HDFC ERGO Health Insurance

HDFC ERGO Health Insurance
 4.0 / 5.0   by 36 users
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Cashless Treatment

Customer Service

Medical Coverage

Claim Experience

HDFC ERGO General Insurance Company Ltd. is a 74:26 joint venture between HDFC Ltd., India?s premier Housing Finance Institution and ERGO International AG, the primary insurance entity of Munich Re Group. HDFC ERGO offers complete range of general insurance products ranging from Motor, Health, Travel, Home and Personal Accident in the retail space and customized products like Property, Marine and Liability Insurance in the corporate space. HDFC ERGO is the 4th largest private sector general insurance company in India.


HDFC ERGO Health Insurance at a Glance

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Coverage for your most loved ones

Total members covered

Coverage for a maximum of 4 family members with up to 2 adults and 2 children

You get a choice of coverage tenure

Pre and Post Hospitalization cover

Medical expenses covered for 60 days before your hospitalization and 90 days for post hospitalization for related medical expenses

The next best thing to having a doc in the family

Health Check-ups

Health Check-up expenses reimbursed on completion of 4 claimless years


Critical Factors of the Plan

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Not a paisa goes from your own pocket!

Co-Pay

No Co-pay

You?re covered for any future medical expenses

Life long renewable

Plans are lifelong renewable and covers you for your entire lifetime.

Get essential cover for existing ailments

Pre-existing Diseases

Any pre-existing condition will be covered after a waiting period of 4 year

Hospital room rent determines your treatment bill

Room Rent

No Sub-limits on hospital room rents


Additional Features of HDFC ERGO Health Insurance

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Good health offers multiple rewards

5% bonus on Sum Insured for every claim-free year

The world is your healthcare oyster

A network of more than 4800+ hospitals to choose from to avail cashless services


Your Premium for Health Insurance is determined by

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The ideal age to buy insurance is when you?re in the prime of youth!

Your current age

Lower premium for younger buyers

The who's who matters here!

Members included

The premium depends on the number
of insured members

A room with a view will certainly cost you more!

Room preference

Your room preference during hospitalization matters (such as shared room, private room or private room with high-end facilities) Remember costlier room means higher treatment charges too!

Existing illnesses could affect your premium

Pre-existing medical condition

Your premium will depend on any pre-existing medical conditions


Key factors for buying a Health Insurance

As the saying goes: Patience is virtue!
Waiting Period

When you buy a health insurance plan, your policy isn?t implemented with immediate effect. There is a wait time of 30-90 days during which the insurance company is not liable to pay any claims while you sit around twiddling your thumbs.

Lifelong Coverage
Lifelong Coverage

The duration of coverage is the most important factor in buying a health insurance policy. Your health is most likely going to deteriorate only in your sunset years so ensure that your coverage is lifelong and not for a few years.

Copay
Copay

A fixed percentage of the hospital bill that will be paid by you while the balance will be paid by the insurance company. Ideally, opt for a ?no co-pay? plan so you don?t have to shell out for every claim.

Exclusions/Diseases Covered
Exclusions/Diseases Covered

Go over the ailment/diseases covered list with a fine-tooth comb. Insurance companies can reject your cashless claims if the disease for which hospitalization is required isn?t covered by the policy. Pleading temporary insanity won?t help!


Smart buying tips for your Health Insurance

Life is all about important choices!
Assess Your needs

You can?t choose your relatives. Luckily, you can decide which family members to include in your health insurance policy. The second important thing is your room preference during hospitalization such as shared room, private room or private room with high-end facilities.

Extra-Coverage for Critical Illness
Extra-Coverage for Critical Illness

A smart health insurance policy is one that covers you for bolts out of the blue ? medical expenses for critical illnesses like cancer, stroke etc.

Know Your Budget
Know Your Budget

Consider your budget in order to avoid a huge premium. Don?t pick all the options available under the insurance policy. This will eventually increase your premium amount. So tighten your purse strings sensibly.

Read the Fine-Print
Read the Fine-Print

The devil is in the details. Always read the ?Terms & Conditions? of the policy i.e. features that are not covered under the policy. Make it a point to ask for sample policy wordings. With the in-depth knowledge about certain definitions, terms & conditions, exclusions and offered benefits, you?ll always be the smarty-pants who?s one step ahead.

*All trademarks, trade names, or logos mentioned or used are the property of their respective owners.
The Information provided are available on the public domain and insurance websites.

