HDFC ERGO Claim Settlement Ratio
- CSR of HDFC ERGO
- Benefits of HDFC ERGO CSR
- HDFC ERGO Claim Settlement Process
With the availability of numerous health insurance companies, selecting an appropriate and suitable health insurance plan has become quite a difficult task. Many times, you end up selecting an insurance plan that fails to meet your entire coverage requirements due to the lack of awareness about health insurance. Thus, to make an informed selection while purchasing health insurance, one needs to have a thorough knowledge of various aspects.
The claim settlement ratio of the insurance company is one such aspect. In India, every health insurance company has a claim settlement ratio. Claim settlement is one of the important factors to be considered while selecting a health insurance company as it tells you about the claim-settling ability of the insurance company. If the company is not able to settle claims in the given time period, then the whole purpose of purchasing insurance goes to vain.
In the article below, we will be discussing the HDFC ERGO Claim settlement ratio. Take a look below to explore the claim settlement ratio of HDFC ERGO health insurance and its claim settling process:
Claim Settlement Ratio or CSR, is the number of claims settled against the total number of filed claims during a financial year. Let’s understand how CSR is determined:
For example, ABC health company has a total of 100 registered claims during a financial year, and it settled only 90 claims out of them, then the health claim settlement ratio of that health company will be 90% for that particular year.
Well, before buying any new product, we check its reliability and the brand’s status. The same goes for buying a health insurance plan. By checking the claim settlement ratio of the company, one can get an insight into how the company is performing when it comes to claiming settlement.
Moreover, it will also give you an insight into the company’s claim settlement ability. The higher the percentage, the better the company’s ability to settle claims. Hence, this factor makes a company more trustworthy amongst its customers.
As per IRDAI, the HDFC ERGO Health Claim Ratio is 98.49%. Take a look at the below-given table that will let you get an insight into the ability of HDFC ERGO Health Claim Settlement.
| HDFC Health Insurance Claim Settlement Ratio 2021-22 | ||||||
| Age Analysis of Number of Claims Paid (%) | < 3 months | 3 months to 6 months | 6 months to < 1 year | 1 year to < 3 year | 3 years to < 5 years | 5 years |
| Claims Settled | 98.49 | 1.03 | 0.22 | 0.2 | 0.04 | 0.02 |
The Incurred Claim Ratio or ICR is the ratio of a health insurance company’s net claims paid out to the total premium collected. For example, if an insurance company receives INR 10 Crore in premiums and pays out INR 8 Crore in claims, the company’s ICR would be 80%.
The greater the ICR, the better the insurance company’s financial health. It means that the insurer is effectively resolving the majority of claims, which is something that every policyholder looks forward to while purchasing an insurance policy.
There are two ways to file a claim. Let’s take a look at them one by one:
Cashless Claim Settlement Process
Reimbursement Claim Settlement Process
You can check the status of your claim through both online and offline mediums.
Procedure for Online
Procedure for Offline
You can call the customer care executive at +91 120 6234 6234 to enquire about the status of your claim.
You can also visit the nearest branch of HDFC ergo general insurance company to know the status of your claim.
HDFC ERGO Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, HDFC ERGO Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
HDFC ERGO Health Insurance
To cater to the different medical needs of an individual & their family, HDFC ERGO Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to HDFC ERGO Health Insurance plans explore more:
Women Health Insurance
HDFC My: Health Women Suraksha is a comprehensive policy that is designed to cater to the evolving needs of health and well-being of today's women. T...
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Individual and Family Health Insurance
The Arogya Sanjeevani Policy from HDFC ERGO is a basic plan designed for individual or family floater coverage. It provides you with the precise medic...
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Individual and Family Health Insurance
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Individual and Family Health Insurance
HDFC ERGO My:Optima Secure health insurance plan offers value that you might require in future to fight against medical discrepancies. Providing you a...
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Individual
Accidental deaths or injuries can be devastating, it can attack your physical, emotional, mental, and financial status to ruin your happy life moment...
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Critical Illness Health Insurance
iCan Cancer Insurance is a cancer-specific plan offered by HDFC Health Insurance Company. The plan covers medical expenses incurred during the treatme...
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Individual and Family Health Insurance
HDFC ERGO Health Suraksha Plan is a comprehensive plan from the house of HDFC ERGO Insurance Company that aims at providing 360-degree protection agai...
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Individual
HDFC ERGO Health Insurance offers an Energy Diabetes plan which is ideal for those who are suffering from diabetes Type 1, diabetes mellitus Type 2, p...
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Individual and Family Health Insurance
HDFC ERGO Health Insurance's Health Wallet plan by HDFC ERGO Health Insurance is a comprehensive health insurance plan that not only ensures your heal...
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Top Up and Super Top Up
HDFC Ergo super top-up plan is the best option by HDFC Ergo to ensure a cushion of ample cover to get the best medical treatment without any restricti...
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Individual and Family Health Insurance
HDFC ERGO Koti Suraksha is a health insurance plan that provides a sum insured of up to INR 1 crore. Koti Suraksha Plan by the HDFC ERGO Insurance Com...
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Individual and Family Health Insurance
HDFC ERGO Optima Restore Policy is the best-selling plan of HDFC ERGO since its launch. It offers comprehensive health cover to you and your family un...
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Know More About Health Insurance Companies
The claim settlement ratio or CSR of the HDFC ERGO health insurance company is 98.59% as per the IRDAI 2022-23 report.
A person must file their reimbursement claim within 3 to 5 days from the date of their discharge.
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Naval Goel is the Founder and CEO of PolicyX.com (IRDA- Approved Insurance Comparison Website). He is a CFA charter holder (USA) and FRM (GARP). He holds an MBA from IIFT, Delhi, and is also an Associate from the Insurance Institute of India. Naval is an avid investor and entrepreneur who has a deep understanding of the Indian equity market and insurance sector. He has been investing for more than 10 years now and is a CFA charter holder.
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