HDFC ERGO Health Insurance Claim Settlement
Since its foundation in 2002, HDFC Ergo Health Insurance has served around 1.5 crore customers. Over 12,000 crore claims have been settled to date, with a track of settling one claim per minute and boasting a claim settlement ratio of 99%. HDFC Ergo Health Insurance has a network of over 13,000. hospitals. They provide coverage for both modern and conventional medical treatments and drugs. Because they provide AYUSH treatment, their policyholders have complete financial stability and the freedom to choose the best course of action.[1] This page contains information about HDFC Ergo Health Insurance's claim settlement ratio, how to check claim status, data in the claim form, and claim initiation. To check the progress of your claim, go to the website or call customer support. To avoid delays, fill out the claim form completely and accurately. Contact customer support to file a cashless or reimbursement claim.
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Claim Settlement Ratio of HDFC Ergo Health Insurance
The claim settlement ratio for HDFC Ergo Health Insurance is calculated by dividing the total claims paid within 30 days by the total number of claims paid. The following are the Claim Settlement Ratios for the preceding five years:
Why is Claim Settlement Ratio Important?
When choosing a health insurance company, it is critical to analyze the company's claim settlement ratio (CSR), which is a solid insurance indicator. CSR enables you to assess the company's ability to pay claims, which is critical for you and your loved ones. There are two primary reasons why CSR is important: 1. Assists in evaluating insurance companies: When purchasing an insurance policy, consider the insurer's Claim Settlement Ratio (CSR). CSR is a statistic that can help you decide if an insurer is right for you or not. Before making a purchase, examine the CSR of various firms to determine which one has the highest ratio. An insurer's claim settlement ratio increases the likelihood that you will get a claim if you need to file one.
HDFC Ergo Health Insurance Claim Initiation
If you need to file a claim from HDFC Ergo Health Insurance, please follow the process mentioned below:-
How To File a Claim
Step 1:- Initiation
When you schedule a medical appointment or have an emergency, contact InsuranceDekho or HDFC Ergo Health Insurance customer service right away.
You can contact HDFC Ergo Customer Support at care@hdfcergo.com or phone the HDFC Ergo Health Insurance customer support team at their toll-free number, 022 6234 6234.[2]
To contact an InsuranceDekho representative, please call 7551196989 or send an email to support@insurancedekho.com.[3]
Step 2:- Verification
When you submit your documents to HDFC Ergo Health Insurance, the claims team will review them thoroughly. If all of your information is correct, your claim will be processed.
Step 3:- Tracking
You can contact HDFC Ergo Health Insurance customer support to follow up on your claim. To receive frequent updates, you can also contact a customer service specialist at InsuranceDekho
Details to be Filled in the HDFC Ergo Health Insurance Claim Form
To submit a claim for HDFC Ergo Health Insurance, you must fill out two areas of information. The separated information is listed below: Furthermore, the following information is also necessary: Duly filled claim form Discharge or daycare summary Final hospital bill Payment receipts Investigation report Pharmacy bills Implant invoice Doctor Prescriptions Consultation Papers Age Proof Indoor Case Paper Copy of canceled cheque KYC Form
Claim Process Of HDFC Ergo
HDFC Ergo Insurance has partnered with over 13,000 healthcare establishments and helps the insured get cashless services there. Notification of scheduled procedures at non-network hospitals must be sent to HDFC Ergo Insurance 48 hours in advance, or within 48 hours of the patient's admission to the hospital in the event of an emergency. Notably, authorization for cashless care at non-network hospitals is subject to completing the requirements mentioned in your HDFC Ergo Insurance policy and the hospital's agreements. Furthermore, the steps to take in the event of cashless or reimbursement claims are mentioned below: Go to the nearest HDFC Ergo network hospital. Contact the front desk to talk with the TPA, or third-party administrator. TPA will fill up and submit your application to HDFC Ergo Insurance on your behalf. If everything is permitted, the claim executive will review the reports and handle the claim. You can start receiving therapy at the hospital as soon as you have approval. Your insurer and the hospital will settle the bill immediately following treatment. Notify HDFC Ergo Insurance of your hospital stay (within 48 hours of an emergency, or 48 hours in advance if planned). Pay your hospital bills in full and submit all relevant documents. Fill out and send in a claim form. Await the insurer's approval and status report. Keep in mind that you must: Submit all documents, including your claim form, within 15 days following release. Save all fully signed papers for submission to guarantee a smooth claim process.Cashless Claims
Reimbursement Claims
How to Check the HDFC Ergo Health Insurance Claim Status?
Follow the steps outlined below to check the status of your HDFC Ergo Health claim both online and offline:
Online
Visit HDFC Ergo Insurance’s official website.
Select the “Claim” option. In the dropdown menu select the “track claim” option. You will be redirected to a new page. Fill in the following details to track your claim status.[1] When you visit the nearest HDFC Ergo Health Insurance branch, please bring a copy of your insurance document. Speak with a branch office executive who will assist you in understanding your coverage and the status of your claim. You can also get an update by sharing your claim reference number with a customer service representative over the phone at 022 6234 6234, which is a toll-free number, or by calling any of the numbers listed on the HDFC Ergo Health Insurance website.[2]Offline
HDFC Ergo Health Insurance Claim Settlement Time
According to the Insurance Regulatory and Development Authority of India (IRDAI), an insurer normally settles a claim 30 days after receiving money or filing claim documentation. To speed up the settlement of your claims, keep the following in mind: Develop a deeper grasp of your policy. Send only full documents. Keep a note of any correspondence with your insurance provider. Maintain an active policy. Examine each document carefully. Consult an attorney if necessary.Tips to Get Your Claim Settlement Faster
HDFC Ergo Health Insurance Claim Assistance and Support
To seek claim assistance and support from HDFC Ergo Health Insurance:[2] Call toll-free at 022 6234 6234 Email at care@hdfcergo.com. Whatsapp HDFC Ergo Health Insurance by saying 'Hi' at 8169 500 500. To obtain claim assistance and support from InsuranceDekho, you may:[3] Email: support@insurancedekho.com
References
[1]https://www.hdfcergo.com/
[2]https://www.hdfcergo.com/customer-care-new
[3]https://www.insurancedekho.com/contact-usFAQs
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What is the process of health insurance claim intimation at HDFC Ergo?
In order to initiate a claim, the policyholder is required to initiate contact at HDFC Ergo at 022-6234-6234. You can also initiate contact with the experts at InsuranceDekho at 7551-196-989.
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When should I intimate HDFC Ergo about the hospitalisation?
Irrespective of whether you opt for cashless treatment or reimbursement mode, make sure you inform HDFC Ergo within 24 hours (emergency hospitalisation) and within 48 hours prior to admission (planned hospitalisation), be it at a network hospital or a non-network hospital.
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What are the documents required for claim settlement process at HDFC Ergo?
At HDFC Ergo, the list of documents needed for registering claim includes:
- Duly filled and signed claim form with HDFC Ergo policy number.
- Original discharge summary.
- Original Investigation reports.
- Past treatment documents, if any.
- Medico Legal Certificate (MLC) or FIR in case of an accident.
- Original final bill comprising detailed breakup.
- Original payment receipt.
- Original pharmacy invoices supported by prescriptions, etc.
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How to calculate the Claim Settlement Ratio (CSR) of HDFC Ergo General Insurance?
You can calculate the Claim Settlement Ratio of HDFC Ergo General Insurance by dividing the total number of claims received by the total number of claims settled in that year.