HDFC ERGO Health Insurance FAQs

HDFC ERGO Health Insurance

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Highlights

10,000+ Network Hospitals

10,66,395 Policies Issued

Lifelong Renewability

83.66% Claim Settlement Ratio on FY19

100% In-House Claim Settlement

Coronavirus (COVID-19) Cover

Claim Settlement

  • What are the health insurance claim settlement options offered by HDFC ERGO?

    HDFC ERGO offers both, cashless treatment or reimbursement facility options to its customers for claim settlement purpose.

  • 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 18001205698.

     

  • 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. 

  • 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. 

Critical Illness

  • Does HDFC ERGO offer critical illness plan?

    Yes! HDFC ERGO provides critical illness cover under its Critical Illness Insurance plan. 

  • What is the eligibility criteria for buying critical illness plan by HDFC ERGO?

    Any individual in the age group of 5 years to 65 years can apply for HDFC ERGO’s critical illness plan.

  • Which critical illnesses are covered by HDFC ERGO under its critical illness plan?

    HDFC ERGO, through its critical illness plan provides coverage for up to 15 critical illnesses. Stroke, Coronary Artery Bypass Surgery, Paralysis, Cancer, Heart Attack (Myocardial Infarction), Major Organ Transplantation, Multiple Sclerosis, and Kidney Failure are a few covered by HDFC ERGO.

  • What are the benefits that HDFC ERGO offers under its critical illness plan?

    To cater to the medical needs of critical illness insured individuals, HDFC ERGO provides lump sum payment in a single transaction on first diagnosis of any of the critical illnesses. Apart from lifelong renewability, the HDFC ERGO offers tax benefits as well as coverage for up to 15 critical illnesses.

Family Floater

  • How do I benefit by purchasing family floater health insurance?

    On buying family floater health insurance, you not only cover your entire family under one policy (sum insured shared by all members), but also make renewals easier. Moreover, the premium becomes less in comparison as that of individual health insurance.

  • What are the options one can go for to opt for family health insurance in HDFC ERGO?

    A policyholder can either choose a family floater plan or cover each member on an individual basis under the same policy. 

  • What if the primary insured in a family health insurance passes away?

    In case, the primary insured individual dies, the other adult individual may carry on with the policy. Note that the sum insured will remain the same. 

  • What are the discounts associated with family health insurance in HDFC ERGO?

    Policyholders get 10% discount on the premium on choosing to cover more than 2 family members on an individual sum insured basis in the same policy. 

Feature

  • What is the waiting period for pre-existing diseases in HDFC ERGO?

    The waiting period for pre-existing diseases in HDFC ERGO is 4 years.

General Information

  • What are the types of plans offered by HDFC ERGO?

    You can choose from Individual Health Insurance, Family Health Insurance, Parents Health Insurance, Senior Citizens Health Insurance, Critical Illness Insurance, and my:health Medisure Super Top-up as per your insurance needs.

  • Why should I buy HDFC ERGO health insurance policy?

    HDFC ERGO helps its customers ‘Take it easy. Experience the convenience.” To ensure the same, the company offers policies that are specifically designed keeping the diverse health insurance needs of customers in mind. Moreover, HDFC ERGO offers benefits such as pre and post hospitalisation coverage, cashless claims, no sub-limits, tax benefits, day care procedures, domiciliary medical treatment, and others.

  • Is there a limitation on entry age for buying health insurance of HDFC ERGO?

    The entry age for children is 91 days. However, there is no maximum entry age for adults.

  • What is the toll free customer care number of HDFC ERGO?

    The customer service number for HDFC ERGO is 022 6234 6234.

  • What is the address of HDFC ERGO Health Insurance?

    HDFC ERGO General Insurance Company Ltd. D-301, Third Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West) Mumbai-400078

  • What is No Claim Bonus under HDFC ERGO?

    When you do not file a claim within the policy year, you get a benefit in the form of discount (NCB or No Claim Bonus) on your subsequent premium in the next year.

Help to Buy

  • How to apply for and buy HDFC ERGO health insurance policy online?

    You can apply for and buy HDFC ERGO health insurance policies online through HDFC ERGO’s website www.hdfcergo.com or through www.insurancedekho.com. Remember, you can make use of net banking, debit card, or credit car to pay the health insurance premium as the company allows flexible payment modes.

Individual

  • What’s the best age to start HDFC ERGO health insurance?

    One should invest in individual health insurance in their early 20s to ensure optimum financial planning and gaining wider coverage at a lower premium. 

  • If I am already covered under my parent’s health insurance. Why should I buy a separate health cover?

