HDFC Life Sanchay Legacy Brochure

Sanchay Legacy
A Non-Participating, Non-linked, Pure Risk Premium/Savings Individual Life Insurance Plan
Now available with new & improved additional features
Get Early RoP3 benefit & higher

accumulation rate for death benefit!
Protect your family’s future

and leave a lasting legacy!
Increasing Life cover with no Acceleration Early RoP3

death benefit medicals/ underwriting1 of death benefit2 benefit
1. savings underwriting guidelines will apply.

2. Lumpsum benefit payout on detection of critical illness.
3. RoP refers to Return of Premiums
Your prime years are spent working so that you and your family are able to live life comfortably. But once the primary
level needs are covered, it is time for you to consider leaving behind your legacy so that your loved ones do not have to
compromise, even after your demise. Securing your family’s financial future, is a very important, if not the most
imperative part of your legacy.
HDFC Life is proud to present HDFC Life Sanchay Legacy, a comprehensive plan that helps you create a legacy for your
family with an increasing death cover throughout the policy term. This plan offers you a cover for whole life and a
flexibility to accelerate your Death benefit against specified Critical Illnesses ; hence ensuring a 360 degree cover on
KEY FEATURES OF HDFC LIFE SANCHAY LEGACY

 Whole Life plan to leave a legacy for your family
 2 Plan Options to choose from as per your needs
a. Life Option – Pure term with a whole of life cover
b. RoP Option – Early RoP benefit at Age 85 or in instalments
 Acceleration of 100% Death benefit on diagnosis of 19 Critical Illness covered
 Waiver of Premium on diagnosis of Critical Illness (through WOP on CI option)
 Waiver of Premium on Total and Permanent Disability (through WOP on TPD option)
 Option to receive Death Benefit in Instalments
 Option to decrease your premiums after 5 years
 Enhanced Protection through Riders
How does this plan protect you
You can ensure financial protection for your family by selecting one of the below plan options:
Plan Option Benefits
Life Option Death Benefit / Accelerated Death Benefit on Critical Illness
RoP Option Death Benefit / Accelerated Death Benefit on Critical Illness / RoP on survival till
the end of each Milestone Year
ELIGIBILITY CRITERIA
Parameters Minimum Maximum

Single Pay: 65 years
Age at Entry 5 & 6 years: 60 years
40 years
(years) 7 to 10 years: 65 years
11 to 15 years: 75 years less PPT
ELIGIBILITY CRITERIA
Parameters Minimum Maximum

Age at Maturity (years) Whole of Life
Single Pay (1.25x DBM)

Premium Paying Term (PPT) 5 years to 15 years (7x DBM)
8 years to 15 years (10x DBM)
Policy Term Whole Life
Single Pay (1.25x DBM) :

1,00,000
Limited Pay:
10x DBM: Consistent with Maximum Sum
Annual: 1,00,000 Assured on Death
Half-yearly: 51,000
Instalment Premium Quarterly: 26,000
Monthly: 8,750
7x DBM:
Annual: 30,000
Half-yearly: 15,300
Quarterly: 7,800
Monthly: 2,625
Single Pay: 1.25 times the Single Pay: 1.25 times the Single Premium
Sum Assured Single Premium
on Death Limited Pay: 7 times the Limited Pay: 10 times the Annualised
Annualised Premium* Premium* subject to the Board Approved
Underwriting Policy (BAUP
All ages are expressed as on last birthday. For all ages, risk commences from the date of inception of the contract.
DBM refers to Death Benefit Multiple. Premium will vary depending on the plan option chosen.
*Annualised Premium means the premium amount payable in a year chosen by the policyholder, excluding the taxes, rider premiums,
underwriting extra premiums and loadings for modal premiums, if any.
For non-annual modes, premiums paid are calculated as: annual premium multiplied by a conversion factor as given below:
Frequency Conversion Factor
Half-yearly 0.5100
Quarterly 0.2600
Monthly 0.0875
The product can also be purchased online via company website.

PLAN OPTIONS
Following options are available under the plan:

1. Life Option – Under this option, the life assured is covered for death benefit for whole of life. The Death
benefit shall be accelerated in case of diagnosis of the covered Critical Illness as mentioned under below.
2. RoP Option – Under this option, the life assured is covered for death benefit for whole of life. The
Death Benefit shall be accelerated in case of diagnosis of the covered Critical Illness as mentioned below.
Further the life assured shall receive Survival Benefit on survival till the end of Milestone Year
The policyholder can choose any one of the above options, 1 & 2 at the outset.
BENEFITS PAYABLE UNDER THE PLAN
1. Death Benefit
A lump sum death benefit is payable immediately upon death of the Life Assured during the policy term. This Death
benefit shall be the highest of:
• Sum Assured on Death or;

• Accumulated Premium Value or;
• 105% of Total Premiums Paid or;
• Surrender Value on date of death.
Where,
Total Premiums Paid means total of all the premiums received, excluding any extra premium, any rider premium and
taxes.
Sum Assured on Death means an absolute amount of benefit which is guaranteed to become payable on death of
the life assured in accordance with the terms and conditions of the policy.
Accumulated Premium Value shall be equal to the value of all Base Premiums paid, as on date of death accumulated
at a rate that depends upon the age, plan option chosen/ benefits opted, premium payment term, premium & policy
year, less the accumulated value of all survival benefits received.
Base Premium means total of all the premiums received, excluding any extra premium, any rider premium, taxes,
loadings for modal premiums and premiums paid for additional benefits mentioned below, if any.
2. Maturity Benefit
There is no maturity benefit under this product .
3. Survival Benefit
a) Life Option: There is no Survival benefit under this option.
b) RoP Option: Survival Benefit is payable on survival of the Life Assured till the end of Milestone Year,
provided all premiums which have fallen due have been paid and provided the policy is not terminated earlier.
There are two early ROP benefit options available. The early ROP option needs to be selected at policy inception and
cannot be changed during the policy tenure.
Option 1 – RoP at Age 85
An amount equal to 100% of Total Survival Benefit** is payable at the end of the Milestone Year.
Where, Milestone Year = 85 – Age at Entry
Option 2 – RoP in Instalments
25% of the Total Survival Benefit** shall be payable on survival till the end of each of the following Milestone Years:
• End of 15th Policy Year
• End of 20th Policy Year or ‘n’, whichever is earlier
Where, n = 85 – Age at Entry
**Total Survival Benefit = Base Premium x Premium Paying Term
4. Acceleration of Death Benefit
100% of Death Benefit shall be paid on being diagnosed on first occurrence of any of the 19 Critical Illnesses
covered. This benefit is available only after the end of 10th policy year or PPT, whichever is later.
Please refer Annexures for the definitions and exclusions of the 19 Critical Illnesses covered.
Upon the payment of death benefit, acceleration of death benefit or maturity benefit as above and surrender
benefit as explained below, the policy and the cover shall terminate and no further benefits shall be payable.
Please note that Acceleration of Death Benefit is not an additional benefit; it only facilitates an earlier payout
of Death Benefit on diagnosis of Critical Illness covered.
ADDITIONAL BENEFITS AVAILABLE UNDER THE PLAN:
1. Waiver of Premium on CI (WOP on CIP) Option

If this additional option is selected, all future premiums payable under the plan will be waived, if the life assured is
diagnosed with any of the 60 Critical Illnesses covered and the life cover, accidental death cover (if applicable) and
terminal illness cover (if applicable) continues.
This option can be chosen only at policy inception and will be available only where premium payment term is other
than Single Pay. Once chosen, the policyholder doesn’t have the option to opt out of this benefit.
To avail this option, additional premium shall be payable.
Please refer Annexures for the definitions and exclusions of the 60 Critical Illnesses covered.
2. Waiver of Premium on Total and Permanent Disability (WOP on TPD) Option
If this additional option is selected, all future premiums payable under the plan will be waived, in case of occurrence of
total and permanent disability and the life cover, accidental death cover (if applicable) and terminal illness cover (if
applicable) continues.
This option can be chosen only at policy inception and will be available only where premium payment term is other
than Single Pay. Once chosen, the policyholder doesn’t have the option to opt out of this benefit.
To avail this option, additional premium shall be payable.
Please refer Annexures for the definitions and exclusions of Total and Permanent Disability.
3. Death benefit as Instalment Option
If this option is selected, the nominee will receive full or part of the death benefit in instalments. The conditions for
choosing this option:
•This option can be chosen by the policyholder at policy inception or by the nominee at the time of claim.
•This option can be opted for full or part of death claim proceeds payable under the policy.
•The instalment can be taken over a chosen period of 5 to 15 years
The instalment shall be paid in advance based on the frequency chosen by the nominee or the policyholder, which can
be either yearly, half-yearly, quarterly or monthly. The instalment amount shall be calculated such that the present
value of the instalments, using a given interest rate, shall equal the amount of death benefit chosen to be taken as
instalments under the policy. This amount shall be a level amount and once chosen by the nominee shall remain fixed
over the instalment period.
The interest rate used to compute the instalment amount shall be equal to the annualized yield on 10 year G-Sec (over
last 6 months & rounded down to nearest 25bps) less 25 basis points. The interest rate shall be reviewed half-yearly
and any change in the interest rate shall be effective from 25th February and 25th August each year. The interest rate
shall be revised every time there is a change, as per the above formula. In case of a revision in interest rate, the same
shall apply until next revision. The source of 10-year benchmark G-sec yield shall be RBI Negotiated Dealing
System-Order Matching segment (NDS-OM).
At any time during the instalment payment phase, the nominee can choose to terminate the instalment payment in
exchange for a lump-sum, in which case, the lump-sum payable shall be equal to the discounted value of all the future
instalments due. The interest rate used to calculate the discounted value will be that as applicable on date of
termination, using the above mentioned formula.
No additional premium is payable for this option.
4. Option to alter premium frequency
The policyholder has the option to alter the premium frequency during the premium payment term.
5. Option to decrease your premiums
After payment of premiums for first five completed policy years, you can decrease the premium up to 50% of the
original Annualized Premium, subject to the minimum premium limits under the product. If this option is chosen, Sum
Assured on Death under the policy will be reduced as per the below formula:
Revised Sum Assured on Death = Original Sum Assured on Death × Revised total premiums payable ÷ Original total
premiums payable
Once decreased, the premium cannot be subsequently increased.
SAMPLE ILLUSTRATIONS
1. Mr. Bansal, a 45 year old businessman wants to leave a legacy for his son. He buys HDFC Life Sanchay Legacy - Life
Option providing coverage for whole of his life. He also opts for WOP on Critical Illness (CI). He starts paying a premium
of Rs. 10,00,000 (excluding taxes) annually which is inclusive of the additional premium paid against WOP on CI for
10 years. The Death Benefit Multiple chosen at policy inception is 7x.
Mr. Bansal pays an annual premium of ` 10,00,000 p.a. for 10 years and
his premium starts accumulating from 1st premium onwards.
On death at age 85, a

lump sum of ` 9.20 Cr is paid to
the nominee and
policy terminates.
All future premiums

waived off Age
85
Age 45
Policy year 0 1 2 3 4 5 6 7 8 9 10 11 12.............25...............................40
Acceleration of death benefit starts after

