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Surgical Care Benefit Rider

Surgical Care Rider that can provide financial support to an individual in times of crisis. Surgical care rider is an additional coverage that can be added to the insurance policy to enhance the coverage of the policy. A surgical care rider can help the life assured to fulfil their hospital expenses in case the life assured needs to undergo a medical surgery. Under the surgical care rider a lump sum amount shall be provided to the life assured in case the life assured is required to undergo an unavoidable medical surgery. A surgical cre rider covers major that directly involves brain, heart, liver or lungs.

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Disclaimer :
1. Premium has been calculated for coverage till 60 years
2. Eligibility depends on income, occupation and educational qualification

What Is A Surgical Care Rider?

Surgical Care Rider is a popular rider that provides a lump sum amount to the life assured in case of a medical surgery. A fixed lump sum amount is offered to the life assured so that they can manage expenses related to their unavoidable medical surgery. Under the rider, the benefit amount provided is equivalent to a certain percentage of the base sum assured. Moreover, the rider provides a fixed lump sum amount in case of being hospitalized for a medical surgery.

Importance of Surgical Care Rider

Surgical care rider is one of the key riders one can add to their term insurance plan and get rid of all their financial concerns. Needless to say, surgical expenses in India are enough to burn a hole in one’s pocket. In an unexpected situation where a surgery is the ultimate requirement, the surgical care rider comes across as a sigh of relief for the insured as well as their family.

Some of the key reasons that make surgical care rider important are:

  • Coverage for Major Surgeries: The surgical care rider provides coverage for major surgeries such as of the brain, heart, lung or liver. The life assured gets expenses covered for a major surgery or any other valid surgical hospitalisation covered.
  • More Claim Opportunities: Under their surgical care rider, a life insured can claim the benefit amount up to a specific number of times in one policy year. Also, the policyholder can claim the surgical care rider benefit up to a specific number of times during the whole policy term.
  • No Financial Concerns: The policyholder or their family can easily come under financial pressure in the case of an unexpected surgical emergency, thereby looking for options to arrange the massive amount of money required to pay for the expenses. The surgical care rider gets rid of this financial pressure by taking care of the surgical and various other expenses. What’s best is that the policyholder does not have to get concerned about a single penny from their savings going down the drain. Moreover, the life assured overcome the expenses incurred for the medical surgery without compromising on their own financial goals. Even the insured and their family are able to handle the stressful situation without any financial concerns in mind.
  • Lump Sum Amount Received: The Surgical Care Rider provides the life assured with a lump sum amount that they can easily use to manage the surgical and other covered expenses.
  • No Premium Changes: You can choose to buy the surgical care rider over your term insurance policy by paying an additional premium. However, note that this does not mean that your premium for the rider will change or increase in case you undergo the surgery. Your premium for the surgical care rider will still remain the same irrespective of your surgical requirements.
  • Tax Benefits: The surgical care rider provides tax benefits as per the prevailing Income Tax Act laws.

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Eligibility Criteria of Surgical Care Rider

Following is the eligibility criteria of Surgical Care Rider:

Eligibility Criteria for Surgical Care Rider



Minimum Entry Age

18 Years

Maximum Entry Age

65 Years

Maximum Maturity Age

70 Years

Sum Assured

Minimum - Same as base policy’s sum assured

Maximum - No Limit

Coverage Time Period

Same as base policy’s term

Premium Payment Term

Same as base policy’s term

Premium Payment Mode

Same as premium payment mode of the base policy

Benefits of Surgical Care Rider

A term insurance policy buyer must add a surgical care rider to their base term insurance cover. As far as the reasons are concerned, it is because this optional cover provides multiple benefits that majorly include:

  • Superior medical assistance.
  • Cover in cases of emergency.
  • Immediate cashless hospital in a partner hospital.
  • Coverage for hospital room service up to a specific limit.
  • The cost of doctors, nurses and others covered under the rider.
  • The patient receives the best treatment under the best health care facilities.
  • Charges of dialysis, cancer chemotherapy and physiotherapy sessions covered under the rider.
  • Pre and post stage consultation covered under the rider.
  • Emergency travelling services for insured patients, depending on the plan.

Documents Required For Surgical Care Rider Claims

Documents required for claiming the surgical rider include:

  • Original Policy Documents
  • Photo ID & Address Proof of Policyholder
  • Medical Reports (stating diagnosed illness)
  • Attending Medical Practitioner's Certificate
  • Medical Test Reports
  • Documents stating the need of surgery
  • Copy of policyholder’s bank statement/cancelled cheque

Surgical Care Rider Exclusions

The list of exclusions under the surgical care rider includes:

  • Pre-existing Medical Conditions
  • Sexually Transmitted Diseases
  • Cosmetic Procedure or Plastic Surgery
  • Organ Donation
  • Pregnancy Complications
  • Attempt to suicide or self inflected injuries

It is not a compulsion for a policyholder to add surgical care rider to their term insurance policy. The surgical care rider is an optional cover that you can buy as an additional benefit to extend your cover and gain benefits at the time of need, if at all the need arises.

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