    Buying a separate health cover will help you when you become ineligible to remain covered your parent’s policy. Your individual health insurance will cover your specific medical needs at that time. 

  • How much cover do I need if I apply for individual health insurance at HDFC ERGO?

    Due to rising medical costs, it is recommended for you to opt for Rs.5Lakh sum insured and above. However, learn that the ideal cover depends on current age, medical history, and a few other factors. 

  • I am covered under employee health insurance. Do I still require an individual HDFC ERGO health insurance?

    Yes. An individual health coverage will protect you from drawbacks of employee health insurance and let you have control over your medical needs and their fulfillment. 

Kids

  • Does HDFC ERGO provide health insurance coverage for kids?

    Yes, at HDFC ERGO you can get health insurance coverage for your children as well. 

  • Can I take an independent health insurance policy at HDFC ERGO for my 4 year kid?

    In case your kid is less than 5 years, he or she would only be covered if you & your spouse are covered under the policy. 

  • Does HDFC ERGO provide coverage for new born baby?

    Yes, HDFC ERGO provides health insurance coverage for new born baby. 

  • What are the benefits that HDFC ERGO offers under its health insurance policy for kids?

    The benefits covered under HDFC ERGO health insurance for kids include pre & post hospitalisation, in-patient treatment, day care procedures, domiciliary hospitalisation, and various other benefits.

     

Maternity

  • Which expenses are covered under maternity benefit by HDFC ERGO?

    HDFC ERGO’s maternity benefits include pre & post natal expenses, normal, c-section, termination of pregnancy, as well as new born baby expenses.

  • How much does one have to wait to avail maternity benefit in HDFC ERGO?

    The maternity benefit in HDFC ERGO comes with 48 months or 4 years of waiting period. 

  • Does HDFC ERGO cover IVF fertility under its maternity insurance cover?

    No, HDFC ERGO doesn’t provide coverage for IVF fertility. 

  • What are the maternity sum insured options available under HDFC ERGO maternity insurance?

    HDFC ERGO’s Health Suraksha Gold policy, maternity sum insured for normal delivery is Rs. 15,000. While for C-section, the sum insured is Rs. 25,000, it is Rs. 15,000 for termination of pregnancy. 

Parents

  • Which is the most affordable base plan for parents health insurance offered by HDFC ERGO?

    HDFC ERGO, through its most affordable base plan, my:health Medisure Classic Insurance offers comprehensive coverage to all the parents.

     

  • What is the maximum entry age for parents health insurance at HDFC ERGO?

    At HDFC ERGO, there is no restriction for maximum entry age to buy health insurance for parents. 

  • Does HDFC ERGO provide Ayurvedic treatment under its parents health insurance?

    Yes, HDFC ERGO offers coverage for Ayurvedic treatment under its parents health insurance.

  • Does HDFC ERGO offer discount on parents health insurance?

    At HDFC ERGO, you get a family discount of 10% on total premium for covering 2 or more family members on individual sum insured basis in a single policy. 

Plan Coverage

  • Does HDFC ERGO cover pre and post hospitalisation expenses?

    Yes, the company provides coverage for pre-hospitalisation expenses up to 60 days and for post-hospitalisation expenses up to 90 days.

Portability

  • Does HDFC ERGO offer the feature of health insurance portability?

    Yes, you can opt for health insurance portability at HDFC ERGO. 

  • When should I apply for health insurance portability at HDFC ERGO?

    If interested in getting your health insurance policy port, it is advisable for you to apply at the insurer at least 45 days before the premium renewal date of the existing policy. 

  • What is the age criteria to be eligible for health insurance portability at HDFC ERGO?

    At HDFC ERGO, the entry age for health insurance portability is dependent on the new policy terms & conditions as well as guidelines. 

  • What are the documents required for health insurance portability at HDFC ERGO?

    The list of documents required includes Portability form, Photocopy of existing policy documents, Policy renewal documents, clearly mentioning continuity of coverage, In case of no claims made on the previous insurer, self-declaration by policyholders. In case of claim settlement, investigation report, discharge summary, and other documents are required to be submitted as proof. 

Premium

  • What are the factors that will affect my HDFC ERGO premium?

    Your HDFC ERGO premium amount will be based on age, number of people, pre-existing diseases, and family history. Note that the higher the age, the higher will be the premium. Also, that the premium for individual coverage would be less in comparison to a family floater.

  • How do I calculate my HDFC ERGO premium?

    Calculating the HDFC ERGO premium is quite easy. You can do so on visiting the official website of HDFC ERGO for ‘Health Insurance Premium Calculator Online’ or you can contact experts at InsuranceDekho at 18001205698. 