Diagnosed with Permanent
the end of PPT i.e. 10 years
Paralysis of Limbs &
claims for WOP benefit on CI
Policy Term (Whole Life)
2. Mr. Kumar, a 55 year old salaried man approaching retirement, buys HDFC Life Sanchay Legacy – RoP Option with RoP
at Age 85 and providing coverage for whole of his life. He starts paying a premium of INR Rs. 10,00,000 (excluding
taxes) annually for 10 years. The Death Benefit Multiple chosen at policy inception is 7x.
Mr. Kumar pays an annual premium of ` 10,00,000 p.a. for 10 years and
his premium starts accumulating from 1st premium onwards
Mr. Kumar gets back On death at age 95, a

his premiums of lump sum of ` 6.44 Cr
` 1 Cr at the age of is paid to thenominee
85 and the policy and policy terminates
continues
Age Age
85 95
Age 55
Policy year 0 1 2 3 4 5 6 7 8 9 10 11 12.............25.............30...............40

Policy Term (Whole life)
3. Mr. Goel, a 40 year old businessman wants to leave a legacy for his daughter. He buys HDFC Life Sanchay Legacy – RoP
Option with RoP in Instalments and providing coverage for whole of his life. He starts paying a premium of INR Rs.
10,00,000 (excluding taxes) annually for 10 years. The Death Benefit Multiple chosen at policy inception is 7x.
Mr. Goel pays an annual premium of ` 10,00,000 p.a. for 10 years and On death at age 95,
his premium starts accumulating from 1st premium onwards a lump sum of
` 8.14 Cr is paid to
the nominee and
policy terminates.
1st 2nd 3rd 4th

instalment instalment instalment instalment
` 25 lakhs ` 25 lakhs ` 25 lakhs ` 25 lakhs
Age
Age Age Age Age 95
55 60 65 70
Age 40
Policy year 0 1 2 3 4 5 6 7 8 9 10 11 ..15.........20...........25............30........55

Policy Term (Whole life)

Non Payment of Premiums
Grace Period is the time provided after the premium due date during which the policy is considered to be in-force with
the risk cover. This plan has a grace period of 30 days for yearly, half yearly and quarterly frequencies from the premium
due date. The grace period for monthly frequency is 15 days from the premium due date.
Should a valid claim arise under the policy during the grace period, but before the payment of due premium, we shall
still honor the claim. In such cases, the due and unpaid premium for the policy year will be deducted from any benefit
payable.
Lapse & Paid-Up
A policy that has acquired a surrender value shall not lapse by the reason of non-payment of further premium but shall
be kept in-force to the extent of the Reduced Paid-up Benefit. In all other cases, the policy lapses on premium
discontinuance without any paid-up value.
Sum Assured on Death and Surivival Benefit for a paid-up policy shall be calculated as follows:
Paid-up value = In-force value × Number of premiums paid ÷ Total Number of premiums payable
Surrender Value
Surrender Value gets acquired immediately upon payment of premium in case of a Single Pay policy and upon payment
of premiums for at least 2 years in case of a Limited Pay policy. The surrender benefits are payable immediately on
surrender. Surrender Value will be calculated as follows:
Where Life Option has been selected
Surrender Value = 75% × Accumulated Premium Value^ ÷ (100 − Age at Entry) x Max (100 – Age at Surrender,0)
Where RoP Option has been selected
Surrender Value will be the higher of Guaranteed Surrender Value (GSV) and Special Surrender Value (SSV), payable
subject to the policy acquiring Surrender Value. Surrender Value gets acquired immediately upon payment of premium
in case of SP and upon payment of premiums for 2 years in case of LP. Where,
GSV shall be calculated as follows:
GSV = Max(GSV Factor × Total premiums paid - any survival benefits applicable till date, 0)
^
Accumulated till date of surrender
Where GSV factors are:
Policy Year GSV Factor
Single Pay Other than Single Pay
1 0%
2 75% 30%
3 35%
4 to 7 50%
8 to (97 less Age at Entry) 90% 50% + 40% × (Policy Year − 7) ÷ (91 − Age at Entry)
(98 less Age at Entry) onwards 90%

SSV shall be calculated as the discounted value of all outstanding survival benefits, calculated using prevailing
Discounting Rate.
Where, Discounting Rate shall be based on prevailing interest rates, derived from yields of the 30 years G-Sec security.
Any change in the interest rate used will be in accordance with the formula below:
Annualized Yield on reference government bond + k, rounded up to the nearest 25 basis points.
Where k = 150 basis points
The Discounting Rate will be reviewed semi-annually and shall be revised using the above mentioned formula and the
any change shall be effective from 25th February and 25th August each year.
Revival
If your Policy has been paid-up or lapsed, it would be revived subject to the terms and conditions specified from time to
time. Currently, the application for the revival should be made within five years from the due date of the first unpaid
Premium and before the expiry of the Policy Term, whichever is earlier. The revival will be subject to satisfactory
evidence of continued insurability of the Life Assured and payment of outstanding Premiums with interest. The current
rate of interest for revival is 9.5% p.a. Any change in the revival interest rates will be in accordance with the following
formula at the time of review:
Average Annualized 10-year benchmark G-Sec Yield (over last 6 months& rounded upto the nearest 50 bps) + 2%
The source of 10-year benchmark G-sec yield shall be RBI Negotiated Dealing System-Order Matching segment
(NDS-OM).
During revival campaigns, the Company may offer reduced interest rates, subject to the rules of the special revival
campaign. The rebates offered during the revival campaign may vary from year to year. The maximum interest rate
rebate may be set up to the prevailing revival interest rate. Once the Policy is revived, you are entitled to receive all
contractual Benefits.
Riders
We offer the following Rider options (as modified from time to time) to help you enhance your protection:
Rider UIN Scope of Benefits**
HDFC Life Income Benefit on A benefit equal to 1% of Rider Sum Assured per month for the next
101B013V03 10 years, in case of an Accidental Total Permanent Disability. There
Accidental Disability Rider
is no maturity benefit available under this rider.
A lump sum benefit equal to the Rider Sum Assured shall be payable
HDFC Life Critical Illness in case you are diagnosed with any of the 19 Critical Illnesses and
101B014V02
Plus Rider survive for a period of 30 days following the diagnosis. There is no
maturity benefit available under this rider.
A benefit as a proportion of the Rider Sum Assured shall be payable

HDFC Life Protect Plus in case on accidental death or partial/total disability due to accident
101B016V01
Rider or if you are diagnosed with cancer as per the option chosen under
this rider. No maturity benefit is payable under this rider.
A lump sum benefit equivalent to Rider Sum Assured shall be payable

on diagnosis of any of the covered 60 Critical Illnesses or benefit as a
HDFC Life Health Plus proportionate of the Rider Sum Assured shall be payable on
101B031V01
Rider diagnosis of Early Stage Cancer / Major Cancer depending on the
option chosen. No maturity benefit is payable under this rider.
**For all details on Riders, kindly refer to the Rider Brochures available on our website.
While attaching riders to the base option(s) under the product, there should be no overlap in benefits offered under different riders & base product. In
case of an overlap, the rider(s) shall not be attached.
TERMS & CONDITIONS