Overview

HDFC ERGO General Insurance

The HDFC ERGO General Insurance Company is the progeny of two immensely respected and influential insurance concerns. HDFC Ltd, is one of India’s premier housing finance institution (74% stake) while ERGO International AG (26% stake) is the insurance wing of the Munich Re Group. The company offers a complete suite of insurance products ranging from motor, health, travel, home and personal accident in the retail space, alongside such products for the corporate sphere such as property, marine and liability insurance. HDFC ERGO General Insurance prides itself at being the 4th biggest private sector general insurance company in India, with 1700+ employees working in 104 branches across 87 cities in India. The company is ISO certified and sports the ‘iAAA’ rating as awarded by the ICRA, which points to the company’s flawless record for a high rate of claim settlements. HDFC ERGO General Insurance is indeed, a front runner when it comes to insurance choices in India.

Health Insurance from HDFC ERGO

The company markets the following health insurance products- Health Suraksha, Health Suraksha Gold, Health Suraksha Regain, Health Suraksha Top Up, Critical Illness and Critical Illness Platinum.

HDFC ERGO’s Health Suraksha Plan

Key Features

  • Affordable rates.
  • Can be purchased and renewed online.
  • Basic Sum Insured per Policy Year- Rs. 2 lakhs, Rs. 3 lakhs, Rs. 4 lakhs or Rs. 5 lakhs.
  • Cashless hospitalization at 4800+ hospitals across India.
  • Choose between Individual or Family Floater Health Insurance plans.
  • Policy tenures range from 1- 2 years.
  • Cumulative Bonus upon completion of every claimless year.
  • When 4 claimless years are completed, get reimbursement on health check-up expenses.
  • Save tax under Section 80(D) of the Income Tax Act.
  • For applicants under 45 years of age, health check-up is not compulsory.
  • Hassle free claims process, limited documentation and fast settlement times.
  • Zero sub-limits on hospital room rents and expenses, doctor fees etc.

Exclusions- Incidents Not Covered by the Policy

  • Claims raised for illnesses or injuries that were caused due to the use of drugs or alcohol.
  • Pre-existing conditions aren’t covered until the policy is in force for the duration of 48 months continuously.
  • Attempted suicide, death or wounds due to self-inflicted injuries.
  • War, armed conflicts, terrorist activities, radioactivity and other man-made conditions.
  • Inoculation and immunizations measures taken as preventive options, including vaccinations.
  • A waiting period of 30 days for claims, and a waiting period of 2 years for particular diseases and treatments like surgery on tonsils, internal tumours, cysts, sinuses etc.
  • Cosmetic or plastic surgeries (unless recommended as a medically crucial treatment).
  • Acquired Immune Deficiency Syndrome (AIDS) and related diseases.
  • Requirement of hospitalization due to injury or illness caused by a criminal act.

HDFC ERGO’s Health Suraksha Gold

Key Features

  • No age limit at entry with lifelong renewability.
  • Very affordable cost for robust health insurance coverage.
  • Choose between Individual or Family Floater Health Insurance plans.
  • Sum Insured Individual: Rs. 2 lakhs, Rs. 3 lakhs, Rs. 4 lakhs, Rs. 5 lakhs, Rs. 7.5 lakhs and Rs. 10 lakhs. Family Floater: Rs. 3 lakhs, Rs. 4 lakhs, Rs. 5 lakhs, Rs. 7.5 lakhs or Rs. 10 lakhs.
  • Avail 10% discount for a 2 year tenure and a discount of 10% if 2 or more members are covered under the Health Suraksha individual sum insured plan.
  • Cashless hospitalization at 4800+ hospitals across India.
  • Save tax under Section 80(D) of the Income Tax Act.
  • Hassle free claims process, limited documentation and fast settlement times.
  • Covers inpatient hospitalization expenses under Ayurveda, Unani, Sidha & Homeopathy without any sub limit as part of AYUSH Cover.
  • At 4+ years from inception of the policy, full maternity benefit alongside new born baby cover.
  • If hospitalization has exceeded 10 continuous days then convalescence benefit is also provided.
  • Zero sub-limits on any disease, room rent, hospitalization charges, doctor’s fee etc.
  • Upon diagnosis of a critical illness, avail our option for E-opinions.

