HDFC ERGO General Insurance Company
HDFC ERGO General Insurance Company
HDFC ERGO holds an unprecedented reputation in the field of the Indian insurance industry. This famous company is a 51:49 joint venture between HDFC Ltd and ERGO (the primary insurance entity of the Munich Re Group of Germany). HDFC ERGO offers a spectrum of insurance products, including health, travel, home, personal accident, and cyber insurance. At present, the company has more than 10,000+ network hospitals and 200 branches in 170 cities.
For its astonishing customer service, HDFC Ergo General Insurance won the “Best Customer Experience Award” in 2016 by KamiKaze. In the health insurance sector, HDFC ERGO offers a host of insurance products, including tailor-made policies for individuals, families, parents, and senior citizens.
Facts about HDFC ERGO Health Insurance
|Incurred Claim Ratio||69.01% F.Y. 19-20|
Why opt for HDFC ERGO health insurance?
Some reasons for choosing HDFC health insurance:
- HDFC health insurance plans offer comprehensive financial assistance and coverage to policyholders against medical emergencies, critical illnesses, women’s health, and accidents.
- The customer support team of HDFC Ergo health insurance is available 24*7 and quickly resolves all queries of customers.
- This eminent insurance company is partnered with more than 10,000 network hospitals. Thus, HDFC medical insurance offers you convenient and hassle-free cashless treatment.
- HDFC ERGO health insurance plans are equipped with additional benefits including, hospital cash, patient care, etc.
- HDFC ERGO medical insurance plans are meticulously designed by experts. The company offers a plethora of health plans for individuals, families, and corporate people.
- After the renewal of the policy, the policyholders are eligible for a free health check-up within 60 days
- Free medical consultation (24X7) for policyholders
- If you are above 18 years, you can purchase the HDFC ERGO policy without any hindrance.
HDFC ERGO Health Insurance Plans
HDFC ERGO health insurance offers multifarious health insurance plans that resonate with all necessities of individuals, families, and corporate people.
- HDFC ERGO My Health Suraksha
- HDFC ERGO Optima Restore
HDFC ERGO Health Insurance Claim Settlement Process
HDFC ERGO Health Insurance Cashless Claim settlement process
HDFC ERGO health insurance offers a trouble-free claim settlement process. Under cashless claim settlement, the insurer directly pays the sum assured to the hospital.
Step 1: Get admitted to the nearest hospital
You need to find out the nearest partnered hospital with HDFC ERGO health insurance and get hospitalized there.
Step 2: Fill and submit the cashless claim form
Now, get a cashless claim form from the hospital, fill it properly and submit it to the hospital with the required documents (your ID proof and health insurance card).
Step 3: Pre-authorization of the claim
Once your submission is completed, the internal claims team of HDFC Ergo General Insurance will approve/reject your claim based on your submitted documents, treatment plan, and coverage. The insurer needs approximately 20 minutes to process the claim.
Step 4: The final claim settlement
Once your claim is approved, you can go for the treatment. You don’t need to spend anything from your pocket. After your discharge, HDFC ERGO health insurance will verify all the documents and discharge summary. Then, the insurer will directly settle the claim with the hospital.
HDFC ERGO Health Insurance Reimbursement Claim process
Follow the below steps for the claim reimbursement process from HDFC ERGO health insurance.
Step 1: Get admitted to any hospital
First, you need to get hospitalized in any hospital.
Step 2: Collect bills and inform the insurer
Once your treatment is completed, collect the bills and initiate the reimbursement claim with the insurer.
Step 3: Fill and submit the reimbursement claim form
Now, fill and submit the claim reimbursement form along with the required documents on the portal of the insurer or at their nearest office.
Step 4: Claim settlement process
Once everything is finished, HDFC ERGO health insurance will settle your claim. But you need to pay the non-payable expenses.
Documents required for HDFC ERGO Claim Reimbursement process
Here are the documents that you need to initiate your claim reimbursement process.
- Copy of your HDFC ERGO health insurance card
- Duly filled and signed claim form
- Original discharge summary from the hospital
- Doctor’s letter for advising admission and consultation papers
- Medical reports (X-ray, blood tests, scans, etc.)
- Invoices, receipts, and bills from pharmacies
- A copy of FIR (for accident or police case)
- A copy of the KYC documents ( if your claim amount is more than 1 lakh)
- NEFT details, Email ID, and contact number
HDFC ERGO Health Insurance Renewal Process
Like all policies, you need to renew your HDFC ERGO policy to enjoy the benefits.
- Step 1: Visit the official website of HDFC ERGO health insurance.
- Step 2: Now, go to the ‘Renew’ section and click on ‘Health Insurance’.
- Step 3: Enter your policy number, email id, and mobile number and click the “Renew Now” button.
- Step 4: Review your policy details and the premium amount before making the payment.
- Step 5: Now, pay the amount at your convenient payment mode.
What are HDFC ERGO health insurance plan exclusions?
HDFC ERGO policy details don’t cover the below-mentioned things.
Any claim due to war or similar conditions.
For sexually transmitted diseases.
Cosmetic surgery, mental disorder, congenital disease, treatment of obesity, etc. are not covered under the policy.
Self-injuries or adventure sports injuries.
Diseases because of drugs consumption or excessive alcohol consumption.
Do HDFC ERGO health insurance plans cover pre-existing illnesses?
HDFC ERGO health plans will not cover pre-existing illnesses at the beginning of the policy. This is called the waiting period. Various pre-existing diseases have different waiting periods. So, check the waiting period for your condition or you may contact HDFC ERGO for your existing disease.
With HDFC ERGO health insurance plans, how many claims are permitted in a year?
Though you can submit any number of claims in a year, remember that your claim amount should not cross the sum assured of your plan. If you have a health insurance policy of Rs. 2 lakh, then you can claim up to Rs. 2 lakh from HDFC ERGO health insurance.
Can I pay my HDFC ERGO health insurance in EMI?
Yes, recently HDFC ERGO has launched a facility for its policyholders to pay health insurance premiums in installments.
Can I port my existing health policy to HDFC ERGO?
If you have renewed your existing policy on time, then you can port it to HDFC ERGO without any hassle.
What things are covered under HDFC ERGO health insurance plans?
HDFC ERGO health insurance plans offer coverage for the below-mentioned things.
Organ transplant expenses
Daycare treatment methods
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