HDFC ERGO Health Insurance is a joint venture between HDFC Limited and ERGO International. In the year 2020, HDFC health insurance merged with Apollo Munich Health insurance after getting approval from the Insurance Regulatory and Development Authority of India (IRDAI). Currently, HDFC health insurance is the second-largest private insurance company in the health insurance business. The company is spread across more than 200 cities with 200+ branches and 7000+ employees working for it. Moreover, HDFC ERGO Health insurance has got an "iAAA" rating by ICRA for its highest claim paying ability.
HDFC ERGO Health Insurance Plans offer a wide range of coverage options that include cashless treatment and hospitalization at 13,000+ hospitals, daycare treatments, no room rent restriction, AYUSH cover, in-patient hospitalization, pre and post-hospitalization, etc.
Key Features of HDFC ERGO Insurance Company
HDFC health insurance is one of the biggest companies in India that provides health insurance. HDFC health insurance always tries to support its customer in every possible way. HDFC ERGO medical insurance has various other key features along with 24x7 customer support. Take a look at the features of the HDFC ERGO health insurance:
Network HospitalsHDFC health insurance has 13000+ network hospitals in which you can get cashless hospitalization and the insurance company will directly settle the bill with the hospital.
Solvency RatioThe solvency ratio of a health insurance company is used to evaluate its capacity to meet its long-term financial obligations. According to the IRDAI, It is mandatory to maintain the Solvency Ratio of 1.5. HDFC ERGO currently has a Solvency Ratio of 1.68.
Market ShareHDFC health insurance plans are designed to meet the needs of people at every stage of life. According to the IRDAI report 2021-22, HDFC ERGO has a Market Share of INR 13,497.55 Cr.
Claim Support RatioThe claim settlement ratio (CSR) is the percentage of total claims that an insurance company settles in a year. HDFC ERGO Health Insurance has a claim settlement ratio of 98.49% which shows the company is reliable and cares about its customers.
No. of BranchesWith more than 200+ branches across India, the company assures that customers may quickly visit their nearest branch if they have any policy or claim-related queries.
All you need to know about HDFC ERGO Health Insurance? Find complete details in one go!
HDFC ERGO health insurance offers a wide variety of medical policies to its customers to meet their needs in terms of comprehensive coverage, flexibility, and affordability. Have a look at mediclaim policies offered by HDFC ERGO:
HDFC ERGO Health Insurance Individual and Family Floater Plans
Designed especially for people with pre-existing diabetes or hypertension. Get coverage for diabetes and hypertension from Day 1 without any waiting period.
Covers all types of cancer at all stages with lifelong renewability option. If diagnosed with IV stage cancer or relapse, this plan pays 100% of SI as a lump sum.
Unique Features
Coverage for modern treatments
Second opinions available
Coverage for follow-up care
HDFC iCan Cancer (Pros)
Ambulance Cover
Follow up care post treatment
Conventional Treatments
Hormonal Treatment
Stem Cell Transplantation
HDFC iCan Cancer (Cons)
No Non Allopathic treatments
No Prosthetic Devices
No Overseas Treatments
Pre-existing condition for Cancer
HDFC iCan Cancer (Other Benefits)
Sum Insured Enhancement
CritiCare Benefit
Family Care Benefit
Lifetime Renewal
MyCare Benefit
HDFC iCan Cancer (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - 65 Years
SI - 5 L to 50 L
Waiting Period - 120 Days
HDFC ERGO Critical Illness, Bonus-oriented health plan, Top-Up, Women-oriented health Plans
An ideal health plan for people with a pre-existing critical illness or a family history of critical illnesses. Get comprehensive coverage for 15 critical illnesses.
A flexible and comprehensive health plan, securing your today & tomorrow. With 'Reserve Benefit' features, this plan grows unused policy amount @6% interest rate.*
Avail of extra cover to meet medical expenses without any limitations by purchasing this deductible-based top-up plan.
Unique Features
Constant premiums post 61 years
No medical checkup up to 55 years
5% discount on 2-year policy term
My:health Medisure Super Top-up (Pros)
In- Patient Hospitalization
High Cover at Low Premium
Post 61 Year No Premium Hike
Day Care Procedure
Pre and Post Hospitalization
My:health Medisure Super Top-up (Cons)
Treatment Of Obesity
Self Inflicted Injury
War Operations Injury
Sexsually Tranmitted Diseases
No Cosmetic Surgery
My:health Medisure Super Top-up (Other Benefits)
Free Look Period
Two Year Policy Period
Guaranteed Renewal for Life
Loading on Renewal
Individual and Floater Options
My:health Medisure Super Top-up (Eligibility Criteria)
Entry Age - 18 years
Max Entry Age - 65 Years
SI - 1 L to 10 L
Waiting Period - 30 Days
Women-oriented health
HDFC ERGO My:health Women Suraksha
Women-oriented health plan providing comprehensive medical insurance with major illnesses cover, and cancer cover all under a single plan but different variants.
