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29 Jun, 2023 | Health Insurance

How Good Is The Secure Benefit Offered By HDFC Ergo Optima Secure? A Review

Team Beshak
By Team Beshak
We breathe insurance :)
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What's inside? 🧐


Health insurance is like a life jacket for your health, it helps protect you when you need it most and keeps you afloat even in the most turbulent waters. 

It is a contract between you and the insurance company where your insurer agrees to cover your medical expenses by providing you with a sum of money called the sum insured in exchange for a fee called a ‘premium’. It ensures that, no matter what happens, you will not have to bear the full brunt of healthcare costs at times of need.

And, to give you an extra layer of protection, health insurance has some amazing features -

  • No Claim Bonus 
    You receive a No Claim Bonus if you do not make any claims during the policy year. It is like a reward - given either in the form of a premium discount or by increasing your sum insured up to a maximum limit set by the insurer. It is also known as a ‘cumulative bonus’. 
  • Restoration Benefit 
    When you use your sum insured for any medical expenses in a policy year, the Restoration Benefit kicks in and replenishes your sum insured by a certain percentage - as per policy T&Cs.

Both of these options, however, will increase your sum insured only if certain conditions are met. What if we told you that there is something that doubles your sum insured as soon as you purchase the policy? It’s like a BOGO (Buy one get one free) offer - where you ‘buy’ one sum insured and get another muft, muft, muft!

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Secure Benefit Under HDFC Ergo Optima Secure

Presenting the Secure Benefit: unlike the No Claim Bonus, where your sum insured increases only if you don't file a claim, or the Restoration benefit, which kicks in only after you fully or partially use up your base sum insured and bonus (if any), within a policy year, this feature gives you a double coverage immediately. This provides you with the convenience of not having to wait or adhere to any specific criteria. It offers you coverage that is twice what you originally purchased without the need to activate it or make a claim.

Say you purchase the Optima Secure Health Insurance Plan with a sum insured of Rs 10 lakhs. In this case, your sum insured will instantly double to Rs 20 lakhs. You may use the additional amount for as many admissible claims as you like during a policy year - subject to policy T&CS.

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Conditions To Look Out For!

In quintessential Beshak style, let’s uncover if there are any conditions or fineprint associated with the Secure Benefit -

1️⃣ Applicable Only Once A Year
The Secure Benefit may only be applied once per policy year and any unused amount cannot be carried over to the next policy year. 
For example, Jayesh has a sum insured of Rs 10 lakhs under his health insurance plan. His plan has a Secure Benefit, because of which his sum insured gets doubled to Rs 20 lakhs. After a few months, he gets hospitalised for surgery that amounts to around Rs 15 lakhs. His insurer will cover the hospital bill. But, the remaining sum insured of Rs 5 lakhs will not be carried forward to the next year. 

2️⃣ Extent Of Coverage
You can use the Secure Benefit only to cover the following expenses -

👉 Hospitalisation Expenses, including - 

  • Medical expenses for a minimum of 24 hours of hospitalisation.
  • Room rent (per-day bed or room charges that you are required to pay when you get admitted to a hospital). 
  • Road ambulance expenses.
  • Inpatient care dental treatment, i.e., dental care expenses incurred due to disease or injury that necessitates hospitalisation.
  • Plastic surgery due to an injury.
  • Day Care Procedures (treatments administered under general or local anaesthesia in a hospital or a day care centre, which take less than 24 hours to complete).

👉 Home Health Care Treatments
Treatments that are undergone from the comfort of your home. 

👉Domiciliary Hospitalisation Expenses
Expenses you incur when undergoing medical treatment at home because you are unable to be moved to a hospital due to the severity of the illness or injury or because there are no beds available at the hospital. 

👉AYUSH Treatments
Treatments that don’t come under the scope of conventional Western medicine. These include Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy systems of medicine.

👉Pre-Hospitalisation Expenses
Medical expenses you incur before you get admitted to the hospital like X-rays, diagnostic tests, consultation fees, etc.

👉Post-Hospitalisation Expenses
Medical expenses you incur after you are discharged from the hospital like tests, rehabilitation, physiotherapy, etc.

👉Organ Donor Expenses
Medical expenses associated with the organ donor's hospitalisation for harvesting the donated organ - where the insured is the organ recipient.

