HDFC Ergo Health Insurance

An overview

HDFC ERGO General Health Insurance Plans offer a wide range of comprehensive indemnity, mediclaim, fixed benefit, top-up, and critical illness plans. You can receive cashless treatment and hospitalisation at over 10,000 hospitals, as well as daycare treatments, no room rent restriction, AYUSH cover, in-patient hospitalisation, pre and post hospitalisation, and other benefits. 

List of best health Insurance Products from HDFC Ergo health insurance

HDFC ERGO – My Health Suraksha

Individuals, families and the elderly are all covered under this plan. There are no room rent caps, no sickness sub-limits, free health checks every year, and much more. 

HDFC ERGO Health Suraksha Policy 

HDFC ERGO’s Health Suraksha Policy is a basic health insurance plan that covers the majority of hospitalization costs. Individual and family floater coverage is provided under this plan.  

Health Suraksha Gold Policy 

Health Suraksha Gold is a more advanced version of the Health Suraksha Plan that includes the option to add critical illness coverage. Individual and family floater coverage are provided under this plan.  

Health Suraksha Regain Policy

Health HDFC ERGO’s Suraksha Regain plan includes a restoration benefit. Individual and family floater coverage are provided under this plan.  

Health Suraksha Top-up Plus Policy 

The Health Suraksha Top-up plan from HDFC ERGO is, as the name suggests, a supplement plan. It provides individual and family floater coverage.  

Critical Illness Silver Policy 

The Critical Illness Plan is one of HDFC ERGO’s benefit plans, and it provides a lump-sum benefit upon a critical illness diagnosis. This plan is available in two variations.  

Critical Illness Platinum Policy 

Individual critical illness coverage ranging from Rs.1 lakh to Rs.50 lakh5 is offered for persons aged 5 to 65 under this plan. In this plan, the policyholder is offered a lump sum payment equal to the amounts covered in the event of 15 catastrophic diseases.  

Personal Accident Insurance Policy

Another benefit plan given by HDFC ERGO is a lump-sum payment in the event of death or disability caused by an accident. Individuals under the age of 65 can get coverage in the range of Rs. 2.5 lakh to Rs. 15 lakh in case of an accident anywhere in the world.  

Health Medisure Super Top Up Insurance

A health insurance plan is developed expressly to satisfy your parents’ medical needs. This plan provides coverage for your parents or elderly relatives.

HDFC Ergo health insurance – Reviews 

In terms of claim settlement ratio, HDFC ERGO has a very good track record. That is extremely encouraging for their prospective customers. In terms of pricing, their items fare well in comparison to competitors’ offerings. In terms of deductions and room rent limits, HDFC ERGO health insurance comes out on top. 

 They have acceptable waiting periods, but their no-claim incentive structure is not the most enticing; they offer a 5% bonus for each claim-free year, with a maximum bonus of 50%. 

HDFC Ergo Health Insurance – Network Hospitals 

If you want to get the best cashless medical treatment available, HDFC Ergo General Insurance can help you with that at any of its 2,710 cashless network hospitals. HDFC Ergo, as a responsible health insurance business, has kept every policyholder’s comfort in mind and provided flexibility to pick by presenting a large list. Instead of wasting your valuable time looking for a decent hospital elsewhere, you can quickly select a network hospital at HDFC Ergo PAN INDIA. 

Do you know why you should not be hesitant to use HDFC Ergo as a cashless network hospital? Because HDFC Ergo will cover all treatment costs, you will not have to spend anything out of your own cash. Furthermore, you will not have to deal with hospital formalities. It would be simple to focus on treatment with the HDFC Ergo cashless network facility.  

HDFC Ergo Health Insurance – Customer Care Numbers / Contact Details

HDFC ERGO is among the popular health insurance providers in India. Their support team is largely available to help customers. So you can easily contact the HDFC ERGO Customer Care department if you have any questions or want to file a complaint about your insurance policy. 

Customers of HDFC ERGO can use the customer care login procedure outlined below to inquire about insurance policy questions

1. Navigate to the official HDFC ERGO website (

2. Choose “Know Your Policy.” 

3. Enter your policy number, mobile phone number, and email address. 

These are the costs incurred prior to or following hospitalization for medical care. Pre-hospitalization costs include doctor’s appointments, whereas post-hospitalization costs include follow-ups after treatment. 

Toll-Free Contact 

To get insurance policy-related questions answered, all existing and prospective HDFC ERGO policyholders can call the company’s toll-free number, which is listed below: 

  • Existing policyholders should call 022 6234 6234/0120 6234 6234. 

