HDFC ERGO (a JV of HDFC Bank and ERGO/Munich Re) offers health, motor, travel and home insurance. After merging with ...Read More
HDFC ERGO (a JV of HDFC Bank and ERGO/Munich Re) offers health, motor, travel and home insurance. After merging with Apollo Munich in 2020, it strengthened its health segment. ...Read Less
16,000+
Cashless hospitals
97.37%
Claim settlement
2 Cr
Max sum insured
13
Active plans
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,721 reviews
🏥 16,000+ hospitals
📊 2x solvency ratio
✅ 97.37% claim settlement
What you get with HDFC ERGO Health Insurance
The headline features and policy mechanics, at a glance.
Sum insured up to 2 Cr
Coverage scales from entry-level individual plans to high-end family-floater protection.
16,000+ cashless hospitals
Direct billing at network hospitals across 299 presence — no out-of-pocket payment at admission.
97.37% claim settlement
Industry-leading approval rate on eligible claims received in the most recent fiscal year.
2x solvency ratio
Well above IRDAI's 1.5× floor — strong indicator of long-term claim-paying ability.
13 active plans
Choose from individual, family floater and senior-citizen variants to match your household.
HDFC ERGO General Insurance started in 2002 as a joint venture between HDFC and ERGO International AG of Germany. In 2020, it merged with Apollo Munich Health Insurance, which made it one of India's largest private health insurers. 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.
Apollo Munich Health Insurance was renamed HDFC ERGO Health Insurance and merged into HDFC ERGO General Insurance in 2020.
With a claim settlement ratio of 97.37% and a solvency ratio of 2.00%, HDFC ERGO General Insurance Company is a leading player in the health insurance sector.
Key Highlights of HDFC ERGO Health Insurance
16,000+ Network Hospitals
2.00 Solvency Ratio
87.04% Incurred Claims Ratio
Sum Insured: Up to 2 Cr
24x7 Customer Support
Features That Set HDFC ERGO Apart
Energy plan covers diabetes and hypertension from day 1
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
BFSI Leadership Awards 2022 for Cyber Insurance and Optima Secure Health Insurance.
ETBFSI Excellence Awards 2021 for best COVID strategy implemented - Customer Experience.
FICCI Insurance Industry Awards September 2021, for claims and customer service excellence.
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences, and a recommendation on who should buy.
HDFC Ergo Health Insurance plans
HDFC Ergo Health Insurance Plan Detailed Review
Why Choose HDFC ERGO?
Versatile and affordable health insurance plans for every need
24x7 customer support for easy claim settlement
Over 16,000 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, Yoga & Naturopathy, Unani, Siddha, and Homeopathy.
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.
HDFC ERGO Health Insurance Performance Over the Last 5 Years
Financial Year
Claims Paid (%)
Health Incurred Claim Ratio
2024-25
98.33%
87.04%
2023-24
99.16%
85.65%
2022-23
98.88%
85.40%
2021-22
99.71%
107.83%
2020-21
98.63%
85.43%
Source: IRDAI Handbook on Indian Insurance Statistics 2024-25 (Tables 53, 62). Claims Paid (%) = claims paid ÷ (paid + repudiated), by number of claims. FY 2021-22 ICR was high because of COVID-19 claims.
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.
Best HDFC ERGO Health Insurance Plans Compared
Plan
Sum Insured
Entry Age
PED Waiting
Key Features
Best For
Expert Advice
my:Optima Secure
₹5L – ₹2 Cr
Adults 18+ (no upper limit); children 91 days – 25 yrs
36 months (optional reduction to 24 or 12 months)
Secure Benefit (extra 100% SI from day 1); Plus Benefit (+50% SI a year, up to 100%); Restore Benefit (100% SI); room at actuals; 60/180 days pre/post; 1–3 year term
Families wanting high cover that grows
Compare plans and get your free quote
Optima Super Secure
₹10L – ₹2 Cr
Adults 18+ (no exit age limit); children 91 days – 25 yrs
36 months. Reducible to 30 days for asthma, hypertension, cholesterol and diabetes
3x cover from day 1, rising to 5x within two years regardless of claims; 5% online discount; optional deductible of ₹25,000 – ₹5,00,000; 30-day initial waiting period and 24 months for specific illnesses
People wanting the highest effective cover
Compare plans and get your free quote
Energy (Gold / Silver)
₹5L – ₹50L
18–65 yrs (diabetes, prediabetes or hypertension only)
Diabetes and hypertension from day 1; other PEDs 2 years
36 months, reducing by 1 year at each renewal / 3x cover from day 1; 4x after two years regardless of claims (Plus Benefit); up to 5x after a claim (Restore Benefit); 3-year term only
People with diabetes or high blood pressure
Compare plans and get your free quote
my:health Medisure Super Top Up
₹3L – ₹20L (deductible ₹2L – ₹5L)
Adults 18–65; children 91 days – 23 yrs
36 months
No sub-limits; no medical tests up to age 55 (no history); premium fixed from age 61; 30/60 days pre/post; 1–3 year term
People with employer cover wanting cheap extra protection
Compare plans and get your free quote
Source: my:Optima Secure prospectus, Energy plan page and Medisure Super Top Up brochure (hdfcergo.com).
