HDFC ERGO Health Insurance Company

HDFC ERGO Health Insurance, a premier Indian insurer, is part of HDFC ERGO General Insurance, a joint venture between HDFC Ltd. and ERGO International AG. With a range of general insurance products, the company envisions being the most admired insurer in the country by working towards the continued progress of customers and being responsive to their needs.

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Highlights of HDFC Ergo Health Insurance Company

Claim settlement ratio 99.5%
NCB* 5%, up to 10% of SI*
PED Waiting# 2-4 Years
Network Hospital 13000+
Top Health Insurance Plans by HDFC Ergo

Compare Top Health Plans from HDFC Ergo Health Insurance Company

The HDFC Ergo health insurance plans are designed to cover the insured against a wide array of medical and health emergencies. Below are some HDFC Ergo health insurance plans sold by the company:

my: Optima Secure Plan
Optima Secure Global Plan
Optima Restore Plan
Features
Cashless hospitals
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Emergency Air Ambulance
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Overseas Treatment Covered
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Free Health Check- up
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Unlimited Restore
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Lifetime renewability
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Features
Cashless hospitals
Emergency Air Ambulance
Overseas Treatment Covered
Free Health Check- up
Unlimited Restore
Lifetime renewability

Awards and accolades won by HDFC ERGO Health Insurance Company

 

HDFC ERGO is the proud recipient of the following awards and achievements

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HDFC Ergo received the BFSI Leadership Awards 2022 for Cyber Insurance and Optima Secure Health Insurance plans under the ‘product innovator’ category.  The award recognises and appreciates the pioneers in the BFSI sector

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The company also is the recipient of ETBFSI Excellence Awards 2021 for Best Covid Strategy Implemented - Customer Experience in Insurance category

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HDFC ERGO is also the receiver of FICCI Insurance Industry Awards in September 2021, which is a highly reputed award that was offered for the company’s Excellence in Claims and Customer Service

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The joint venture also received the ICAI Awards in 2015-16 for their Excellence in Financial Reporting under Category IV (non – life). They already received this award 3 times before during their insurance journey

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SKOCH Order-of-Merit is another glory of the company received for Claims Survey Management (CMS) for qualifying amongst the Top 100-projects in India

Key Highlights of HDFC ERGO Health Insurance Company

Features

Meaning

Network Hospitals Available

12000+

Waiting Period (Pre-existing Ailments)

Between 2 years to 4 years

Claims Settlement Ratio

99.90%

Policies Issued

1.5 Crore

Covid-19 Cover

Yes

Renewability

Lifetime (in most plans)

Features of HDFC ERGO Health Insurance

Features

Meaning

Cashless Hospital Network

A wide range of Cashless Hospital Network of over 12,000+ across India.

Tax Benefits

The policyholder can avail tax benefits under the HDFC ERGO health insurance schemes.

Renewal Benefit

Allows HDFC ERGO health insurance renewal benefit in the form of Free Health Check-up within 60 Days of policy renewal.

Claims

HDFC ERGO health insurance company is known to settle 1 claim per minute and approve claim within 20 minutes (T&C applicable).

Hospitalization Cover

The health insurance plans under HDFC ERGO allow coverage on Hospitalization Expenses, Day Care Treatments, Home Treatments, AYUSH Treatment, Organ Donor Expenses and more.

Pre-Hospitalization Cover

These plans cover expenses for 60 days of pre-hospitalization.

Post-Hospitalization Cover

These plans also cover expenses for 180 days of post-hospitalization coverage.

Exclusions of HDFC ERGO Health Insurance Plans

Below are the key exclusions that are not covered as part of most HDFC ERGO health insurance plans:

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Expenses of any injury caused due to adventure or hazardous sports are not included.

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It doesn’t include any self-inflicted injuries that you have self-imposed knowingly.

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Expenses on treatment caused due to war are also not covered under HDFC ERGO health insurance plans.

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HDFC ERGO also doesn’t cover accidental injury that were incurred upon by insured while participating in defense operations including Army/Navy/Air Force.

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The venereal or sexually transmitted diseases are also not covered under HDFC ERGO health insurance plans.

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The health insurance plans offered by HDFC ERGO also do not cover the expenses of treatment of obesity or cosmetic surgery.

Health insurance plans offered by HDFC Ergo

Some of the best health insurance plans offered by HDFC ERGO Health Insurance are;

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Optima Secure Health Insurance Plan:

This is a health plan offering four times the health cover at no extra cost. Here are some features:

  • Sum Insured – ranges between 5 Lakhs to 2Cr
  • Multiple Discount Options – you can save up to 50% that you pay on premium using different discount options offered by the insurer
  • Protect Benefit – Allows the insured to enjoy zero deductions on non-medical expenses listed under the plan

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my:health Suraksha Health Insurance Plan:

This is a comprehensive but affordable health insurance plan with numerous benefits. Here are some features:

  • No room rent capping – The plan allows the insured to choose their favorite hospital room as the plan doesn’t levy any room rent capping
  • Preventive Health Check-up -The plan allows the insured to enjoy precautionary health check-up every time they go for HDFC ERGO health insurance renewal online
  • Sum insured Rebound – This is another best feature of the plan that allows sum insured back-up which gets reinstated once the existing sum insured exhausts

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Optima Restore Health Insurance Plan:

This is a beneficial plan especially recommended for small families.  Here are some features:

  • Sum Insured – It ranges from 5 lakhs to 50 lakhs
  • Restore Benefit – The plan allows immediate addition of 100% basic SI to your insurance plan on the first claim you raise
  • Multiplier Benefit – This benefit allows the insured to doubles their sum insured in two successive years of no claim

