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HDFC Ergo Health Insurance

HDFC Ergo General Insurance Company Limited is found as a joint venture between two major companies – HDFC Limited and ERGO International AG. While HDFC Limited is a well-known conglomerate in the Indian industrial sector, ERGO International AG is the main insurance company of the renowned Munich Re Group. Thus, both the founders enjoy great reputation in the industrial sector and combine together to form an equally great general insurance company. The company has widespread network of 108 branches which are located in 91 cities of India. The company sells its insurance products directly and also through middlemen like brokers, corporate agents, retail agents and bancassurance channels.

Why to Buy HDFC Health Insurance Policy?

There are multiple reasons favouring the purchase of a health insurance policy through HDFC ERGO. Here they are –

  • The company has the ‘iAAA’ rating which is assigned by ICRA due to its highest claim paying ability. Tis makes the company trustworthy
  • The company is an ISO certified insurer for its services rendered with respect to claims, issuance of the policy, customer service and standard information security process
  • The company offers a range of health insurance products. You can find indemnity health plans and fixed benefit health plans too
  • You can buy the policy directly from then company’s website instantly
  • The company offers claim assistance in case of any health claim
  • The coverage features are extensive compared to which the premium rates are quite affordable
  • The company has won various awards ever since it was formed. These awards signify that the company is efficient and also offers the best in health insurance solutions.

Key Advantages and Benefits of HDFC ERGO Health Insurance Plans

HDFC ERGO health insurance plans have some keys features which give an added edge to the plans. These are as follows –

  • The premium rates are very affordable thus suiting the pockets of every individual
  • There are different types of health insurance plans for varied health insurance needs of individuals
  • The company has a tie-up with more than 6000 hospitals across the country. This vast tie-up enables the company to settle cashless claims easily
  • All the health plans of the company offer lifelong renewability. Thus, at older ages the individuals do not have to worry about their health insurance cover lapsing
  • Many health insurance plans have no restriction on the entry age criterion. Individuals of all ages can buy such plans. This makes the company’s plans universally suitable for all age groups
  • Free health check-ups are also allowed under the plans after 1-4 years of continuous policy renewals
  • Both individual health insurance and family floater health insurance plans are available with the company

Types of HDFC ERGO Health Insurance Plans

Health insurance plans offered by HDFC ERGO can be divided into two broad categories – indemnity health insurance plans and fixed benefit health insurance plans.

  • Indemnity health insurance plans

    Indemnity health insurance plans are those plans which pay for the actual medical costs incurred. These plans are normal hospitalisation health insurance plans. In case of a claim, the insurance company acquires the relevant medical bills and pays the claim for the actual value of the bill. The maximum liability of the HDFC ERGO is, however, limited to the sum insured chosen by the policyholder. HDFC ERGO offers a range of indemnity health insurance plans which come with different coverage features and meet different requirements.

  • Fixed benefit health insurance plans

    Fixed benefit health insurance plans are different from indemnity health insurance plans. Under these plans, a fixed lump sum benefit is paid to the insured. This benefit is irrespective of the actual costs incurred. So, whether the actual costs are lower or higher than the fixed benefit, it would have no effect on the claim amount. HDFC ERGO offers critical illness plan which is a fixed benefits plan. The plan pays the sum insured in one lump sum in case the insured is diagnosed with the covered critical illness.

List of HDFC ERGO Health Insurance Policies

Here is a list containing all the health plans of HDFC ERGO –

  • HDFC ERGO Health Suraksha

    This plan can be taken both by an individual as well as by a family. A family floater plan covers the policyholder, spouse and up to two dependent children. Other features include the following –

    • There is no restriction on the entry age of the insured. Individuals aged 18 years and above can apply for the plan. In case of dependent children, the minimum entry age is 91 days.
    • Sum insured levels allowed include Rs.3 lakhs, Rs.4 lakhs, Rs.5 lakhs and Rs.7.5 lakhs
    • No sub-limits are applicable on hospitalisation expenses like room rent, medicine costs, etc.
    • Maternity Insurance and new born baby cover is inbuilt under the plan
    • Non-allopathic AYUSH treatments are covered by the plan
    • The plan is renewable throughout the lifetime of the insured if renewed on time
    • Free health check-ups are allowed after every 4 claim-free policy years
    • 5% increase of the sum insured is allowed as no claim bonus if no claim is made in a policy year
    • There are two types of premium discounts of 10% each. The first discount is allowed if the policy is bought for two consecutive years and the bi-annual premium is paid at once. The second discount is allowed if two or more family members are covered under the plan on an individual sum insured basis.
    • Medical check-ups before buying the policy are not required till 55 years of age. If the insured is more than 55 years of age, medical check-ups would be required before the company issues the policy.
    • 144 day care treatments are covered by the plan which do not require a hospital stay of 24 hours of more because of advanced medical treatments
    • The plan also covers domiciliary treatments. Domiciliary treatments are those which are taken at home either because there are no hospital beds available or because the insured was not able to be transferred to the hospital. Moreover, if the medical practitioner has recommended domiciliary treatments, coverage would be available
    • There are more than 6000 preferred hospitals at which the insured can avail the facility of cashless claim settlement
    • Coverage for organ donor expenses is available under the plan. Organ donor expenses include expenses incurred by the donor for donating the organ to the insured. It does not cover the cost of the organ.
  • HDFC ERGO my: health Medisure Classic Insurance Plan