We recommend that you read and understand this product brochure & customized benefit illustration and
understand what the plan is, how it works and the risks involved before you purchase.
A) Risk Factors:
(1) HDFC Life Insurance Company Limited is the name of our Insurance Company and “HDFC Life Click 2 Protect Super”
is the name of this plan. The name of our company and the name of our plan do not, in any way, indicate the quality
of the plan, its future prospects or returns.
(2) Please know the associated risks and the applicable charges, from your Insurance agent or the Intermediary or
policy document issued by insurance company.
B) Suicide Exclusion
In case of death due to suicide within 12 months from the date of commencement of risk under the policy or from
the date of revival of the policy, as applicable, the nominee or beneficiary of the policyholder shall be entitled to at
least 80% of the total premiums paid till the date of death or the surrender value available as on the date of death
whichever is higher, provided the policy is in force.
C) Tax Benefits
Tax benefits under this plan may be available. Premiums paid under this plan and the benefits received
from this policy may be eligible for tax benefits as per the applicable sections of the Income Tax
Act, 1961, as amended from time to time.
You are requested to consult your tax advisor for advice on Tax Benefits.
D) Cancellation in the Free-Look period
In case the policyholder is not agreeable to any policy terms and conditions under this product, the policyholder
shall have the option of returning the policy to us stating the reasons thereof, within 15 days from the date of
receipt of the policy, as per IRDAI (Protection of Policyholders’ Interests) Regulations, 2017, as modified from time
to time. If the policyholder has purchased the policy through the Distance Marketing mode, this period will be 30
days. On receipt of the letter along with the original policy document, we shall refund the premium, subject to
deduction of the proportionate risk premium for the period on cover, expenses incurred on medical examination of
the proposer and stamp duty (if any).
Distance Marketing refers to insurance policies sold through any mode apart from face-to-face interactions such as
telephone, internet etc (Please refer to “Guidelines on Distance Marketing of Insurance Product” for exhaustive
definition of Distance Marketing)
E) An underwriting extra premium may be charged in case of Sub-standard lives and Smokers as per our prevalent
Underwriting policy.
F) Policy Loan
Policy loans is not available under this plan.
G) Enhanced Benefit for High Premium Policies
We also offer additional rate of accumulation for the policies with Annualised / Single Premium more than 5 lacs.
Annualised/Single
Single Pay Limited Pay
Premium (Rs.)
30k to < 5 lac 0.00% 0.00%
5 lac to < 25 lac 0.50% 0.10%
25 lac+ 0.60% 0.15%
H) Nomination as per Section 39 of the Insurance Act 1938 as amended from time to time:
(1) The policyholder of a life insurance on his own life may nominate a person or persons to whom money secured by
the policy shall be paid in the event of his death.
(2) Where the nominee is a minor, the policyholder may appoint any person to receive the money secured by the policy
in the event of policyholder’s death during the minority of the nominee. The manner of appointment to be laid
down by the insurer.
(3) Nomination can be made at any time before the maturity of the policy.
(4) Nomination may be incorporated in the text of the policy itself or may be endorsed on the policy communicated to
the insurer and can be registered by the insurer in the records relating to the policy.
(5) Nomination can be cancelled or changed at any time before policy matures, by an endorsement or a further
endorsement or a will as the case may be.
(6) A notice in writing of Change or Cancellation of nomination must be delivered to the insurer for the insurer to be
liable to such nominee. Otherwise, insurer will not be liable if a bonafide payment is made to the person named in
the text of the policy or in the registered records of the insurer.
(7) Fee to be paid to the insurer for registering change or cancellation of a nomination can be specified by the
Authority through Regulations.
(8) A transfer or assignment made in accordance with Section 38 shall automatically cancel the nomination except in
case of assignment to the insurer or other transferee or assignee for purpose of loan or against security or its
reassignment after repayment. In such case, the nomination will not get cancelled to the extent of insurer’s or
transferee’s or assignee’s interest in the policy. The nomination will get revived on repayment of the loan.
(9) The provisions of Section 39 are not applicable to any life insurance policy to which Section 6 of Married Women’s
Property Act, 1874 applies or has at any time applied except where before or after Insurance Laws (Amendment)
Act 2015, a nomination is made in favour of spouse or children or spouse and children whether or not on the face of
the policy it is mentioned that it is made under Section 39. Where nomination is intended to be made to spouse or
children or spouse and children under Section 6 of MWP Act, it should be specifically mentioned on the policy. In
such a case only, the provisions of Section 39 will not apply.
I) Assignment as per Section 38 of the Insurance Act 1938 as amended from time to time:
(1) This policy may be transferred/assigned, wholly or in part, with or without consideration.
(2) An Assignment may be effected in a policy by an endorsement upon the policy itself or by a separate instrument
under notice to the Insurer.
(3) The instrument of assignment should indicate the fact of transfer or assignment and the reasons for the
assignment or transfer, antecedents of the assignee and terms on which assignment is made.
(4) The assignment must be signed by the transferor or assignor or duly authorized agent and attested by at least one
witness.
(5) The transfer or assignment shall not be operative as against an Insurer until a notice in writing of the transfer or
assignment and either the said endorsement or instrument itself or copy there of certified to be correct by both
transferor and transferee or their duly authorized agents have been delivered to the Insurer.
(6) Fee to be paid for assignment or transfer can be specified by the Authority through Regulations.
(7) On receipt of notice with fee, the Insurer should Grant a written acknowledgement of receipt of notice. Such notice
shall be conclusive evidence against the insurer of duly receiving the notice.
(8) The Insurer may accept or decline to act upon any transfer or assignment or endorsement, if it has sufficient
reasons to believe that it is (a) not bonafide or (b) not in the interest of the policyholder or (c) not in public interest
or (d) is for the purpose of trading of the insurance policy.
(9) In case of refusal to act upon the endorsement by the Insurer, any person aggrieved by the refusal may prefer a
claim to IRDAI within 30 days of receipt of the refusal letter from the Insurer.
Section G (Nomination) and H (Assignment or Transfer) are simplified versions prepared for general information only
and hence are not comprehensive. For full texts of these sections please refer to Section 38 and Section 39 of the
Insurance Act, 1938 as amended by The Insurance Laws (Amendment) Act, 2015.
J) Prohibition of Rebates: In accordance with Section 41 of the Insurance Act, 1938 as amended from
time to time:
(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or
renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the
whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person
taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in
accordance with the published prospectuses or tables of the insurer.
(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may
extend to ten lakh rupees.
K) Non-Disclosure: In accordance with Section 45 of the Insurance Act, 1938 as amended from time
to time:
(1) No policy of life insurance shall be called in question on any ground whatsoever after the expiry of three years from
the date of the policy, i.e., from the date of issuance of the policy or the date of commencement of risk or the date
of revival of the policy or the date of the rider to the policy, whichever is later.
(2) A policy of life insurance may be called in question at any time within three years from the date of issuance of the
policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to the policy,
whichever is later, on the ground of fraud: Provided that the insurer shall have to communicate in writing to the
insured or the legal representatives or nominees or assignees of the insured the grounds and materials on which
such decision is based.
(3) Notwithstanding anything contained in sub-section (2), no insurer shall repudiate a life insurance policy on the
ground of fraud if the insured can prove that the mis-statement of or suppression of a material fact was true to the
best of his knowledge and belief or that there was no deliberate intention to suppress the fact or that such
mis-statement of or suppression of a material fact are within the knowledge of the insurer: Provided that in case of
fraud, the onus of disproving lies upon the beneficiaries, in case the policyholder is not alive.
(4) A policy of life insurance may be called in question at any time within three years from the date of issuance of the
policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to the policy,
whichever is later, on the ground that any statement of or suppression of a fact material to the expectancy of the
life of the insured was incorrectly made in the proposal or other document on the basis of which the policy was
issued or revived or rider issued: Provided that the insurer shall have to communicate in writing to the insured or
the legal representatives or nominees or assignees of the insured the grounds and materials on which such
decision to repudiate the policy of life insurance is based: Provided further that in case of repudiation of the policy
on the ground of misstatement or suppression of a material fact, and not on the ground of fraud, the premiums
collected on the policy till the date of repudiation shall be paid to the insured or the legal representatives or
nominees or assignees of the insured within a period of ninety days from the date of such repudiation.
(5) Nothing in this section shall prevent the insurer from calling for proof of age at any time if he is entitled to do so,
and no policy shall be deemed to be called in question merely because the terms of the policy are adjusted on
subsequent proof that the age of the Life Insured was incorrectly stated in the proposal.
L) In case of fraud or misstatement including non-disclosure of any material facts, the Policy shall be cancelled
immediately and the Surrender Value shall be payable, subject to the fraud or misstatement being established in
accordance with Section 45 of the Insurance Act, 1938, as amended from time to time.
M) Taxes:
Indirect Taxes
Taxes and levies as applicable shall be levied as applicable. Any taxes, statutory levy becoming applicable in future
may become payable by you by any method including by levy of an additional monetary amount in addition to
premium and or charges.
Direct Taxes
Tax will be deducted at the applicable rate from the payments made under the policy, as per the provisions of the
Income Tax Act, 1961, as amended from time to time.
N) A policyholder can now have his life insurance policies in dematerialized form through a password protected online
account called an electronic Insurance Account (eIA). This eIA can hold insurance policies issued from any insurer in
dematerialized form, thereby facilitating the policy holder to access his policies on a common online platform.
Facilities such as online premium payment, changes in address are available through the eIA. Furthermore, you
would not be required to provide any KYC documents for any future policy purchase with any insurer. For more
information on eIA visit http://www.hdfclife.com/customer-service/life-insurance-policy-dematerialization.
Annexures
Definitions and Exclusions of 19 CIs covered under Acceleration of Death Benefit, 60 CIs covered under WOP on
CI and WOP on TPD
1. Acceleration of Death Benefit

