HDFC ERGO Health Insurance

HDFC ERGO Health Insurance Overview

HDFC ERGO Health Insurance is offered by HDFC ERGO General Insurance Company Limited. HDFC ERGO is 4th largest general insurance company in India. It was founded in the year 2002 and operates in 89 cities through its 109 branches. It is a JV between HDFC Ltd and ERGO International AG. ERGO International AG is the primary entity of the Munich Re Group, whereas HDFC Ltd is India's leading housing finance company. ERGO International AG holds 49% stake while HDFC holds 51% stake, making HDFC Ltd the major shareholder in the venture. This is headquartered at Mumbai.

Why to Buy HDFC ERGO Health Insurance?

HDFC ERGO General Insurance Company offers a wide range of health insurance plans that cover an individual and the family as well. These plans offer comprehensive coverage at affordable premium prices and are backed by more than 5,000 hospitals all over India. Offering significant features like cashless hospitalization, high no health claim benefit, and flexible payment modes, these health insurance plans are highly recommended for today's generation whose lifestyle makes them more prone to diseases that result from poor choices that eventually require medical intervention. Any medical emergency in the event of an accident or sickness requiring daycare procedures along with both pre and post hospitalization costs is covered by these affordable health insurance plans. These mediclaim plans also assure happiness to your family as well as you, thereby providing you with lump sum benefit.

Advantages and Benefits of Availing HDFC ERGO Health Insurance

The HDFC ERGO General Insurance Company is called the leader in the insurance industry because it gives its customers a little extra benefit when they buy any HDFC ERGO health insurance plan from the HDFC ERGO. Below are the advantages of buying HDFC ERGO health insurance plans:

• HDFC health insurance has a tie-up with 4,800+ network hospitals across the country, which facilitates cashless facility and other health care services
• There is a facility of 24*7 call assistance for settlement of health insurance claims
• The insurance company offers Value Added Services which enables the policyholder to enhance the sum insured in cases of claim free years
• The list of Services provided by the insurance company includes cover for pre-hospitalization and post-hospitalization expenses, day care procedures, costs incurred at home towards the treatment of the patient (domiciliary) and other such related expenditures
• The company offers a quick and easy insurance policy renewal process

Critical Factors of the HDFC Ergo Health Insurance Plan

• With a network of more than 6,000 hospitals in the country, availing cashless hospitalization and healthcare facilities is very easy with HDFC ERGO Health Insurance
• The policy period of the plan can be of 1 year or 2 years, with the basic sum insured per year between Rs. 3 lakhs and Rs. 10 lakhs
• HDFC ERGO Health insurance offers the additional benefit of ‘Cumulative Bonus’ after every claim-free year as well as reimbursement of health check-ups expenses after the completion of 4 consecutive claim-free years
• The plan also offers Income Tax benefits. The company promises a hassle-free claim procedure
• The plan does not have a cap on hospital room rents, hospital charges, specific diseases and even doctor

HDFC ERGO Health Insurance Highlights

The highlights of HDFC ERGO Health Insurance are:

• Tax Benefit under section 80D
• No Medical Check-up up to 45 years
• No sub-limits on any disease, room rent, hospital charge and doctor’s fee
• Cashless Treatment at Network Hospitals
• 5% bonus on Sum Insured for every claim-free year
• Offers one­-year or two-year policy coverage period
• Avail a family discount of 10% if 2 or more members of a family are covered under the same individual policy
• Life Long Renewability

HDFC ERGO Health Insurance offers two types of policies:

• Indemnity Health Insurance Policy
• Lump Sum Payment Health Insurance Policy

Indemnity Health Insurance Plan

Under this category, the health policy buyer gets compensations for the actual amount of financial losses incurred by him, subject to maximum amount of the sum insured.

