal transplantation is carried out.The diagnosis has to be confirmed by a specialistMedical PractitionerDef. 6.Major Organ/ Bone Marrow Transplant:The actual undergoing of a transplant of: One of the following human organs - heart,lung, liver, pancreas, kidney, that resulted fromirreversible end-stage failure of the relevantorgan or; Human bone marrow using hematopoieticstem cells.The undergoing of a transplant must b

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, . 3 Preventive Health Check-up 16 4 Multiplier Benefit 17 Section C Waiting Period & Exclusions 17 1 Standard Waiting Period 17 2 Standard Exclusions 19

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