Exclusions- Incidents Not Covered by the Policy

  • Any hospitalization and treatments within 30 days from inception of the policy. Accidental injuries not included.
  • Initial 4 years waiting period before the maternity benefits kick in.
  • For the first 48 months, pre-existing conditions will not be covered. Also, specific illnesses and treatments might require 24 months as a waiting period before the policy will be applicable.
  • Acquired Immune Deficiency Syndrome (AIDS) and related diseases.
  • Claims raised for illnesses or injuries that were caused due to the use of drugs or alcohol.
  • Hospitalization resulting from terrorist activities, war, radioactive war, nuclear, chemical and biological weapons and warfare.
  • Pregnancy, dental and external aids, unless covered under specific plans.
  • Insanity, mental disorders, cosmetic surgeries, weight control treatments.

HDFC ERGO’s Health Suraksha Regain

Key Features

  • No age limit at entry with lifelong renewability.
  • Very affordable cost for robust health insurance coverage.
  • Choose between Individual or Family Floater Health Insurance plans.
  • Sum Insured- Rs. 3 lakhs, Rs. 4 lakhs, Rs. 5 lakhs, Rs. 7.5 lakhs and Rs. 10 lakhs.
  • Avail 10% discount for a 2 year tenure and a discount of 10% if 2 or more members are covered under the Health Suraksha individual sum insured plan.
  • Cumulative Bonus at 10% for every claim free year, up to 100% of the sum insured.
  • Cashless hospitalization at 4800+ hospitals across India.
  • Save tax under Section 80(D) of the Income Tax Act.
  • Hassle free claims process, limited documentation and fast settlement times.
  • Covers inpatient hospitalization expenses under Ayurveda, Unani, Siddha, and Homeopathy without any sub limit as part of AYUSH Cover.
  • REGAIN Benefit- Ensures automatic availability of sum insured upon its exhaustion.
  • Zero sub-limits on any disease, room rent, hospitalization charges, doctor’s fee etc.

Exclusions- Incidents Not Covered by the Policy

  • Any hospitalization and treatments within 30 days from inception of the policy. Accidental injuries not included.
  • For the first 48 months, pre-existing conditions will not be covered.
  • Acquired Immune Deficiency Syndrome (AIDS) and related diseases.
  • Claims raised for illnesses or injuries that were caused due to the use of drugs or alcohol.
  • Hospitalization resulting from terrorist activities, war, radioactive war, nuclear, chemical and biological weapons and warfare.
  • Pregnancy, dental and external aids, unless covered under specific plans.
  • Insanity, mental disorders, cosmetic surgeries, weight control treatments.

HDFC ERGO’s Health Suraksha Top Up Plus

Key Features

  • A supplement for your existing Mediclaim policy, that helps insure you for a larger sum insured limit at a lower cost.
  • Sum Insured- Rs.2 lakhs, Rs.3 lakhs, Rs.4 lakhs, Rs.5 lakhs, Rs.7.5 lakhs and Rs.10 lakhs.
  • Deductible- Rs.1 lakh, Rs.2 lakhs, Rs.3 lakhs, Rs.4 lakhs and Rs.5 lakhs.
  • When the deductible as per this policy is exhausted, a top-up cover is initiated.
  • No exit age- stay covered for life! Children covered from 91 days onwards.
  • No pre policy check-ups for individuals under the age of 55 years.
  • Choose between 1 & 2 years policy tenure for Individual or Family Floater plans.
  • Save tax under Section 80(D) of the Income Tax Act, which is over and above 80C.

Exclusions- Incidents Not Covered by the Policy-

  • No payments unless the medical expenses exceed the deductible.
  • For the first 48 months, pre-existing conditions will not be covered. Also, specific illnesses and treatments might require 24 months as a waiting period before the policy will be applicable.
  • A waiting period of 30 days applies to all claims.

HDFC ERGO’s Health Critical Illness Insurance

Key Features

  • Provides a lump sum benefit that can be used for- Hospitalization costs, care & treatment, recuperation aids, to pay off debts, compensate for lost income due to decreasing earning ability, and fund a complete change of lifestyle.
  • Save tax under Section 80(D) of the Income Tax Act.
  • 8 Critical Illnesses covered under the plan-
    • Heart Attack (Myocardial Infarction)
    • Coronary Artery Bypass Surgery
    • Stroke
    • Cancer
    • Kidney Failure
    • Major Organ Transplantation
    • Multiple Sclerosis
    • Paralysis

Exclusions- Incidents Not Covered by the Policy

  • 90 days waiting period applies to all claims.
  • Claims raised for illnesses or injuries that were caused due to the use of drugs or alcohol.
  • Attempted suicide, death or wounds due to self-inflicted injuries, criminal or unlawful acts.
  • Acquired Immune Deficiency Syndrome (AIDS) and related diseases.
  • War, invasion, acts propagated by foreign enemies, activities consistent with war.
  • Treatments arising from pregnancy (including voluntary termination), miscarriage, maternity or birth (including caesarean section).
  • Participation in such activities as racing, diving, aviation, scuba diving, parachuting, hang gliding, mountain climbing or activities pertaining to naval, military or air force operations.

