A to Z about HDFC ERGO Health Insurance | Get Now

HDFC Ergo General Insurance Co. Ltd. is a 51:49 joint venture between HDFC Ltd. and ERGO International AG. HDFC ERGO is the 3rd biggest private general insurer in India, with a market share of 6.2 percent. Brokers, retail and corporate agents, bancassurance, and the company’s direct sales team made the company’s vast distribution network. 

The business provides a wide range of items to meet the needs of Indian customers one of them being Health Insurance.

Why choose HDFC ERGO Health Insurance?

• Full medical coverage: It covers hospitalization expenditures, pre-and post-hospitalization costs, daycare treatments, laboratory tests, prescription drugs, and ambulance charges.
• Keep your money safe: You don’t have to drain your bank account or dispose of family assets to pay for life-saving medical operations. Your health insurance policy will allow you to receive the best possible care without breaking the bank.
• No cash required: You won’t have to worry about organizing significant sums of money for treatment at the last minute if you have health insurance. Cashless treatment is available at nearly 10,000 network hospitals for both planned and emergency treatments.
• Covers COVID-19: This covers all of your ICU, nursing, diagnostic, and doctor costs if you get infected with COVID-19.
• 7500+ crores claim settlement with more than 1.5 crores customers.

Types of Health Insurance Plan

1. Indemnity health insurance plan: Up to the sum covered, this type of health insurance plan pays for your actual medical bills on a cashless and repayment basis. This is the most essential type of health insurance that everyone should have. This includes 4 different plans, make a choice:
   1. Optima secure: Optima secure includes
      1. Amount insured from 5 lakhs to 2 crores.
      2. No deduction on listed non-medical expenses
      3. So many discounts option and save up to 50% on premium
      4. 2x coverage and 100% increase in coverage after 2 years.
   2. Optima restore (for small families)
      1. Amount insured 5 lakhs to 50 lakhs
      2. 100% additional policy cover with no claim bonus
      3. Coverage before 60 days and after 180 days of hospitalization.
      4. 100% addition to your basic amount insured at your first claim.
      5. 2x your insured amount if not claimed in 2 years.
   3. My: healthSuraksha
      1. No medical test up to 45 years, secure your health when you are young.
      2. Offers free health checkups on every renewal
      3. If you do not claim your amount you will be rewarded, 10-25% max up to 200% addition to the sum insured.
   4. My: health Koti Suraksha
      1. You can secure an amount of 50 lakhs and 1 crore.
      2. Unlimited daycare procedures.
      3. There is no room rental cap up to a private AC room.
2. Top-up Health Insurance Plan: This is a Super-top-up plan that supplements your existing health insurance. It provides a lot of coverage at a modest price. This includes:
   1. My: health Medisure Super Top-higher
      1. Consistent premium from age 61
      2. No medical test up to 55 years, secure your health when you are young.
      3. Covers pre-post hospitalization charges.
      4. Less premium amount
      5. Covers daycare procedure.
3. Fix benefits Health Insurance Plan: It is a health insurance plan with a lump sum benefit that pays you all at once. It’s useful for covering unending medical bills resulting from serious illnesses like stroke, cancer, paralysis, Multiple Sclerosis, and so on. That includes
   1. Critical Illness Insurance
      1. Covered up to 15 Critical illnesses.
      2. Lumpsum amount in a single transaction.
      3. You can buy it for 1 and 2 years.
   2. iCan Cancer Insurance
      1. All types of cancer covered
      2. Cashless treatment
      3. For lumpsum payment 60% sum is available.
      4. Avail 100% of sum insured.

What covers under HDFC ERGO Health Insurance?

• Health checkups
• Hospitalization expenses
• Pre-Post hospitalization expenses
• Daycare treatment
• Mental Healthcare
• Home Healthcare
• Organ donor expenses
• Recovery Benefit
• AYUSH benefits
• Life long renewability 
• 2x Benefits

What does not cover under HDFC ERGO Health Insurance?

• Injuries during adventure sports
• Self-inflicted harm
• War or participation in defense activities
• Cosmetic operations
• Sexually Transmitted Diseases.

How to Claim your Health Insurance Plan?

1. Cashless Claims( only if you select their network hospital among 10,000+ you can avail cashless claims)
   • Select hospital and fill the pre-authorization form.
   • Submit the form and wait for our answer, your request will accept or reject.
   • If the request is accepted the person can be admitted, the company will settle expenses directly with the hospital.
2. Reimbursement Claims( if you do not select hospital from our network list)
   • Admit the person to the hospital and pay all the expenses that arise.
   • Collect all the bills and make a claim for your expenses with the company.
   • Your documents will verify, wait for the approval.
   • Your expenses will be paid after approval.

Contact Details

Call –  022 6234 6234 / 0120 6234 6234

Whatsapp –  8169 500 500 ( just say ‘hi’)

E-mail – nsp@hdfcergo.com (for network hospitals issues), preauth@hdfcergo.com (for authorization issues)

Customer Service Address – D-301, 3rd Floor, Eastern Business District ( Magnet Mall), LBS Marg, Bhandup (West) Mumbai-400078

Official Website – HDFC ERGO

FAQs

1). Do pre-existing diseases covered in Health Insurance policy?

Pre-existing conditions are usually barred from insurance coverage for a while. Diabetes, hypertension, thyroid disease, asthma, and other conditions could be the cause.

2). What is cashless hospitalization?

Cashless hospitalization is a method in which an insured person does not have to pay any medical expenses out of pocket in the event of a hospitalization or operation, and the entire bill is covered by the insurance company.

3). Can I have more than one health insurance policy at one time?

Yes, Because each plan operates differently and offers various benefits, you can always have more than one health insurance plan based on your needs and coverage requirements.

4). What if I missed my health insurance renewal dates?

You typically have a grace period of 30 days to renew your policy; however, if your grace period has elapsed, your policy will lapse, and you will need to contact your insurer to renew your expired health insurance plan.

5). What is the Claim settlement ratio(CSR)?

The claim settlement ratio (CSR) is the percentage of claims paid out by an insurer in a given financial year. In layman’s terms, it tells you if your insurance has sufficient financial resources to cover claims.