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

Network hospitals

12000+

premium

Incurred claim ratio

79.04%

premium

Sum insured

Up to 2 CR

premium

No. of Plans

11

premium

Solvency Ratio

1.7

premium

Pan India Presence

200+

Customized Health Insurance Plan for you.

Get upto 15% Online Discount*

Select Members You Want To Insure

Age of Eldest Member

premium

Network hospitals

12000+

premium

Incurred claim ratio

79.04%

premium

Sum insured

Up to 2 CR

premium

No. of Plans

11

premium

Solvency Ratio

1.7

premium

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

Customer Review Image

Anshul Parera

Bhopal

Today

PolicyX was a great resource when I was shopping for health insurance. Got to know a few insights about the company I hold a policy with, Niva Bupa.

Customer Review Image

Pankaj Srivastava

Allahabad

March 21, 2024

Thank ful for Amit Sharma. Whose give good support and suggestions for care health insurance plan. And policyX is good platform puchase of health insurance.that could made easily process. Thank...

Customer Review Image

Nihal

Vadodara

March 18, 2024

I was looking for a plan that supports me in case of international travels, this is when PolicyX insurance experts suggested me ManipalCigna Pro Health and I am satisfied

Customer Review Image

Ashish

Vishakapatnam

March 18, 2024

I have been a policyholder of the ManipalCigna Pro Health for years now, I am glad PolicyX helped me in finding the health plan

Customer Review Image

Rehaan Khan

Ranchi

March 18, 2024

PolicyX saved me hours of research and provided valuable information about coverage options and claim settlement ratios. Highly recommend this platform to anyone looking for a hassle-free way t...

Customer Review Image

Jainab Aslam

Vijayawada

March 18, 2024

PolicyX impressed me with its ability to suggest plans that fit my specific needs and budget. After answering a few questions, I received a personalized list of relevant insurance options. I ch...

Customer Review Image

Ankur Nigam

Cuttack

March 18, 2024

I appreciated PolicyX& 039;s clear presentation of premium costs. They displayed the breakdown of charges, including any applicable taxes or additional fees, upfront. I had a lot of questions r...

Customer Review Image

Shrishti Srivastava

Dehradun

March 18, 2024

PolicyX made the application process for my Care health insurance plan surprisingly smooth. I could easily initiate the application directly through their platform and track the progress conven...

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.