1.1 Critical Illnesses Covered
1.1.1 Aorta Graft Surgery
The actual undergoing of surgery (including key-hole type) for a disease or injury of the aorta needing
excision and surgical replacement of the diseased part of the aorta with a graft.
The term “aorta” means the thoracic and abdominal aorta but not its branches. Stent-grafting is not covered.
1.1.2 Apallic Syndrome
Apallic Syndrome or Persistent vegetative state (PVS) or unresponsive wakefulness syndrome (UWS) is a
Universal necrosis of the brain cortex with the brainstem remaining intact. The diagnosis must be confirmed
by a Neurologist acceptable to us and the patient should be documented to be in a vegetative state for a
minimum of at least one month in order to be classified as UWS, PVS, Apallic Syndrome.
1.1.3 Loss of Independent Existence
The Insured person is physically incapable of performing at least three (3) of the six (6) “Activities of Daily
Living” (either with or without the use of mechanical equipment, special devices or other aids or adaptations
in use for disabled persons) for a continuous period of at least six (6) months, signifying a permanent and
irreversible inability to perform the same. For the purpose of this definition, the word “permanent” shall mean
beyond the hope of recovery with current medical knowledge and technology. The Diagnosis of Loss of
Independent Existence must be confirmed by a Medical Practitioner who is a specialist.
1.1.4 Third Degree Burns
There must be third-degree burns with scarring that cover at least 20% of the body’s surface area. The
diagnosis must confirm the total area involved using standardized, clinically accepted, body surface area
charts covering 20% of the body surface area.
1.1.5 Stroke resulting in permanent symptoms
Any cerebrovascular incident producing permanent neurological sequelae. This includes infarction of brain
tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extracranial source.
Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical clinical symptoms
as well as typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological deficit lasting for
at least 3 months has to be produced.
The following are excluded:
a. Transient ischemic attacks (TIA)
b. Traumatic injury of the brain
c. Vascular disease affecting only the eye or optic nerve or vestibular functions.
1.1.6 Permanent Paralysis of Limbs
Total and irreversible loss of use of two or more limbs as a result of injury or disease of the brain or spinal cord.
A specialist medical practitioner must be of the opinion that the paralysis will be permanent with no hope of
recovery and must be present for more than 3 months.
1.1.7 Open Heart Replacement or Repair of Heart Valves
The actual undergoing of open-heart valve surgery to replace or repair one or more heart valves, as a conse
quence of defects in, abnormalities of, or disease-affected cardiac valve(s). The diagnosis of the valve
abnormality must be supported by an echocardiography and the realization of surgery has to be confirmed by
a specialist medical practitioner. Catheter based techniques including but not limited to, balloon valvotomy/
valvuloplasty are excluded.
1.1.8 Open Chest CABG
The actual undergoing of heart surgery to correct blockage or narrowing in one or more coronary artery(s), by
coronary artery bypass grafting done via a sternotomy (cutting through the breast bone) or minimally invasive
keyhole coronary artery bypass procedures. The diagnosis must be supported by a coronary angiography and
the realization of surgery has to be confirmed by a cardiologist.
• Angioplasty and/or any other intra-arterial procedures
1.1.9 Major Organ /Bone Marrow Transplant
The actual undergoing of a transplant of:
a. One of the following human organs: heart, lung, liver, kidney, pancreas, that resulted from irreversible
end-stage failure of the relevant organ, or
b. Human bone marrow using haematopoietic stem cells. The undergoing of a transplant has to be confirmed
by a specialist medical practitioner.
a. Other stem-cell transplants
b. Where only Islets of Langerhans are transplanted
1.1.10 Major Head Trauma
Accidental head injury resulting in permanent Neurological deficit to be assessed no sooner than 3 months
from the date of the accident. This diagnosis must be supported by unequivocal findings on Magnetic
Resonance I maging, Computerized Tomography, or other reliable imaging techniques. The accident must be
caused solely and directly by accidental, violent, external and visible means and independently of all other
causes. The Accidental Head injury must result in an inability to perform at least three (3) of the following
Activities of Daily Living either with or without the use of mechanical equipment, special devices or other aids
and adaptations in use for disabled persons. For the purpose of this benefit, the word “permanent” shall mean
beyond the scope of recovery with current medical knowledge and technology.
The following is excluded:
• Spinal cord injury.
1.1.11 Benign Brain Tumor
Benign brain tumor is defined as a life threatening, non-cancerous tumor in the brain, cranial nerves or
meninges within the skull. The presence of the underlying tumor must be confirmed by imaging studies such
as CT scan or MRI.
This brain tumor must result in at least one of the following and must be confirmed by the relevant medical
specialist:
a. Permanent Neurological deficit with persisting clinical symptoms for a continuous period of at least 90
consecutive days or
b. Undergone surgical resection or radiation therapy to treat the brain tumor.
The following conditions are excluded:
• Cysts, Granulomas, malformations in the arteries or veins of the brain, hematomas, abscesses, pituitary
tumors, tumors of skull bones and tumors of the spinal cord.
1.1.12 Blindness
Total, permanent and irreversible loss of all vision in both eyes as a result of illness or accident.
The Blindness is evidenced by:
a. corrected visual acuity being 3/60 or less in both eyes or;
b. the field of vision being less than 10 degrees in both eyes.
The diagnosis of blindness must be confirmed and must not be correctable by aids or surgical procedure.
1.1.13 End Stage Lung Failure
End stage lung disease, causing chronic respiratory failure, as confirmed and evidenced by all of the following:
a. FEV1 test results consistently less than 1 litre measured on 3 occasions 3 months apart; and
b. Requiring continuous permanent supplementary oxygen therapy for hypoxemia; and
c. Arterial blood gas analysis with partial oxygen pressures of 55mmHg or less (PaO2< 55 mmHg); and
d. Dyspnea at rest.
1.1.14 End Stage Liver Failure
Permanent and irreversible failure of liver function that has resulted in all three of the following:
a. permanent jaundice; and
b. ascites; and
c. hepatic encephalopathy.
Liver failure secondary to drug or alcohol abuse is excluded.
1.1.15 Loss of Limbs
The physical separation of two or more limbs, at or above the wrist or ankle level limbs as a result of injury or
disease. This will include medically necessary amputation necessitated by injury or disease. The separation
has to be permanent without any chance of surgical correction. Loss of Limbs resulting directly or indirectly
from self- inflicted injury, alcohol or drug abuse is excluded.
1.1.16 Kidney Failure Requiring Regular Dialysis
End stage renal disease presenting as chronic irreversible failure of both kidneys to function, as a result of
which either regular renal dialysis (haemodialysis or peritoneal dialysis) is instituted or renal transplantation
is carried out. Diagnosis has to be confirmed by a specialist medical practitioner.
1.1.17 Coma of specified Severity
A state of unconsciousness with no reaction or response to external stimuli or internal needs. This diagnosis
must be supported by evidence of all of the following:
• No response to external stimuli continuously for at least 96 hours;
• Life support measures are necessary to sustain life; and
• Permanent neurological deficit which must be assessed at least 30 days after the onset of the coma.
The condition has to be confirmed by a specialist medical practitioner. Coma resulting from alcohol or drug
abuse is excluded.
1.1.18 Cancer of Specified Severity
A malignant tumor characterized by the uncontrolled growth & spread of malignant cells with invasion &
destruction of normal tissues. This diagnosis must be supported by histological evidence of malignancy. The
term cancer includes leukemia, lymphoma and sarcoma.
The following are excluded –
a. All tumors which are histologically described as carcinoma in situ, benign, pre- malignant, borderline
malignant, low malignant potential, neoplasm of unknown behavior, or non-invasive, including but not limited
to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN -2 and CIN-3.
b. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes or beyond;
c. Malignant melanoma that has not caused invasion beyond the epidermis;
d. All tumors of the prostate unless histologically classified as having a Gleason score greater than 6 or
having progressed to at least clinical TNM classification T2N0M0
e. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
f. Chronic lymphocytic leukaemia less than RAI stage 3
g. Non-invasive papillary cancer of the bladder histologically described as TaN0M0 or of a lesser classification,
h. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM Classification) or below and
with mitotic count of less than or equal to 5/50 HPFs;
1.1.19 Myocardial Infarction (First Heart Attack of Specific Severity)
The first occurrence of heart attack or myocardial infarction, which means the death of a portion of the heart
muscle as a result of inadequate blood supply to the relevant area. The diagnosis for Myocardial Infarction
should be evidenced by all of the following criteria:
a. A history of typical clinical symptoms consistent with the diagnosis of Acute Myocardial Infarction (for e.g.
typical chest pain)
b. New characteristic electrocardiogram changes
c. Elevation of infarction specific enzymes, Troponins or other specific biochemical markers.
• Other acute Coronary Syndromes
• Any type of angina pectoris
• A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease OR following an
intra-arterial cardiac procedure
1.2 Definitions
1. A Medical practitioner is a person who holds a valid registration from the medical council of any state of
India and is thereby entitled to practice medicine within its jurisdiction; and is acting within the scope and
jurisdiction of his license but excluding the Practitioner who is:
• Insured/Policyholder himself or an agent of the Insured
• Insurance Agent, business partner(s) or employer/employee of the Insured or
• A member of the Insured's immediate family.
2. Activities of Daily Living are:
• Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means.
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances.
• Transferring: the ability to move from a bed or an upright chair or wheelchair and vice versa.
• Mobility: The ability to move indoors from room to room on level surfaces.
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to
maintain a satisfactory level of personal hygiene.
• Feeding: the ability to feed oneself once food has been prepared and made available.
1.3 Waiting Period and Survival Period
• Waiting Period
No waiting period applies
• Survival Period
No survival period is applicable.
1.4 General Permanent Exclusions
No critical illness benefit will be paid out if the critical illness has occurred directly or indirectly as a result of
any of the following.
• Intentionally self-inflicted injury or attempted suicide, irrespective of mental condition.
• Alcohol or solvent abuse, or voluntarily taking or using any drug, medication or sedative unless it is an "over
the counter" drug, medication or sedative taken according to package directions or as prescribed by a Medical
Practitioner.
• Taking part in any act of a criminal nature with criminal intent.
• Failure to seek or follow medical advice (as recommended by a Medical Practitioner).
• Radioactive contamination due to nuclear accident
2. Waiver of Premium on Critical Illness (WOP on CI)
2.1 Definitions
2.1.1 Alzheimer’s Disease
Alzheimer’s (presenile dementia) disease is a progressive degenerative disease of the brain, characterised by
diffuse atrophy throughout the cerebral cortex with distinctive histopathological changes. It affects the brain,
causing symptoms like memory loss, confusion, communication problems, and general impairment of mental
function, which gradually worsens leading to changes in personality.
Deterioration or loss of intellectual capacity, as confirmed by clinical evaluation and imaging tests, arising
from Alzheimer’s disease, resulting in progressive significant reduction in mental and social functioning,
requiring the continuous supervision of the Insured Person. The diagnosis must be supported by the clinical
confirmation of a Neurologist and supported by our appointed Medical Practitioner.
The disease must result in a permanent inability to perform three or more Activities of daily living with Loss of
Independent Living” or must require the need of supervision and permanent presence of care staff due to the
disease. This must be medically documented for a period of at least 90 days.
The following conditions are however not covered:
a. neurosis or neuropsychiatric symptoms without imaging evidence of Alzheimer’s Disease
b. Alcohol related brain damage; and
c. any other type of irreversible organic disorder/dementia not associated with Alzheimer’s Disease
The Activities of Daily Living are:
i. Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
ii. Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
iii. Transferring: the ability to move from a bed to an upright chair or wheelchair and vice versa;
iv. Mobility: the ability to move indoors from room to room on level surfaces;
v. Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to
maintain a satisfactory level of personal hygiene;
vi. Feeding: the ability to feed oneself once food has been prepared and made available.
2.1.2 Parkinson’s disease
The unequivocal diagnosis of progressive, degenerative idiopathic Parkinson’s disease by a Neurologist
acceptable to us.
The diagnosis must be supported by all of the following conditions:
a. the disease cannot be controlled with medication;
b. signs of progressive impairment; and
c. inability of the Insured Person to perform at least 3 of the 6 activities of daily living as listed below (either
with or without the use of mechanical equipment, special devices or other aids and adaptations in use for
disabled persons) for a continuous period of at least 6 months.
Activities of daily living:
i. Washing: the ability to wash in the bath or shower (including getting into and out of the
shower) or wash satisfactorily by other means;
iii. Transferring: The ability to move from bed to a upright chair or wheelchair and vice versa;
iv. Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to
v. Feeding: The ability to feed oneself once the food has prepared and made available;
vi. Mobility: The ability to move indoors from room to room on level surfaces.
Parkinson’s disease secondary to drug and/or alcohol abuse is excluded.
2.1.3 Aorta Graft Surgery
The actual undergoing of major Surgery to repair or correct aneurysm, narrowing, obstruction or dissection of
the Aorta through surgical opening of the chest or abdomen. For the purpose of this cover the definition of
“Aorta” shall mean the thoracic and abdominal aorta but not its branches.
The insured person understands and agrees that we will not cover:
a. Surgery performed using only minimally invasive or intra-arterial techniques.
b. Angioplasty and all other intra-arterial, catheter based techniques, "keyhole" or laser procedures.
Aorta graft surgery benefit covers Surgery to the aorta wherein part of it is removed and replaced with a graft.
2.1.4 Amputation of Feet due to Complications from Diabetes
Diabetic neuropathy and vasculitis resulting in the amputation of both feet at or above ankle as advised by a
Medical Practitioner who is a specialist as the only means to maintain life. Amputation of toe or toes, or any
other causes for amputation shall not be covered.
2.1.5 Apallic Syndrome
Apallic Syndrome or Persistent vegetative state (PVS) or unresponsive wakefulness syndrome (UWS) is a
Universal necrosis of the brain cortex with the brainstem remaining intact. The diagnosis must be confirmed
by a Neurologist acceptable to us and the patient should be documented to be in a vegetative state for a
minimum of at least one month in order to be classified as UWS, PVS, Apallic Syndrome.
2.1.6 Aplastic Anaemia
Chronic persistent bone marrow failure which results in anaemia, neutropenia and
thrombocytopenia requiring treatment with at least one of the following:
a. Blood or Blood product transfusion;
b. Marrow stimulating agents;
c. Immunosuppressive agents; or
d. Bone marrow transplantation.
The diagnosis must be confirmed by a haematologist using relevant laboratory investigations including Bone
Marrow Biopsy resulting in bone marrow cellularity of less than 25% which is evidenced by any two of the
following:
a. Absolute neutrophil count of less than 500/mm3 or less
b. Platelets count less than 20,000/mm3 or less
c. Reticulocyte count of less than 20,000/mm3 or less
Temporary or reversible Aplastic Anaemia is excluded.
2.1.7 Bacterial Meningitis
Bacterial infection resulting in severe inflammation of the membranes of the brain or spinal cord resulting in
significant, irreversible and permanent neurological deficit. The neurological deficit must persist for at least 6
weeks resulting in permanent inability to perform three or more of six Activities of daily Living.
This diagnosis must be confirmed by:
a. The presence of bacterial infection in cerebrospinal fluid by lumbar puncture; and
b. A consultant neurologist.
2.1.8 Brain Surgery
The actual undergoing of surgery to the brain under general anaesthesia during which a craniotomy is
performed. Keyhole surgery is included however, minimally invasive treatment where no surgical incision is
performed to expose the target, such as irradiation by gamma knife or endovascular neuroradiological
interventions such as embolizations, thrombolysis and stereotactic biopsy are all excluded. Brain surgery as a
result of an Accident is also excluded. The procedure must be considered medically necessary by a Medical
Practitioner who is a qualified specialist.
2.1.9 Cardiomyopathy
An impaired function of the heart muscle, unequivocally diagnosed as Cardiomyopathy by a
Medical Practitioner
who is a cardiologist, and which results in permanent physical impairment to the degree of New York Heart
Association classification Class IV, or its equivalent, for at least six (6) months based on the following classifi
cation criteria:
NYHA Class IV - Inability to carry out any activity without discomfort. Symptoms of congestive cardiac failure
are present even at rest. With any increase in physical activity, discomfort will be experienced.
The Diagnosis of Cardiomyopathy has to be supported by echocardiographic findings of compromised ventric
ular performance.
Irrespective of the above, Cardiomyopathy directly related to alcohol or drug abuse is excluded.
2.1.10 Chronic Adrenal Insufficiency (Addison's Disease)
An autoimmune disorder causing a gradual destruction of the adrenal gland resulting in the need for life long
glucocorticoid and mineral corticoid replacement therapy. The disorder must be confirmed by a Medical
Practitioner who is a specialist in endocrinology through one of the following:
• ACTH simulation tests;
• insulin-induced hypoglycemia test;
• plasma ACTH level measurement;
• Plasma Renin Activity (PRA) level measurement.