HDFC ERGO vs Care Health vs Niva Bupa vs Star Health vs Aditya Birla
Parameter
HDFC ERGO
Care Health
Niva Bupa
Star Health
Aditya Birla
Claim Settlement Ratio (FY26)
97.37%
96.74%
92.39%
86.34%
95.68%
Claims Paid by Count (FY25, IRDAI)
98.33%
96.85%
92.55%
86.42%
95.94%
Health ICR (FY25)
87.04%
65.10%
61.63%
70.53%
75.97%
Solvency Ratio (Mar 2025)
2.00x
2.00x
3.03x
2.21x
1.84x
Network Hospitals
16,000+
22,100+
10,000+
16,000+
16,500+
Branch Offices
299
269
212
913
225
Health Lives Covered (FY25)
1.57 Cr
2.55 Cr
2.17 Cr
2.38 Cr
1.90 Cr
HDFC ERGO is a general insurer; the others are standalone health insurers.
Verdict line: HDFC ERGO has the highest claim settlement ratio and claims-paid share of the five. Care has the largest hospital network, Star the most branches, and Niva Bupa the strongest solvency.
How to Buy HDFC ERGO Health Insurance Plans?
If you are looking to purchase HDFC ERGO Health Insurance online, follow these simple steps:
Step 1: Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.
Step 2: Click on 'Get free quotes' and compare HDFC ERGO Health Insurance Plans as per your needs.
Step 3: Select your preferred HDFC ERGO health insurance plan and pay premiums online.
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:
Step 1: Visit the official website of PolicyX.
Step 2: Fill in details such as your name, the number of family members to be covered, city, and other relevant information.
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:
Step 1: Visit the website of HDFC ERGO Health Insurance, select the "Claim" option, and then click on "Claim Intimation" to access the form.
Step 2: Now select "health claim" and provide the required information such as policy number, date of birth, and other details.
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.
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.
Step 5: Upload the requested documents and click on the "review" button.
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:
Step 1: Visit the official website of HDFC ERGO Health Insurance Company.
Step 2: Click on the ‘Renew’ tab.
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.
Pros and Cons of HDFC ERGO Health Insurance
Pros
Cons
97.37% CSR, higher than Care, Niva Bupa, Star and Aditya Birla
Health ICR of 87.04% is high, so margins on health are thin
Paid more than 98% of claims every year since FY 2020-21
Network (16,000+) is smaller than Care's (22,100+)
Optima Secure gives 2x cover from day 1 and grows to 3x with the Plus Benefit
Premiums are often higher than standalone health insurers
Energy plan covers diabetes and hypertension from day 1
36-month PED wait in flagship plans unless you buy the reduction add-on
Backed by HDFC Bank and Munich Re's ERGO
Fewer branches (299) than Star Health (913)
Why HDFC ERGO Health Claims Get Rejected
In FY 2024-25, HDFC ERGO paid 98.33% of the health claims it decided (IRDAI).
Reason
How to Avoid
Pre-existing disease not disclosed
Declare every condition and medication in the proposal form
Claim made during a waiting period (30 days / 24 months / 36 months)
Check the waiting periods on your policy schedule
Treatment falls under permanent exclusions
Read the exclusion list in the policy wording
Room above the eligible category (Optima Lite/Select)
Choose the room type in your policy, or expect a proportionate deduction
To port your existing policy to HDFC ERGO Health Insurance, follow the steps mentioned below:
Step 1: Fill out the portability form and send the application to HDFC ERGO Health Insurance Company at least 30 days, but not earlier than 60 days, before your existing plan's renewal date.
