HDFC ERGO Health Insurance Claim Settlement

The reimbursement process is for those who get treatment at a non-network hospital. HDFC Ergo reimburses the amount within a short time. The process for this facility is as follows:

• Contact the nearest hospital and intimate within 24 hours (emergency hospitalisation) or 48 hours (planned hospitalisation).
• Register a claim, fill out the reimbursement claim form, and send the same with the required documents to the HDFC Ergo Claim Office.
• After scrutinizing the documents, HDFC Ergo will approve the claim.
• If additional documents or information are needed, HDFC Ergo will contact you.
• After adequate receipt of the required documents, the claims will be settled by the insurer.
• You will receive the status update through email/SMS on every phase of the claim. 
• Upon receipt of complete documents, the claim would be processed by HDFC Ergo and paid through NEFT.

Here is a list of documents required for filing a reimbursement claim for HDFC ERGO Health Insurance Claim Settlement:

• Original investigation reports
• Final hospital discharge summary
• FIR or post-mortem report it happened
• Pharmacy bills along with the prescription
• Original bills, receipts, and discharge report
• Indoor case papers and duly filled claim form
• Original hospital bills and a valid photo ID proof
• Treating doctor's report, and original consultation notes
• Nature of operation performed and surgeon's bill and receipt
• Test reports along with attending doctor’s or surgeon’s report

All claims with amounts Rs. 1 Lakh and above require a KYC form along with a photocopy of any KYC document (Aadhaar card, voter ID, passport, driver's license, etc).

In case of any query, contact the customer care executives at InsuranceDekho for the HDFC ERGO health insurance claim settlement ratio.

The Incurred Claim Ratio (ICR) indicates the overall performance of insurance companies and gives people an overview of what they can expect from their insurer. The Incurred HDFC ERGO Claim Settlement Ratio for FY 2018-19 is 62%. It clearly indicates that HDFC Ergo is in a position to clear claims without having to overburden its finances.