Only autoimmune cause of primary adrenal insufficiency is included. All other causes of adrenal insufficiency
are excluded.
2.1.11 Chronic Relapsing Pancreatitis
An unequivocal diagnosis of Chronic Relapsing Pancreatitis, made by a Medical Practitioner who is a specialist
in gastroenterology and confirmed as a continuing inflammatory disease of the pancreas characterised by
irreversiblemorphological change and typically causing pain and/or permanent impairment of function. The
condition must be confirmed by pancreatic function tests and radiographic and imaging evidence.
Relapsing Pancreatitis caused directly or indirectly, wholly or partly, by alcohol is excluded.
2.1.12 Severe Crohn's Disease
Crohn’s Disease is a chronic, transmural inflammatory disorder of the bowel. To be considered as severe, there
must be evidence of continued inflammation in spite of optimal therapy, with all of the following having
occurred:
• Stricture formation causing intestinal obstruction requiring admission to hospital, and
• Fistula formation between loops of bowel, and
• At least one bowel segment resection.
The diagnosis must be made by a Medical Practitioner who is a specialist Gastroenterologist and be proven
histologically on a pathology report and/or the results of sigmoidoscopy or colonoscopy.
2.1.13 Aortic Dissection
A condition where the inner lining of the aorta (intima layer) is interrupted so that blood enters the wall of the
aorta and separates its layers. For the purpose of this definition, aorta shall mean the thoracic and abdominal
aorta but not its branches. The diagnosis must be made by a Medical Practitioner who is a specialist with
computed tomography (CT) scan, magnetic resonance imaging (MRI), magnetic resonance angiograph (MRA)
or angiogram. Emergency surgical repair is required.
2.1.14 Ebola
Infection with the Ebola virus where all the following conditions are met:
• presence of the Ebola virus has been confirmed by laboratory testing;
• there are ongoing complications of the infection persisting beyond thirty (30) days from the onset of
symptoms; and
• the infection does not result in death.
2.1.15 Elephantiasis
Massive swelling in the tissues of the body as a result of destroyed regional lymphatic circulation by chronic
filariasis infection. The unequivocal diagnosis of elephantiasis must be confirmed by a Medical Practitioner who
is a specialist physician. There must be clinical evidence of permanent massive swelling of legs, arms,
scrotum, vulva, or breasts. There must also be laboratory confirmation of microfilariae infection.
Swelling or lymphedema caused by infection with a sexually transmitted disease, trauma, post-operative
scarring, congestive heart failure, or congenital lymphatic system abnormalities is excluded.
2.1.16 Encephalitis
Severe inflammation of brain substance (cerebral hemisphere, brainstem or cerebellum) caused by viral
infection and resulting in permanent neurological deficit. This diagnosis must be certified by a Medical
Practitioner who is a consultant neurologist and the permanent neurological deficit must be documented for at
least 6 weeks. The permanent deficit should result in permanent inability to perform three or more of six
Activities for Daily Living (listed below).
Activities of daily living are:
2.1.17 Fulminant Hepatitis
A sub-massive to massive necrosis of the liver by the Hepatitis virus, leading precipitously to liver failure. This
diagnosis must be supported by all of the following:
a. Rapid decreasing of liver size;
b. Necrosis involving entire lobules, leaving only a collapsed reticular framework;
c. Rapid deterioration of liver function tests;
d. Deepening jaundice; and
e. Hepatic encephalopathy.
Acute Hepatitis infection or carrier status alone does not meet the diagnostic criteria.
2.1.18 Loss of Independent Existence (cover up to Insurance Age 74)
The Insured person is physically incapable of performing at least three (3) of the six (6) “Activities of Daily
Living” as defined below (either with or without the use of mechanical equipment, special devices or other
aids or adaptations in use for disabled persons) for a continuous period of at least six (6) months, signifying a
permanent and irreversible inability to perform the same. For the purpose of this definition, the word “perma
nent” shall mean beyond the hope of recovery with current medical knowledge and technology. The Diagnosis
of Loss of Independent Existence must be confirmed by a Medical Practitioner who is a specialist.
Only Life Insured with Insurance Age between 18 and 74 on first diagnosis is eligible to receive a benefit under
this illness.
i. Washing: the ability to wash in the bath or shower (including getting into and out of the shower) or wash
satisfactorily by other means;
v. Feeding: the ability to feed oneself once food has been prepared and made available;
2.1.19 Medullary Cystic Disease
Medullary Cystic Disease where the following criteria are met:
• the presence in the kidney of multiple cysts in the renal medulla accompanied by the presence of tubular
atrophy and interstitial fibrosis;
• clinical manifestations of anaemia, polyuria, and progressive deterioration in kidney function; and
• the Diagnosis of Medullary Cystic Disease is confirmed by renal biopsy. Isolated or benign kidney cysts are
specifically excluded from this benefit.
2.1.20 Muscular Dystrophy
A group of hereditary degenerative diseases of muscle characterised by weakness and atrophy of muscle. The
diagnosis of muscular dystrophy must be unequivocal and made by a Medical Practitioner who is a consultant
neurologist. The condition must result in the inability of the Life Insured to perform (whether aided or
unaided) at least 3 of the 6 “Activities of Daily Living” for a continuous period of at least 6 months.
i. Washing: the ability to wash in the bath or shower (including getting into and out of the shower) or wash
satisfactorily by other means;
v. Feeding: the ability to feed oneself once food has been prepared and made available;
2.1.21 Myasthenia Gravis
An acquired autoimmune disorder of neuromuscular transmission leading to fluctuating muscle weakness
and fatigability, where all of the following criteria are met:
• Presence of permanent muscle weakness categorized as Class IV or V according to the Myasthenia Gravis
Foundation of America Clinical Classification given below; and
• The Diagnosis of Myasthenia Gravis and categorization are confirmed by a Medical Practitioner who is a
neurologist.
Myasthenia Gravis Foundation of America Clinical Classification:
• Class I: Any eye muscle weakness, possible ptosis, no other evidence of muscle weakness elsewhere.
• Class II: Eye muscle weakness of any severity, mild weakness of other muscles.
• Class III: Eye muscle weakness of any severity, moderate weakness of other muscles.
• Class IV: Eye muscle weakness of any severity, severe weakness of other muscles.
• Class V: Intubation needed to maintain airway.
2.1.22 Other Serious Coronary Artery Disease
The narrowing of the lumen of at least one coronary artery by a minimum of 75% and of two others by a
minimum of 60%, as proven by coronary angiography, regardless of whether or not any form of coronary
artery intervention or surgery has been performed. Coronary arteries herein refer to left main stem, left
anterior descending, circumflex and right coronary artery (but not including their branches).
2.1.23 Poliomyelitis
The occurrence of Poliomyelitis where all of the following conditions are met:
• Poliovirus is identified as the cause,
• Paralysis of the limb muscles or respiratory muscles must be present and persist for at least 3 months.
2.1.24 Progressive Scleroderma
A systemic collagen-vascular disease causing progressive diffuse fibrosis in the skin, blood vessels and
visceral organs. This diagnosis must be unequivocally supported by biopsy and serological evidence and the
disorder must have reached systemic proportions to involve the heart, lungs or kidneys.
• Localised scleroderma (linear scleroderma or morphea);
• Eosinophilic fasciitis; and
• CREST syndrome.
2.1.25 Progressive Supranuclear Palsy
Confirmed by a Medical Practitioner who is a specialist in neurology of a definitive diagnosis of progressive
supranuclear palsy. There must be permanent clinical impairment of motor function, eye movement disorder
and postural instability.
2.1.26 Severe Rheumatoid Arthritis
Unequivocal Diagnosis of systemic immune disorder of rheumatoid arthritis where all of the following criteria
are met:
• Diagnostic criteria of the American College of Rheumatology for Rheumatoid Arthritis;
• Permanent inability to perform at least three (3) “Activities of Daily Living”;
• Widespread joint destruction and major clinical deformity of three (3) or more of the following joint areas:
hands, wrists, elbows, knees, hips, ankle, cervical spine or feet; and
• The foregoing conditions have been present for at least six (6) months.
2.1.27 Severe Ulcerative Colitis
Acute fulminant ulcerative colitis with life threatening electrolyte disturbances. All of the following criteria
must be met:
• the entire colon is affected, with severe bloody diarrhoea; and
• the necessary treatment is total colectomy and ileostomy; and
• the diagnosis must be based on histopathological features and confirmed by a Medical Practitioner who is
a specialist in gastroenterology.
2.1.28 Systemic Lupus Erythematosus with Lupus Nephritis
A multi-system autoimmune disorder characterised by the development of autoantibodies directed against
various self-antigens. In respect of this Policy, systemic lupus erythematosus will be restricted to those forms
of systemic lupus erythematosus which involve the kidneys (Class III to Class V Lupus Nephritis, established by
renal biopsy, and in accordance with the WHO Classification). The final diagnosis must be confirmed by a
Medical Practitioner specialising in Rheumatology and Immunology.
The WHO Classification of Lupus Nephritis:
• Class I Minimal Change Lupus Glomerulonephritis
• Class II Mesangial Lupus Glomerulonephritis
• Class III Focal Segmental Proliferative Lupus Glomerulonephritis
• Class IV Diffuse Proliferative Lupus Glomerulonephritis
• Class V Membranous Lupus Glomerulonephritis
2.1.29 Pneumonectomy
The undergoing of surgery on the advice of an appropriate Medical Specialist to remove an entire lung for
disease or traumatic injury suffered by the life assured.
a. Removal of a lobe of lungs (lobectomy)
b. Lung resection or incision
2.1.30 Third Degree Burns
There must be third-degree burns with scarring that cover at least 20% of the body’s surface area. The
diagnosis must confirm the total area involved using standardized, clinically accepted, body surface area
charts covering 20% of the body surface area.
2.1.31 Stroke resulting in permanent symptoms
Any cerebrovascular incident producing permanent neurological sequelae. This includes infarction of brain
tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extracranial source.
Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical clinical symptoms
as well as typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological deficit lasting for
at least 3 months has to be produced.
a. Transient ischemic attacks (TIA)
b. Traumatic injury of the brain
c. Vascular disease affecting only the eye or optic nerve or vestibular functions.
2.1.32 Primary (Idiopathic) Pulmonary Hypertension
An unequivocal diagnosis of Primary (Idiopathic) Pulmonary Hypertension by a Cardiologist or specialist in
respiratory medicine with evidence of right ventricular enlargement and the pulmonary artery pressure above
30 mm of Hg on Cardiac Cauterization. There must be permanent irreversible physical impairment to the
degree of at least Class IV of the New York Heart Association Classification of cardiac impairment.
The NYHA Classification of Cardiac Impairment are as follows:
a. Class III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes
symptoms.
b. Class IV: Unable to engage in any physical activity without discomfort. Symptoms may be present even
at rest.
Pulmonary hypertension associated with lung disease, chronic hypoventilation, pulmonary thromboembolic
disease, drugs and toxins, diseases of the left side of the heart, congenital heart disease and any secondary
cause are specifically excluded.
2.1.33 Permanent Paralysis of Limbs
Total and irreversible loss of use of two or more limbs as a result of injury or disease of the brain or spinal cord.
A specialist medical practitioner must be of the opinion that the paralysis will be permanent with no hope of
recovery and must be present for more than 3 months.
2.1.34 Open Heart Replacement or Repair of Heart Valves
The actual undergoing of open-heart valve surgery to replace or repair one or more heart valves, as a conse
quence of defects in, abnormalities of, or disease-affected cardiac valve(s). The diagnosis of the valve
abnormality must be supported by an echocardiography and the realization of surgery has to be confirmed by
a specialist medical practitioner. Catheter based techniques including but not limited to, balloon valvotomy/
valvuloplasty are excluded.
2.1.35 Open Chest CABG
The actual undergoing of heart surgery to correct blockage or narrowing in one or more coronary artery(s), by
coronary artery bypass grafting done via a sternotomy (cutting through the breast bone) or minimally invasive
keyhole coronary artery bypass procedures. The diagnosis must be supported by a coronary angiography and
the realization of surgery has to be confirmed by a cardiologist.
• Angioplasty and/or any other intra-arterial procedures
2.1.36 Multiple Sclerosis with Persisting Symptoms
The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and evidenced by all of the following:
a. investigations including typical MRI findings which unequivocally confirm the diagnosis to be multiple
sclerosis and
b. there must be current clinical impairment of motor or sensory function, which must have persisted for a
continuous period of at least 6 months.
Neurological damage due to SLE is excluded.
2.1.37 Motor Neuron Disease with Permanent Symptoms
Motor neuron disease diagnosed by a Specialist Medical Practitioner as spinal muscular atrophy, progressive
bulbar palsy, amyotrophic lateral sclerosis or primary lateral sclerosis. There must be progressive degenera
tion of corticospinal tracts and anterior horn cells or bulbar efferent neurons. There must be current signifi
cant and permanent functional neurological impairment with objective evidence of motor dysfunction that
has persisted for a continuous period of at least 3 months.
2.1.38 Major Organ /Bone Marrow Transplant
The actual undergoing of a transplant of:
a. One of the following human organs: heart, lung, liver, kidney, pancreas, that resulted from irreversible
end-stage failure of the relevant organ, or
b. Human bone marrow using haematopoietic stem cells. The undergoing of a transplant has to be confirmed
by a specialist medical practitioner.
a. Other stem-cell transplants
b. Where only Islets of Langerhans are transplanted
2.1.39 Major Head Trauma
Accidental head injury resulting in permanent Neurological deficit to be assessed no sooner than 3 months
from the date of the accident. This diagnosis must be supported by unequivocal findings on Magnetic Reso
nance Imaging, Computerized Tomography, or other reliable imaging techniques. The accident must be caused
solely and directly by accidental, violent, external and visible means and independently of all other causes.
The Accidental Head injury must result in an inability to perform at least three (3) of the following Activities of
Daily Living either with or without the use of mechanical equipment, special devices or other aids and
adaptations in use for disabled persons. For the purpose of this benefit, the word “permanent” shall mean
beyond the scope of recovery with current medical knowledge and technology.
The following is excluded:
• Spinal cord injury.
2.1.40 Benign Brain Tumor
Benign brain tumor is defined as a life threatening, non-cancerous tumor in the brain, cranial nerves or
meninges within the skull. The presence of the underlying tumor must be confirmed by imaging studies such
as CT scan or MRI.
This brain tumor must result in at least one of the following and must be confirmed by the relevant medical
specialist:
a. Permanent Neurological deficit with persisting clinical symptoms for a continuous period of at least 90
consecutive days or
b. Undergone surgical resection or radiation therapy to treat the brain tumor.
• Cysts, Granulomas, malformations in the arteries or veins of the brain, hematomas, abscesses, pituitary
tumors, tumors of skull bones and tumors of the spinal cord.
2.1.41 Blindness
Total, permanent and irreversible loss of all vision in both eyes as a result of illness or accident.
The Blindness is evidenced by:
a. corrected visual acuity being 3/60 or less in both eyes or;
b. the field of vision being less than 10 degrees in both eyes.
The diagnosis of blindness must be confirmed and must not be correctable by aids or surgical procedure.
2.1.42 Deafness
Total and irreversible loss of hearing in both ears as a result of illness or accident. This diagnosis must be
supported by pure tone audiogram test and certified by an Ear, Nose and Throat (ENT) specialist. Total means
“the loss of hearing to the extent that the loss is greater than 90decibels across all frequencies of hearing” in
both ears.
2.1.43 End Stage Lung Failure
End stage lung disease, causing chronic respiratory failure, as confirmed and evidenced by all of the following:
a. FEV1 test results consistently less than 1 litre measured on 3 occasions 3 months apart; and
b. Requiring continuous permanent supplementary oxygen therapy for hypoxemia; and
c. Arterial blood gas analysis with partial oxygen pressures of 55mmHg or less (PaO2< 55 mmHg); and
d. Dyspnea at rest.
2.1.44 End Stage Liver Failure
Permanent and irreversible failure of liver function that has resulted in all three of the following:
a. permanent jaundice; and
b. ascites; and
c. hepatic encephalopathy.
Liver failure secondary to drug or alcohol abuse is excluded.
2.1.45 Loss of speech
Total and irrecoverable loss of the ability to speak as a result of injury or disease to the vocal cords. The
inability to speak must be established for a continuous period of 12 months. This diagnosis must be supported
by medical evidence furnished by an Ear, Nose, Throat (ENT) specialist.
2.1.46 Loss of Limbs
The physical separation of two or more limbs, at or above the wrist or ankle level limbs as a result of injury or
disease. This will include medically necessary amputation necessitated by injury or disease. The separation
has to be permanent without any chance of surgical correction. Loss of Limbs resulting directly or indirectly
from self- inflicted injury, alcohol or drug abuse is excluded.
2.1.47 Kidney Failure Requiring Regular Dialysis
End stage renal disease presenting as chronic irreversible failure of both kidneys to function, as a result of
which either regular renal dialysis (haemodialysis or peritoneal dialysis) is instituted or renal transplantation i
s carried out. Diagnosis has to be confirmed by a specialist medical practitioner.
2.1.48 Infective Endocarditis
Inflammation of the inner lining of the heart caused by infectious organisms, where all of the following
criteria are met:
• Positive result of the blood culture proving presence of the infectious organism(s);
• Presence of at least moderate heart valve incompetence (meaning regurgitant fraction of 20% or above)
or moderate heart valve stenosis (resulting in heart valve area of 30% or less of normal value) attributable to
Infective Endocarditis; and
• The Diagnosis of Infective Endocarditis and the severity of valvular impairment are confirmed by a Regis