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.
Step 3: Once the policyholder's details are verified, the new insurance company must communicate its decision – either approval or rejection – within 15 days.
All 13 HDFC ERGO Health Insurance plans
Every plan currently being sold by HDFC ERGO Health Insurance, shown side-by-side so you can shortlist quickly.
Most popularIndividual
Optima Lite Health Insurance Plan
HDFC ERGO Optima Lite offers affordable health insurance for individuals and families, especially in Tier 2 and Tier 3 cities. It provides …
The 20 most-asked questions about HDFC ERGO Health Insurance, answered.
You can include your children from 91 days up to 25 years of age (Optima Secure). Children under 5 are covered only with a parent.
Yes, to buy HDFC health insurance policy, you may be required to undergo a medical examination. Some health insurance policies only require it if you have a pre-existing condition or you are above 40yrs of age.
If you are suffering from health-related problems at the time of buying a health insurance plan or you have had any medical history such as hypertension, high blood pressure, diabetes, etc then this should be informed to your respective health insurance company. HDFC ERGO covers preexisting diseases after 36 months (3 years), which can be reduced to 24 or 12 months with an add-on. Its Energy plan covers diabetes and hypertension from day 1.
Yes, You can add a family member to your existing plan. But for this you need to fill the required forms, such as the health declaration form and endorsement form and pay an extra premium amount.
You can file any number of claims over a year. However, this should be kept in mind that total claims can't exceed your sum insured plus any bonus, Secure Benefit or Restore Benefit in your plan.
HDFC ERGO goes beyond health insurance; it cares not only for the physique but for the mind of the policyholder as well. Integrated Wellness application will help you to embrace a healthy lifestyle, track your calorie intake, monitor your physical activity, maintain proper health care, and enjoy well-being at its best.
Yes, it is possible, if required. You can change the hospital at the time of your treatment. However, you are required to provide the necessary details for a quick and smooth process.
Most of the health insurance plans available in the market usually have a free look period of 30 days. During this, you can cancel your policy with a full premium refund. However, in that case, if you want to cancel your policy in mid then you are required to provide a suitable reason.
Yes, it is possible to port your existing health policy to HDFC ERGO health insurance, provided you have renewed your previous policy without any break.
Yes, HDFC ERGO has recently launched the facility to pay the health insurance premium in installments.
You are required to show the bills and duly file a claim application to the insurer. After the inspection, the bills are reimbursed by the insurance provided to the policyholder.
Pre-existing illnesses will be covered in the Super Top Up Policy only after 3 years of continuous coverage.
Every individual has a different set of healthcare needs which may vary from individual to individual. Therefore, there are no specific criteria to select the number one health insurance. If all your healthcare needs are met by any HDFC Health plan then you should go for it.
Apollo Munich Health Insurance was bought by HDFC ERGO, renamed HDFC ERGO Health Insurance, and merged into HDFC ERGO General Insurance in 2020. Old Apollo Munich policies continued without a break.
HDFC ERGO has a much higher CSR (97.37% vs 86.34%) and the same network size (16,000+). Star has a higher solvency ratio (2.21x vs 2.00x) and more branches (913 vs 299).
Their CSRs are close (97.37% vs 96.74%). HDFC ERGO has a higher solvency ratio (2.00x vs 1.68x). Care has a larger network (22,100+ vs 16,000+).
my:Optima Secure suits most families, with 2x cover from day 1. Energy suits people with diabetes or hypertension. Medisure Super Top Up adds cheap extra cover over a base or employer policy.
It was 2.00x in March 2025, above IRDAI's 1.5x minimum.
Its health ICR was 87.04% in FY 2024-25 (IRDAI Handbook).
If you are suffering from health-related problems at the time of buying a health insurance plan or you have had any medical history such as hypertension, high blood pressure, diabetes, etc then this should be informed to your respective health insurance company. HDFC ERGO covers preexisting diseases after 36 months (3 years), which can be reduced to 24 or 12 months with an add-on. Its Energy plan covers diabetes and hypertension from day 1.
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Aggregate ratings from 2,721 verified PolicyX customers who bought a HDFC ERGO Health Insurance plan.
4.4
out of 5
★★★★☆
2,721 reviews
5 star
60%
4 star
25%
3 star
10%
2 star
4%
1 star
1%
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