• HDFC ERGO Health Insurance - Compare plans, reviews & renew online

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    HDFC ERGO Health Insurance is a popular and well-reputed insurance firm that offers a wide range of health insurance products. HDFC ERGO General Insurance Company Limited is a joint venture between HDFC Ltd. and ERGO International AG.

    HDFC Ergo Health Insurance HighlightsUpdated on 26 Jun 2019

    Factor Details
    Health insurance plans 7 different health insurance plans available
    E-services offered Buy policy, Renew policy and Track claim
    Renewability Lifetime renewability
    Entry age No restrictions
    Branch offices 108 branches
    Network hospitals 6,000 hospitals

    Features and Benefits of HDFC ERGO Health Insurance

    • 24/7 Customer Support Team: HDFC ERGO has a well-equipped customer support team that handles everything from claims, purchases, and renewals on a 24/7 basis in a speedy and efficient manner.
    • Faster Claim Settlement: Claims are settled in a hassle-free and speedy manner to help customers have faster access to cashless claim services and make the reimbursement claim process more customer-friendly.

    Plans provided by HDFC ERGO Health Insurance

    Plan Name Plan Basis Sum Insured (Min and Max) Policy Term
    my:health Medisure Classic Insurance Individual and Family
    • Individual Policies: Rs.1 lakh to Rs.5 lakh
    • Floater Policies: Rs.2 lakh to Rs.5 lakh
    1 or 2 years
    Health Suraksha Silver Individual and Family
    • Min: Rs.3 lakh
    • Max: Rs.7.5 lakh
    1 or 2 years
    Health Suraksha Silver with Regain and ECB Individual and Family
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    1 or 2 years
    Health Suraksha Gold with Maternity Coverage Individual and Family
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    1 or 2 years
    Health Suraksha Gold with Regain and ECB Individual and Family
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    1 or 2 years
    Critical Illness Silver Individual
    • Min: Rs.5 lakh
    • Max: Rs.10 lakh
    1 or 2 years
    Critical Illness Platinum Individual
    • Min: Rs.2.5 lakh
    • Max: Rs.10 lakh
    1 or 2 years

     

    my:health Medisure Classic Insurance

    The my:health Medisure Classic Insurance Plan offers comprehensive coverage against planned and unplanned hospitalisation expenses. The policy covers in-patient treatment, pre-hospitalisation expenses, post-hospitalisation expenses, day care procedures, etc.

    Unique Features of my:health Medisure Classic Insurance Plan

    • Affordable premiums
    • Can raise cashless claims at network hospitals
    • 5% cumulative bonus is offered at the completion of each claim-free policy year
    • Insurer offers lifetime renewability
    • Tax benefits can be availed under Section 80D of the Income Tax Act, 1961
    • Optional covers can be availed by paying an additional premium
    • A health check-up, which amounts to 1% of the sum insured excluding the Cumulative Bonus, can be availed at the end of 4 claim-free policy years
    • Policy covers in-patient hospitalisation expenses, pre and post-hospitalisation expenses, day care procedures, domiciliary hospitalisation, hospitalisation due to an accident, maternity and newborn baby benefits, Ayurvedic treatments, and pre-existing diseases after the waiting period.

    Plan Details

    Policy term 1 or 2 years
    Entry Age
    • Adults: 18 years of age
    • Children: 3 months (provided either of the parents is covered under this plan)
    Plan Basis Individual or floater
    Sum Insured Range
    • Individual Policies: Rs.1 lakh to Rs.5 lakh
    • Floater Policies: Rs.2 lakh to Rs.5 lakh
    Premium Premium will vary based on one’s age, sum insured, policy term, etc.
    Co-Payment 10% co-pay for individuals over 80 years of age
    Waiting Period Pre-existing diseases will be covered after 36 months of coverage
    Cumulative Bonus Cumulative bonus of 5% is offered for each claim-free year, subject to a maximum cumulative bonus of 50%
    Discounts
    • Cumulative Bonus
    • Two-year policy discount
    • Family discount

    Health Suraksha Silver

    The Health Suraksha Silver Plan provides good coverage with a wide range of benefits such as cumulative bonus, in-patient treatments, domiciliary treatment, emergency ambulance services, etc.

    Unique Features of Health Suraksha Silver Plan

    • Tax benefit applicable under Section 80D of the Income Tax Act
    • Affordable premiums
    • Cumulative bonus is offered for every claim-free year
    • Free health check-up after completing 4 claim-free years
    • Cashless claim network
    • Coverage for in-patient treatment, pre and post-hospitalisation expenses, day care procedures, domiciliary costs, ambulance, AYUSH treatments, and organ donor’s treatment expenses.

    Plan Details

    Policy term 1 or 2 years
    Entry Age No maximum age limit.
    Plan Basis Individual and Family
    Sum Insured Range
    • Min: Rs.3 lakh
    • Max: Rs.7.5 lakh
    Premium Depends on age, sum insured, etc.
    Medical Screening Must after 45 years
    Waiting Period 30 days for general coverage, 48 months for pre-existing diseases
    Cumulative Bonus Cumulative bonus of 5% is offered to the policyholder at the completion of each claim-free year, up to a maximum of 50%
    Discounts
    • Cumulative bonus
    • Family discount

    Health Suraksha Silver with Regain and ECB

    The Health Suraksha with Regain and ECB Plan offers comprehensive health coverage to the policy buyer. In addition, the plan also offers an optional Enhanced Cumulative Bonus option and Regain Benefit.

