HDFC ERGO Health Insurance Limited (formerly known as Apollo Munich Health Insurance) is a consolidated collaboration between HDFC Ltd and Munich Health. HDFC Ltd is one of India’s leading housing finance companies in India located in Mumbai and Munich Health is a reinsurance company that has its headquarters in Germany. HDFC ERGO Health Insurance is known for crafting contemporary health plans that cover pre and post hospitalization expenses, daily cash for hospital rooms, free health checkups, medical expert opinion, daycare procedures, worldwide emergency ambulance, special coverage for cancer, hypertension, and diabetes, etc.
Apart from these benefits, HDFC ERGO Health Insurance also offers comprehensive coverage with the optional rider to make it more productive and efficient. With the support of this health cover, wipe out all your health-related anxieties and complexities towards the future expenses pertaining to health.The company is appraised with several awards for instituting innovative health insurance plans that cater to the prevailing health associated needs of the current generation.
|Number of Network Hospitals||4500+|
|Claim Settlement Ratio||62.47%|
|Renewability of the Policy||Lifetime|
|Additional Rider Benefit available||Available|
|Discounts and Rebates||Available|
|Waiting period||3 years|
A health insurance plan which is suitable for both individual and family healthcare needs.
HDFC ERGO Easy Health Plan ensures financial assistance. It covers hospitalization costs incurred on the treatment of any defined illness and other related medical expenses of the insured.
It is the most preferred plan of HDFC ERGO Health Insurance which offers comprehensive cover for hospitalization for all major and minor diseases.
A plan that offers great coverage options at affordable premiums. The plan is great at providing comprehensive cover.
An individual plan that is crafted to meet the increasing cost of healthcare sector and provides timely coverage to the insured with 4,500 hospitals located in 800 cities.
This plan covers all the necessary medical costs that are crucial for the health of the insured and becomes effective at the time of retirement.
A uniquely designed health insurance that covers critical diseases whose treatment is way too extravagant that may leave you bankrupt at a point of time. The plan safeguard the savings and create an additional reserve of money for medical expenses.
An exclusive health insurance plan to deal with widespread diseases called diabetes whether it is Type 1 or Type 2. This gives financial assistance to combat and treats the complicated illness of diabetes.
A special plan dedicated to providing coverage for minor illnesses that are excluded from the many other health insurance plans. This plan takes care of all the minor injuries to illness such as a normal stomach infection, allergies, sore throat, eyesight weakness, dental treatment, etc.
This plan will give you advanced protection from cancer which has rapidly built its home in the human body. To eradicate the roots of cancer, this plan ensures complete coverage for the treatment without any limitation.
For Enhance Plan Only:
HDFC ERGO’s concern towards growing cancer cases mostly in the female population. Hence, the company has designed iCan Cancer Insurance which takes care of the women and mainly cancer issues.
For Advanced Plan:
A dengue specific plan that covers the expenses arising from hospitalization whether in-patient or outpatient treatment. Anybody from a child to an adult person can easily purchase the plan as there are no age limitations.
Simple health insurance that guarantees coverage for medical expenses occurred over the treatment and hospitalization of senior citizens. Anybody who is above the age of 61 years can buy this plan and can live the rest of life tension free.
