HDFC ERGO Health Insurance

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Policies Issued

15,000,000+

Year of Inception

2000

No. of Branches

421+

Network Hospitals

12,000+

About HDFC ERGO Health Insurance

HDFC Ergo General Insurance Company is a leading name in the general insurance industry. The company has been established as a joint venture between HDFC Limited and ERGO International AG. While HDFC Limited is a leading financial services company of India, ERGO International AG is the main insurance company of the Munich Re Group. HDFC Ergo offers a range of general insurance products which meet the insurance requirements of common individuals as well as corporate entities. You can find motor insurance plans, travel insurance plans, fire insurance plans, commercial insurance plans and health insurance plans offered by HDFC Ergo. All the company’s plans provide a good scope of cover and come with competitive premiums

The company is spread across more than 100 cities of India with 120+ branches and 3000+ employees working for it
ICRA has conferred the company with a rating of ‘iAAA’ because of the high claim settlement record that the company has
The company also enjoys ISO certification for its efficient services in customer service, policy issuance, technological developments, etc.
The company has won various awards over the years since it was established
More than 1 crore customers are currently being served by HDFC Ergo

HDFC ERGO Claim Settlement Ratio

99.39%

HDFC ERGO

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. HDFC ERGO has a claim settlement ratio of 99.39%, as compared to the industry average of 94.21%.

HDFC ERGO Health Insurance Plans

HDFC ERGO health insurance offers 9 health insurance plans. The premium of these plans starts from Rs. 180/yr. The sum insured ranges from Rs. 7,500 - 75 Lakh. Details of the comprehensive coverage provided by the following 9 HDFC ERGO health insurance plans are listed below:

HDFC ERGO Critical Illness Platinum Plan

Starting Premium- ₹ 550/yr

This is also a critical illness health insurance plan which pays a fixed benefit on diagnosis of the covered illnesses.However, the plan covers more illnesses and has the following features

15 critical illnesses are covered under the plan
The policy can be renewed lifelong
The survival period can be chosen to be as low as 15 days

Eligible Age

5 years - 65 years

PED Waiting Period

4 years

Coverage

1 Lakh - 50 Lakh

NCB

HDFC ERGO Critical Illness Silver Plan

Starting Premium- ₹ 450/yr

This is a fixed benefit health insurance plan which covers a list of critical illnesses. If you are diagnosed with any of the covered illness,the plan pays the sum insured in lump sum irrespective of the medical costs that you incur.The features of the plan are as follows

8 major illnesses are covered under the plan
Coverage of up to INR 50 lakhs can be taken against the covered illnesses
You can choose the survival period after which the critical illness claim would be paid by the company

Eligible Age

5 years - 65 years

PED Waiting Period

4 years

Coverage

1 Lakh - 50 Lakh

NCB

HDFC ERGO Health Suraksha Gold Plan

Starting Premium- ₹ 2,908/yr

This is another variant of the HDFC ERGO Health Suraksha policy albeit with a wider scope of coverage.The features of the plan are as follows

A family discount of 10% is allowed in the premium rate if two or more members are covered under the policy
Coverage is available up to INR 10 lakhs
There is no limit on the entry age
Maternity expenses and newborn baby cover is inbuilt in the plan’s coverage features
You can also get an e-opinion from the company’s team of medical experts if you suffer from a critical illness.This service would be free of cost
This HDFC Ergo medical insurance plan has an optional regain benefit which refills the sum insured in case it is used up in a claim in the policy year
You can also choose to enhance the no claim bonus to 10% by paying an additional premium

Eligible Age

5 years onwards

PED Waiting Period

4 years

Coverage

3 Lakh - 10 Lakh

NCB

5% increase in cover;max upto 50%

View All Plans

HDFC ERGO Top-up Plans

HDFC ERGO health insurance provides 2 top-up plans. The premium of these top-up plans start from Rs. 1,100/yr. The sum insured ranges from Rs. 3 Lakh - 20 Lakh. HDFC ERGO top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each HDFC ERGO top-up insurance policy below:

HDFC ERGO Health Suraksha Topup Plan

Starting Premium- ₹ 1,100/yr

This is a supplemental health insurance plan like a super top-up plan.Under this plan also the aggregate claims are considered against the deductible limit and if the total claim in a year exceeds the deductible limit, the claim is paid.The features of the plan are as follows