    Unique Features of Health Suraksha Silver with Regain and ECB

    • Tax benefit applicable under Section 80D of the Income Tax Act
    • Affordable premiums, cumulative bonus
    • 10% Enhanced Cumulative Bonus for each claim-free year and up to 100% of the sum insured
    • Regain benefit for sum insured
    • Free health check-up after completing 4 claim-free years
    • Cashless claim network
    • The policy covers in-patient treatment, pre and post-hospitalisation expenses, day care procedures, domiciliary costs, organ donor expenses, emergency ambulance services, and AYUSH treatments

    Plan Details

    Policy term 1 or 2 years
    Entry Age No limit for entry age
    Plan Basis Individual and Family
    Sum Insured Range
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    Premium Depends on age, sum insured, etc.
    Medical Screening Must after 45 years
    Waiting Period 30 days for general coverage, 24 months for specific ailments as mentioned in the policy brochure, and 48 months for pre-existing diseases
    Enhanced Cumulative Bonus 10% Enhanced Cumulative Bonus is offered for each claim-free year up to a maximum of 100% of the sum insured
    Discounts
    • Enhanced Cumulative Bonus
    • 10% discount for the 2-year policy term
    • Family discount

    Health Suraksha Gold with Maternity Coverage

    The Health Suraksha Gold with Maternity Coverage Plan is a comprehensive health insurance policy that provides good coverage at affordable rates. One of the key benefits of this policy is that it offers maternity benefits after the 4-year waiting period.

    Unique Features of Health Suraksha Gold with Maternity Coverage Plan

    • Cashless claim network
    • Tax benefits under Section 80D of the Income Tax Act, 1961
    • Lifelong renewability option
    • The policy covers AYUSH treatments, newborn baby cover, maternity cover, convalescence benefit, e-opinion for critical illness, in-patient treatment, pre and post-hospitalisation expenses, day care procedures, domiciliary costs, organ donor expenses, and emergency ambulance services
    • Cumulative bonus is offered
    • Health check-up is offered once in four consecutive claim-free years

    Plan Details

    Policy term 1 or 2 years
    Entry Age No limit for entry age
    Plan Basis Individual and Family
    Sum Insured Range
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    Premium Depends on age, sum insured, etc.
    Waiting Period 30 days for general coverage, 48 months for pre-existing diseases, 4 years for maternity benefits, and 24 months for specific treatments and illnesses
    Cumulative Bonus 5% of the sum insured will be offered as the cumulative bonus at the end of each claim-free year, subject to a maximum cumulative bonus of 50%
    Discounts
    • Cumulative bonus
    • Family discount of 10%
    • 10% discount for 2-year policy

    Health Suraksha Gold with Regain and ECB

    The Health Suraksha Gold with Regain and ECB Plan offers enhanced health insurance coverage. It also offers an optional Regain benefit and an Enhanced Cumulative Bonus to policyholders.

    Unique Features of Health Suraksha Gold with Regain and ECB

    • Tax benefit applicable under Section 80D of the Income Tax Act
    • Affordable premiums
    • 10% Enhanced Cumulative Bonus for each claim-free year and up to 100% of the sum insured
    • Basic sum insured will be reinstated once it is exhausted
    • Cashless claim network
    • Coverage for in-patient treatment, pre and post-hospitalisation expenses, AYUSH treatments, day care procedures, maternity cover, newborn baby cover, domiciliary costs, emergency ambulance services, organ donor expenses, and e-opinion in case of a critical illness is provided

    Plan Details

    Policy term 1 or 2 years
    Entry Age No maximum age limit
    Plan Basis Individual and Family
    Sum Insured Range
    • Min: Rs.3 lakh
    • Max: Rs.10 lakh
    Premium Depends on age, sum insured, etc.
    Medical Screening Must after 45 years
    Waiting Period 30 days for general coverage, 48 months for pre-existing diseases, and 2 years for specific illnesses
    Enhanced Cumulative Bonus An Enhanced Cumulative Bonus of 10% is offered for each claim-free year, subject to a maximum of 100%
    Discounts
    • Enhanced Cumulative Bonus
    • Family discount of 10%
    • 10% discount for 2-year policy

    Critical Illness Silver

    The Critical Illness Silver plan provides coverage for specific critical illnesses. The policy pays a lump sum benefit up to the sum insured amount upon diagnosis of any of the specified critical illnesses.

    Unique Features of Critical Illness Silver

    • Tax benefit applicable
    • Pays a lump sum benefit upon diagnosis of any specified critical illness
    • Provides coverage to 8 specific illnesses

    Plan Details

    Policy term 1 or 2
    Entry Age 5 to 65 years
    Plan Basis Individual
    Sum Insured Range
    • Min: Rs.5 lakh
    • Max: Rs.10 lakh
    Premium Depends on age, sum insured, etc.
    Medical Screening Must after 45 years of age
    Waiting Period 90 days

    Critical Illness Platinum

    The Critical Illness Platinum Plan provides comprehensive coverage for as many as 15 specified illnesses.

