*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 ensured an impressive HDFC ERGO health insurance claim settlement ratio of 95% in FY 2021-22.
The claim settlement ratio (CSR) indicates the total claims paid compared to the total number of claims received. Thus, the above CSR suggests that the insurance company paid 95% of the total claims received in the financial year ending March 31, 2022.
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 methods below:
Follow the steps given below to file an cashless claim with HDFC ERGO health insurance:
Policyholders must inform the insurance company about their planned hospitalization at least 48 hours in advance and about emergency hospitalization within 24 hours.
Show your HDFC ERGO health card and a valid photo ID at the network hospital for cashless treatment.
The network hospital will send the pre-authorization form to the HDFC ERGO General Insurance Company and seek approval for cashless treatment.
The insurer will go through the documents received by the hospital and will approve/reject your cashless claim request.
If approved, the hospital will send the final bill and other required documents to the insurer for final authorization after your treatment.
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 directly to the network hospital.
Here are the steps to file a reimbursement claim with HDFC ERGO health insurance:
Inform HDFC ERGO General Insurance Company about your hospitalization within the specified timeline and obtain the treatment.
While getting discharged from the hospital, pay all the medical bills and collect all the medical documents.
Upload all the required documents to the insurer’s website for claim processing.
The insurance company will review all the submitted documents and process the claims within 7 days. The claim amount will be paid to you online.
Take a look at the list of documents required to file an HDFC ERGO health insurance claim:
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