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HDFC ERGO Health Insurance Claim Settlement

HDFC ERGO Health Insurance provides a variety of health insurance services along with cashless facilities with daycare treatments. It offers good health plans and policies which are much cost-effective in nature. HDFC ERGO Health Insurance provides quality service for its customers. The process of HDFC ERGO Health Insurance Claim is simple and customer-friendly. It provides coverage against medical-related expenses by giving financial support. Therefore, the HDFC ERGO Health Insurance plan is important for securing financial stability.

HDFC ERGO Claim Settlement Process for Cashless Treatment

HDFC ERGO Health Insurance allows network hospitals to avail of cashless claims. HDFC ERGO Health provides a wide range of network hospitals. Here are the steps of HDFC ERGO Health Insurance Claim For the cashless claim process are as follows:

  • Firstly, you need to find an HDFC ERGO Health network hospital to get cashless treatment
  • In case of planned hospitalization, HDFC ERGO Health provides the emergency hospitalization within 24 hours to 48 hours before admission
  •  You need to carry an HDFC ERGO Health Card/Policy number and one photo ID proof.
  •  Fill the form of pre-authorization request available at the hospital and submit it to the hospital.
  •  The hospital sends your pre-authorization request form to HDFC ERGO Health Insurance after your identity is verified.
  • On your registered email id or mobile number, you will receive an update via SMS/e-mail on every phase of the claim 
  •  The final bill is generated by the hospital and sent to HDFC Ergo for authorization purposes.
  •  The insurer gives the final authorization (if the transactions are approved) to the hospital after verifying the same.
  •  The amount of any inadmissible expenses, co-payments, and deductions is paid by the policyholder.

HDFC ERGO Claim Settlement Process for Reimbursement Treatment

Reimbursement claims can be entered in case you got treatment at a network or non-network hospital. Here are the step of reimbursement claim process are as follow:

  • Visit the nearest hospital and provide it within 24 hours of an emergency hospitalization or 48 hours of planned hospitalization.
  •  Firstly, you need to register and fill the reimbursement claim form
  • Then send the required documents to the HDFC Ergo Health Insurance Claim Office.
  • HDFC Ergo will approve the claim after verifying the documents.
  • HDFC Ergo will inform you if certain documents or information are required
  • The claims will be cleared by the insurer after a few receipts of the required documents
  •  Through email/SMS you will receive the status update on every process of the claim. 
  •  After verifying with complete documents, the claim would be processed by HDFC Ergo and paid through NEFT 

How to Check HDFC ERGO Health insurance Insurance Claim Status

To view your claim status of HDFC ERGO Health, you need to either follow the online method or offline method. 

1. Online Procedure: To check your claim status, you can easily follow the steps given below:

  • Visit the official website of HDFC ERGO Health Insurance.
  •  Choose the ‘Claim’ section tab and
  •  Fill in the details of your policy number/ mobile number/ email id to log in to your account.
  • Once you have filled in all the details, you receive OTP on your registered mobile number or email Id.
  •  You can easily check your claim status from there.
  • Then click on the ‘Go’ Tab. 

2. Offline procedure: Even if you can’t check your claim status online, you can use the offline mode also. Simply, you need to call HDFC ERGO Health customer care representative at Toll-Free Number and ask regarding the same. Customer care representatives will request the intimation number and ID card number.

Documents Required For HDFC ERGO Health Insurance Claim

Mentioned below is the list of documents required for filing an HDFC ERGO Health Insurance claim.

  • Required Original investigation reports
  •  Required final hospital discharge summary
  •  Report of FIR or post-mortem if happened
  •  The prescription of Pharmacy bills 
  •  Original bills, receipts, and discharge report
  •  Indoor case papers and filled claim form
  •  Required original hospital bills and a valid photo ID proof
  •  Required doctor’s report, and original consultation notes
  •  Bill and receipt of surgeons 
  •  Test reports of surgeon’s along with attending doctor’s

Benefits Of HDFC ERGO Health Insurance

Here are the benefits of HDFC ERGO Health Insurance claim can be mentioned as below:

  • HDFC Ergo Health Insurance provides no medical test up to 45 years of age.
  • Within 60 days a free health check-up is offered HDFC ERGO after the renewal of the policy with the insurer.
  • HDFC ERGO Health Insurance has no age restriction to buy health insurance plans. All individuals having an age up to at least 18 years.
  • It provides lifetime health insurance plans renewability
  • HDFC ERGO Health Insurance Claim has a good claim ratio of settlement

What is included in the HDFC ERGO Health Insurance?

Mentioned below are the inclusions of HDFC ERGO Health Insurance Claim-

  • In-patient Hospitalisation:
  • Procedure of daycare
  • Expenses of organ donor
  • Pré-Hospitalisation and Post-Hospitalisation:
  • Modern Treatments
  • Health check-up
  • Inpatient Ayush treatment

What is excluded in the HDFC ERGO Health Insurance?

Mentioned below are the exclusions of HDFC ERGO Health Insurance Claim-

  • Surgery of Plastic and Cosmetic
  • Self-inflicted injury
  • Injury due to war or invasion
  • Venereal Transmitted Diseases
  • Injury due to adventure sports
  • Illness due to intoxicating substances
  • Participation in Defense Operations


HDFC ERGO Health Insurance Claim provides a simple and efficient process for its customers. It also provides health insurance claim coverage for critical illnesses and personal accidents. HDFC ERGO Health Insurance has good customer service and efficiency in the claim settlement. It also offers a claim settlement team to make the process quick and easy without any problems.

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