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.
Policyholders can use the HDFC health insurance premium calculator to calculate the premiums online. HDFC ERGO health insurance premium depends on various factors such as the lifestyle of the applicant, sum insured amount, policy tenure, etc. To give you a better understanding of the premiums, PolicyX.com has shown some sample premiums of HDFC ERGO mediclaim plans based on the different coverage amounts (Sum Insured amount) and different family sizes.
HDFC ERGO Health Insurance Optima Restore
Age: 30 years
1 Adult
2 Adult
2 Adult+1 Child
Average Premium (INR)
5L
8852
15935
22603
15796
15L
13873
24971
34017
24287
HDFC ERGO Health Insurance Optima Secure for Senior Citizens
Age: 65 years
1 Adult
2 Adult
Average Premium (INR)
5L
49045
71114
60079
15L
135205
109556
122380
HDFC ERGO Health Insurance Critical Illness Silver
Age: 30 years
1 Adult
Average Premium (INR)
5L
1475
15796
10L
2950
24287
Why HDFC ERGO Health Insurance?
HDFC ERGO medical insurance offers various coverage benefits under its plans. You may get several added advantages on buying HDFC ERGO mediclaim policies as the insurer provides the following: If you're looking for health insurance, don't forget to check the HDFC ERGO policy details on PolicyX.com and get a quote in seconds.
Cashless claim approval in just 20 mins
Dedicated application for all your policy-related concerns
Offers preventive health checkup coupons
Offers free renewal health checkups
Offers wellness programs to keep you healthy
13000+ HDFC ERGO network hospitals
In-house claim settlement team
Covers Omicron variant of Coronavirus
HDFC Health Insurance Exclusion list
Here are some general health conditions that are not covered under HDFC health insurance plans.
Adventure Sport Injuries
Self-Inflicted Injuries (suicide or attempted suicide injuries)
War-Related Injuries
Cosmetic Surgery
Treatment Of Obesity
Venereal Or Sexually Transmitted Diseases
Participation In Defence Operations
Hospitalization due to alcohol, and drug abuse
HDFC ERGO Health Insurance Buying process
HDFC ERGO offers a smooth and quick buying process for every type of HDFC ERGO Health Insurance policy. You can buy the HDFC health insurance plans from the company's official website as well as through PolicyX.com.
Buy from the Company
Visit the company's official website.
Choose the desired health plan and click on the 'Buy' button.
Fill in all the necessary details.
Calculate the premium and make the payment.
The insurer will send the policy documents to your registered email address.
Pay the premium and your HDFC ERGO policy document will be shared on your registered email.
Why Buy HDFC ERGO Health Insurance Plans from PolicyX?
PolicyX is a reliable source to buy health insurance policies. Well, we are here to answer. about why PolicyX.com is the best option to buy the HDFC ERGO health insurance policy.
IRDAI ApprovedPolicyX.com is an IRDAI approved web aggregator that helps consumers in comparing, choosing, and buying policies online.
Free Comparison ServicePolicyX.com provides a single platform where you can compare different insurance companies, insurance plans, and their premiums.
Compare 15 companies in 30 secConsumers can compare up to 15 companies in just 30 sec on PolicyX.com.
Buy Insurance within 5minsPolicyX offers a simple and quick buying process where consumers can buy insurance in less than 5mins.
24x7 Customer ServicePolicyX is always with their customers as we offer 24x7 customer care service.
Free Future Claim AssistancePolicyX is always there to help and assist your claim under any term insurance company.
HDFC ERGO Health Insurance Renewal
HDFC Medical Insurance offers a simple and quick renewal process to make policy renewals easier for the customer. You can renew your policy with HDFC health insurance in just a few clicks. Here is the process for HDFC ERGO health insurance renewal online.
Visit the official website and click on 'renewal'.
Enter your existing details such as policy number, mobile number, email-id, etc.
Click on the 'Renew Now' button.
Pay online and renew your HDFC ERGO mediclaim policy.
HDFC ERGO Health Insurance Claim Process
HDFC ERGO Health insurance offers two simple claim process to file claims i.e. Cashless Claim Process and Reimbursement Claim Process. Take a look at both claim settlement processes of HDFC medical insurance in the section below:
The company claims to approve cashless claims within 20 mins and the process is defined below:
Intimate the company by filling the pre-auth form
The company will update you on the status of the form
Hospitalization will be done on the basis of claim form approval
At the time of discharge of the patient, the company will settle the claim directly with the hospital.
