HDFC ERGO Health Insurance

HDFC ERGO Health Insurance: An Overview

Health insurance provides financial support by covering healthcare expenses during medical emergencies. Therefore, it is crucial to choose health insurance that offers comprehensive coverage. HDFC ERGO is one of the best health insurance companies, aiming to provide 360-degree coverage. The company was founded as a joint venture between HDFC Limited and ERGO International AG, a Germany-based company, and became HDFC ERGO General Insurance in 2020. They offer a variety of insurance products like motor, health, travel, home, personal, marine, and much more.

What Does HDFC ERGO Health Insurance Do?

In the health insurance vertical, HDFC ERGO General Insurance offers a wide array of products. These include customized health insurance policies for individuals, families, parents, and senior citizens. They also provide tailored coverage for critical illness and personal accidents, which can be availed during emergencies.

Interesting Facts About HDFC ERGO Health Insurance Company

• HDFC ERGO General Insurance Company Limited was promoted by Erstwhile Housing Development Finance Corporation Limited.
• Earlier, HDFC ERGO Health Insurance was known as Apollo Munich Health Insurance Company.
• With a claim settlement ratio of 95.30% and a solvency ratio of 1.68%, HDFC ERGO General Insurance Company is a leading player in the health insurance sector.

Key Highlights of HDFC ERGO Health Insurance

• 15,000+ Network Hospitals
• 1.68 Solvency Ratio
• 87.70% Incurred Claims Ratio
• Sum Insured: Up to 2 Cr
• 24x7 Customer Support

Features That Set HDFC ERGO Apart

• Special health plans for autism and diabetes
• A comprehensive wellness system to promote a healthy lifestyle
• Emergency air ambulance services
• International travel for treatments
• Unlimited teleconsultations

HDFC ERGO's Awards and Achievements

1. BFSI Leadership Awards 2022 for Cyber Insurance and Optima Secure Health Insurance.
2. ETBFSI Excellence Awards 2021 for best COVID strategy implemented - Customer Experience.
3. FICCI Insurance Industry Awards September 2021, for claims and customer service excellence.

Why Choose HDFC ERGO?

• Versatile and affordable health insurance plans for every need
• 24x7 customer support for easy claim settlement
• Over 12,000 network hospitals across India
• Offers comprehensive coverage at affordable premiums
• Tax benefits under Section 80D of the Income Tax Act

What Is Covered By HDFC ERGO Health Insurance?

Pre and Post Hospitalization Expenses

HDFC ERGO Health Insurance offers products that cover pre and post-hospitalization expenses related to in-patient hospitalization.

AYUSH Treatments

Most HDFC ERGO Health Insurance plans have in-built alternative treatment cover, including Ayurveda, Unani, Siddha, and Homeopathy treatments.

Hospitalization Expenses

HDFC ERGO health insurance plans cover hospital expenses like room rent, ICU charges, surgery expenses, doctor consultations, and other such expenses.

Day Care Treatments

Many procedures do not require 24-hour hospitalization. A majority of HDFC ERGO health insurance plans are designed to cover daycare procedures for policyholders.

Domiciliary Hospitalization

On a doctor's recommendation, a policyholder can avail medical care in the comfort of their home. HDFC ERGO health insurance plans cover domiciliary hospitalization up to specified sub-limits.

What Is Not Covered By HDFC ERGO Health Insurance?

Self-Inflicted Injuries

HDFC ERGO health policies do not cover injuries or hospitalization caused by self-harm.

Cosmetic Procedures

HDFC ERGO Health Insurance plans do not cover any kinds of cosmetic surgeries or treatments.

Adventure Sports

HDFC ERGO Health Insurance plans will not cover you for hospitalizations or accidents caused due to adventure sports.

Obesity and Weight Control Treatments

HDFC ERGO Health Insurance plans mostly do not cover treatments related to obesity and weight management such as bariatric surgeries.

Involvement in Illegal Activities

HDFC ERGO health insurance company plans do not cover individuals or families for hospitalization or injuries caused due to unlawful activities.

What Are The Different Waiting Periods In HDFC ERGO Health Insurance Plans?