tered Doctor who is a cardiologist.
2.1.49 Coma of specified Severity
A state of unconsciousness with no reaction or response to external stimuli or internal needs. This diagnosis
must be supported by evidence of all of the following:
• No response to external stimuli continuously for at least 96 hours;
• Life support measures are necessary to sustain life; and
• Permanent neurological deficit which must be assessed at least 30 days after the onset of the coma.
The condition has to be confirmed by a specialist medical practitioner. Coma resulting from alcohol or drug
abuse is excluded.
2.1.50 Cancer of Specified Severity
A malignant tumor characterized by the uncontrolled growth & spread of malignant cells with invasion &
destruction of normal tissues. This diagnosis must be supported by histological evidence of malignancy. The
term cancer includes leukemia, lymphoma and sarcoma.
The following are excluded –
a. All tumors which are histologically described as carcinoma in situ, benign, pre- malignant, borderline
malignant, low malignant potential, neoplasm of unknown behavior, or non-invasive, including but not
limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN -2 and CIN-3.
b. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes or beyond;
c. Malignant melanoma that has not caused invasion beyond the epidermis;
d. All tumors of the prostate unless histologically classified as having a Gleason score greater than 6 or having
progressed to at least clinical TNM classification T2N0M0
e. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
f. Chronic lymphocytic leukaemia less than RAI stage 3
g. Non-invasive papillary cancer of the bladder histologically described as TaN0M0 or of a lesser
classification,
h. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM Classification) or below and
with mitotic count of less than or equal to 5/50 HPFs;
2.1.51 Myocardial Infarction (First Heart Attack of Specific Severity)
The first occurrence of heart attack or myocardial infarction, which means the death of a portion of the heart
muscle as a result of inadequate blood supply to the relevant area. The diagnosis for Myocardial Infarction
should be evidenced by all of the following criteria:
a. A history of typical clinical symptoms consistent with the diagnosis of Acute Myocardial Infarction (for e.g.
typical chest pain)
b. New characteristic electrocardiogram changes
c. Elevation of infarction specific enzymes, Troponins or other specific biochemical markers.
• Other acute Coronary Syndrome
• Any type of angina pectoris
• A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease OR following an
intra-arterial cardiac procedure
2.1.52 Creutzfeldt-Jacob Disease (CJD)
Creutzfeldt-Jacob disease is an incurable brain infection that causes rapidly progressive deterioration of
mental function and movement. A Medical Practitioner who is a neurologist must make a definite diagnosis of
Creutzfeldt-Jacob disease based on clinical assessment, EEG and imaging. There must be objective neurologi
cal abnormalities on exam along with severe progressive dementia.
2.1.53 Multiple System Atrophy
A diagnosis of multiple system atrophy by a Specialist Medical Practitioner (Neurologist). There must be
evidence of permanent clinical impairment for a minimum period of 30 days of either:
a. Motor function with associated rigidity of movement; or
b. The ability to coordinate muscle movement; or
c. Loss of Bladder control and postural hypotension
2.1.54 Loss of One Limb and One Eye
Total, permanent and irrecoverable loss of sight of one eye and loss by severance of one limb at or above the
elbow or knee.
The loss of sight of one eye must be clinically confirmed by a Medical Practitioner who is an eye specialist, and
must not be correctable by aids or surgical procedures.
2.1.55 Necrotising Fasciitis
Necrotizing fasciitis is a progressive, rapidly spreading, infection located in the deep fascia causing necrosis of
the subcutaneous tissues. An unequivocal diagnosis of necrotizing fasciitis must be made by a Medical
Practitioner who is a specialist and the diagnosis must be supported with laboratory evidence of the presence
of a bacteria that is a known cause of necrotising fasciitis. There must also be widespread destruction of muscle
and other soft tissues that results in a total and permanent loss or function of the affected body part.
2.1.56 Hemiplegia
The total and permanent loss of the use of one side of the body through paralysis persisting for a period of at
least 6 weeks and with no foreseeable possibility of recovery caused by illness or injury, except when such
injury is self-inflicted.
2.1.57 Tuberculosis Meningitis
Meningitis caused by tubercle bacilli, resulting in permanent neurological deficit persisting for at least 180
consecutive days. Such a diagnosis must be confirmed by a Medical Practitioner who is a specialist in
neurology. Permanent neurological deficit with persisting clinical symptoms means symptoms of dysfunction
in the nervous system that are not present on clinical examination and expected to last throughout the
lifetime of life assured.
2.1.58 Myelofibrosis
A disorder which can cause fibrous tissue to replace the normal bone marrow and results in anaemia, low
levels of white blood cells and platelets and enlargement of the spleen. The condition must have progressed
to the point that it is permanent and the severity is such that the Life Insured requires a blood transfusion at
least monthly. The diagnosis of myelofibrosis must be supported by bone marrow biopsy and confirmed by a
Medical Practitioner who is a specialist.
2.1.59 Pheochromocytoma
Presence of a neuroendocrine tumour of the adrenal or extra-chromaffin tissue that secretes excess
catecholamines requiring the actual undergoing of surgery to remove the tumour.
The Diagnosis of Pheochromocytoma must be confirmed by a Medical Practitioner who is an endocrinologist.
2.1.60 Eisenmenger's Syndrome
Development of severe pulmonary hypertension and shunt reversal resulting from heart condition. The
diagnosis must be made by a Medical Practitioner who is a specialist with echocardiography and cardiac cathe
terisation and supported by the following criteria:
• Mean pulmonary artery pressure > 40 mm Hg;
• Pulmonary vascular resistance > 3mm/L/min (Wood units); and
• Normal pulmonary wedge pressure < 15 mm Hg.
2.2 Permanent Exclusions
1. Any Illness, sickness or disease other than those specified as Critical Illnesses under this Policy;
2. Any Pre-existing Disease or any complication arising therefrom.
Pre-existing Disease means any condition, aliment, injury or disease / critical illness / disability:
a. That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issuance or
its reinstatement; or
b. For which medical advice or treatment was recommended by, or received from, a Physician within 48
months Prior to the effective date of the policy issuance or its reinstatement
Coverage under the policy after the expiry of 48 months for any pre-existing disease is subject to the same
being declared at the time of application and accepted by us.
3. Any Critical Illness caused due to treatment for, Alcoholism, drug or substance abuse or any addictive
condition and consequences thereof.
4. Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner,
5. Any Critical Illness caused due to intentional self-injury, suicide or attempted suicide
6. Any Critical Illness caused by or arising from or attributable to a foreign invasion, act of foreign enemies,
hostilities, warlike operations (whether war be declared or not or while performing duties in the armed forces
of any country during war or at peace time), civil war, public defense, rebellion, revolution, insurrection,
military or usurped power;
7. Any Critical Illness caused by ionizing radiation or contamination by radioactivity from any nuclear fuel
(explosive or hazardous form) or from any nuclear waste from the combustion of nuclear fuel, nuclear,
chemical or biological attack.
8. Congenital External Anomalies, inherited disorders or any complications or conditions arising therefrom
including any developmental conditions of the Insured;
9. Any Critical Illness caused by any treatment necessitated due to participation as a professional in hazard
ous or adventure sport, 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
10. Participation by the Insured Person in any flying activity, except as a bona fide, fare- paying passenger of a
recognized airline on regular routes and on a scheduled timetable.
11. Any Critical Illness caused by Medical treatment traceable to childbirth (including complicated deliveries and
caesarean sections incurred during hospitalization) except ectopic pregnancy. Any Critical Illness caused
due to miscarriages (unless due to an accident) and lawful medical termination of pregnancy during the policy
period.
12. Any Critical Illness caused by any unproven/ experimental treatment, service and supplies for or in
connection with any treatment. Unproven/ experimental treatments are treatments, procedures or supplies
that lack significant medical documentation to support their effectiveness.
13. Any Critical Illness based on certification/diagnosis/treatment from persons not registered as Medical
Practitioners, or from a Medical Practitioner who is practicing outside the discipline that he/ she is licensed
for.
14. Any Critical Illness caused due to any treatment, including surgical management, to change characteristics
of the body to those of opposite sex.
15. Any Critical Illness caused due to cosmetic or plastic surgery or any treatment to change the appearance
unless for reconstruction following an Accident, Burn(s), or Cancer or as part of medically necessary treat
ment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessi
ty, it must be certified by the attending Medical Practitioner.
16. Any Critical Illness caused due to surgical treatment of obesity that does not fulfil all the below conditions:
a. Surgery to be conducted is upon the advice of the Doctor
b. The Surgery / Procedure conducted should be supported by clinical protocols
c. The member has to be 18 years of age or older and
d. Body Mass Index (BMI):
• greater than or equal to 40 or
• greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure
of less invasive methods of weight loss:
i. Obesity related cardiomyopathy
ii. Coronary heart disease
iii. Severe Sleep Apnea
iv. Uncontrolled Type 2 Diabetes
17. Any Critical Illness caused due to treatments received in health hydros, nature cure clinics, spas or similar
establishments or private beds registered as a nursing home attached to such establishments or where
admission is arranged wholly or partly for domestic reason.
18. Any Critical Illness caused by treatment directly arising from or consequent upon any Insured Person
committing or attempting to commit a breach of law with criminal intent.
19. In the event of the death of the Insured Person within the stipulated survival period as set out above.
20.Any Critical Illness caused by sterility and infertility. This includes:
a. Any type of contraception, sterilization
b. Assisted Reproductive services including artificial insemination and advanced reproductive technologies
such as IVF, ZIFT, GIFT, ICSI
c. Gestational Surrogacy
d. Reversal of sterilization
2.3 Waiting Period
An initial waiting period of 90 days applies from the policy commencement date, or policy revival date, as the
case may be. No waiting period applies for Critical Illness claims arising solely due to an accident.
2.4 Survival Period
A 15-day survival period is applicable. This refers to the period from the diagnosis and fulfilment of the
definition of the conditions covered which the life assured must survive before the benefit will be paid.
Claim payment will only be made with confirmatory diagnosis of the conditions covered while the insured is
alive (i.e., a claim would not be admitted if the diagnosis is made post-mortem).
3. Waiver of Premium on Total and Permanent Disability (WOP on TPD)
3.1 Definitions
Total and Permanent Disability (TPD) shall mean the occurrence of any of the following conditions as a result
of accidental bodily injury, sickness or disease:
3.1.1 Permanent Disability
Disability means inability of the Insured Person to perform at least 3 of the 6 activities of daily living as listed
below (either with or without the use of mechanical equipment, special devices or other aids and adaptations
in use for disabled persons) for a continuous period of at least 6 months.
• Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances
• Transferring: the ability to move from a bed to an upright chair or wheelchair and vice-versa
• Mobility: the ability to move indoors from room to room on level surfaces
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain a
satisfactory level of personal hygiene
• Feeding: the ability to feed oneself once food has been prepared and made available.
3.1.2 Physical Impairment
• Total and irrecoverable loss of sight of both eyes. The blindness must be confirmed by an Ophthalmologist, OR
• Loss of use or loss by severance of two or more limbs at or above wrists or ankles; OR
• The total and irrecoverable loss of sight of one eye and loss of use or loss by severance of one limb at or above
wrist or ankle.
The above disability must have lasted, without interruption, for at least six consecutive months from the date
of diagnosis or accident and must, in the opinion of a qualified medical practitioner appointed by the Company,
be deemed permanent.
“Accident” means sudden, unforeseen and involuntary event caused by external, visible and violent means.
“Accidental Injury” means bodily injury of the insured caused solely, directly and independently of any other
intervening causes from an accident {i.e. a traumatic event of violent, unexpected, external and visible
nature).
The loss of use of a limb is considered as a loss of use when such loss of use involves total and permanent loss
of function of the limb affected as determined by a registered medical practitioner nominated by the
Company.
3.2 Exclusions
TPD arising directly or indirectly from any of the following are specifically excluded:
We shall not be liable to make any payment under this Policy towards the TPD benefit, directly or indirectly
caused by, based on, arising out of or howsoever attributable to any of the following:
• Pre-existing Disease means any condition, aliment, injury or disease / critical illness / disability:
a. That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issuance or
its reinstatement; or
b. For which medical advice or treatment was recommended by, or received from, a Physician 48 months
Prior to the effective date of the policy issuance or its reinstatement Coverage under the policy after the
expiry of 48 months for any pre-existing disease is subject to the same being declared at the time of
application and accepted.
• Any disability caused due to treatment for, Alcoholism, drug or substance abuse or any addictive condition
and consequences thereof.
• Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner.
• Any disability caused due to intentional self-injury, suicide or attempted suicide, whether the person is
medically sane or insane.
• Any disability, caused by or arising from or attributable to a foreign invasion, act of foreign enemies,
hostilities, warlike operations (whether war be declared or not or while performing duties in the armed forces
of any country during war or at peace time), civil war, public defense, rebellion, revolution, insurrection,
military or usurped power.
• Service in any military, air-force, naval, paramilitary or similar organization.
• Any disability caused by ionizing radiation or contamination by radioactivity from any nuclear fuel (explosive
or hazardous form) or from any nuclear waste from the combustion of nuclear fuel, nuclear, chemical or
biological attack.
• Working in underground mines, tunneling or involving electrical installations with high tension supply, or as
race jockeys or circus personnel.
• Congenital External Anomalies, inherited disorders or any complications or conditions arising therefrom
including any developmental conditions of the Insured.
• Any disability caused by any treatment necessitated due to participation as a professional in hazardous or
adventure sport, 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 and selfie accidents.
• Participation by the Insured Person in any flying activity, except as a bona fide, fare- paying passenger of a
recognized airline on regular routes and on a scheduled timetable.
• Any disability, caused by Medical treatment traceable to childbirth (including complicated deliveries and
caesarean sections incurred during hospitalizatiosn) except ectopic pregnancy. Any disability due to
miscarriages (unless due to an accident) and lawful medical termination of pregnancy during the policy
period.
• Any disability, caused by any unproven / experimental treatment, service and supplies for or in connection
with any treatment. Unproven / experimental treatments are treatments, procedures or supplies that lack
significant medical documentation to support their effectiveness.
• Any disability based on certification/diagnosis/treatment from persons not registered as Medical
Practitioners, or from a Medical Practitioner who is practicing outside the discipline that he/ she is licensed
for.
• Any disability, caused due to any treatment, including surgical management, to change characteristics of the
body to those of opposite sex.
• Any disability caused due to cosmetic or plastic surgery or any treatment to change the appearance unless for
reconstruction following an Accident, Burn(s), or Cancer or as part of medically necessary treatment to
remove a 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.
• Any disability, caused due to surgical treatment of obesity that does not fulfil all the below conditions:
a. Surgery to be conducted is upon the advice of the Doctor
b. The Surgery / Procedure conducted should be supported by clinical protocols
c. The member has to be 18 years of age or older and
d. Body Mass Index (BMI):
o greater than or equal to 40 or
o greater than or equal to 35 in conjunction with any of the following severe co- morbidities following failure
of less invasive methods of weight loss:
i. Obesity related cardiomyopathy
ii. Coronary heart disease
iii. Severe Sleep Apnea
iv. Uncontrolled Type 2 Diabetes despite optimal therapy
• Any disability caused due to treatments received in health hydros, nature cure clinics, spas or similar
establishments or private beds registered as a nursing home attached to such establishments or where
admission is arranged wholly or partly for domestic reason.
• Any disability, caused by treatment directly arising from or consequent upon any Insured Person committing
or attempting to commit a breach of law with criminal intent.
• In the event of the death of the Insured Person within the stipulated survival period as set out above.
• Any disability, caused by sterility and infertility. This includes:
a. Any type of contraception, sterilization
b. Assisted Reproductive services including artificial insemination and advanced reproductive technologies
such as IVF, ZIFT, GIFT, ICSI
c. Gestational Surrogacy
d. Reversal of sterilization
3.3 Waiting Period
There is a waiting period of 90 days from the policy commencement date or revival of cover. In case the insured event
happens during this period, no benefit shall be payable.
Waiting period is not applicable for claims occurring solely due to an accident. However, the permanency of the
disability needs to be established for the claim to be payable under accidental TPD benefit.
Contact us today
To buy: 1800-266-9777 (Toll free)