👉Non-Medical Expenses
Costs associated with consumables such as gloves, nebulisation kits, etc.

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What’s The Catch?

Despite how unique its proposition may seem, this health insurance plan comes with some disadvantages as well - 

1️⃣ The Plan is Expensive
The plan’s premiums are higher than those offered by other insurers for twice the coverage, making it apparent that it doesn’t necessarily provide a cost benefit if you look at it from all angles. Here’s a comparative table to understand this better - 

Health Insurance PlanSum InsuredPremium
HDFC Optima SecureRs 10 LakhsRs 15,134
HDFC Optima RestoreRs 20 LakhsRs 17,400
ICICI Health AdvantEdgeRs 20 LakhsRs 14,393
Tata Medicare PremierRs 20 LakhsRs 14,059

Note: The premiums are for a 30-year-old male and were taken on 24th May 2023.

2️⃣ You May End Up With Coverage More Than You Need
It is obvious that a sum insured of Rs 5 lakhs or Rs 10 lakhs will increase to Rs 10 lakhs or Rs 20 lakhs, respectively. This means a higher cover amount, such as Rs 25 lakhs or Rs 30 lakhs, will rise to Rs 50 lakhs or Rs 60 lakhs. Insurers are aware that even if you purchase such a large cover amount, not many claims will be made for that entire sum. This is similar to a restaurant offering an all-you-can-eat buffet: on the surface, it appears to be a great deal, but in reality, most people don’t actually need to eat that much. 

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Wait Wait Wait…There’s More!

Health insurance plans, by construct, can change. Here a few other things you should be aware of before you invest in one - 

1️⃣ Premium Hikes Happen At Every Renewal
Most health insurance products on the market usually determine premiums based on specific age bands or age slabs. For example, individuals who belong to age groups 25-30, 30-35, 35-40, etc. may have different premium rates for each age slab. Suppose you are 25 years old. You will need to pay a premium amount as set for the age group 25-30. This amount will remain the same until you reach the age of 30. So, you can enjoy the same premiums for these 5 years.

However, the premiums for the health insurance plans increase with every renewal. Furthermore, the insurer can increase the premium at any time - and there’s no upper cap to it. This is especially concerning as it can leave you vulnerable to dramatic and unexpected increases in premiums with no way to anticipate or plan for them.

2️⃣ Features Can Be Withdrawn Anytime
Imagine you’ve chosen a low sum insured, say 10 lakhs, hoping to get 20 lakhs. Sounds like a decent sum. Right? 

Wrong! What if we said you've taken a huge risk?

Opting for a low sum insured is like walking across a frozen lake: it may appear to be a safe bet but in reality, it carries a huge risk of disaster. 


According to IRDAI regulations, insurers can withdraw a product or its features at any time. This can be done per their internal product policies and approvals from internal product committees, just by notifying the regulator (IRDAI). Their only obligation is to prove they are experiencing losses based on current terms and pricing. Sometimes, you can even be moved to another product that doesn't have this feature.

You may also feel the need to upgrade your cover, having chosen a lower sum insured. However, as you age and develop lifestyle diseases or medical conditions, upgrading your insurance may become more challenging, as mentioned in the beginning. It is possible that the insurance company may reject your application or charge you a higher premium if you request an upgrade. You may also have to serve additional waiting periods from the year of the upgrade. 

You should, therefore, be prepared for the possibility of your benefits or features becoming obsolete in the future. Emphasising this, it is important to always stay informed of industry trends.

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So, What Should You Do?

Don't get swayed by a plan simply because of its attractive features or benefits - view them as extra rewards. 

Say you are looking to buy a car, you may be tempted to buy the one with all the flashy features like a fancy stereo set, plush interiors, etc. But, you need to pay close attention to the engine and core components under the hood to make sure it’s reliable and will last for a long time. 

Likewise, only your core coverage will remain a constant companion for the duration of your plan. So -

  • Opt for an optimal sum insured at the time of policy purchase that can provide you with adequate coverage and keep up with ever-increasing medical costs throughout your lifetime. 
  • Ensure that there are minimal or no financial limits on room rent, specific treatments, organ donations, modern treatments, etc.

Not to mention the fact that HDFC Ergo Optima Secure’s premiums are quite higher than the premiums charged by other insurance companies for 2x the cover amount. So, you don’t necessarily get a cost benefit as well. 