The various waiting periods associated with HDFC ERGO Health plans are:

Initial Waiting Period

The initial waiting period, also known as the cooling period, is typically 30 days and applies to most HDFC ERGO health insurance policies.

Pre-existing Disease Waiting Period

HDFC ERGO Health Insurance plans cover listed pre-existing diseases, but a specific waiting period must be completed, as determined at the time of policy purchase.

Disease-specific Waiting Period

Certain diseases like cataracts, ENT conditions, and hernias have specific waiting periods.

Waiting Period for Maternity Cover

Many insurance policies include a waiting period before you can claim for maternity expenses under health insurance plans.

How to Buy HDFC ERGO Health Insurance Plans?

If you are looking to purchase HDFC ERGO Health Insurance online, follow these simple steps:

1. Step 1

   Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.

2. Step 2

   Click on 'Get free quotes' and compare HDFC ERGO Health Insurance Plans as per your needs.

3. Step 3

   Select your preferred HDFC ERGO health insurance plan and pay premiums online.

4. Step 4

   Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your HDFC ERGO Health Insurance plan.

Documents Required For HDFC ERGO Health Policy Claim Settlement

Submit the following documents when filing for HDFC ERGO health claims:

• Duly completed and signed claim form (original)
• Valid photo-ID proof
• Medical practitioner's referral letter and prescription
• Original bills, receipts, and discharge summary from the hospital/medical practitioner
• Original bills from pharmacy/chemists
• Original pathological/diagnostic test reports, radiology reports, and payment receipts
• Indoor case papers
• First Information Report (FIR) and final police report, if applicable
• Post-mortem report, if conducted
• Any other document required by the company to assess the claim

How To Calculate HDFC ERGO Health Insurance Policy Premiums?

To compare and calculate premiums for HDFC ERGO health policies using the PolicyX premium calculator, follow these simple steps:

1. Step 1

   Visit the official website of PolicyX.

2. Step 2

   Fill in details such as your name, the number of family members to be covered, city, and other relevant information.

3. Step 3

   Click on 'Get Quotes'.

For HDFC ERGO health insurance policy premium inquiries, connect with PolicyX health insurance experts at 1800-4200-269.

HDFC ERGO Health Insurance Plan Claim Process Steps

You can file for both cashless and reimbursement claims for your HDFC ERGO Health Insurance Plans by following these easy steps:

1. Step 1

   Visit the website of HDFC ERGO Health Insurance, select the "Claim" option, and then click on "Claim Intimation" to access the form.

2. Step 2

   Now select "health claim" and provide the required information such as policy number, date of birth, and other details.

3. Step 3

   Select the "claim type," whether you want to opt for a cashless claim or reimbursement. Click 'Authorize' to receive an OTP on your verified number.

4. Step 4

   Verify with the OTP, then fill in the hospital admission information. Select the hospital, or provide hospital details if it's a non-network hospital.

5. Step 5

   Upload the requested documents and click on the "review" button.

6. Step 6

   After reviewing, submit the intimation for the company's review. You will receive a claim intimation number; please note it down for future reference.

HDFC ERGO Health Insurance Renewal Process

To renew your HDFC ERGO Health Insurance policy, follow these steps:

1. Step 1

   Visit the official website of HDFC ERGO Health Insurance Company.

2. Step 2

   Click on the ‘Renew’ tab.

3. Step 3

   Enter your Policy Number, Date of Birth, and other required details.

Connect with our insurance experts for HDFC ERGO health insurance policy renewal at 1800-4200-269 and learn more about the renewal process.

How To Port To HDFC ERGO Health Insurance?

To port your existing policy to HDFC ERGO Health Insurance, follow the steps mentioned below:

1. Step 1

   Fill out the portability form and send the application to HDFC ERGO Health Insurance Company at least 30 days before your existing health plan's renewal date.

2. Step 2

   As per the guidelines of IRDAI, the new insurance company will cross-check your medical and claims history with your previous insurer within 7 days of receiving the portability form.

3. Step 3

   Once the policyholder's details are verified, the new insurance company must communicate its decision – either approval or rejection – within 5 days.