HDFC ERGO’s Health Critical Illness Platinum

Key Features

  • Provides a lump sum benefit that can be used for- Hospitalization costs, care & treatment, recuperation aids, to pay off debts, compensate for lost income due to decreasing earning ability, and fund a complete change of lifestyle.
  • Save tax under Section 80(D) of the Income Tax Act.
  • 15 Critical Illnesses covered under the plan-
    • Heart Attack (Myocardial Infraction)
    • Coronary artery Bypass Surgery
    • Stroke
    • Cancer
    • Kidney failure
    • Major organ transplantation
    • Multiple Sclerosis
    • Paralysis
    • Aorta Graft Surgery
    • Primary Pulmonary Arterial Hypertension
    • Heart Valve Replacement
    • Benign Brain Tumour
    • Parkinson's disease
    • Alzheimer's disease
    • End Stage Liver disease

Exclusions- Incidents Not Covered by the Policy

  • 90 days waiting period applies to all claims.
  • Claims raised for illnesses or injuries that were caused due to the use of drugs or alcohol.
  • Attempted suicide, death or wounds due to self-inflicted injuries, criminal or unlawful acts.
  • Acquired Immune Deficiency Syndrome (AIDS) and related diseases.
  • War, invasion, acts propagated by foreign enemies, activities consistent with war.
  • Treatments arising from pregnancy (including voluntary termination), miscarriage, maternity or birth (including caesarean section).
  • Participation in such activities as racing, diving, aviation, scuba diving, parachuting, hang gliding, mountain climbing or activities pertaining to naval, military or air force operations.

In Summation- HDFC ERGO Health Insurance brings the best of many worlds to its patrons in India- simplicity, scalability, reliability and a robust customer support ecosystem. Why look elsewhere when all this is available at just the click of a button? Check out HDFC ERGO Health Insurance today!


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HDFC ERGO Health Insurance Reviews

HDFC ERGO   Health Insurance Reviews
86 % of our customers would recommend this Insurance Company. (31 out of 36) Write Review
Customer Reviews
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  • Validated User
    (0)

    Plans are very good in HDFC Ergo on Health Insurance. If anything happens incorrectly to us, we can claim amount for emergency and medical needs, also it covers cashless treatment thus I picked health insurance. I have to pay premium till my age of 55 and premium is yearly. HDFC Ergo have tie up with several hospitals so really customers would be benefited.

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  • Validated User
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    HDFC Ergo is having several features and also they are providing it to their customers. According to my experience health insurance is very much mandatory to all the customers as it covers in emergency cases. HDFC Ergo covers all the medical needs except dental and maternity. I am paying premium using my credit card and opened for tenure of 1 year.

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  • Validated User
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    HDFC Ergo is responding customers immediately and queries are being resolved timely. Health Insurance is important as it helps in emergency cases. My tenure is for 3 years and on quarterly basis, paying 10,000. HDFC Ergo makes settlement to respective hospital in 7 days from the date we submit all the bills.

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  • Validated User
    (0)

    The health insurance which I have with HDFC Ergo was through my company. I would say that there is no issues with them as every detail was collected from my office and even the premium amount of Rs.190 is getting deducted from the salary account directly. The policy is or around 1 year and the sum assured is Rs.100000. The customer support is really good and they offer benefits like if there is hospitalisation more than 24 hours there is a cashless benefit given. They also provide a Reimbursement option if there is no hospitalisation.

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  • Validated User
    (0)

    I am holding a HDFC ergo insurance policy. The policy amount's approximately one lakh . I am unhappy with their service, as when I was hospitalized and when I tried to claim the amount, they asked for too many question one after the other. They were asking me for my application number and lot of other documents which was unable to product at that point of time as I was hospitalized. Finally, I can-celled this and I got it reimbursed through my company.

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  • Validated User
    (0)

    I am doing yearly premium of 16,000 and HDFC Ergo is providing cashless treatment offer to customers who availed Health Insurance. Most of the sectors wonâ??t provide cashless treatment on ICU but HDFC Ergo covers ICU as well, which is very good feature. Medical coverage is around 4lakhs. Initially I did face few issues but it got resolved later so I suggest HDFC Ergo to improve on customer service.