(Available all days 10am to 7pm)
Visit us at www.hdfclife.com
HDFC Life Insurance Company Limited (“HDFC Life”). CIN: L65110MH2000PLC128245. IRDAI Registration No. 101.
Registered Office: 13th Floor, Lodha Excelus, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai - 400 011.
Email: service@hdfclife.com, Help line: 022-68446530 (Local charges apply ) | Available Mon-Sat 10 am to 7 pm IST . | Website: www.hdfclife.com.
The name/letter 'HDFC' in the name/logo of HDFC Life Insurance Company Limited (HDFC Life) belongs to HDFC Bank Limited and is used by HDFC Life under licence from
HDFC Bank Limited.
HDFC Life Sanchay Legacy (UIN: 101N177V02) is a Non-Linked, Non-Participating, Individual, Pure Risk Premium/ Savings Life Insurance Plan. Life Insuarnce
Coverage is available in this product. This version of the product brochure invalidates all previous printed versions for this particular plan. This Product brochure is
indicative of the terms, warranties, conditions and exclusions contained in the insurance policy. Please know the associated risk and applicable charges from your
insurance agent or the intermediary or the policy document of the insurer. ARN: PP/03/24/9664.
BEWARE OF SPURIOUS PHONE CALLS AND FICTITIOUS/FRAUDULENT OFFERS

• IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums.
Public receiving such phone calls are requested to lodge a police complaint.

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Sanchay Legacy

A Non-Participating, Non-linked, Pure Risk Premium/Savings Individual Life Insurance Plan

Now available with new & improved additional features

Get Early RoP3 benefit & higher

Protect your family’s future

Increasing Life cover with no Acceleration Early RoP3

1. savings underwriting guidelines will apply.

KEY FEATURES OF HDFC LIFE SANCHAY LEGACY

How does this plan protect you

Plan Option Benefits

Life Option Death Benefit / Accelerated Death Benefit on Critical Illness

Parameters Minimum Maximum

Parameters Minimum Maximum

Single Pay (1.25x DBM)

Policy Term Whole Life

Single Pay (1.25x DBM) :

The product can also be purchased online via company website.

Following options are available under the plan:

BENEFITS PAYABLE UNDER THE PLAN

• Sum Assured on Death or;

ADDITIONAL BENEFITS AVAILABLE UNDER THE PLAN:

1. Waiver of Premium on CI (WOP on CIP) Option

On death at age 85, a

All future premiums

Acceleration of death benefit starts after

Mr. Kumar gets back On death at age 95, a

Acceleration of death benefit starts after

Policy Term (Whole life)

1st 2nd 3rd 4th

Acceleration of death benefit starts after

Policy Term (Whole life)

Where GSV factors are:

Policy Year GSV Factor

Single Pay Other than Single Pay

(98 less Age at Entry) onwards 90%

A benefit as a proportion of the Rider Sum Assured shall be payable

A lump sum benefit equivalent to Rider Sum Assured shall be payable

TERMS & CONDITIONS

30k to < 5 lac 0.00% 0.00%

5 lac to < 25 lac 0.50% 0.10%

25 lac+ 0.60% 0.15%

1. Acceleration of Death Benefit

To buy: 1800-266-9777 (Toll free)

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