You can buy the plan on a family floater basis also
If you insure three or more family members on an individual coverage basis, you can avail a premium discount of 10%
There are no sub-limits on room rents,doctor’s fee and other inpatient hospitalisation expenses
Domiciliary treatments are also covered under the policy

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

3 Lakh - 10 Lakh

NCB

5% increase in cover

HDFC ERGO My Health Medisure Super Topup Insurance Plan

Starting Premium- ₹ 1,430/yr

This is a super top-up health insurance policy which has a specific deductible limit.If the total claims in a policy year exceed the deductible limit,the plan pays the excess claim.This plan can be taken to increase your sum insured.The features of the plan are as follows

There are different combinations of the sum insured and deductible options to choose from
The premiums remain fixed after you attain 61 years of age
No capping is done on inpatient hospitalisation coverage
You can buy the policy either on an individual basis or on a family floater sum insured basis
Premiums are not increased on renewals even if a claim is made
5% premium discount is allowed if you buy a two-year policy

Eligible Age

91 days - 65 years

PED Waiting Period

3 years

Coverage

3 Lakh - 20 Lakh

NCB

Top Features From HDFC ERGO Health Plans

Key features of HDFC Ergo health insurance plans

A range of health insurance policies is issued by the company. You can buy a policy to cover yourself, your family members and also dependent senior citizen parents
Critical illness policy is also offered by the company which covers a list of critical illnesses and pays a lump sum benefit on their diagnosis
Personal accident plans are also available which cover accidental injuries and pay a lump sum benefit at the time of claims
All health plans offered by the company allow lifelong renewals
There are optional coverage benefits too which can be added to your policy for a more inclusive scope of cover

Benefits of HDFC Ergo medical insurance plans

The company offers you round the clock assistance for your grievances and product related queries
90% of the pre-authorised cashless claims which are made under HDFC Ergo health insurance plans are approved by the company within 20 minutes. This ensures that your claim settlement is easy and quick
HDFC Ergo health insurance plans offer the facility of a Wellness Application which can be downloaded on your Smartphone. This application helps you lead a healthy lifestyle and also rewards you for doing so
HDFC Ergo medical insurance policies are issued online without the need of lengthy paperwork. This makes buying the policies an easy affair
The company has a network of more than 10,000 hospitals across India to cater to cashless claim settlements

Coverage benefits

Inpatient hospitalisation expenses which include the cost of room rent, doctor’s fee, nurse’s fee, treatment costs, etc.
Pre hospitalisation expenses
Post hospitalisation expenses
Daycare treatments
Cost of road ambulance
Domiciliary treatments which are taken at your home
Organ donor treatments where the cost of harvesting the organ is covered
Free health check-ups at specified intervals during the policy

Exclusions Across HDFC ERGO Health Plans

Pre-existing illnesses are not covered from the start of the policy. They are covered after a specified waiting period
Illnesses incurred within the first 60 to 90 days of buying the policy are not covered
Pregnancy-related costs and expenses are not covered unless they are specifically included in the plan’s coverage benefits
Cosmetic treatments, LASIK surgery, dental treatments, etc. are not covered
Unproven and experimental treatments are not covered
Self-inflicted injuries and attempted suicides are excluded from coverage
Injuries or illnesses due to war, radiation, nuclear contamination, etc. are not covered
Participation in defence-related activities or any other hazardous activities would not be covered
HIV/AIDS and other sexually transmitted illnesses are not covered

HDFC ERGO Premium Calculator

Use the HDFC ERGO health insurance premium calculator to estimate your health insurance premiums.

Premium Calculator

Enter just a few details to calculate your health insurance premium within 30 seconds.

HDFC ERGO Customer Care

Customer Care Number

2262 3462 34

Email ID

preauth@hdfcergo.com

HDFC ERGO Claim Process

HDFC ERGO supports both cashless claims and reimbursement claims. This section covers the information on how to check HDFC ERGO health insurance claim status, fill HDFC ERGO health insurance claim form, and the claim settlement process.

Hospitalization : Find out to locate nearest network hospital
Avail Cashless Hospitalization & Submission of Documents by showing your health card and valid photo ID
Preauthorization: Hospital will send the cashless request to HDFC ERGO and coordinate with with Network Hospital for the Pre-authorisation form
At the time of Discharge & Settlement of claim : HDFC ERGO/ TPA will scrutinize all the received documents and convey the final stand on the claim
Status Update: You will receive an update through SMS/Emails at every stage of the claim on your registered mobile number or email id
Cashless authorisation & Approval of Claim: Hospital shall send the final bill to HDFC ERGO for authorisation and HDFC ERGO shall scrutinize the same and give final authorization in case of approved transactions to the hospital. Any inadmissible expenses, copayments, deductions will have to be paid by Customer

Hospitalisation: You need to pay the bills initially and preserve the original invoices
Register A Claim: Post hospital discharge send us all your invoices and treatment documents
Verification: verify your claim related invoices and treatment documents
Claim Settlement: We send the approved claim amount to your bank account.