The company claim that it settles the reimbursement claim within 6 working hours and the process is mentioned below:
Intimate the company within 48 hours of hospitalization (24 hours in case of emergency)
Submit the claim form along with ID proofs, KYC documents, and a canceled cheque
Claim team will verify the form and the documents
The company will send the approval letter
Insurance company will reimburse the claim amount within 6 working days
How To Contact HDFC ERGO Health Insurance?
For HDFC ERGO mediclaim policy related queries, you can contact the company in the following ways:
Registered & Corporate Office
1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020
Health Insurance Claim office (HCS - Noida)
5th floor, Tower 1, Stellar IT Park, C-25, Sector-62, Noida, UP, India - 201301
Contact through Whatsapp App:
73045 24888, 8169500500
For buying a new policy: 022 6242 6242
HDFC ERGO Health Insurance: Frequently Asked Questions
1. When can I include my kids in HDFC health insurance policies?
You can include your kids post 90 days of birth up to 21 years of age in HDFC health insurance policies.
2. Is it necessary for me to undergo medical tests before buying health insurance?
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.
3. Will a health plan offered by HDFC ERGO cover pre-existing illness?
Your respective insurance company will not cover pre existing illnesses for a certain time period at the starting of your policy term. This is called the waiting period. Different pre-existing diseases have different waiting periods, so you can get in touch with your insurance company or go through your policy documents once and find out about the waiting period for your disease. Some of the conditions which are pre-existed are completely excluded from the health plans.
4. What is the waiting period for pre-existed illness in HDFC ERGO Health Insurance?
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 pre-existing diseases after a 4 years waiting period. So once your waiting period is covered for the informed diseases, you can claim under it.
5. Can I add a family member to my existing family health plan?
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.
6. In HDFC ERGO, how many claims are permissible in a year?
You can file any number of claims over a year. However, this should be kept in mind that the claim amount should not exceed the sum assured of your plan. For example, if you have a health insurance of INR 2 lakh, then you can claim up to INR 2 lakh only from your insurance company.
7. What is the integrated Wellness App of HDFC ERGO General Insurance?
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.
8. Is it possible to change my hospital during the course of treatment?
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.
9. What if I want to cancel my policy in mid- duration?
Most of the health insurance plans available in the market usually have a cooling period of 15 days i.e., called free look up period. During which you can cancel your policy with 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.
10. Is it possible to port my existing health policy to HDFC ERGO?
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.
11. Can I pay the premiums of HDFC ERGO Health Insurance plans in EMI?
Yes, HDFC ERGO has recently launched the facility to pay the health insurance premium in installments.
12. How can you get the reimbursement for pre and post hospitalization expenses under this policy?
You are required to show the bills and duly filed a claim application to the insurer. After the inspection, the bills are reimbursed by the insurance provided to the policyholder.
13. Will my pre-existing illness be covered in Super Top up Policy?
Pre existing illnesses will be covered in Super Top Up Policy only after 3 years of continuous coverage.
14. Is buying HDFC Ergo Health plan a good choice?
As per the IRDAI Annual report of 2021-22, the company comes with a good CSR, fulfils the solvency ratio criteria, and has a wide network of empanelled hospitals. All these features make HDFC Ergo a good choice.
15. Is HDFC the no.1 health insurance company in India?
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.
I am satisfied with the customer service provided to me when I had a small query regarding my HDFC health insurance policy. Thank you to the customer support team of PolicyX
Subhro Jha
Hyderabad
September 14, 2022
It was great experiance with Policyx.com about the claims as i got rejection my claim from HDFC Ergo but after getting support of policyx.com i got my claim and the complete amount is given by...
Vedika Verma
Delhi
May 25, 2022
With several health plans, HDFC ERGO offers looks after the healthcare need of every individual. I am glad that I chose to buy health insurance from HDFC ERGO
Vedantu Singhania
Coimbatore
August 5, 2021
Thanks to HDFC ERGO Health Insurance company for ensuring that all the healthcare needs of your customers are looked after. I am glad that I got in touch with PolicyX.com who helped me at every...
Usha Dodiya
Indore
May 20, 2021
Policyx.com give very good insurance policy I will recommend to everyone and manager support is very gool
harish kumar
Delhi
March 16, 2021
thanks to Policyx and HDFC to provide good service at the time of claims he help me two times and provide 100% cashless benefit
ambika chauhan
Chennai
March 4, 2021
i am happy that i recieved my claim today. got good support. after first rejection i was scared, but i got it due to the sipport of policyx
Ashu Goyal
Ludhiana
March 4, 2021
I have taken the policy of HDFC ergo by Policy X.Com , Claim settlement Tat is very Good . Policy X.com team is helpful about claim settlement without any issue.