|Name of the product||Minimum Age of entry||Maximum Age of entry||Sum Insured/ Daily Cash||Number members can be included||Premium Paying Modes||Policy Term|
|For Individuals and Family:|
|Health Wallet||5 years/ 91 days (for children)||65 years||Rs 3 lakhs to Rs 50 lakhs||Individuals and Family Floater: 6 members||Annually/ Monthly||One Year/Two Year|
|Optima Restore||5 years/ 91 days (for children)||65 years||Rs 3 lakhs to Rs 50 lakhs||Individual: 6 members Family Floater: 6 members (2 adults & 5 children)||Annually/ Monthly||One Year/ Two Year|
|Easy Health||5 years/ 91 days (for children)||65 years||For Individual: Rs 1 to 15 lakhs For the family: Rs 3 lakhs to Rs 50 lakhs||Individual: 6 members (4 adults & 5 children) Family Floater: 6 members (maximum of 5 adults and 2 children)||Annually/ Monthly||One Year/ Two Year|
|Day2Day Care- Silver||For children: 91 days to 25 years For Adults: 18 years||65 years||Not Specified||Individual: 6 members Family Floater: 4 members||Annually/ Monthly||One Year/ Two Year|
|Optima Super||5 years/ 91 days (For children)||65 years||Rs 5 lakhs/ 7 lakhs/ 10 lakhs||Individual: 6 members Family Floater: 4 members (maximum of 2 adults and 2 children)||Annually/ Monthly||One Year/ Two Year|
|For Individuals Only|
|Optima Cash||5 years/ 91 days (for children)||65 years||Rs 1000/ 2000/ 3000||Not Applicable||Annually/ Monthly||One Year/ Two Year|
|Optima Plus||5 years/ 91 days (for children)||65 years||Rs 5 lakhs||6 members (maximum of 4 adults and 5 children)||Annually/ Monthly||One Year/ Two Year|
|Optima Vital||18 years||65 years||Rs 1 lakhs to Rs 50 lakhs||6 members (maximum of 4 adults and 5 children)||Annually/ Monthly||One Year/ Two Year|
|Energy Plan||18 years||65 years||Rs 2/ 3/ 5/ 10/ 15/ 20/ 25/ 50 lakhs||Only for one member||Annually/ Monthly||One Year/ Two Year|
|Maxima Plan||5 years/ 90 days (for children)||65 years||Rs 3 lakhs||Only for one individual||Annually/ Monthly||One Year/ Two Year|
|iCan Cancer Insurance||5 years||The whole of the life||Rs 5/ 10/ 15/ 20/ 25/ 50 lakhs||Only for one individual||Annually/ Monthly||One Year/ Two Year|
|iCan Cancer Insurance for Women||18 years||The whole of the life||Rs 5/ 10/ 15/ 20 lakhs||Only for one female individual||Annually/ Monthly||One Year/ Two Year|
|Dengue plan||91 days to 25 years (for children 18 years (for adults)||65 years||Rs 50,000 to 1 lakh||6 members (Maximum of 4 adults and a maximum of 5 children)||Annually/ Monthly||One Year/ Two Year|
|For Senior Citizens:|
|Optima Senior||61 years||No maximum age limitations||Rs 2/ 3/ 5 lakhs|
Claim Settlement Ratio
Before taking a step to buy health insurance, a person must check the company’s claim settlement ratio to get an idea about the credibility of the insurer. HDFC ERGO Health Insurance with its decent claim ratio has maintained a trustworthy image in the health insurance sector.
HDFC ERGO Health Insurance is one legal entity that contains the power of two colossal brands namely HDFC Ltd. and Munich Health, recognized as a global player in the health insurance sector. Consequently, when a person buys the policy, they get the benefit of domestic as well as an international brand.
Quick Customer Service
While you purchase a health insurance policy, the factor of customer service should be taken into consideration. HDFC ERGO Health Insurance customer care team strives to settle each claim within 15 to 30 days to keep the customer engaged with current policy and not switch to other health insurers.
Almost every health insurance plan formulated by HDFC ERGO Health Insurance contains the rider benefit whose objective is to provide additional security to family and individuals. Through the inclusion of these riders, you can make your health plan super worthwhile.
HDFC ERGO Health Insurance plans give you the feature of lifelong renewability where the policyholder can renew online health cover on every policy anniversary. On renewals, all the benefits scored in the previous year will be carried forward to the next year.
Insured, after buying health insurance can receive a huge amount of tax benefits up to Rs 25,000 per year. The tax exemption will be given on the annual Income tax submitted every year on the annual salary or profit earned from a business.
Cashless service at any network hospital is like a blessing to policyholder and settlement of the same is equally significant. HDFC ERGO Health Insurance has statistics of establishing 90% cashless claim authorization within 2 hours if all the information regarding the claim is truly represented by the insured.
