HDFC ERGO Health Insurance FAQs

In order to initiate a claim, the policyholder is required to initiate contact at HDFC Ergo at 022-6234-6234. You can also initiate contact with the experts at InsuranceDekho at 7551-196-989.

Irrespective of whether you opt for cashless treatment or reimbursement mode, make sure you inform HDFC Ergo within 24 hours (emergency hospitalisation) and within 48 hours prior to admission (planned hospitalisation), be it at a network hospital or a non-network hospital.

At HDFC Ergo, the list of documents needed for registering claim includes:

• Duly filled and signed claim form with HDFC Ergo policy number.
• Original discharge summary.
• Original Investigation reports.
• Past treatment documents, if any.
• Medico Legal Certificate (MLC) or FIR in case of an accident.
• Original final bill comprising detailed breakup.
• Original payment receipt.
• Original pharmacy invoices supported by prescriptions, etc.

You can calculate the Claim Settlement Ratio of HDFC Ergo General Insurance by dividing the total number of claims received by the total number of claims settled in that year.

As per HDFC Ergo General Insurance, it usually approves cashless health insurance claims within 20 minutes. To process cashless claim under health insurance plans by HDFC Ergo, you will be required to follow the steps given below:

• Fill the pre-authorisation form at the network hospital for cashless approval
• Once the hospital updates HDFC Ergo General Insurance, then the insurance company will send you the status update
• Hospitalisation will be done on the basis of pre-authorisation approval
• At the time of discharge, the insurance company will directly settle the medical bill at the network hospital.

As per HDFC Ergo General Insurance, it usually settles reimbursement health insurance claims within 6 hours. To make reimbursement claims under health insurance plans by HDFC Ergo General Insurance, you will be required to follow the steps given below:

• Get hospitalised at a non-network hospital, pay the bills, and preserve the original invoices
• Register a claim by sending all the invoices and treatment documents to the insurer
• Your documents will be verified by the insurer. i.e., HDFC Ergo General Insurance
• You will receive the approved claim amount in your bank account within the stipulated time.

In case of planned hospitalisation, you must inform HDFC Ergo General Insurance at least 48 hours prior to hospitalisation. Whereas in case of emergency hospitalisation, the insurer must be informed within 24 hours of hospitalisation.

As per the IBAI’s General Insurance Claim Insights Handbook For Policyholders-4th and 5th Edition, the Claim Settlement Ratio (CSR) of HDFC Ergo general Insurance for the financial years 2018-19 and 2019-20 is 83.66% and 86.52% respectively.

Any individual in the age group of 5 years to 65 years can apply for HDFC Ergo's critical illness plan.

HDFC Ergo, through its critical illness plan provides coverage for up to 15 critical illnesses. Stroke, coronary artery bypass surgery, paralysis, cancer, heart attack (myocardial infarction), major organ transplantation, multiple sclerosis, and kidney failure are a few critical illnesses covered by HDFC Ergo.

To cater to the medical needs of critical illness insured individuals, HDFC Ergo provides lump sum payment in a single transaction on first diagnosis of any of the critical illnesses. Apart from lifelong renewability, the HDFC Ergo offers tax benefits as well as coverage for up to 15 critical illnesses.

Under the HDFC Ergo General insurance Plans, different type of diseases are covered depending upon the type of plan chosen by the policyholder. For example, HDFC Ergo Critical Illness Insurance Plan covers 15 critical illnesses such as heart attack, stroke, cancer, paralysis etc.

To buy critical illness cover offered by health insurance by HDFC Ergo, you must follow the steps given below:

• Visit www.insurancedekho.com and click on the ‘Health’ tab.
• Select your gender and enter name and mobile number. You will receive an OTP on the given mobile number. Kindly enter that.
• Answer the question ‘When do you plan to buy insurance policy’ by selecting an option from the drop-down menu. Click on ‘View Instant Quotes’ and proceed.
• Select the family members you want to add under your policy. And click on the ‘Continue’ button.
• Enter your Email ID and City. Then click on the ‘Submit and View Quotes’ button. You will see several suitable quotes displayed on your screen. Choose the one you wish to buy.
• Select the policy term and provide required details and pay online via a secured payment gateway.

Anyone who is aged more than 18 years and is a resident of India can buy a critical illness plan offered by HDFC Ergo General Insurance.

Yes. You can avail tax benefits under Section 80D of the Income Tax Act, 1961, on the premium paid for critical illness plans offered by HDFC Ergo General Insurance.

The minimum age criteria for critical illness cover offered under HDFC Ergo plans is 18 years. Also, you must be a resident of India to seek cover.