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  • Validated User
    (0)

    Happy to have Health Insurance as it is important. Medical coverage is normal so no hassles on that regard with HDFC Ergo. I am not getting solution for my queries via mail instead they are asking to visit branch so HDFC Ergo should enhance customer service. I never applied else claimed for cashless treatment so have no idea on cashless treatment. No much extra benefits thus it would be great if HDFC gives more offers.

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  • Validated User
    (0)

    Health Insurance is very important to all so I advise customers to have it. Health Insurance helps us in emergency period. If we met with an accident HDFC Ergo is giving 5,000 and Rs.500 per day if we admit. In addition to that they are giving 15 days salary to privilege customers. We can make premium either monthly or yearly however I am doing it monthly through my credit card. On the whole, I am happy to have Health Insurance with HDFC Ergo.

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  • Validated User
    (0)

    Everyone should have Health Insurance as it helps our family members in most of the cases. While taking insurance the agents mentioned different features but at present I unable to recall such things. We will be benefited in International hospitals as well if we avail Health Insurance with HDFC Ergo. This is like monthly premium where we have to pay around 500 to 600 in a month. I am using credit card for making premium and tenor is fixed for 1 to 2 years.

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  • Validated User
    (0)

    Overall good experience in availing health insurance from HDFC. Its almost 3 years before I did take the policy where I get cash less benefit and few medical treatments could be availed. One of the plus point which is good is if been hospitalized, 1000rs a day would be afforded.

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  • Validated User
    (0)

    As per the customer's point of view, accidental insurance provided by HDFC ERGO is quite good. Its like a health insurance where the benefits provided is beneficial for present and for future as well. However, as I haven't submitted any claim, not sure about the claim percentage.

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  • Validated User
    (0)

    Best with HDFC Ergo is their customer service team who handles each and every queries of customers and handle it in a proper way. They resolve the issues upfront. Its a general health insurance and services are really good. As of now, I haven't submitted any medical claim.

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  • Validated User
    (0)

    Every year HDFC ERGO is giving additional discounts and offers on Health insurance for all customers. I do renew for every year the Health Insurance and also they are giving very good benefits if customer met with any accident. Overall, I am satisfied so I like to recommend to others the Health Insurance. I have taken Health Insurance against my credit card.

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  • Validated User
    (0)

    I am paying my health insurance to HDFC ERGO through my credit card . I am paying monthly for 2 years . Till now I havent got any exp in claiming my policy . However it is just for 6 months . They provide all the list of hospitals which will provide facilities of claiming. Each and every documentation I got through mail and e-post.One of the most important thing was the ambulance service charges for one way will be debited initially and credit back to my credit card if I am not able to go myself . They mentioned some hospital who can claim the amount.

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  • Validated User
    (0)

    Before 2 months, I had got this health insurance from HDFC ERGO. They provide benefits based on their terms and conditions where it provides accidental coverage as well. AS of now, I haven't submitted any medical claim or gone through any treatment.

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  • Validated User
    (0)

    I availed Health Insurance with HDFC ERGO on the month of June 2014. Benefits are available when customer hospitalized and there are more benefits like the same. Yearly I am paying Rs.4000, Rs.7000 for my mother and Rs.3800 for my brother. I use credit card to make life insurance payment. I would recommend definitely the health insurance to my friends and colleagues.

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  • Validated User
    (0)

    This HDFC ERGO insurance was offered based on my HDFC credit card. I am getting a medi claim up to 2 lakh for me and my family. Monthly I used to pay rs400 for a tenure of 2 years after renewal if I wish to continue with this . I would be getting double the returns for which I am really happy and I have taken this one recently before 6 months.

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  • Validated User
    (0)

    While getting up the credit card before 3 years, I did opt for health insurance from HDFC ERGO. I haven't availed any benefits from this insurance, however I did get an intimation stating these benefits would be covered, but later it was not done. Premium would get deducted from EMI payments.

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  • Validated User
    (0)

    The HDFC ERGO product is good and the premium is very low compared to other health insurances. However they don't process claims for a genuine cases also and they didn't respond to all my queries. I pay a premium of rs4000 per annum and they cover upto 5 lakhs for me and my spouse. I would suggest HDFC Ergo to give good services to the customers by processing their claims.

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  • Validated User
    (0)

    I am not getting any kind of response from hdfc bank for my health insuarance. When at the time of sales they used to call and sell all the policies . However when I found how to use I am unaware of how to use. There was no proper guidance from them. May be they can improve on the same

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Customer Reviews
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