  • To purchase plans or become a new customer, dial 1800 2666 400. (toll-free) 

Major Benefits of HDFC Ergo Health Insurance Plans  

  • HDFC Ergo Insurance is rated BBB+ (which means stable) by the ICRA rating committee.  
  • All of the company’s policies are created with the demands of various consumer classes and age groups in mind. 

  • The organization has a track record of providing excellent customer service after the sale of a policy. 

  • The plan covers up to four members of your family, which is adequate for today’s nuclear family setups. 

  • HDFC Ergo’s health insurance plans are renewable for life, relieving you from the worry of unanticipated medical emergencies. 

  • There are health insurance policies accessible with no sub-limit on room rents. 
  • For each year without a claim, the firm gives a 5% bonus on the total covered. 

  • The policy includes a provision for repayment of medical check-up fees after four claim-free years. 

Features of HDFC Ergo Health Insurance Plans 

  1. Renewability  – The plan provides lifelong regeneration in a quick and simple manner. It protects your finances from financial stress caused by medical emergencies and keeps you ready to deal with any critical/difficult scenario. 
  1. Ratio of Solvency – The solvency ratio is an important criterion to consider when choosing a good insurance company to lead a financially secure life. It assesses the company’s capacity to satisfy its long-term financial obligations. A corporation is said to be solvent if its assets are sufficient to pay off claims as they occur. 
  1. Market Share – In recent years, a wide range of innovative Insurance products and services have been introduced. The bar graph below depicts HDFC Ergo’s market share in India from 2016 to 2020. The brand’s increase in market share from 2016 to 2020 suggests a strong hold on the sector. 
  1. Make a Support Claim – Claim settlement is an important feature to consider when choosing a health insurance company since it informs you about the insurance company’s ability to resolve claims. Several companies promise to resolve claims within a certain time frame. According to the IRDA, Annual Report 2019-2020, HDFC Ergo has settled 99.8% of claims within three months. The higher the percentage, the more capable the company is of settling claims. 

Why HDFC Ergo Health Insurance?  

An organization that offers extra benefits to its clients is the best option. We’ve outlined some of the benefits of HDFC Ergo health insurance and why it might be a suitable fit for you. Read all of the points and make an informed decision about your plan. 

  1. Health care medical support at home – If you and your family wish to receive medical treatment at home, HDFC Ergo can certainly assist you in obtaining the best medical support as well as home care coverage amenities. It also provides cashless home health care services. 
  1. Customer-centeredness – HDFC Ergo provides 24X7 contact help for resolving health insurance claims. The company provides health insurance plans that may be simply purchased online at low prices and without the involvement of agents. 
  1. There are no age limitations. – If you are 18 years old or older, you are eligible for HDFC Ergo health insurance. Their plans are available to persons of various ages. 
  1. Simple Payment Method – Installments are available via HDFC Ergo Health. It can be advantageous if you do not have a steady source of income but are prepared to get Health Insurance and pay the premiums in installments. 
  1. There are discount alternatives available. – HDFC Ergo plans offer a variety of discounts, including a family discount, a long-term policy discount, and a loyalty discount. It depends on the plan you avail.  

Inclusions of HDFC Ergo Health Insurance 

Health insurance policies are numerous; they are designed to appeal to a diverse demographic and hence differ in coverage. A health insurance plan that meets the needs of your family member may not meet the needs of your employee at work.  

Consider the situation of a HEALTH INSURANCE POLICY for a member of one’s family or an employee working for a company. An individual health insurance plan will suffice for a family member, but a group insurance plan will suffice for an employee. 

As a result, it would not be inaccurate to state that this is highly subjective. However, there are a few givens that serve as the foundation for what may be referred to as the finest health insurance policy for an individual. 

Exclusions of HDFC Ergo Health Insurance 

  • Accidents that occur while participating in sports are not covered by the policy.  

  • Self-inflicted wounds result from the use and abuse of intoxicating or hallucinogenic substances such as drugs and alcohol.  

  • HDFC Ergo doesn’t address any claims which are due to war or similar situations.  

  • It also excludes sexually transmitted diseases and venereal diseases.  

  • This policy excludes lunacy, hereditary illness, mental illnesses, cosmetic surgery, and obesity therapy.  

  • Expenses incurred for HIV/AIDS treatment or linked disorders.  

