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HDFC ERGO Health Wallet Health Insurance

6 reviews Rate This
Health Wallet
Claim Settlement Ratio86.52%
COVID-19 CoverYes
In-House Claim SettlementAvailable
Network Hospitals10,000+
Policies Sold10,66,395
Renewability Lifelong Renewability

About HDFC ERGO Health Wallet Health Insurance

Health Wallet by HDFC ERGO General Insurance is a medical insurance plan which provides unique coverage benefits. It is an indemnity oriented health insurance plan which pays for the hospitalisation costs incurred. Moreover, the plan can be taken on an individual or family floater basis. A unique feature about the plan is that the unutilised amount of the plan’s coverage under Reserve Benefit can be carried forward to the next year and can be accumulated for high medical costs later on. Moreover, the accumulated carried forward benefit can also be used to pay for OPD expenses or the premium of the policy.

The sum insured under the policy starts at Rs. 3 Lakh and goes up to Rs. 50 Lakh. All the basic coverage benefits are included like inpatient hospitalisation, ambulance costs, organ donor cover, day care treatments, etc. Moreover, there are value-added benefits like multiplier benefit, restore benefit, recovery benefit, etc.

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Key Inclusions and Exclusions of the Plan

What's Included

  • 100% restoration of sum insured if the coverage limit is used up in a policy year
  • Lump sum recovery benefit of INR 10,000 if hospitalisation exceeds 10 days
  • Free annual health check-ups every year
  • Worldwide emergency coverage for up to 50% of the sum insured
  • Reserve benefit of Rs. 5000 to Rs. 25,000 every year which can be carried forward if not utilised

What's Not Included

  • Attempted suicide or self-inflicted injuries
  • Treatment for an injury due to war and related perils are not covered
  • Expenses incurred for the diseases due to the use or abuse of alcohol and drugs are excluded
  • All treatment related to cosmetic is not covered under the policy
  • Obesity or wealth control related treatments are not covered by the policy

1957 HDFC ERGO Cashless Network Hospitals in India

Choose HDFC ERGO Critical Illness Plan

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HDFC ERGO Health Wallet Brochure

  • 786.34 KB
  • PDF Document
  • Nov 09, 2020

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.

FAQs on Health Wallet Health Insurance Plan

  • How does Reserve Benefit work?

    There is a coverage limit on Reserve Benefit under the plan. This benefit covers the OPD expenses incurred by the policyholder on consultations, diagnostic tests, medicines, etc. After the end of the policy year, if the Reserve Benefit coverage is not utilised in full, the unused amount is carried forward to the next year. This accumulation continues every year there is an unused balance. Moreover, 6% bonus is also added on the carried forward balance. The accumulated balance can then be used to pay the premium or for OPD expenses.

  • What is the multiplier benefit?

    Multiplier benefit is a no claim bonus which is allowed if no claim is made in a policy year. For every claim-free year, the sum insured increases by 50% and, therefore, doubles after two claim-free policy years.

  • What are the eligibility requirements of buying the plan?

    Individuals aged 91 days and above and up to 65 years can buy the plan. Children aged 91 days to 5 years are allowed coverage only when either parent is insured under the plan

  • Which family members can be covered under the plan?

    Self, spouse, dependent children, dependent parents and dependent parents-in-law can be covered.

  • For how long can the policy be renewed?

    The policy offers lifelong renewals without a maximum limit on exit age.

  • What are the waiting periods under the plan?

    There is an initial waiting period of 30 days after buying the policy during which illnesses suffered would not be covered. Thereafter, specific ailments like hernia, cataract, etc. are covered after a waiting period of 2 years. For pre-existing illnesses, the waiting period is 3 years.

  • What is the limit of coverage on ambulance costs?

    Ambulance costs are covered for up to Rs. 2000 per instance of hospitalisation.

  • What is AYUSH Treatment?

    AYUSH treatments mean treatments taken under non-allopathic medical practices like Ayurveda, Unani, Siddha and Homeopathy.

  • Are medical check-ups required before buying the policy?

    Pre-entrance medical check-ups might be required depending on the age of the insured and the sum insured opted for. If the tests are conducted and the policy is accepted by the insurance company, the cost of the medical check-ups would be reimbursed fully.

  • What does worldwide emergency care cover?

    Under worldwide emergency care, if the insured suffers a medical emergency when travelling abroad and is hospitalised in an international hospital, the cost of treatments are covered.

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