Lump Sum Payment Health Insurance Plan

Under this category, the payment is made to the policyholders as soon as the illness or accident or any kind of related event occurs. This helps the policy holder to take care of every small expense to be made

• During the course of treatment.
• Comes at affordable pricing.
• Available on an Individual or FHPL basis.
• This health insurance plan offers Income Tax exemption u/s 80D of Income Tax Act
• Insurance claim settlement procedure is very easy and hassle-free.
• Provides coverage for inpatient treatment which includes all the hospitalization expenses.
• Provides a reimbursement of pre and post hospitalization expenses for up to 60 days and 90 days, respectively.
• Provides reimbursements incurred towards any kind of transportation charges or towards organ donor charges, if any kind of organ transplantation has been done.
• Provides Ayush Benefits i.e. inpatient hospitalization expenses undertaken under Ayurvedic, Sidha and Homeopathy are covered by the plan.

List of Health Insurance Policies from HDFC ERGO

The HDFC health insurance policies come in seven variants. Let us take a look at each of them in detail:

• HDFC Health Suraksha Insurance Policy
• HDFC Health Suraksha Gold Insurance Policy
• HDFC Health Suraksha Regain Insurance Policy
• HDFC Health Suraksha Gold Regain Insurance Policy
• HDFC Health Suraksha Top Up Insurance Policy
• Critical Illness Insurance Policy
• Critical Illness Platinum Insurance Policy

HDFC ERGO's Health Suraksha Plan

HDFC ERGO health insurance plan takes care of an individual and their family members.

Key Features and Benefits of HDFC Health Suraksha insurance Plan

• Can be bought as an annual policy or a two-year insurance policy
• Enhances sum insured by 5% in the form of Cumulative Bonus for every claim free year
• Issues Health insurance without any medical check-up for individuals below the age of 65 years.
• Health checkups are not mandatory for people who are less than 45 years at time of buying the policy
• Covers pre and post hospitalization expenses for 60 days and 90 days respectively
• Cover alternative treatments under Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH)
• No upper limit fixed on hospitalization expenses. No sub-limits on specific costs such as room rent, doctor's fees, hospital expenses, etc.
• The sum insured each year per insurance policy are Rs. 3 Lakhs, Rs. 4 Lakhs, Rs. 5 Lakhs, Rs.7.5 Lakhs, and Rs.10 Lakhs
• Provides a cover for organ donation
• Provides for free health checkups amounting up to 1% of the original sum insured subject to a maximum of Rs.5000, in case of 4 claim free years
• Provides enhancement of the sum insured by 5%, subject to a maximum of 50% of the sum assured for each claim-free year.
• Has a 2-year waiting period for certain diseases and illnesses
• HDFC Ergo health insurance policy holders can avail income tax benefits under section 80D of the Income Tax Act
• The HDFC ERGO Health Insurance plan has an easy and hassle free renewal process

HDFC ERGO's Health Suraksha Gold Plan

This HDFC ERGO mediclaim insurance plan is for the individual and his family along with extra added benefits.

Key Features and Benefits of HDFC ERGO Health Suraksha Gold Insurance Plan

• No specified age limit
• In cases of Individual plans the sum insured amounts are: 3 Lakh, 4 Lakh, 5 Lakh, 7.5 Lakh, and 10 Lakh while in cases of Family Floater, the sum insured amounts are: 3 Lakh, 4 Lakh, 5 Lakh, 7.5 Lakh, and 10 Lakh
• Provides facility to renew the insurance plan for lifelong
• Gives maternity Benefits along with newborn baby cover, subject to a minimum waiting period of 4 years. The HDFC ERGO Health Insurance plan offers inpatient medical expenses coverage for newborn babies up to 90 days after birth
• Provides convalescence benefit in cases of more than 10 consecutive and continuous days of hospitalization
• Covers pre and post hospitalization expenses for 60 days and 90 days respectively
• The plan from HDFC ERGO Health Insurance covers 144 specified daycare procedures
• Cover alternative treatments under Ayurveda, Yoga, Siddha and Homeopathy (AYUSH) without any sub-limits
• No fixed limits on hospitalization expenses. No sub-limits on specific costs such as room rent, doctor’s fees, hospital expenses, etc.
• Provides reimbursements for any kind of transportation expenses incurred for the purpose of hospitalization and post hospitalization, subject to limits as mentioned:

