*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply
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HDFC ERGO General Insurance Company has an efficient in-house claim settlement team that decides on all the claims without third party administrator (TPA) involvement. As a result, the Company ensures an HDFC ERGO health insurance claim settlement ratio of 98.5%.
The claim settlement ratio (CSR) indicates the total claims paid compared to the total number of claims received. Thus, the above CSR suggests that 98.5% of the total claims received were paid in the last three months.
HDFC ERGO General Insurance Company has an easy and hassle-free claim process. Policyholders can either raise a cashless health insurance claim or a reimbursement claim. Take a look at the step-by-step guide to file a claim through both processes below:
Step 1: Inform the Insurer
Policyholders must inform the insurance company about their planned hospitalization at least 48 hours in advance and about emergency hospitalization within 24 hours.
Step 2: Display Documents for Cashless Treatment
Show your HDFC ERGO health card and a valid photo id at the network hospital to avail cashless treatment.
Step 3: Pre-authorization Form
The network hospital will send the pre-authorization form to the HDFC ERGO General Insurance Company and seek approval for cashless treatment.
Step 4: Cashless Claim Approval
The insurer will go through the documents received by the hospital and will approve/reject your cashless claim request.
Step 5: Document Submission
The hospital will send the final bill and other required documents to the insurer for final authorization after the treatment.
Step 6: Claim Settlement
The insurer will verify all the documents and authorize the claim within 2 hours of receiving all the documents. The bill amount will be paid to the network hospital.
Step 1: Inform the Insurer and Obtain Treatment
Inform HDFC ERGO General Insurance Company about your hospitalization and obtain the treatment.
Step 2: Pay Hospital Bills
At the time of getting discharged from the hospital, pay all the medical bills and collect all the medical documents.
Step 3: Upload All Documents
Upload all the required documents to the insurer’s website for claim processing.
Step 4: Claim Settlement
The insurance company will review all the submitted documents and process the claims within 7 days. The claim amount will be paid online.
Take a look at the list of documents required to file an HDFC ERGO health insurance claim:
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