    This plan is a senior citizen health insurance plan meant for older individuals. The coverage features and benefits of the plan include the following –

    • Entry age has no restrictions. Individuals who have completed 18 years of age can buy the plan.
    • The premium rates are very affordable so that it does not burn a hole in the pockets of older individuals
    • All types of day care treatments are covered by the plan. Day care treatments are those in which hospitalisation takes place but the hospital stay is for a limited time. It does not last for 24 hours or more. This is because of the specialised treatments which have been developed due to medical science.
    • If no claim is made in a policy year, a 5% no claim bonus is allowed. This bonus increases the sum insured by 5% without increasing the premium rate
    • Renewal of the health plan is allowed lifelong. As such, there is no coverage ceasing age
    • Premiums paid for the plan qualify for tax deduction under Section 80D of the Income Tax Act
    • There is a critical illness add-on under the plan. You can choose the add-on and get coverage for specified critical illnesses. The add-on requires an additional premium but on diagnosis of any of the covered illnesses, double the sum insured is paid in lump sum irrespective of the actual costs incurred.
    • There is a sub-limit on room rent. However, there is also an option to waive off the sub-limit. By paying an additional premium, the policyholder can choose to waive off the sub-limits
    • A daily cash benefit is available for each day of hospitalisation. This benefit is a fixed benefit which is payable over and above the actual medical costs incurred under the plan
    • A lump sum recovery benefit is also paid if the hospital stay exceeds a specified number of days. This benefit is also paid irrespective of other medical costs incurred
    • The term of the policy is one year and two year. The policyholder can choose any term as per requirement.
    • Pre and post hospitalisation expenses are covered for 30 days and 60 days respectively
    • Ayurvedic and other alternative treatments are covered under the plan for up to Rs.25, 000
    • The waiting period for pre-existing illnesses is 3 years. Illnesses which existed at the time of buying the policy are covered 3 years after buying the plan.
  • HDFC ERGO my: health Medisure Super Top-up Insurance

    As the name suggests, this is a super top-up health insurance plan. It has a sum insured limit and a deductible limit. Claims up to the deductible limit are not entertained by the plan. However, if the total claims made during the policy year exceed the chosen deductible limit, the policy comes into force. It pays the excess claim. The policy, thus, helps individuals to increase their sum insured levels without charging them higher premiums. If individuals already have a health insurance plan, they can buy this super top-up plan and boost their health insurance coverage amount. The features of the plan are as follows –

    • The sum insured ranges from Rs.3 lakhs to Rs.20 lakhs while the deductible amount ranges from Rs.2 lakhs to Rs.5 lakhs. Thus, the plan gives the policyholder a wide choice of choosing the sum insured and deductible level which suits his needs.
    • The policy term is one year or two years. Renewal of the policy is allowed for the lifetime. 5% premium discount is allowed if the policy is taken for a continuous period of 2 years and the premium is paid at once.
    • The company boasts of settling its claims within the shortest possible time. The company’s response to the claim is guaranteed within 6 hours otherwise the company pays a penalty.
    • Coverage under the plan includes inpatient hospitalisation, pre and post hospitalisation for 30 and 60 days respectively and day care treatments. There are no sub-limits or restrictions under any of these coverage benefits.
    • The policy is available on an individual as well as on a floater sum insured basis
    • Under the plan’s family floater variant the members which can be covered include grandparents, siblings, grandchildren, daughter in law, son in law, nephew and niece besides self, spouse and dependent children.
    • Pre-entrance medical check-ups are not required if the insured is within 55 years of age. Beyond 55 years of age, medical check-ups are required. 50% of the cost of such check-ups, if required, is reimbursed by the insurance company once the policy is accepted and issued by it.
    • Illnesses which are pre-existing in nature are covered after continuous policy tenure of 36 months.
  • HDFC ERGO Critical Illness Insurance Policy

    HDFC ERGO’s Critical Illness Insurance Policy is a fixed benefits insurance plan. This plan pays a lump sum amount, which is the sum insured, irrespective of the actual treatment or medical costs incurred by the policyholder. The policy covers a specified list of critical illnesses. If the insured is diagnosed with any of the covered illness, the sum insured selected at the time of buying the plan is paid. This is how the plan works. Here are the other benefits and features of the plan –

    • The plan comes in two variants of Silver and Platinum. The Silver variant covers nine critical illnesses while the Platinum variant covers sixteen critical illnesses.
    • There is a survival period of 30 days under the plan. After diagnosis of a covered illness, the insured must survive for the specified survival period to become eligible to receive the claim under the plan
    • The sum insured is paid in lump sum once the insured survives the survival period. This amount can be used for treatments or for any other financial expenses incurred by the policyholder. There is no restriction on the usage of the claim paid under the plan.
    • Illnesses covered under the silver variant include heart attack, multiple sclerosis, cancer, stroke, paralysis, major organ transplant, kidney failure and coronary artery bypass surgery
    • Under the platinum variant, besides the above-mentioned illnesses, other illnesses are also covered. These include benign brain tumour, aorta graft surgery, heart valve replacement, Parkinson’s disease, Alzheimer’s disease, primary pulmonary arterial hypertension and end stage liver disease.
    • The plan offers sum insured levels of Rs.5 lakhs and Rs.10 lakhs. The term is one year or two years.
    • Individuals aged 5 years to 65 years can buy the plan. Pre-policy health check-ups are required if the insured is more than 45 years of age. The cost of such check-ups is borne by the insurance company. If the proposal is rejected, 50% of the cost of check-ups is refunded back.