The company also gives complete freedom to port your previous health insurance policy into HDFC ERGO Health Insurance policy, if you are not satisfied. The insured has to submit an application for 30 days before the renewal date by filing a portability form and submitting previous policy details.
When you buy HDFC ERGO Health Insurance, you get rewards for staying healthy and keeping yourself miles away from consuming tobacco or smoking. The policyholder will get monetary rewards like lower rates of premiums. Also, if the policyholder does not make any claim for one year or more, then a bonus equal to 50% of the sum assured will be added to the basic coverage.
By choosing this additional cover, the insured can enjoy never-ending benefits that come along with the plan. Here’s a list of add-ons to make your plan more efficient in a comprehensive manner:
Critical Advantage Rider
This cover gives you a treatment facility at network hospitals present globally. Also, it also gives coverage transportation expenses of insured and the attending member, accommodation expenses, post-hospitalization, and second opinion expenses.
The illnesses covered under this rider are-
Critical Illness Benefit Rider
In this rider, the policyholder can get protection from 8 major diseases that can degrade the health of the insured if not treated timely.
What illnesses are covered?
All these exclusions are common to all HDFC ERGO Health Insurance plans. However, there are specific exclusions for some specific HDFC ERGO plans and the policyholders are requested to check the particular plan page for which they are planning.
Reimbursement Claim Process
Cashless Claim Process
Following is the list of documents mandatory for claim settlement process:
Online Renewal Process of HDFC ERGO Munich health insurance-
Conditions to be followed
HDFC ERGO Health Insurance has been rated as the topmost preferred company for ensuring financial protection from health insecurities through broad coverage from the rising expenditure of the medicare sector. It is highly reputed and got excellent reviews from its customers throughout its journey.
With connectivity to 4,550 hospitals spread across various zones of the country and faster settlement of the claim, proposals have earned them satisfied customers. Due to this gesture of service, 80% of the customers are returning to renew their health insurance policy on the policy anniversaries. Also, the benefits which are covered in each HDFC ERGO Health plan are duly paid as promised during the commencement of the policy.
For a planned hospitalization, the HDFC ERGO health insurance company must be informed within 7 days before the event takes place.
In case of emergencies, the company must be notified about the claim within 24 hours of succeeding in the happening of an event.
Yes, Pre-Policy check-up is necessary on the basis of age and sum insured value. The medical reports of the check-up are valid for 90 days from the date of check-up.
However, in some of the policies mentioned above, the requirement for a pre-policy medical checkup is not compulsory.
Yes, some HDFC ERGO Health Insurance plans contain 50% to 100% reimbursement of expenses incurred during the medical examination. Please read the policy wordings before purchasing a particular plan to get an idea about the reimbursement of pre-policy medical checkups cost.
Yes, pre-existing diseases will be covered after a waiting period of 36 months or from the date of commencement of risk based on the type of health insurance policy chosen.
A maximum period of 30 days is taken to settle the payment of the claim for which bank details of the insured are necessary to get the electronic transfer of funds. The payment will be made through a cheque issued in the name of the person proposing the
It allows the insured to gather health rewards in the form of discounts on the premium. The simple requirement to avail of this benefit is to walk as far as possible to gain a healthy body and gain an 8% discount on the premium paid on every renewal.
The documents for the claim settlement will be submitted to the respective TPA, kindly check your ID and user guide for TPA details.
Yes, there is a tax benefit for the premiums paid for the health insurance plans from HDFC ERGO under Section 80D of the Income Tax Act.
For all sales policy, HDFC ERGO has its own efficient claim settlement team and for group policies, the TPA is Family Health Plan Limited (FHPL) instead they have many other TPAs’ for various needs of the company.
Yes, the insured will pay for the cost of Pre-Policy Check-up (PPC) in which the insured has to do the tests from HDFC ERGO doctors and labs via responsible TPA. Reimbursement of 50% of the expenses will be provided by HDFC ERGO on submitting original bills and receipts.
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Last updated on 06-02-2020