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HDFC ERGO Health Insurance

Car Insurance
  • Premiums as low as Rs.5 Lakhs
  • 10,000+ hospitals for cashless treatment
  • Get plans with no limit on room rent

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

Features & 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 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(individual, family, etc) Sum Insured (Min and Max) Policy Term
Health Suraksha Individual and Family Min: Rs.3 lakh Max: Rs.10 lakh 1 or 2
Health Suraksha with Regain and ECB Individual and Family Min: Rs.3 lakh Max: Rs.10 lakh 1 or 2
Health Suraksha Gold Individual and Family Min: Rs.3 lakh Max: Rs.10 lakh 1 or 2
Health Suraksha Gold with Regain and ECB Individual and Family Min: Rs.3 lakh Max: Rs.10 lakh 1 or 2
Critical Illness Silver Individual and Family Min: Rs.2.5 lakh Max: Rs.10 lakh 1 or 2
Critical Illness Platinum Individual and Family Min:Rs.2 lakh Max: Rs.10 lakh 1 or 2

Health Suraksha

The Health Suraksha insurance plan provides good coverage with a wide range of benefits such as cumulative bonus, room rent, in-patient treatments, etc.

Unique Features of Health Suraksha

  • Tax benefit applicable under Section 80D of the Income Tax Act
  • Affordable premiums, cumulative bonus
  • Free health check-up after completing 4 claim-free years
  • Cashless claim network
  • Coverage for inpatient treatment, pre, and post hospitalization expenses, day care, domiciliary costs, ambulance, alternative treatments

Plan Details

Policy term 1 or 2
Entry Age From 91 days. 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
Co-Payment 10% or 20%
Waiting Period 30 days for general coverage, 48 months for pre-existing diseases
No Claim Bonus Yes
Discounts Cumulative bonus

Health Suraksha with Regain and ECB

The Health Suraksha with Regain and ECB plan has the same features as the Health Suraksha plan but comes with the Enhanced Cumulative Bonus option and top up of sum insured after exhaustion.

Unique Features of Health Suraksha 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 sum insured
  • Regain benefit for sum insured
  • Free health check-up after completing 4 claim-free years
  • Cashless claim network
  • Coverage for inpatient treatment, pre, and post hospitalization expenses, day care, domiciliary costs, ambulance, alternative treatments

Plan Details

Policy term 1 or 2
Entry Age From 91 days. 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
Co-Payment 10% or 20%
Waiting Period 30 days for general coverage, 48 months for pre-existing diseases
No Claim Bonus Yes
Discounts Enhanced Cumulative bonus

Health Suraksha Gold

The Health Suraksha Gold plan is a comprehensive health insurance policy that provides good coverage at affordable rates.

Unique Features of Health Suraksha Gold

  • Cashless claim network, tax benefit or lifelong renewal option
  • Coverage for alternative treatments
  • Maternity cover
  • Convalescence benefit, critical illness expert e-opinion
  • Coverage for inpatient treatment, pre, and post hospitalization expenses, day care, domiciliary costs, ambulance, alternative treatments
  • Cumulative bonus, health check-up

Plan Details

Policy term 1 or 2
Entry Age From 91 days. 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
Co-Payment 10% or 20%
Waiting Period 30 days for general coverage, 48 months for pre-existing diseases
No Claim Bonus Yes
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 is an enhanced plan with similar features as the Health Suraksha Gold plan except it comes with regain and ECB benefit.

Unique Features of Health Suraksha Gold 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 sum insured
  • Free health check-up after completing 4 claim-free years
  • Regain benefit for sum insured
  • Cashless claim network
  • Coverage for inpatient treatment, pre, and post hospitalization expenses, day care, domiciliary costs, ambulance, alternative treatments

Plan Details

Policy term 1 or 2
Entry Age From 91 days. 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
Co-Payment 10% or 20%
Waiting Period 30 days for general coverage, 48 months for pre-existing diseases
No Claim Bonus Yes
Discounts Cumulative bonus, family discount of 10%, 10% discount for 2-year policy

Critical Illness Silver

The Critical Illness Silver plan provides good coverage for specific illnesses to both individuals and families.

Unique Features of Critical Illness Silver

  • Tax benefit applicable
  • Coverage for health care treatments, recuperation aids, debt repayment, provision of funds
  • Provides coverage to 8 specific illnesses. For details on the illnesses log on to their website

Plan Details

Policy term 1 or 2
Entry Age 5 to 45 years
Plan Basis Individual and Family
Sum Insured Range Min:Rs.2.5 lakh Max:Rs.10 lakh
Premium Depends on age, sum insured, etc
Medical Screening Must after 45 years of age
Co-Payment As mentioned in the policy document
Waiting Period 90 days
No Claim Bonus Yes

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
  • Coverage for health care treatments, recuperation aids, debt repayment, provision of funds
  • Provides coverage to 15 specific illnesses. For details on the illnesses log on to their website

Plan Details

Policy term 1 or 2
Entry Age 5 to 65 years
Plan Basis Individual and Family
Sum Insured Range Min:Rs.2 lakh Max: Rs.10 lakh
Premium As mentioned in the policy document
Medical Screening Must for those above 45
Co-Payment As mentioned in the policy document
Waiting Period 90 days
No Claim Bonus Yes

Checklist before Buying HDFC ERGO Health Insurance

  • Finalize on coverage amount as per health needs
  • Finalize 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

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 number of claims that are settled by the insurance company in a particular year. This number is usually calculated using a formula and is given out as a percentage.

Year Incurred Claim Ratio
2015-16 51%

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 beauty spas and other health services

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 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 health care services. To locate the nearest empanelled hospital, log on to the website.

Claim Procedure in HDFC ERGO Renewal

Cashless claim:

  • Inform the insurance provider immediately
  • Seek prior approval, provide health card
  • Bills will be paid by the insurance company directly to the network hospital

Reimbursement claim:

  • Fill claim form
  • Bills, invoices, and discharge summary should be kept ready
  • Submit the relevant documents along with the claim form
  • Reimbursements will be made within 7 working days

Terms and Conditions of the Insurer

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