HDFC ERGO Health Insurance Renewal Process

Online Process For HDFC ERGO Health Insurance Renewal

Here are 3 quick steps to renew HDFC ERGO health insurance online

Step 1: Visit their website www.hdfcergo.com and click on "RENEW"
Step 2: Enter either your policy details, registered email id or your mobile no. and click on ‘Renew Now’ to proceed
Step 3: Make the payment for policy renewal via your preferred mode of payment

You should consider renewal as an opportunity to carefully review all policy details and make necessary adjustments as per your needs. Please note that you can renew your expired policy within 30 days from expiry date

Offline Process For HDFC ERGO Health Insurance Renewal

For the offline method of renewing your HDFC ERGO Health Policy, you can call on 022-62346234/ 0120-62346234 or visit their nearest branch.
You can also reach out to your nearest Turtlemint insurance advisor who can assist you in quick renewal of your policy. Visit www.turtlemint.com now for your HDFC ERGO health policy renewal

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FAQs

If you already have existing health insurance coverage and are looking to increase it without paying expensive premiums, you can choose top-up and super top-up health insurance plans. These plans have a deductible and a sum insured. Claims above the deductible limits are paid and so the premiums are low. When you have existing coverage, you can choose a deductible matching the existing plan’s sum insured so that any excess claim would be paid by the top-up or super top-up plan

You can get numerous tax benefits when you buy a health insurance plan. These benefits are allowed under Section 80D of the Income Tax Act, 1961 and are as follows

Premiums paid for a plan covering you, your spouse and dependent children would be allowed as a deduction up to INR 25,000
If you are a senior citizen, the deduction limit would increase to INR 50,000
Premiums paid for a plan covering your dependent parents would be allowed as an additional deduction for up to INR 25,000
If your parents are senior citizens, the deduction limit would increase to INR 50,000
If you buy two policies, one for yourself and your family and the other for your parents, you can claim a deduction of up to INR 50,000. If you or your parents are senior citizens, the limit increases to INR 75,000. If both you and your parents are senior citizens, the limit would be INR 1 lakh

Yes, a free-look period of 15 days is allowed from the date of policy issuance under HDFC Ergo health insurance plans. During this period you can cancel the policy if you want and avail the refund of the premium paid

The claim process of HDFC Ergo health insurance plans has been explained earlier. You need to intimate the insurance company of your claim and then follow the above-mentioned steps to get the settlement of your claims faster

You can buy HDFC Ergo health insurance plans online either from the website of the company or from Turtlemint itself. When you buy through Turtlemint, you can compare HDFC Ergo’s plans with other health insurance plans and then choose the best one. The process of buying the policy has been explained earlier above

HDFC Ergo’s health insurance plans do not cover specific illnesses and treatments some of which include the following

Self-inflicted injuries
Cosmetic treatments
Congenital illnesses
HIV, AIDS and venereal diseases
Pre-existing conditions during the waiting period
Injuries suffered due to war or nuclear perils
Unproven or experimental treatments, etc.

There are online premium calculators offered both by HDFC Ergo as well as by Turtlemint which allows you to calculate the premium of HDFC medical insurance plans. You can enter the relevant details which affect the premium calculation and find the premium rates. These details include the following

Age
Sum insured
Number of members to be covered
Medical history
Pre-existing illnesses
Term of the plan
Add-ons if needed

Based on these factors, the premiums would be calculated and displayed

A health card is issued for all insured members when you buy HDFC Ergo health insurance plans. This health card is needed at the time of cashless claims as the card contains a unique customer identification number. When you are admitted to a networked hospital, you need to present the health card to avail cashless treatments. Thus, you should get a health card from HDFC Ergo health insurance

HDFC Ergo is a leading name in the general insurance segment and its health insurance plans are comprehensive plans at affordable premiums. The company offers a range of health insurance plans for your coverage needs and you can find a suitable policy easily. The plans offered by the company offer optimal coverage levels and benefits and are also light on your pockets. So, HDFC Ergo health insurance is a good choice for your health insurance needs.