At the time of claim under HDFC Ergo plans, you would require the following documents:

• Valid ID proof
• Doctor’s prescription advising medical tests, medicines, consultations, etc.
• Original diagnostic test reports, radiology reports and payment receipts
• Doctor’s letter recommending hospitalisation
• Original bills from the pharmacies
• Post mortem report, if applicable
• Original receipts, bills, and discharge forms duly signed by the doctor
• First Information Report (FIR) if it is a police case.

In case, the primary insured individual dies, the other adult individual may carry on with the policy. Note that the sum insured will remain the same.

A policyholder can either choose a family floater plan or cover each member on an individual basis under the same policy.

Policyholders get 10% discount on the premium on choosing to cover more than 2 family members on an individual sum insured basis in the same policy.

HDFC ERGO family health insurance offers multiple advantages to the policyholder. The major benefits include cover for family under a single sum insured amount, no need to manage different policies, sum insured up to Rs. 10 Lakh, easy claim settlement, cashless facility at 10,000+ network hospitals, no room rent capping, no disease sublimit, integrated wellness services, family discount, affordable premium rate and more.

HDFC ERGO family health insurance is meant for people who want to secure the health of their dear ones along with themselves in a single plan. If you have been looking for a cover for yourself, your spouse, dependent children and dependent parents, my:health Suraksha would be a must buy.

No! Making changes to the sum insured amount of HDFC ERGO family health insurance during the policy tenure is not allowed. However, a policyholder can request for the change at the time of policy renewal.

HDFC ERGO family health insurance my:health Suraksha provides cover for pre & post hospitalization expenses, 144 day care procedures, AYUSH treatment, optional covers like maternity and newborn baby cover, outpatient dental Treatment, convalescence benefit, hospital daily cash, and many more.

Yes! HDFC ERGO family health insurance policy provides tax benefits under Section 80D of the Income Tax Act, 1961.

When you do not file a claim within the policy year, you get a benefit in the form of discount (NCB or No Claim Bonus) on your subsequent premium in the next year.

You can choose an ideal plan from a variety of health insurance plans provided by HDFC Ergo General Insurance like Individual Health Insurance Plan, Family Health Insurance Plan, my:Health Medisure Super Top up Plan, Corona Kavach Policy, Health Suraksha Silver Smart Plan, Parents Health Insurance Plan, my:Health Women Suraksha Plan, and Critical Illness Insurance Plan.

HDFC Ergo General Insurance provides coverage on the basis of the specific type of policy selected by an individual. However, generally most of the plans provide cashless home health care, hospitalisation expenses, pre-hospitalisation expenses, post-hospitalisation expenses, AYUSH benefits, daycare procedure, organ donor expenses, free renewal health checkup etc.

To contact HDFC Ergo General Insurance company you can call on their helpline number 1800 200 1999 (Toll Free) or 1860 200 0700. Otherwise, you can also write to them at Healthclaims@hdfcergo.com.

If you wish to port your policy from HDFC Ergo General Insurance company to some other insurance company, inform HDFC Ergo at least 45 days prior to the expiry date of the current policy.

For individuals up to 55 years of age, if the insured is not subject to any pre-existing health adversity, in that case, medical checkups are not required. However, for individuals above 55 years of age, some regular medical health checkups are needed before buying HDFC Ergo General Insurance Policy.

Under HDFC Ergo General Insurance health plan, the waiting period for any pre-existing disease is 48 months.

HDFC Ergo General Insurance Company Ltd. D-301, Third Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West) Mumbai-400078

HDFC Ergo helps its customers ‘Take it easy. Experience the convenience.' To ensure the same, the company offers HDFC Ergo best health insurance plans that are specifically designed keeping the diverse health insurance needs of customers in mind. Moreover, HDFC health insurance policy offers benefits such as pre and post hospitalisation coverage, cashless claims, no sub-limits, tax benefits, day care procedures, domiciliary medical treatment, and others.

The entry age for children is 91 days. However, there is no maximum entry age for adults to buy HDFC Ergo health insurance plans.

HDFC Ergo best health insurance plans involve individual health insurance plans, family health insurance plans, parents health insurance plans, senior citizen health insurance plans, critical illness insurance plans, and a super top-up insurance plan.

To download HDFC Ergo General Insurance payment receipt simply visit the official website or app of the insurance company.

InsuranceDekho helps the policyholder in comparing various insurance plans by different insurance companies on a single platform. Additionally, it also lets the holder customize the plans as per their unique requirements.

