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HDFC ERGO Health Insurance

HDFC ERGO Health Insurance
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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


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!

HDFC Ergo Health Insurance FAQs

  1. Why choose health insurance plans (Health Suraksha) from HDFC Ergo?
  2. ‘Health Suraksha’ plan provides extensive health coverage at competitive prices. This plan is not only limited to hospitalization expenses but also includes pre and post hospitalization care, domiciliary treatment, ‘Ayush’ benefits, day care procedures, emergency ambulance facilities, and organ donor charges, among other benefits.


  3. What are the types of health insurance plans available from HDFC Ergo?
  4. There are 4 different plans under Health Suraksha basic policy – 1 Adult; 2 Adults; 2 Adults and 1 Child; 2 Adults and 2 Children. The coverage ranges from ? 3 lakhs- 4 lakhs. Individuals within ages 3 months – 65 years can avail these plans. Other HDFC Ergo health insurance policies include Health Suraksha Gold, Health Suraksha Regain, Health Suraksha Gold Regain, Critical Illness, and Critical Illness Platinum.


  5. What tax benefits will I get?
  6. Tax exemptions are available for all HDFC Ergo health insurance policyholders. Exemption benefits on payment of premium regularly throughout the policy tenure, may be availed up to a maximum of ? 15,000 of the overall premium paid according to Section 80D. Senior citizens receive more benefits at ? 20,000.


  7. What do you mean by Pre and Post-Hospitalization charges?
  8. Pre hospitalization expenses are the health care expenses incurred during a specified period of time (60 days for this company) before the actual hospitalization of a policyholder. Similarly, post-hospitalization expenses are the expenses incurred during a specified number of days (90 days) after actual hospitalization is over.


  9. What do you mean by day care procedures?
  10. Due to immense advancements in healthcare technologies, some surgeries/medical procedures can be completed within a day, eliminating the need for hospitalization.


  11. What do you mean by Domiciliary Hospitalization expenses?
  12. These are the expenses incurred for medical treatments that a patient undergoes at home at the advice of a medical practitioner due to inability to move to a hospital.


  13. What are Ayush benefits?
  14. Ayush refers to Ayurveda, Unani, Sidha, and Homeopathy, and policy holders can demand reimbursement for the treatments named above, when they are explicitly covered by the plan.


  15. What are organ donor expenses?
  16. These are the expenses of donating an organ to an insured individual for organ transplant procedures.


  17. I read about Cumulative Bonus. What is it?
  18. Cumulative Bonus refers to the bonus awarded from the insurer after completion of a claim-free year, subject to a maximum cap. HDFC Ergo health insurance plans provide 5% cumulative bonus up to a maximum of 20%.


  19. What are pre-existing diseases?
  20. Pre-existing diseases refer to any condition, injury, or ailment suffered by the insured during the 48 months before buying the policy from HDFC Ergo health insurance.


  21. What are injuries?
  22. Injuries are physical, accidental, external bodily harm that occur suddenly, and have no relation to ailments suffered in the past.


  23. Why should I get a Health Card from HDFC Ergo health insurance?
  24. Health cards contain contact details of your insurer’s TPA. You can call on the numbers provided in case of emergencies, or for any kind of assistance from the insurance provider. This card is also required when getting hospitalized, so that the relevant hospital authorities may identify you and your association with the insurance firm, and initiate further processing.


  25. Who or what is a TPA?
  26. TPA stands for Third Party Administrators. In case of HDFC Ergo Health Suraksha policy, FHPL (Family Health Plan) is the TPA for policies issued before 1st April 2012, and HCS for policies after that. HCS is HDFC’s in-house claims section.


  27. What are some of the network hospitals associated with HDFC Ergo health insurance?
  28. Following are some of the network hospitals associated with HDFC Ergo health insurance-

CITY NAME OF HOSPITAL
DELHI AASTHA HOSPITAL
MUMBAI AASHIRWAD HOSPITAL
KOLKATA ADITYA HOSPITAL
BANGALORE ABHAYA EYE HOSPITAL
CHENNAI A C HOSPITAL

HDFC ERGO Health Insurance Reviews

HDFC ERGO   Health Insurance Reviews
83 % of our customers would recommend this Insurance Company. (95 out of 115) Write Review
Customer Reviews
Page 1 of 6 1 2 3 4 5
  • Validated User
    (0)

    I hold a health insurance with HDFC ERGO which I got when applying for a credit card with the bank.It covers all accidental benefits for 15 lakh and they provide 18000 for bone fractures. In case of hospitalization I will be getting 1500 everyday valid for 40days.The tenure period of this insurance is 2years and it will be better if it exceeds 5 years.In this policy I have a option of EMI payment so I pay EMI of 350Rs monthly.I wont recommend this plan to my friends because there is less tenure period offered.

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    I hold a health insurance with HDFC Ergo which is covered for my total family.I am very happy with the product explanation provided by HDFC and I got the best offers which was voluntarily explained by the executive. Its a health insurance which covers accident benefits as well and the premium rates differ.I pay 22thousand for my whole family.The hospital charges are covered for 3lakh per head.I have not claimed anything as of now but generally I will be getting a PDF copy through mail about the payments.

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  • Validated User
    (0)

    I am having a health insurance from HDFC Ergo. It is basically a mediclaim policy. It has got an accidental coverage of 2 lakhs which includes my family members as well and additionally thousand rupees will be covered for them as a room charge in case of hospitalization. Especially in my case if I am admitted in ICU, I will be given an additional amount of 2000 excluding the insurance coverage. I use my credit card for this and in case if the premium amount exceed 2000 they will be able to block it and raise the statement on every month.