1. For sum insured amounts of 300000, 400000, and Rs.500000, this mediclaim plans reimburses up to Rs.2000 and
2. For sum insured amounts of 750000 & 1000000, this insurance policy reimburses up to Rs.3500.
3. Insurance covers organ donation expenses
4. Provides for free health checkups amounting up to 1% of the original sum insured subject to a maximum of RS.5000 in case of 4 claim free years.
5. Provides enhancement of the sum insured by 5%, subject to a maximum of 50% of the sum insured for each claim-free year. In cases of claims within a given year, the sum insured will be decreased by 5%.
6. This HDC Ergo medical insurance plan also gives up to 10% discount on 2-year policy renewals and a family discount of up to 10% in cases where 2 or more family members have availed this policy as an individual plan.
7. This health insurance policy from HDFC ERGO Health Insurance offers an e-opinion option for critical illnesses
8. The HDFC health insurance plan does not cover pre-existing illnesses for a period of 48 months
9. There is a waiting period of 24 months for coverage of certain specified illnesses
10. Offers income tax benefits for every renewal under section 80D of the Income Tax Act
11. The renewal process under this HDFC ERGO Health Insurance policy cover is both easy and hassle free

HDFC ERGO's Health Suraksha Regain Plan

Key Features and Benefits of HDFC ERGO Health Suraksha Regain Insurance Policy

1. The health plan from HDFC ERGO Health Insurance offers an optimised cover at affordable prices
2. No specified age limit for entry
3. The sum assured each year per insurance policy are Rs. 3 Lakhs, Rs. 4 Lakhs, Rs.5 Lakhs, Rs.7.5 Lakhs and Rs.10 Lakhs
4. Provides reimbursements for any kind of transportation expenses incurred for the purpose of hospitalization and post-hospitalization, subject to limits as mentioned:

• A reimbursement of up to Rs. 2,000 for a sum assured of Rs. 3 Lakhs, 4 Lakhs, and 5 Lakhs
• A reimbursement of up to Rs. 3500 for a sum assured of Rs. 7.5 Lakhs, and 10 Lakhs
• The plan guards against 144 specified daycare procedures
• The policy insures against pre hospitalisation expenses for 60 days and post hospitalisation expenses for 90 days
• The Insurance plan covers alternative treatments under Ayurveda, Yoga, Siddha and Homeopathy (AYUSH) without any sub-limits
• Offers organ donation cover
• Regain Benefits: This HDFC medical insurance plan provides for automatic restoration of the plan to the original sum insured amount in the event of complete exhaustion of the original amount during the policy period. It can be availed only once in a year and will not be carried forward to next year if not utilized within the given plan period.
• Provides enhancement of the sum insured by 10%, subject to a maximum of 100% of the sum assured for each claim-free year. In cases of claims within a given year, the sum insured will be decreased by 10%.
• This HDFC Ergo health insurance plan also gives up to 10% discount on plans that have been approved a 2-year renewal and a family discount of 10% in cases where 2 or more members of the family have availed this policy as an individual sum assured plan.
• Pre-existing illnesses are not covered for a period of 48 months
• No illness are covered within the first 30 days of taking the policy except accidental injuries
• Provides tax benefits for each year of renewal u/s 80D of the Income Tax Act
• Policyholders can also opt for the hassle free and easy renewal process for this HDFC ERGO Health Insurance plan to cover their health risks every year

HDFC ERGO's Health Suraksha Gold Regain Plan

Key Features and Benefits of HDFC Health Suraksha Gold Regain Insurance Policy

1. This HDFC ERGO Health Insurance policy is an optimised cover provided at affordable rates
2. There is no specific limit on entry age
3. The sum assured each year per policy are Rs. 3 Lakhs, Rs. 4 Lakhs, Rs. 5 Lakhs, Rs. 7.5 Lakhs, and Rs.10 Lakhs
4. Covers pre hospitalisation and post hospitalisation expenses for 60 days for 90 days respectively
5. The HDFC ERGO Health Insurance plan covers alternative medicine treatments under Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) without sub-limits
6. There are no sub-limits on specific costs such as room rent, doctor’s fees, hospital expenses, etc.
7. Offers organ donation cover
8. Regain Benefits: This insurance plan provides for automatic restoration of the plan to the original sum insured amount in the event of complete exhaustion of the original amount during the policy period. It can be availed only once in a year and will not be carried forward to next year if not utilized within the given plan period
9. Provides enhancement of the sum insured by 10%, subject to a maximum of 100% of the sum assured for each claim-free year. In cases of claims within a given year, the sum insured will be decreased by 10%.
10. This insurance plan also gives up to 10% discount on plans that are filed with a 2 year renewal period and a family discount of 10% in cases where 2 or more family members have availed this policy under individual sum insured plan
11. Provides cover towards maternity expenses incurred, subject to the following limits:

• In cases of normal delivery, this plan reimburses up to Rs. 15,000
• In Cases of LSCS, this plan reimburses up to Rs. 25,000
• In cases of termination, the plan reimburses up to Rs. 15,000.
• HDFC ERGO Health Insurance offers income tax benefits for every renewal under section 80D of the Income Tax Act.
• The plan has a hassle free and easy renewal process

HDFC ERGO's Health Suraksha Top Up Plus

It provides for extra coverage at very low costs. It is issued in accordance with an already existing health plan.

Key Features and Benefits of HDFC Ergo Health Suraksha Top UP Plus Insurance Policy

In case of exhaustion of the deductible, the top up is initiated.

• No maximum age limit specified
• Provides the option to change the Top Up policy to the Health Suraksha policy
• Can be availed as an individual or family floater plan for 1 year or 2-year policy
• Covers pre-hospitalization costs for 60 days and post hospitalization for 90 days
• Insures against 140 daycare procedures that do not need any hospitalization
• Does not cover alternative treatments
• The sum assured each year per insurance policy are Rs.2 Lakhs, Rs.3 Lakhs, Rs.4 Lakhs, Rs.5 Lakhs, Rs.7.5 Lakhs and Rs.10 Lakhs
• The deductible amounts are Rs. 1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs. 4,00,000 and Rs. 5,00,000
• A fully complete proposal form has to be submitted by the buyer
• The company gives a family discount of 10% in cases where 3 or more members of the family have availed this policy under individual sum insured plan
• Provides enhancement of the sum insured by 5%, subject to a maximum of 50% of the sum insured for each claim-free year. In cases of claims within a given year, the sum insured will be decreased by 10%
• Any person lying between the ages of 5 years to 65 years can opt for this plan. Even children above 91 days can be covered if both the parents are covered
• The policy can be availed for a maximum of 1 year or 2 years period. Renewal can also be done for 1 year or 2 years
• In case of applicants above the age of 55 years, a pre-policy check up is required before a policy is issued or before a plan renewal
• Provides reimbursements incurred towards any kind of transportation charges up to Rs.2000
• Has an initial waiting period of 30 days except for accidents, 2 years for specified cases and 4 years for pre-existing conditionss
• The plan offers tax benefits under section 80D of the Income Tax Act for every new year of renewal
• The renewal process for this HDFC ERGO Health Insurance plan is hassle free and easy

HDFC ERGO's Critical Illness Insurance

The HDFC ERGO Health Insurance online plan can be purchased by any individual meeting the relevant criteria specified below. Renewal of the HDFC ERGO Health Insurance cover is also easy and hassle-free.

Key Features and Benefits of HDFC ERGO Critical Illness Insurance Plan

• Issued in the form of lump sum amount in the event of occurrence of a sudden disease or an accident, subject to a survival period of 30 days of the plan buyer
• The sum insured under this HDFC ERGO Health Insurance policy ranges from Rs. 2,50,000 to Rs, 10,00,000
• Individuals in the 5-45 years age group and children between the ages of 5 years to 18 years can avail the policy
• It can be utilized for payment towards treatment undertaken, any aids required for recuperation, paying off liabilities in the form of debts
• It can be used as a substitute for any income loss owing to decreasing capacity to earn
• The plan provides cover against diseases such as Heart Attack (Myocardial Infarction), Multiple Sclerosis, Stroke, Cancer, Major Organ Transplantation, Coronary Artery Bypass Surgery, Kidney Failure, and paralysis
• No health checkups are required for people below the age of 45 years
• There is an initial waiting period of 90 days and a waiting period of 48 months for pre-existing illnesses
• Offers tax benefits for every year of renewal under section 80D of the Income Tax Act
• The health insurance renewal process under the plan is quite easy