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my:health Koti Suraksha Health Insurance Plan:

This comprehensive and cost-effective policy allows big coverage at small prices. Here are some features:

  • Sum Insured - Ranges from 50 lakhs to 1crore
  • No room rent capping – The plan is available with no room rent capping up to private AC room
  • Unlimited day-care – The plan allows unlimited day care procedures

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HDFC ERGO Critical Illness Insurance:

Here are some features of this plan:

  • Up to 15 critical illness covered
  • Lump sum payment in a single transaction
  • 2 variants of the plan are available
  • You can buy the plan for 1 or 2 Years

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iCan Cancer Insurance:

Here are some features of the plan:

  • It covers all kinds of cancers
  • Allows cashless treatment of cancer
  • 60% Sum insured is offered to the policyholder as lump sum payout
  • 100% SI can also be availed for cancer treatment

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my:health Medisure Super Top-up:

This is a plan offering greater health cover at premium prices that are pocket-friendly. Here are some features:

  • No health checkups up to 55 years of age
  • Constant premiums from 61 years of age
  • The plan allows the insured to get more while paying less
  • It covers pre-and post-hospitalization expenses
  • The plan allows the insured to work on aggregate deductibles
  • It also covers day care procedures

The premium for the above plans can be calculated with the help of HDFC ERGO health insurance premium calculator.  Here you can see the HDFC ERGO health insurance premium chart to buy plans suiting your needs.

Eligibility conditions

Minimum age of entry

18 years for adults, 91 days for children

Maximum age of entry

65 years for adults, 18 years for dependent children

Number of family members covered

Self, spouse, dependent children, and dependent parents

Pre-existing Diseases (PED) Waiting Period

2 years – 4 years

Sum Insured

INR 5 lakhs – INR 2 Crores

How to buy HDFC Ergo Health Insurance Plan?

Go to the official portal of HDFC Ergo Health Insurance. Fill in the “Get Health Insurance
Quote” form on the homepage and apply for the same. Answer a few questions about the policy
seeker and submit.

Or visit the Paybima portal and select health insurance from the options available.

1

Visit the Paybima homepage and click on the ‘Health Insurance’ tab in the dropdown menu.

2

Fill in your required details and request a callback.

3

A Paybima representative will help you buy the most suitable plan.

4

You may also reach us at 1800 267 67 67 from 10 AM to 7 PM, or

5

You can visit a Paybima branch near you.

The process of renewing HDFC Ergo Health Insurance Policy

What is the Process for Filing a Claim for HDFC Ergo Health Insurance Plan?

Health insurance claims are generally settled in two ways – cashless claims or reimbursement claims

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Cashless Claims Procedure

Under a cashless claim process the policyholder is not required to make any payments from their own pocket at the time of hospital discharge. Here, the insurance company is directly in touch with the hospital and they make the payment on their own. However, for a successful cashless claim you must ensure that your particular medical insurance plan covers the disease that is being treated in the hospital. Also, you must ensure that the hospital you have chosen to get the treatment done is one of the hospitals enrolled in the network of the insurer.

2
Reimbursement Claim Procedure

Unlike in cashless claims, the policyholder has to make all the payments under the reimbursement claim process. If you have gone through the treatment in a non-network hospital, you have to go through a reimbursement claim process. Here, you can undergo the treatment as per the procedure of the normal hospitalization and make the payment at the time of discharge. However, after getting discharged you must reach out to the insurance company as soon as possible to raise a claim. For that you have to submit a duly filled claim form and all the relevant documents which are mentioned below.

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Documents Required to Claim a HDFC ERGO Health Insurance Plan

Here are the documents needed to claim a HDFC ERGO health insurance policy:

  • You need to submit the duly filled and signed claim form mentioning the HDFC Ergo policy number
  • You would also need the original discharge summary of your bill
  • Do not forget to submit the original final bill along with the break-up of payment details and receipt as well as original pharmacy invoices and prescriptions for medicines
  • Further, you would also need original investigation reports of any diagnosis and tests etc.
  • You may also require implant sticker/invoice (if any used for the treatment)
  • Also, requirement of any past treatment papers might be there, if applicable
  • If it is an accident, Medico Legal Certificate (MLC) or a copy of FIR might be required
  • Also, you may need any other relevant documents, as required by your insurer
  • NEFT details for payment such as a canceled cheque in the name of the proposer is also needed

 

Guaranteed Claim Support

When you buy or renew a health insurance plan from us, we guide at every step till your claim is settled.

Start your claim process with us to get our support

Review of HDFC Ergo Health Insurance Company

HDFC Ergo Health Insurance offers a wide variety of health insurance policies to cater to your requirements. Other highlights include the following:

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The customer found HDFC Ergo Health Insurance to offer comprehensive coverage with prompt claim settlements, ensuring peace of mind.

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The policyholder appreciated HDFC Ergo's hassle-free online services and quick response times, making health insurance easy to manage.

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The insured praised HDFC Ergo for its extensive hospital network and efficient cashless claim process, simplifying medical emergencies.

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HDFC Ergo was commended by the client for its transparent policies and helpful customer support, fostering trust and reliability.
 

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The user noted that HDFC Ergo Health Insurance provided excellent value for money with its affordable premiums and wide-ranging benefits.

Sahi Advice,
Sahi Insurance

If you have any questions on how to choose the best insurance plan, you can connect with our IRDAI certified insurance advisors.

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