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  • Validated User
    (0)

    HDFC ergo is very good ,as it has got the top most hospitals in its list where we can get the claim from. They are providing very good support and the customer care executive has got the sound knowledge about the product and their quality of service is very good. Till now I did not face any issues with them.

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  • Validated User
    (0)

    I hold a health insurance with HDFC Ergo which is covered for my total family.I am very happy with the product explanation provided by HDFC and I got the best offers which was voluntarily explained by the executive. Its a health insurance which covers accident benefits as well and the premium rates differ.I pay 22thousand for my whole family.The hospital charges are covered for 3lakh per head.I have not claimed anything as of now but generally I will be getting a PDF copy through mail about the payments.

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  • Validated User
    (1)

    I hold a general insurance with HDFC Ergo and I am really happy with the service provided by HDFC.I hold this policy for more than 6 years and I have my total family covered in this policy.I pay a premium of 9000 yearly for the insurance.The best part of the Insurance is it has both medical and ayurvedic coverage through this plan. I have claimed several times and I got a very good cashless service provided and I have recommended this Insurance for more than 100 people.

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  • Validated User
    (1)

    HDFC ERGO medi claim was taken based on my credit card. I am getting coverage for normal illness and I am holding this policy for 2 years no drawback as such . I did not face any issues with them as such and I am supposed to pay this policy for 5 years. It was my friend who gave this idea about this policy.

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  • Validated User
    (1)

    HDFC ERGO Health Insurance is nice because whatever amount I pay they will provide me bill which will be very useful for us when we have any issues.They provide very good and quick process,one executive came to my office for collecting the documents which saved me some time.We can pay them through online,I pay 1500RS every month.Good thing is they are very good in medical claim.

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  • Validated User
    (1)

    HDFC ERGO medi claim insurance is really good. It is provided by my company. The coverage amount is 3 lakh and on top of that they have provided one lakh for critical illness. More than all ,they have provided cash less card which provides a coverage for pre existing diseases up to the age of 85 years. I have been holding this policy for 2 years.

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  • Validated User
    (2)

    I have got a medi claim insurance with HDFC Ergo. Till now it is good, I cannot comment much about that. On a general note I would say it is very much beneficial for me. As it provides coverage for critical illness and its over a year now since I am holding this insurance. This was taken for a period of 2 years and once in every 2 years I have to renew this policy.

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  • Validated User
    (1)

    Did not claim with HDFC Ergo in respect to health insurance till date so not sure how fast they process it. Cashless treatment are available in HDFC Ergo and I think they are covering pre existing diseases. Network hospitals are wide in cities so customer will be benefited.

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  • Validated User
    (1)

    I am having a health insurance from HDFC Ergo. I have taken this policy for 2 years and after 2 years I have got to renew it. The customer service executives were very helpful as they have answered all my queries and the plan covers all the accidents, hospitalized conditions and also the critical illnesses. Overall I would say that it is a value for money.

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  • Validated User
    (1)

    HDFC ergo medical insurance is really good. I have gone through it only once. I dont have much idea about it. The reason why I have chosen this insurance is because my friend gave idea about this insurance. I am holding this insurance for the past 2 months and I have got all policy documents on time.

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  • Validated User
    (1)

    HDFC ERGO was good ,when I took this I felt like its nice to move with but after filling the form they said like its compulsory to get accident insurance also. They were hiding to share little things at the beginning,and also I was informed that I will be getting 5% cash back if the payment is done through credit card but still I havent got it. I was supposed to get a call me as per they said but still i am waiting around 2 months for them to call .

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  • Validated User
    (1)

    I have to pay only minimum premium to maintain health insurance with HDFC Ergo where 2700 per annum. As my account is with HDFC so without submitting any documents got this insurance. HDFC Ergo have lot of hospitals in their list so very well customer can get cashless facilities. Somewhere around 20lakhs is the coverage amount.

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  • Validated User
    (1)

    I am holding a health insurance from HDFC Ergo and the services offered by the company is awesome.The plan is for 5 years and it covers almost all the major hospitalized and illnesses. I will be provided with rs 1000 for per day in case of hospitalization and also till the last day of discharges I will be given 1000 rs for every day. I just have to give the card and everything is been taken care by the company.

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  • Validated User
    (1)

    I am holding a HDFC ERGO it was very much reasonable. This insurance was issued based on credit card. I have discontinued that, as the premium is substantially high. In terms of coverage they would give only 2.5 lakhs as a premium and the amount what I am supposed to pay is rs 15000 a year.

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  • Validated User
    (1)

    I did not use any of the services from HDFC Ergo so far thus no clear idea about health insurance. Initially they covered entire family but later they changed to one individual without prior information so they have to take care of it. I got this health insurance against my credit card. Response is not proper for claiming process.

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  • Validated User
    (1)

    I had been given a health insurance from HDFC Ergo along with the personal loan I took. It was a mandatory insurance and it was automatically deducted from my account along with the loan. It covers all the accidental conditions and also its good as my family will not suffer in case if I am not able to pay the loan. In case of my death or organ failure I will be provided with the insurance amount starting from 75000. It is good that for before every installment I will be getting message and mail notifications and I feel it is very useful. Whatever was explained they had done.

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  • Validated User
    (1)

    I am holding a health insurance from HDFC Ergo general insurance. The insurance was given to me along with the loan which I have taken. It is for 24 months and its a one time payment. I had to renew the payments if I wish to continue. It covers all the accidents and also the hospitalized conditions.

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