Claim Process of HDFC Ergo Health Insurance

There are two ways to file a claim under a Health Insurance Policy: cashless and reimbursement. To put it simply, if you want to make a cashless claim, you must seek treatment only at a network hospital or the insurance provider that is serving your policy. To receive therapy, you must first obtain authorization in accordance with the procedures outlined and in the prescribed form.  

In the event of a reimbursement claim, the insurance company must be notified in accordance with their policies. After hospitalization, the policyholder must ensure that papers such as the claim form, discharge summary, medicines, and bills to be filed for reimbursement are received. 

Claims Types 

When it comes to health insurance claims, there are essentially two sorts of settlements. 

Claims Made Without Cash

  • If you choose this sort of claim, you will not have to pay for the expenditures out of your own money. Your insurer would deal directly with the hospital and cover the costs. There are two prerequisites for this to happen. 

  • To begin, your health insurance policy must cover the illness that you or a family member has been diagnosed with. 

  • Second, the hospital you wish to visit should be on your insurer’s list of network hospitals. 

  • If the first two conditions are met and the hospitalization is scheduled, you can file a cashless claim. 

Claims for Reimbursement

  • A reimbursement claim is the inverse of a cashless claim. Reimbursements claims are made when you do not opt for the cashless process or are admitted in a hospital outside the network.  

  • You can complete the payment while still undergoing your standard hospitalisation procedure. When you are discharged, contact your insurance as soon as possible and submit a claim together with all essential hospital documentation. Then after this, the amount will be transferred to bank account.  
  • The filing process will differ slightly depending on the type of claims you choose. In the event of planned hospitalization, you should notify your insurer. If you do, they will provide you with a Pre-Authorization Form, which you must fill out and submit at the hospital’s Third Party Administration counter. 
  • In the event of a reimbursement claim, you must notify your insurance within 30 days of discharge and complete the reimbursement claim form. Both processes necessitate their own set of documentation, which your insurer will assist you with. 

Things to Think About

Here are a few things you should think about before making your claim. 

  • It is recommended that you thoroughly review the pre-authorization form and provide all of the facts as accurately as possible. 

  • Because you must provide all original documents to your insurer, making photocopies of them for future reference is advised. 

  • If you fail to renew your insurance on time, you may lose out on several advantages.  

HDFC Ergo Health Insurance – FAQs

Q1. Do I need separate health insurance I’m already covered under my employer’s group policy?  

Ans: It is generally advised that you have your own medical insurance plan in addition to any policy that may cover you during your employment and continue to provide coverage when you retire. In this manner, you can avoid having to tap into your savings to cover medical bills.  

Q2. What are the benefits of a health insurance policy for the current policyholders?  

Ans: The benefits of the Health Insurance portability for the Policyholders are 

Coverage customization – Portability allows policyholders to alter their policy to meet their current health needs. Also, they can add nominees or additional cover for other members.  In the event of policy portability, the existing Sum Insured is added to the Accrued Bonus to give the new Sum Insured. During portability, the No Claim Bonus is also added to the new Sum Insured. 

No time-bound exclusions — Individuals can choose portability without fear of time-bound exclusions. 

Continuation of previous benefits – Even after portability, all advantages of an old policy remain in effect. 

Lower rates — As competition increases, companies are more prepared to offer current benefits at lower premiums, allowing policyholders to save money.  

Q3. What do you mean by Pre-Existing Disease? 

Ans: A pre-existing illness is any medical condition that the proposer had prior to acquiring a health insurance policy. Pre-existing conditions include any health difficulties ranging from high blood pressure to thyroid problems, as well as the obvious suspects like diabetes and asthma.  

Q4. In a health insurance policy, what does cashless hospitalization mean? 

Ans: When receiving treatment in a hospital, the policyholder is not required to pay upfront due to the cashless aspect of the health insurance coverage. In such a circumstance, bill settlement is handled between the insurance company and the hospital, with no cash payment required from the policyholder.  

Q5. What are pre- and post-hospitalization expenses?

Ans: These are the costs incurred prior to or following hospitalization for medical care. Pre-hospitalization costs include doctor’s appointments, whereas post-hospitalization costs include follow-ups after treatment.  

Q6. How many times can medical insurance be claimed? 

Ans: If you have a health insurance policy, you can file several claims within the policy period as long as they are within the sum insured. The coverage limit is predetermined, and the policyholder can only obtain coverage up to that amount. During the insurance period, an infinite number of claims can be covered in accordance with the scope of coverage specified in the policy wordings.

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