You can buy HDFC Erfgo General Insurance Plan by showing your ID proof and Address Proof to the insurance company.

You can apply for and buy HDFC Medical Insurance plans online through the HDFC Ergo website www.hdfcergo.com or through www.insurancedekho.com. Remember, you can make use of net banking, debit card, or credit card to pay the premium of HDFC health insurance policy as the company allows flexible payment modes.

Due to rising medical costs, it is recommended for you to opt for Rs. 5 lakh sum insured and above. However, learn that the ideal cover depends on current age, medical history, and a few other factors.

One should invest in individual health insurance in their early 20s to ensure optimum financial planning and gaining wider coverage at a lower premium.

Yes. An individual health coverage will protect you from drawbacks of employee health insurance and let you have control over your medical needs and their fulfillment.

HDFC ERGO individual health insurance policy is an ideal health insurance choice for an individual who wants to cover themselves only and gain maximum benefits out of the coverage purchased. So, if your family is already covered for health insurance, buying HDFC ERGO individual plan would be beneficial to you.

No! An HDFC ERGO individual health insurance policyholder is not allowed to make sum insured changes during the policy tenure. The ideal time to change the sum insured amount is policy renewal time.

HDFC ERGO individual health insurance comes with advantages like sum insured options up to Rs. 10 lakh, cashless treatment at 9,000+ network hospitals, no sub-limits on room rent & disease, no entry age restriction, long-term discounts, Integrated wellness services, additional optional of critical illness cover, e-opinion in case of a critical illness, etc.

HDFC ERGO individual health insurance policy my:health Suraksha provides cover for pre & post hospitalization, 144 daycare procedures, maternity and newborn baby cover, AYUSH treatment, domiciliary treatment, optional cover for outpatient dental treatment and others.

Yes! Under an HDFC ERGO individual health insurance policy, a policyholder is eligible to gain tax benefits according to Section 80D of the Income Tax Act, 1961.

Yes, at HDFC Ergo you can get health insurance coverage for your children as well.

Yes, HDFC Ergo provides health insurance coverage for new born baby.

The benefits covered under health insurance plans for kids by HDFC Ergo include pre-hospitalisation and post-hospitalisation, in-patient treatment, day care procedures, domiciliary hospitalisation, and various other benefits.

HDFC ERGO kids health insurance is a must buy for people looking forward to securing the health of their kids along with themselves to gain financial security against expenses incurred during an unexpected medical emergency.

No, not during the policy tenure! If you want to change the sum insured, the ideal time would be policy renewal.

HDFC ERGO kids health insurance plan covers ​e-opinion in case of critical illness, pre & post hospitalization, 144 day care procedures, emergency ambulance expenses, AYUSH cover, organ donor expenses, convalescence benefit, policy tenure discount, family discount and more.

Yes! HDFC ERGO kids health insurance provides tax benefits as per Section 80D of the Income Tax Act, 1961.

The maternity benefit in HDFC Ergo comes with 48 months or 4 years of waiting period.

No, HDFC ERGErgoO doesn’t provide coverage for IVF fertility.

HDFC Ergo's Health Suraksha Gold policy, maternity sum insured for normal delivery is Rs. 15,000. While for c-section, the sum insured is Rs. 25,000, it is Rs. 15,000 for termination of pregnancy.

Health Suraksha Gold with Regain and ECB, the ultimate HDFC ERGO maternity health insurance policy is perfect for married couples and women who are planning to start their family in the coming years.

Unfortunately, you cannot! Any changes to sum insured may not be allowed during the policy tenure, but you can increase or decrease your HDFC ERGO maternity health insurance at the time of policy renewal.

HDFC ERGO maternity health insurance comes with many advantages such as easy claim settlement, lifelong renewability, up to Rs. 10 Lakh sum insured, no medical checkup up to 45 years, cover for maternity expenses and newborn baby cover, no sub-limits on room rent, hospital charges, diseases, and doctor fee, etc.

HDFC ERGO maternity health insurance grants coverage for maternity expenses, newborn baby cover, unlimited day care procedures, AYUSH treatment, convalescence benefit, 5% bonus on the sum insured for every claim free year, family discount, optional benefits like Regain Benefit & Enhanced Cumulative Bonus and more.

Yes! HDFC ERGO maternity health insurance policy gives tax benefits as per Section 80D of the Income Tax Act, 1961.

At HDFC ERGErgoO, there is no restriction for maximum entry age to buy health insurance for parents.

Yes, HDFC Ergo offers coverage for ayurvedic treatment under its parents health insurance.

