HDFC ERGO Health Claims Status
  • Types of insurance claims
  • Process of filing claims
  • Tracking of claim status
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Network hospitals

12000+

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Incurred claim ratio

79.04%

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Sum insured

Up to 2 CR

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No. of Plans

11

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Solvency Ratio

1.7

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Pan India Presence

200+

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Age of Eldest Member

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Network hospitals

12000+

premium

Incurred claim ratio

79.04%

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Sum insured

Up to 2 CR

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No. of Plans

11

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Solvency Ratio

1.7

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Pan India Presence

200+

HDFC ERGO Health Insurance Claims Status

An insurance claim is a formal request to the insurance provider for reimbursement against losses covered under your insurance policy. A health care claim status inquiry and response transaction is a communication between an insurer and a policyholder about a health care claim.The claim process does not end just by submitting claim forms. HDFC ERGO Health Insurance involves certain documents which need to be examined actively. This will help the customers to deal with situations like incorrect redirections of funds, rejection of ID, rollout of lesser amount of funds.

HDFC ERGO is a 51:49 joint venture between HDFC Ltd and ERGO, which is the primary insurance entity of the Munich Re Group of Germany. In the health insurance space, HDFC Ergo General Insurance features a wide array of products including customized policies made for Individuals, Families, Parents and Senior Citizens.

Health Insurer Policy And Claim Status

Types of Claims

There are two types of Claims in the insurance Market. They are:

  1. Cashless Claims

    Cashless claims in health insurance is a mode of claim settlement where the policy holder does not have to pay cash for treatment and the settlement of the bills is taken care of directly between the hospital and the insurance company. HDFC ERGO cashless claim settlement helps in paying off the hospital bill instantly, upfront. Cashless claims are gaining popularity every day, and more and more people getting health insurance policies are availing this feature for the comfort it offers.

  2. Reimbursement of the claims

    The second type of health insurance claims are reimbursement claims. In this type of claim, you can visit any hospital, not just those under your insurer’s cashless network. Here, you get your treatment done at the hospital, pay out of your pocket, and then apply for a reimbursement for the expenses with your insurer. At the time of making the claim, the customer needs to submit all hospital bills, prescriptions, and medical documents. These will need to be approved by HDFC ERGO Health Insurance Company before the claim is processed, meaning that it can take slightly more time to get through.

Other Health Insurance Companies

Here’s How You Can File Your Cashless Claims Online

Step 1: Find the network hospitals of HDFC ERGO Health Insurance and get admitted to only those hospitals that fall into the network of your insurer.

Step 2: Now, notify HDFC ERGO Health Insurance Company about the hospitalization. In case of pre hospitalization inform the insurer about the hospitalization prior to getting admitted.

Step 3: The customer needs to fill the pre authorization form and submit it to the hospital. The pre-authorization form is then sent for the approval to HDFC ERGO Health Insurance Company. Once the form is approved,the customer can avail the medical treatment.

Step 4: At the time of discharge fill in all the medical documents and pay for the services that are not covered under the policy.

Step 5: The hospital will send the hospital bills to HDFC ERGO Health Insurance Company . After review the company will pay the bill directly to the hospital.

Here’s How You Can File Your Reimbursement Claims online

Step 1: You need to call HDFC ERGO Health Insurance within two days of your admission date. Post company’s call, they send you a link where you can upload the soft copies of all original documents (bills, reports, etc) and bank details of your desired bank account.

Step 2: Before uploading, you need to sign all the documents yourself.

Step 3: Upload the documents within 30 days from the date of discharge or when you receive the link.

Step 4: You will receive the payment within 30 days from the receipt of the last necessary claim document.

Here’s How You Can track HDFC ERGO Health Insurance Online

The process of checking HDFC Ergo Health Insurance claims is very permissive. To check the claim status online here are the following steps.

Step 1: Visit the official website of HDFC ERGO Health Insurance or you can download their Application form play store.Sign in into the account by entering the login details.

Step 2: Now, go to the option of tracking claim status.

Step 3: Enter the required details in the form such as claim receipt or file number,policy number, date of birth etc. Submit all details.

Step 4: The present status of claim will be displayed.

Here’s How You Can track HDFC ERGO Health Insurance Reimbursement Claim Online

The process of checking HDFC Ergo Health Insurance claims is very permissive. To check the claim status online here are the following steps.

Step 1: Visit the HDFC ERGO Health Insurance Company's official website.

Step 2: Now Select 'Track Claim Status'

Step 3: It will redirect you to a new page where you provide your Customer ID, Policy Number, Claim Number, and date of birth.

Step 4: Now enter the 'Submit' button. This will display your reimbursement claim status.

HDFC ERGO Health Insurance Network Hospital List

HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13,000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside in.

HDFC ERGO Health Claims Status: FAQs

1. How long does it take to review a claim?

It can take as little as 7-8 days, and up to more than 30 days. It totally depends on the company and the product you are purchasing.

2. How long does the claim stay on the insurance?

Policyholders typically want information about all claims within the past three to five years, including their value. During the three to five years an accident or another claim remains on your insurance record.

What Our Customers Have to Say

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Achintya Sharma

Ranchi

May 10, 2024

I’ve been covered by HDFC ERGO Platinum Health Guard plan for years now, and it has been a lifesaver. The coverage is extensive, and the claim process is so easy. I highly recommend the p...

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Parag Mehta

Jamshedpur

May 10, 2024

I’m impressed with the assistance of the ManipalCigna Prime Senior Insurance policy that I’ve bought for my father. I don’t fear now being a NRI because I’m assured of h...

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Anshul Garg

Vishakapatnam

May 10, 2024

The ManipalCigna LIfestyle Protection Critical Care Policy has coverage for up to 30 critical illnesses with a sum insured of up to 25 Crores. If you’re searching for a policy like this, ...

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Shivalika Varghese

Delhi

May 10, 2024

If you are searching a health insurance like ManipalCigna ProHealth choose that offers straightforward claim assistance and the flexibility to optimize your coverage, go for it.

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Pratibha Chandrakar

Kolkata

May 10, 2024

I was majorly focused on pre and post-hospitalization expenses coverage and found the best health coverage for these with the ManipalCigna ProHealth insurance policy.

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Kanupriya Ghadge

Nagpur

May 10, 2024

For anyone who’s looking for a comprehensive health insurance policy, I would recommend buying the ManipalCigna ProHealth Prime insurance plan as it provides maximum coverage.

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Neelam Sharma

Bengaluru

May 10, 2024

Star health has been my health insurer for more than 2 years and I am happy. Thanks to PolicyX for suggesting me Star Health

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Adi Kukreja

Jalandhar

May 10, 2024

My wife fell ill and was diagnosed with jaundice, due to which she had to be hospitalised for a week. But Star’s Family Health Optima Insurance Plan helped me pay the bill and PolicyX mad...

Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.