HDFC ERGO's Critical Illness Insurance Platinum Plan

Key Features and Benefits of HDFC Ergo Critical Illness Insurance Platinum Policy

• Issued in the form of the lump sum in the event of occurrence of a sudden disease or an accident, subject to a survival period of 30 days of the plan buyer
• This HDFC Ergo health insurance coverage includes 15 critical illnesses
• It can be utilized for payment towards treatment undertaken, any aids required for recuperation, paying off liabilities in the form of debts
• It can be used as a substitute for any income loss owing to decreasing capacity to earn
• The health insurance plan provides cover against diseases, such as Heart Attack (Myocardial Infarction), Multiple Sclerosis, Cancer, Stroke, Kidney Failure, Aorta Graft Surgery, Alzheimer’s disease, End Stage Liver Disease, Major Organ Transplantation, Parkinson’s Disease, Kidney, Primary Pulmonary Arterial Hypertension, Coronary Artery Bypass Surgery, and Benign Brain Tumour
• The health insurance cover has an initial waiting period of 90 days
• The HDFC ERGO Health Insurance plan allows a policyholder to avail tax benefits under section 80D of the Income Tax Act for every year of renewal
• The insurance plan has a quick and hassle-free renewal process

HDFC ERGO Online Facilities

One can easily purchase HDFC ERGO Health Insurance online by following the below steps:

• Calculating the premium using health insurance premium calculator
• Providing all your details
• Making the payment

Other than that, HDFC ERGO offers several other online facilities. These are:

• E-Mail Policy Copy
• 80D Tax Certificate
• Updating Contact Details Online (Email id/Contact Number/Address)
• Make Changes/Endorsement
• Transfer of Insurance - Motor
• Creation of Service Request
• Upload Documents
• Cancellation Of Policy
• Track Interaction Status
• Claim Status
• Link Aadhaar and PAN
• Motor Claim Intimation
• Payments

HDFC ERGO Health Insurance Premium Calculator

At PolicyBazaar, we provide you with an all-inclusive health insurance premium calculator to enable you to calculate the premium you are liable to pay in exchange for HDFC ERGO Health Insurance coverage. You can log onto policybazaar.com and calculate your health insurance premium by providing certain details of yours. HDFC ERGO medical insurance premium calculator facilitates you to purchase adequate health coverage for your family and you. All you need to do is select and provide the right details at the time of calculating the health premium.

HDFC ERGO Health Insurance Renewal

HDFC ERGO health insurance policies can be applied to or renewal opted for through multiple channels like:

• Individuals wishing to buy HFDC ERGO Health insurance plans can simply call the Sales helpline of the company and speak to the customer service representative. For those opting for renewal, calling the customer care with existing details will work
• They can provide their name, email id and mobile number on the website of the company and request a call-back. The same applies for a renewal
• Online HDFC ERGO health insurance policies can be simply applied to by clicking the ‘Buy Online’ tab available on the company’s website. The process of policy purchase can be done in three easy steps:

1. All he needs to do is log into the company’s website and select the relevant tab. This opens a new page and the person needs to provide the details like date of birth, country of residence of the individual and his family, the type of health policy and the sum insured amount he wishes to opt for. Based on the information provided by the buyer the page calculates the premium to be paid by the buyer in order to avail the insurance policy. On having supplied the necessary details and having reached a suitable premium amount, the buyer needs to click on the ‘Proceed’ tab.
2. This opens a new page that requires the health insurance policy seeker to fill out the details like name, email ID, address, telephone number, correspondence address and other such related details. The person also needs to fill out certain relevant details, which must be accurate. Once the details are provided, click on the ‘Proceed’ tab.
3. This opens a new page that allows the policyholders to make the premium payment.

• HDFC ERGO health Insurance customers may also visit the company’s branches or get in touch with an agent to buy the plans required, or opt for renewal of existing ones.

How to File a Claim with HDFC ERGO?