At HDFC Ergo, you get a family discount of 10% on total premium for covering 2 or more family members on individual sum insured basis in a single policy.

HDFC ERGO parents health insurance my:health Medisure Classic is a perfect health insurance plan for elderly who want to gain financial security against unexpected medical expenses.

No, HDFC ERGO does not allow any changes to sum insured during the policy tenure. If you want to change your HDFC ERGO parents health insurance sum insured, the best time to request the same would be policy renewal period.

No entry age restrictions, wide cover, sum insured up to Rs. 5 lakh, 10% co-payment for every claim for insured above the age of 80 years, 5% long term policy discount, 10% family discount, 5% cumulative bonus, are some of the prime advantages of HDFC ERGO parents health insurance.

HDFC ERGO parents health insurance policy grants cover for inpatient treatment, pre & post hospitalisation, daycare procedures, domiciliary hospitalisation, hospitalisation due to accident, Ayurvedic treatment, Recovery Benefit, optional covers of Double Sum Insured for Critical Illness and Waiver of Room Rent Sub-limits, etc.

Yes, it does! HDFC ERGO parents health insurance policy offers tax benefits as per Section 80D of the Income Tax Act, 1961.

At HDFC Ergo, the entry age for health insurance portability is dependent on the new policy terms and conditions as well as guidelines.

The list of documents required includes portability form, photocopy of existing policy documents, policy renewal documents, clearly mentioning continuity of coverage, in case of no claims made on the previous insurer, self-declaration by policyholders. In case of claim settlement, investigation report, discharge summary, and other documents are required to be submitted as proof.

Yes, you can opt for health insurance portability under health insurance plans by HDFC Ergo.

Premium payment at HDFC Ergo is not at all a task. You can make payment through net banking, credit/debit card, cheque, UPI, or cash. For more information, initiate contact with InsuranceDekho experts at 7551-196-989.

HDFC Ergo General Insurance premium calculator is very easy to use. You just need to visit insurancedekho website, then click on the 'Health' section and enter the details as required.

Very basic details are required for using HDFC Ergo General Insurance premium calculator like your age, medical history, coverage details, your city, number of members insured and their age.

Premium amount for HDFC Ergo General Insurance is affected by factors such as your age, pre-existing diseases, family history, members insured and policy tenure.

The best method to do a premium comparison is by the means of using HDFC Ergo General Insurance Premium Calculator. With the help of a calculator you can perform comparison on the basis of coverage, PED waiting period, co-payment clause and restoration benefits.

You get numerous benefits by using HDFC Ergo General Insurance premium calculator like convinence in comparison of various premium amounts, ease in financial planning, error free calculations and customization of coverage as per your requirements.

Your premium amount for the HDFC Ergo plan will be based on age, the number of people, pre-existing diseases, and family history. Note that the higher the age, the higher will be the premium. Also, the premium for individual coverage would be less in comparison to a family floater.

The ideal way to perform a premium comparison and choose the best HDFC Ergo policy is the calculation of premiums, and comparing coverage as well as exclusions.

To calculate premiums of health insurance plans for parents offered by HDFC Ergo General Insurance, you can use InsuranceDekho’s health insurance premium calculator. It is a free tool that uses several factors to calculate the premium for health insurance plans for parents, including sum insured, policy term, add-on cover(s), members covered under the policy, pre-existing illnesses, etc.

Following are the benefits of using HDFC Ergo General Insurance’s premium calculator:

• It saves you from doing complex calculations of health insurance premium
• It gives you an estimate of the premium to be paid and hence you can do the financial planning well in advance
• It allows you to add or reduce coverage features and choose the best ones in accordance with the premium.

There are several factors that affect the health insurance premium of HDFC Ergo plans. These include sum insured, members to be covered under the policy, policy period, add-on cover(s), pre-existing illnesses, etc.

Yes. You will be required to pay GST at the rate of 18% on premiums paid for health insurance plans offered by HDFC Ergo General Insurance.

To lower the health insurance premiums for HDFC Ergo plans, you must follow the tips given below:

• Purchase top-up plans for extended coverage at affordable premiums
• Be informed when choosing deductibles and co-payment
• Buy health insurance policies on floater basis instead of an individual basis.

Yes, you can, even if you are living your retirement life.

Yes, senior citizen health insurance in HDFC Ergo allows the insured to avail up to Rs. 30,000 tax exemption under Section 80D of the Income Tax Act, 1961.

Ideal HDFC Ergo General Insurance Plan for people aged over 65 years is Suraksha Silver Smart Plan to cater to their healthcare needs at a nominal premium rate.

