Network hospitals
12000+
Incurred claim ratio
79.04%
Sum insured
Up to 2 CR
No. of Plans
11
Solvency Ratio
1.7
Pan India Presence
200+
Network hospitals
12000+
Incurred claim ratio
79.04%
Sum insured
Up to 2 CR
No. of Plans
11
Solvency Ratio
1.7
Pan India Presence
200+
HDFC Ergo Claim Process is the interaction between the insured and insurer, where the policyholder seeks compensation for the medical expenses incurred during the treatment. The company orchestrated a quick and efficient claims process which enables the customer to access medical treatment without any delays. They have designed a user-friendly website, where the policyholder can easily register the claims and upload documents. This provides a seamless and efficient experience to the policyholders even in the time of medical emergencies. Let us explore how HDFC Ergo Online Claim Process works.
Based on the type of hospitalization and the timing of payment of medical bills, the HDFC Ergo Claim Process is divided into two categories. Lets us examine each type one by one:
Cashless Claims:A type of health insurance claim, where the policyholder can avail of a treatment, without paying the bills upfront. The insurance company later settles the bill with the hospital.
Reimbursement Claims: These claims where the policyholder seeks compensation for the medical expenses incurred during treatment at the non-network hospital. The policyholder pays the bill at the time of discharge and later the insurance company settles the claim by transferring the amount into the customer's bank account.
For planned hospitalization, the policyholder needs to inform the company 48 hours before, being admitted to the hospital, and for emergency hospitalization within 24 hours of hospitalization. HDFC Ergo Reimbursement process can be performed in four simple steps. Let us have a look at the procedure:
Step 1: Claim Registration
Note:
Step 2: Processing of Claims
HDFC Ergo's team of doctors will verify all the documents. On successful verification of the documents a 'Post Satisfactory Receipt ' will be sent to the customer, within 7 days.
Note:
Step 3: Uploading any Pending Document
The company may even ask for additional documents, and scan and upload the document.
Step 4: Settlement of the Claim
After successful verification, HDFC Ergo Health Insurance Company will settle all the claims by transferring the amount to the customer's bank account through NEFT.
Note: The amount will be transferred, within 7 days of the last document received by the company.
HDFC Ego cashless claims are unmatched, as the company settles the bill just 2 hours after receiving the last document. for cashless claims, policyholders need to inform the company within 24 hours of emergency hospitalization and 48 hours for planned hospitalization. The process for cashless claims is as follows:
Step 1: Hospitalization
Step 2: Submit the Documents
After receiving the treatment, collect all the documents. Scan and submit all the documents to the company.
Step 3: Pre-Authorization
Step 4: Verification
The company will verify all the submitted documents and details. HDFC Ergo has an in-house team of doctors that verify the documents.
Step 5: Claim Settlement
As soon as the claims and the documents are verified the company will transfer the amount to the hospital.
Step 6: Status Update
HDFC Ergo Health Insurance company keeps the policyholder informed via text messages at every stage of the claim. The text messages are sent to the registered mobile number of the customer.
Point To Be Noted:
If the policyholders are facing any issue at any stage of claim processing, they can call customer care of the company. HDFC Ergo Health Insurance Customer Support Number is: 022 6234 6234 / 0120 6234 6234
The list of the documents is as follows:
HDFC Ergo Health Insurance offers a hassle-free claim process. Policyholders can easily submit their documents online or opt for offline options through the TPA. This smooth claim process makes HDFC Ergo one of the top choices for buying health insurance.
HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside in.
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April 8, 2024
I was looking for the best health insurance policy. PolicyX came up and eased up my whole task. They suggested HDFC ERGO Optima Secure, it is the best decision ever.
April 8, 2024
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, HDFC ERGO.
April 8, 2024
I would extend my gratefulness to the PolicyX team who helped me get the best health insurance policy from HDFC ERGO.
April 8, 2024
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April 8, 2024
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March 15, 2024
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March 14, 2024
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March 14, 2024
I had a kidney problem, so I chose to buy an HDFC ERGO Critical Illness policy with the help of PolicyX. After completing the waiting period, now I am completely eligible to claim for my medica...
Priya has been in the content writing industry for over 8 years. She has been religiously following the insurance sector since the start of her career which makes her an avid insurance expert. Her forte lies in health, term, and life insurance writing, along with her knowledge of the latest developments in the insurance sector.
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