Claims are of two categories and these are explained below:

• Cashless Claims: HDFC ERGO Health Insurance has 6000+ network of hospitals. When policyholders go to any of these hospitals, they are eligible to get a cashless claim since the insurance company will directly settle the bill with the hospital. However, the disease, too, has to be eligible for such a cover.
• Reimbursement Claims: If the hospital is not network-listed, the policyholder can get the expenses reimbursed against the hospital bills.

Below are the documents you need to submit for smooth processing of claims.

• NEFT details in the claim form along with a cancelled cheque.
• KYC form along with a photocopy of any one KYC document for claims amounting to Rs. 1 lakh or more. KYC Documents: Aadhaar Card, Passport, Driving License Voter ID

HDFC ERGO Health Insurance Customer Care

HDFC ERGO Health Insurance has several self-help options, and also a customer care apparatus in place.

By submitting the policy number, mobile no., or email ID, one can also create a service request online.

HDFC ERGO Health Insurance Network Hospitals

With over 4,800+ hospitals across the nation, HDFC ERGO health insurance provides you with an assurance of quality medical treatment at a hospital of your choice. You can avail medical treatment at these hospitals either as planned hospitalization or in the event of a medical emergency. In the meanwhile, keep your TPA informed about your plan to get hospitalized to avail the treatment or as soon as you get hospitalized in an emergency.

HDFC ERGO's Health Insurance FAQs

Q1. What does HDFC ERGO Health Insurance cover?

Ans. HDFC ERGO health insurance plans provide comprehensive coverage to the insured and the family. The company offers affordable health insurance plans with the cashless benefit at over 5000 hospitals all over India. Additional features are flexible payment options, enhanced NCB (No Claim Bonus), and so forth.

Q2. What other policies are offered by HDFC ERGO Health Insurance Company?

Ans. In addition to health insurance, following policies are offered by HDFC ERGO:

• Health Suraksha Top Up Plus Plan
• Critical Illness Policy
• Critical Illness Platinum Policy

Q3. Can I apply online for the insurance policy?

Ans. Yes, you can easily apply online for HDFC ERGO health insurance. You can download the policy form from the company website and take a printout. Fill in the details and submit it at the nearby branch.

Q4. How do I pay the insurance premium?

Ans. HDFC ERGO Health Insurance accepts premium payment in following three modes:

• Auto-deduction from your bank account
• In the form of cash or cheque deposit
• Online payment

Q5. How can I check policy status for HDFC Ergo health insurance?

Ans. You can check the status of your insurance policy from the company’s website. Log in and right-click on the policy number to get the status details.

Q6. How do I choose the best policy for me?

Ans. The simplest way to choose the best HDFC ERGO health insurance policy is to compare its various plans and choose the one that offers the maximum coverage within your budget.

Q7. How do I start for HDFC ERGO health insurance policy renewal?

Ans. Your health insurance policy is subject to auto-renewal, in case you chose the option auto-debit from your bank account at the time of purchasing the policy. You can anytime call on the toll-free number, i.e. 1800-2-700-700 (available in India only).

Q8. What is the maximum age at entry for HDFC ERGO health insurance policies?

Ans. There is no age limit for policy entry. One can apply for a health insurance plan at the minimum age of 91 days.

Q9. How do I find a hospital to avail cashless facility under my HDFC ERGO health insurance policy?

Ans. The company provides you with a wide network of over 5000 hospitals to avail the cashless facility. Along with the policy documents, you get a list of those hospitals. Alternatively, you can visit the company website and click on network hospitals right on the top to find the nearest hospital in your city.

Q10. What is the procedure for Claim Settlement?

Ans. For insurance claim settlement, follow the steps listed below:

• Make sure you register your insurance claim not more than 7 days of discharge from the hospital.
• Submit the duly signed insurance claim form along with other required document within 15 days of the occurrence of the particular incident.
• In case of deficiency of any of the document(s) required, you will receive a deficiency letter within 7 days of documents submission.
• The insurance claim settlement statement will be sent to you within 30 days after submitting complete documents along with a permissible payment.

You might be interested following insurance plans provided by HDFC ERGO

• HDFC ERGO Car Insurance
• HDFC ERGO Two Wheeler Insurance
• HDFC ERGO Home Insurance
• HDFC ERGO Travel Insurance
• HDFC ERGO Personal Accident