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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

    * For a family health cover product.

    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

    *These Features may be included as part of different products and are subject to the insurer's terms & conditions.

    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

    *These add-ons may be included as part of different products and are subject to the insurer's terms & conditions.

    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.


    How To Apply HDFC ERGO Health Insurance Online?


    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.


    Examples of Network Hospitals in Major Cities

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

    *Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.

    News About HDFC ERGO Health Insurance

    • HDFC’s general insurance arm bought by ERGO

      Housing Development Finance Corporation Ltd (HDFC) and the ERGO Insurance Group, Germany (ERGO) have announced that according to the terms agreed upon, ERGO would increase its stake in HDFC ERGO General Insurance Company.

      Germany's ERGO International has decided to buy 22.9% additional stake in HDFC ERGO General Insurance for Rs 1,122 crore. With this deal, ERGO International will become the latest foreign insurer to increase holding in Indian venture following relaxation of FDI norms in the sector.

      Under the agreement, ERGO will buy 12,33,57,262 shares of HDFC ERGO at a price of Rs 90.97 per share aggregating to Rs 1,122 crore. As a result of this, the shareholding of ERGO shareholding in HDFC will increase from 25.84% to 48.74%, whereas HDFC’s shareholding will come down from 73.63% to 50.73%. Furthermore, the value of HDFC ERGO, that will remain a subsidiary of the Corporation, will be around at Rs 4,900 crore. Under the shareholders' agreement between HDFC and ERGO, ERGO can increase its shareholding from 26% in HDFC ERGO as and when the laws permitted such increase.

      21st December 2015

    • “#TakeItEasyonRoads” – HDFC ERGO’s new online campaign

      HDFC ERGO General Insurance Company, one of the major general life insurance providers in India recently launched a new brand campaign called “#TakeItEasyonRoads” to generate awareness on road safety. Given the increase in the number of road accidents, the company considers that creating awareness on road safety is of utmost importance in the present time. The campaign also targets to popularize Motor Insurance that can protect drivers against the cost incurred in dealing with road accidents. The campaign is particularly played in social media like Facebook and Twitter and designed for new divers and women. This is an online campaign and the major focus of the campaign is to promote safe driving.

      7th September 2015

    • HDFC Life Launches ‘Cancer Care’ Health Insurance

      HDFC Life has become the first health insurance company to launch a new product that is centred on cancer and its treatment. Claiming that cancer is now one of the major reasons for deaths in India, the MD and CEO of the company, Amitabh Chaudhry, said that treatment for cancer is very expensive these days and has the potential to wipe out a family’s savings if other financial solutions are not available.


      The new plan - ‘Cancer Care’ offer policyholders a waiver of future premiums when they are diagnosed with cancer of any stage, early or advanced. It also provides them with a regular payment to help pay for the expenses raised by the treatment. The policy has met with favourable acceptance since 12,000 policies were sold in just the first week alone.

      9th June 2015

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