In all, focus on the core coverage of whichever health insurance plan you buy and ensure that it gives you the best value for your money. 

Having a hard time understanding health insurance plans? Want them simplified? Introducing - Beshak Health Decoder - a one-stop destination to understand the ins and outs of different health insurance plans!  

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Key takeaways
  1. Although the Secure Benefit under HDFC Ergo Optima Secure health insurance enhances your protection by doubling your sum insured right from the time you purchase the policy, but at the same time the plan’s premium is higher than other products with twice the coverage! So in effect, it turns out to be just a marketing ploy.
  2. The premium increases with every renewal with no particular limit.
  3. Insurers may withdraw the feature/product or move you to another plan without this feature. 
  4. And, if you have a low sum insured, upgrading may prove to be difficult – the insurer may either reject or impose higher premiums. You may also have to serve additional waiting periods.
  5. Treat such features as mere extras. Choose an adequate sum insured at the time of policy purchase to ensure complete and continuous coverage.
Team Beshak
Written by,
Team Beshak, We breathe insurance :)

We are a group of young members of the Beshak community. We come together to brainstorm, write relevant and useful content for people (just like us) who want to figure insurance on their own. If you too want to share inputs/write for us - send us a "hey" to

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Rs. 1799


09 Aug, 2023
by: Gagan

Thanks for this article. Was not aware of this much premium difference!! Can you pls answer queries from @Barshan below, I too have few of them!

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22 Aug, 2023
by: Aayush Dubey

Hi Gagan! Queries have been answered below. Thanks!

23 Jul, 2023
by: Barshan Ghosal

Great article, thanks! A few questions : 1) Any idea on what is the usual premium hike YoY, and what all factors does it depend on if any? 2) The example of SI 10 lakhs but claim 15 lakhs being settled you gave, is it actually true? Because in the policy wording there is clear mention of the sequence in which the claim amount will be disbursed. And there, secure benefit (2X) comes at the last. First is SI, then bonus and then 2X. So if I am taking 10 lakhs SI and my claim in the first year itself comes to be of 15 lakhs, how will that 5 lakhs be paid (as I won't have any bonus this year) ? 3) It has no mention of modern treatments and robotic surgeries, so does it mean it won't cover them? 4) It says consumables are covered but again there is an entire list of under Annexure B detailing what all are not covered. Its confusing. What all will be finally covered in non-medical ground and what all will be not? 5) If I am opting for deductible, can that amount be used to pay for the non-medical (consumable items) bill that the hospital would have? Or will I have to pay both separately? Would be extremely helpful if someone can enlighten on these 5 questions. Thank you very much in advance.

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22 Aug, 2023
by: Aayush Dubey

Hello Barshan! Completely missed replying over here, sincere apologies! Answers are as follows. 1) Generally, the premium hike can be anywhere from 3-5% to 10-15%. It depends on the age band of the customer and is completely on insurers discretion. Means can be changed by the insurer anytime they want. Most insurers does not make the renewal premium rates public. 2) Th.e sequence of SI utilization for claim settlement is applicable only after the bonus comes to the picture. You cover amount will be doubled as soon as you policy gets issued. Meaning that if you get a SI of 10 Lakhs, you will be eligible for 20 Lakhs of claim from Day1. 3) Modern Treatments are covered in this policy without any sub-limits. 4) The consumables highlighted in their Annexure B will be covered under their Protect benefit without any sub-limits. 5) My comment on the previous point answers this question. Hope this helps! Thanks!

20 Aug, 2023
by: Barshan Ghosal

Thanks @Gagan, for answering these. Hoping to get response from Beshak team also

09 Aug, 2023
by: Gagan

Good questions, hope one of the experts answer these. I will answer a few basis my reading of Optima Secure prospectus. 2) The order of usage is SI, Bonus, Secure Benefit etc. But if Bonus is Zero, then Secure will be used. 3) As per IRDA 2019 rule, all Health Insurance Policies need to cover Modern Treatment. So even if not mentioned, it is included 4) Annexure B Non-Medical expenses are indeed covered via Protect Benefit of this plan 5) For deductible, it is not mentioned anywhere that non-medical expenses are excluded. But on safer side, any amount as eligible for reimbursement via this policy Policy should be considered for deductible

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