  • What is the best way to compare HDFC ERGO health insurance premium?

    The ideal way to perform a premium comparison and choose the best HDFC ERGO policy is the calculation of premiums, and comparing coverage as well as exclusions. 

  • How do I pay my HDFC ERGO premium?

    Premium payment at HDFC ERGO is not at all a task. You can make payment through net banking, credit/debit card, cheque, UPI, or cash. For more information, initiate contact with InsuranceDekho experts at 18001205698.

Senior Citizen

  • What is the eligibility criteria for purchasing HDFC ERGO senior citizen insurance?

    There is no age restriction for buying HDFC senior citizen health insurance. 

  • Can I buy HDFC ERGO’s health insurance post-retirement for myself and/or my spouse?

    Yes, you can, even if you are living your retirement life. 

  • Does HDFC ERGO health insurance come with any disease restriction for senior citizens?

    No, there are no disease-specific restrictions for senior citizens in HDFC ERGO. 

  • Is a senior citizen entitled to tax exemption in HDFC ERGO?

    Yes, senior citizen health insurance in HDFC ERGO allows the insured to avail up to Rs. 30,000 tax exemption under Section 80D. 

Tax Benefit

  • What tax benefits can I expect to get?

    Policyholders are entitled to get tax benefits for premiums that they pay towards an HDFC ERGO health insurance policy under Section 80D.

Top-up

  • Does HDFC ERGO health insurance offer Top-up plans?

    Yes! HDFC ERGO provides my:health Medisure Super Top-up in the category. 

  • Why should I choose HDFC ERGO’s top-up plan?

    A few elements that make the top-up plan by HDFC ERGO an ideal choice to go for include constant premiums from age 61, no health check-ups up to age 55, in-patient hospitalisation, pre & post hospitalisation coverage, etc. 

  • Does HDFC ERGO cover pre-existing diseases under its top up plan?

    Yes, HDFC ERGO provides coverage for pre-existing diseases under its top-up plan, but only after 36 months of continuous coverage. 

  • Are any discounts offered by HDFC ERGO under its top up policy?

    HDFC ERGO provides a 5% discount under its top up plan on choosing a two-year period and a 10% family discount when 3 or more family members are covered on individual sum insured basis. 

Woman

  • Are there any HDFC ERGO health insurance plans that cover specific needs of women?

    At HDFC ERGO, women can get themselves covered for maternity without any hassle. Health Suraksha Insurance Gold and my:health Medisure Classic Insurance are plans that cover maternity expenses. 

  • Does HDFC ERGO offer hospitalisation coverage delivering baby via normal and cesarean?

    Yes, at HDFC ERGO you can avail in-patient hospitalisation benefit for both normal and cesarean.

  • What benefits does HDFC ERGO offer under its women-centric health insurance plans?

    Some of the common benefits covered under HDFC ERGO’s plans for women include:

    • No entry age restriction.
    • Maternity benefit along with newborn baby cover.
    • Lifelong renewability.
    • Free health check-ups on completing 4 claim-free years.
    • Tax savings up to Rs. 60,000 under Section 80D of the Income Tax Act.

  • What are the sum insured options offered by HDFC ERGO under its maternity coverage?

    Under its Health Suraksha Gold plan, HDFC offers maternity sum insured Rs. 15,000 for normal delivery, Rs. 25,000 for C-section, and Rs. 15,000 for termination of pregnancy.

    Under my:health Medisure Classic, maternity sum insured for normal delivery is max 10% of sum insured or Rs. 20,000, max 20% of sum insured or Rs. 40,000 for C-section, and max 10% of SI or Rs. 20,000 for termination of pregnancy. 

HDFC ERGO Health Insurance Plan List

Name of PlanSum Insured
Critical Illness PlanMin: 5 Years; Max: 65 Years 5 Lakh Get Quotes Now
my: health SurakshaMin: 91 Days; Max: No Limit3 Lakh Get Quotes Now
my:Health Medisure ClassicMin: 3 Months; Max: No Limit1 Lakh Get Quotes Now
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years1 Lakh - 5 Lakh Get Quotes Now
Corona Kavach PolicyMin: 1 day ; Max: 65 years50,000 - 5 lakh Get Quotes Now

HDFC ERGO Health Insurance Top Up List

Name of PlanSum Insured
my: Health Medisure Super Top-upMin: 3 Months; Max: 65 Years3 Lakh Get Quotes Now

Claim Process at HDFC ERGO Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

HDFC ERGO Health Insurance User Reviews

What users are saying
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    On: Feb 24, 2020
  • Good additional plan

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