HDFC ERGO Health Insurance

HDFC ERGO Health Insurance – Plans, Benefits & Claim Process

Plan Your Family’s Health

By proceeding, you agree to our Terms & Conditions & Privacy Policy

Overview of HDFC ERGO Health Insurance

HDFC ERGO Health Insurance is a leading health insurer in India, backed by HDFC Ltd. and ERGO Group AG, part of the Munich Re Group. The company offers a wide range of health insurance solutions catering to retail, senior citizen, and corporate segments.

HDFC ERGO focuses on technology-driven insurance services, offering paperless policy issuance, digital claims processing, and customer-centric health insurance products.

Care Senior Health Plan Specifications

investkraft

2024
Enhanced digital health insurance services and customer experience platforms

2023
Expansion of hospital network and health insurance product portfolio

2022
Strengthened claim settlement and underwriting systems

2021
Launch of upgraded health insurance plans with broader coverage

Choose the Best Health Insurance Plan

that provides all the necessary coverage benefits you need at affordable premiums.

Similar Insurance Company Plans

Health Insurance Premium Calculator

Calculate your health insurance premium within seconds with InvestKraft Health Insurance Premium Calculator.



Health Insurance Calculator

Key Features of HDFC ERGO Health Insurance

Other Insurance Company Plans

 

HDFC ERGO Health Insurance Add-on Riders

 

What’s Covered and Not Covered in HDFC ERGO Health Insurance

HDFC ERGO Health Insurance Inclusions

  • Inpatient hospitalisation for illness or injury
  • Room rent, ICU charges, and doctors’ fees
  • Pre-hospitalisation and post-hospitalisation expenses
  • Day-care medical procedures
  • Emergency ambulance services
  • AYUSH treatments as per policy terms
     

HDFC ERGO Health Insurance Exclusions

  • Pre-existing diseases during the waiting period
  • Self-inflicted injuries
  • Alcohol or drug-related treatments
  • Cosmetic procedures, unless medically necessary
  • Infertility treatments and IVF
  • War, riot, or nuclear-related events
 

Claim Process Of HDFC ERGO Health Insurance

More than 13,000+ network hospitals offer cashless treatment through HDFC ERGO Health Insurance across India. For planned hospitalisation, intimation and pre-authorisation should be provided in advance, while in the case of an emergency, intimation must be given within the stipulated timeframe after admission. Cashless treatment is subject to approval as per the terms and conditions of the HDFC ERGO Health Insurance policy and the arrangements with the treating hospital.

Cashless Claims Process

  1. Visit a network hospital of HDFC ERGO
  2. Inform the hospital insurance desk about your policy
  3. Hospital submits pre-authorisation request
  4. The claim is reviewed and approved
  5. Treatment begins after approval
  6. The hospital and insurer settle the bill directly

Reimbursement Claims Process

  • Inform HDFC ERGO about hospitalisation within the specified timelines
  • Pay hospital expenses upfront
  • Submit the claim form and required documents
  • Claim is assessed by the insurer
  • The approved amount is reimbursed to the policyholder
 
 

Documents Required for Buying a Health Insurance

  • Valid ID proof like an Aadhar card, voter ID, PAN card, or passport is required.
  • Accepted address proofs include utility bills, rent agreements, and bank statements.
  • Insurance providers must do CDD for new policyholders using provided KYC documents.

Documents Required for Health Insurance Claim Process

  • Filled and signed claim form with name, policy number, illness details and address.
  • Include all medical test reports and relevant documentation.
  • Original hospital bills, discharge summaries and payment receipts are crucial for claim verification.
  • Attach pharmacy bills and corresponding prescriptions for medication used during treatment.
  • Include police FIR and post-mortem report (if applicable) for accident claims.

 

Best Health Insurance Plans in India

The following are some of the best health insurance plans in India that you can buy from InvestKraft:

Insurance Provider Plan Name Coverage Type Sum Insured Range Age Limit (Adults) Important Parameters
Care Advantage Health Insurance Plan Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
ICICI Elevate Health Insurance Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
IFFCO Tokio Family Health Protector Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
Niva Bupa Aspire Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
Arogya Supreme Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium
TATA AIG Medicare Lite Policy Individual & Family Floater ₹2 Lakh - ₹6 Crore 18-65 years
  • Extensive network hospitals
  • Customizable coverage options
  • Wellness programs
Check Premium

Frequently Asked Questions (FAQs)

A.

Both are strong insurers. HDFC ERGO is known for digital services and corporate-backed stability, while Star Health is popular for retail-focused health plans. The better option depends on coverage needs, budget, and plan features.

A.

HDFC ERGO premiums may be higher due to comprehensive coverage, higher room rent limits, strong hospital network, and additional benefits like lifelong renewability and wide add-on options.

A.

Top health insurers in India generally include HDFC ERGO Health Insurance, Star Health Insurance, LIC Health Insurance, Care Health Insurance, and Digit Health Insurance.

A.

Key benefits include cashless hospitalization, wide hospital network, comprehensive medical coverage, lifelong renewability, and fast digital claim processing.

A.

Yes, HDFC ERGO offers family floater plans that cover multiple members under a single sum insured with flexible coverage options.

A.

Yes, cashless treatment is available at a large network of hospitals across India, subject to pre-authorization and policy terms.

A.

Yes, HDFC ERGO offers dedicated senior citizen health insurance plans with age-specific coverage features.

A.

HDFC ERGO offers individual plans, family floater plans, senior citizen plans, super top-up plans, and group health insurance.

A.

Claims can be filed through cashless or reimbursement modes using the mobile app or online portal, making the process largely paperless.

A.

Yes, most HDFC ERGO health insurance plans come with lifelong renewability, subject to policy terms and conditions.

Scroll Top ↑ Free Financial Report
WhatsApp
Subcribe - Investkraft Newsletter

Subscribe to our newsletter