    Unique Features of Critical Illness Platinum

    • Tax benefit applicable
    • At the first diagnosis of a critical illness that is specified in the policy brochure, a lump sum benefit up to the sum insured amount will be paid to the policyholder
    • Provides coverage to 15 specific illnesses

    Plan Details

    Policy term 1 or 2 years
    Entry Age 5 to 65 years
    Plan Basis Individual
    Sum Insured Range
    • Min: Rs.2.5 lakh
    • Max: Rs.10 lakh
    Premium As mentioned in the policy document
    Medical Screening Must for those above 45 years old
    Waiting Period 90 days

    Checklist before Buying HDFC ERGO Health Insurance

    • Finalise on coverage amount as per health needs
    • Finalise on premium paying frequency
    • Decide on the add-ons needed
    • Choose a plan wisely as per individual or family needs
    • Check the claim settlement ratio

    Documents Required for Purchasing HDFC ERGO Health Insurance

    • ID proof
    • Address proof
    • Medical certificates, if any

    *Note: Any other documents that are requested for will have to be submitted.

    Reasons to choose HDFC ERGO Health Insurance

    Affordable premiums
    Easy purchase and renewal
    Online transactions

    Incurred Claim Ratio of HDFC ERGO

    The incurred claim ratio refers to the total value of all claims settled by the insurance company against the total premium collected by the insurer in a particular year. This number is usually calculated using a formula and is given out as a percentage.

    Updated on 26 Jun 2019

    Year Incurred Claim Ratio
    2016-17 50.76%
    2017-18 52.58%

    Extra Benefits from HDFC ERGO

    Grievance Redressal All complaints and grievances of customers are addressed through the grievance redressal mechanism
    Customer Delight This provides policyholders unique access to services offered by health and beauty clinics, spas, pharmacies, etc.

    HDFC ERGO Renewal

    To renew an HDFC ERGO health insurance policy, log on to their website and click on the ‘Instant Renewal’ option. Once this is done, key in the policy number, and proceed to make the payment.

    HDFC ERGO Renewal Network Hospitals for Cashless Treatment

    HDFC ERGO has a wide network of pan-India network hospitals where customers can avail direct healthcare services. To locate the nearest empanelled hospital, log on to the website.

    Claim Procedure for HDFC ERGO Health Insurance Plans

    Cashless claim:

    • Locate the nearest network hospital through the insurer’s website.
    • Avail cashless services at the hospital by displaying your health card and photo ID.
    • The healthcare provider will send the insurer a cashless request. The hospital will also coordinate with the insurer for authorisation of the cashless request.
    • The insurer or the TPA will verify the documents and convey their decision to the hospital.
    • You will receive updates about the claim via SMS or email.
    • The hospital will send the final bills to the insurer. Approved bills will be paid by the insurance company directly to the network hospital. Any inadmissible expenses will have to be borne by you.

    Reimbursement claim:

    • Register your claim and fill claim form. Bills, invoices, and discharge summary should be kept ready.
    • Submit the relevant documents along with the claim form.
    • The insurer will verify the documents and approve the claim. You will be notified if any additional documents are required by the insurer.
    • You will be notified of the claim status via email or SMS.
    • Upon receiving all documents, the claim will be processed. The payment will be made via NEFT.

    Terms and Conditions of the Insurer

    • The insurance provider has the right to withdraw the policy at any point in time if any information provided by the policyholder is untrue, misrepresented, or concealed.
    • Incomplete claim forms will not be processed.
    • All claims should be made within the stipulated time period mentioned in the policy.
    • Claims cannot be made for any exclusions.

    FAQs on HDFC Ergo Health Insurance

    1. Can I buy HDFC health insurance policies online?
    2. Yes, you can buy any HDFC health insurance policy online. Once you read up and finalise on a product, you can open the link to the plan on the official website and click on ‘Buy now’.

    3. How do I find out how much premium I have to pay for my health insurance policy?
    4. The premium payable of a health insurance plan depends on a number of factors like age, plan type, tenure, sum insured, and so on. HDFC Ergo has an online premium calculator that you can use to find out how much premium you have to pay. All you have to do is choose the desired options and enter your contact details to find out the premium amount payable.

    5. Do HDFC Ergo plans have the lifetime renewability option?
    6. Yes, all HDFC Ergo health insurance plans can be renewed throughout the life of the policyholder.

    7. How do I know if a hospital nearby is a network hospital of HDFC Ergo?
    8. Once you purchase the health insurance policy, the insurer will provide you with a list of network hospitals from which you can ascertain whether the nearby hospital is a network hospital or not. Additionally, you can locate network hospitals on the official website of the insurance company.

    9. What is meant by ‘waiting period’?
    10. During the waiting period, insurance coverage is not offered to the policyholder. For example, if the general waiting period is 30 days, you cannot raise any claims during this period. Certain health insurance policies also come with waiting periods for specific ailments and pre-existing diseases.

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