No, there are no disease-specific restrictions for senior citizens in health insurance plans by HDFC Ergo.

HDFC ERGO senior citizen health insurance is a great health insurance choice for individuals aged above 61 years who want to secure themselves and their finances against unexpected medical expenses.

No! You cannot make any changes to the sum insured during the policy tenure. But, if requested at the time of policy renewal, the change can be allowed.

HDFC ERGO senior citizen health insurance policy Optima Senior features benefits such as no maximum entry age, lifelong renewal option, easy claim settlement, portability benefits, no claim discount, e-opinion, and no claim-based loading or claim-based underwriting, affordable premium, etc.

HDFC ERGO senior citizen health insurance plan Optima Senior provides cover for inpatient hospitalization, pre-hospitalisation & post-hospitalisation expenses, domiciliary treatment, one e-opinion per policy, organ donor expenses, domiciliary treatment, emergency ambulance expenses, and more.

Yes, it does! HDFC ERGO senior citizen health insurance policy provides tax benefits according to Section 80D of the Income Tax Act, 1961.

Yes, HDFC Ergo provides coverage for pre-existing diseases under its top-up plan, but only after 36 months of continuous coverage.

HDFC Ergo provides a 5% discount under its top-up plan on choosing a two-year period and a 10% family discount when 3 or more family members are covered on an individual sum insured basis.

Yes. HDFC Ergo provides my: health Medisure Super Top-up in the category.

Top up plans by HDFC Ergo offer you additional coverage beyond the threshold limit of your base health insurance policy. And super top-up plans are similar to top-up plans except they cover a single claim above the threshold limit but super top up plans cover multiple hospitalisation bills above the threshold limit.

A rider in health insurance plan by HDFC Ergo is an add-on cover that enhances the scope of an insurance policy. You can purchase a rider voluntarily by paying an extra premium. Whereas a top-up policy is designed to offer additional health insurance coverage along with the existing health insurance policy.

Following are the advantages of top-up policies offered by HDFC Ergo General Insurance:

• Available at an affordable premium
• Can be purchased with both individual and family floater plans
• You can enjoy tax benefits under Section 80D of the Income Tax Act on the premium paid for these plans
• It is a better option to go for a top-up policy in order to increase coverage at a nominal cost.

In case you are not satisfied with the coverage benefits of your existing health insurance policy and want more extensive coverage, then you can opt for a top-up policy by HDFC Ergo General Insurance. It comes at an affordable premium and offers you the required coverage.

Anyone who is aged above 18 years, lives in India and has a regular health insurance policy can buy a top-up policy by HDFc Ergo General Insurance.

Some of the common benefits covered under HDFC Ergo's plans for women include:

• No entry age restriction.
• Maternity benefit along with newborn baby cover.
• Lifelong renewability.
• Free health check-ups on completing 4 claim-free years.
• Tax savings up to Rs. 60,000 under Section 80D of the Income Tax Act, 1961.

Under its Health Suraksha Gold plan, HDFC Ergo offers maternity sum insured Rs. 15,000 for normal delivery, Rs. 25,000 for C-section, and Rs. 15,000 for termination of pregnancy.

Under my: health Medisure Classic, maternity sum insured for normal delivery is maximum 10% of sum insured or Rs. 20,000, max 20% of sum insured or Rs. 40,000 for C-section, and max 10% of sum insured or Rs. 20,000 for termination of pregnancy.

At HDFC Ergo, women can get themselves covered for maternity without any hassle. Health Suraksha Insurance Gold and my:health Medisure Classic Insurance are plans that cover maternity expenses.

HDFC ERGO woman health insurance plan is for every woman who wants to secure her and her family's health against high medical bills incurred during any unexpected medical emergency situation.

No! Changes in the sum insured amount during the policy tenure are not allowed. However, a policyholder can raise a request for the sum insured changes at the time of policy renewal.

HDFC ERGO woman health insurance has many advantages. The major ones include maternity expenses (maximum up to Rs. 15,000 for normal and Rs. 25,000 for C-section delivery), newborn baby expenses up to 90 days, sum insured up to Rs. 10 lakh, lifelong renewability, no sub limit for room rent & diseases and others.

HDFC ERGO woman health insurance policy provides cover for maternity expenses, newborn baby medical expenses, E-opinion for critical illness, in-patient treatment, pre & post hospitalization, convalescence benefit, integrated wellness services, 144 day care procedures, organ donor expenses, emergency ambulance expenses, etc.

Yes, HDFC ERGO woman health insurance provides tax benefits under Section 80D of the Income Tax Act, 1961.