    These are the health insurance plans offered by HDFC ERGO. In all these plans, there are some instances of claims which are not covered. These are called plan exclusions. Some common list of exclusions which are found in all health insurance plans offered by HDFC ERGO include the following

    • Any treatments which occur within the first 30 days or 90 days of the policy
    • Injuries resulting due to war, revolutions or war-like situations.
    • Injuries suffered due to nuclear radiation or contamination, under the influence of alcohol or drugs, because of acts of criminal nature, suicide or attempted suicide, participation in defence operations and because of participation in adventurous and hazardous sports or activities, etc.
    • Sexually transmitted diseases or venereal diseases
    • Maternity related treatments and complications unless they are specifically covered under the plan
    • Pre-existing illnesses are not covered in the initial years of plan called the waiting period. Different plans have different waiting periods which can be 3 years or 4 years.
    • Cosmetic surgeries, mental disorders and dental treatments are not covered
    • Treatments which are experimental and unproven in nature are not covered by the health insurance plans offered by the company
    • Out-patient medical expenses are not covered unless they are specifically included in the plan’s scope of coverage

    All of HDFC ERGO’s health insurance plans offer tax benefits too. Premiums paid are allowed as a tax deduction under Section 80D. The maximum limit of deduction which can be availed is Rs.25, 000. This limit increases if the individual is a senior citizen aged more than 60 years. In such cases, the limit becomes Rs.50, 000. If the individual buys a separate health insurance plan for dependent parents, he can claim dual tax deductions. One for the premiums paid for self and family and the other for the premiums paid for dependent parents. Thus, a maximum of Rs.1 lakh can be availed as tax deduction if the individual himself is a senior citizen and also pays for the health insurance of senior citizen parents.

HDFC ERGO Health Insurance Renewal

HDFC ERGO health insurance policies can be renewed online through the website of the company. The website is easy to use and navigate, the payment gateways are secured and the process is very simple. Thus, if you want to renew HDFC ERGO’s health insurance plans, you can simply do them online using the following steps –

  • Visit the company’s website at www.hdfcergo.com
  • On the home page you would be able to view the different tabs specifying the type of insurance policies available with the company. Choose ‘Health Insurance’ and the type of health insurance policy which you want to renew, i.e. whether it is individual health plan, family health plan, health plan for parents, etc.
  • When the type of policy is selected, a new page opens which shows the policy and its details. On that page, in a box, there are two tabs for renewal. One is the ‘Instant Renewal’ tab and the other is the ‘Renew Online’ tab. Both these tabs help in online renewals of HDFC ERGO health insurance policies. When you choose ‘Instant Renewal’ a scroll down menu opens which asks for the existing policy number. In case of ‘Renew Online’, a new page opens which also asks for the existing HDFC ERGO health insurance policy number.
  • Once the policy number is provided in either of the tabs, the details of the existing policy opens. You can see the coverage level and the benefits of the plan.
  • You can make changes in your existing policy at the time of renewal like increasing or decreasing the sum insured or adding or deleting family members, etc.
  • After the changes are done, the new renewal premium would be displayed
  • You would have to accept the policy terms and conditions and pay the premium online
  • The website supports online payments through credit or debit cards, net banking facility, mobile wallets and other means.
  • After the premium is paid online, the policy is renewed.

HDFC ERGO Health Insurance Network Hospitals

HDFC ERGO health insurance plans have a tie-up with more than 6000 hospitals across the country. This is also one of the USPs of the company as it helps in cashless claim settlements. A network hospital is one where the policyholder can avail cashless treatments. The hospital is tied-up with the insurance company. Any medical bills incurred on hospitalisation are sent by the hospital to the insurance company directly. The insurance company, then, pays the bills directly and the policyholder is spared the financial burden of paying then bills himself. The policyholder can find the company’s network hospitals either by visiting the company’s website or by calling the company’s customer care number.

HDFC ERGO Health Insurance Premium Calculator

HDFC ERGO health insurance plans provide the facility of online premium calculator. You can use HDFC ERGO medical insurance premium calculator to calculate the premium of the plan you are interested in. You would just have to select the plan you are considering to buy and enter your details. HDFC ERGO medical insurance premium calculator does the rest. The details which are required include the following –

  • Type of plan – individual or family floater
  • The sum insured level you want
  • Date of birth of the insured members
  • Personal details of the policyholder which include name, mobile number, email id, state and city of residence.
  • Once you consent to the company contacting you, you can calculate the premium and buy the plan.

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