HDFC ERGO Health Insurance

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HDFC ERGO Health Insurance Company is a joint venture between HDFC Ltd. and ERGO International AG. ERGO International AG holds 48.231% stakes while HDFC holds a 51.769% stakes, making HDFC Ltd the major shareholder in the venture. HDFC ERGO Health Insurance has only one focus and that is providing the customers best and hassle-free services. The company offers a wide range of insurance products starting from motor insurance, health insurance, home insurance, travel insurance, and personal accident insurance among others. HDFC Ergo Health Insurance has 126 branch offices across 106+ cities with 3600 employees. It is currently expanding its network across India. The insurer also has a large distribution network with channels like brokers, corporate agents, retail, direct sales, and bancassurance which provides broader connectivity.

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On HDFC ERGO Official Website

Updated: 18-05-2024 03:09:40 PM

Highlights Of HDFC ERGO Health Insurance

Renewability Lifelong
Cashless network hospitals 10000+
Waiting period 4 years
Grievances solved 100.00%

Why Go for HDFC ERGO Health Insurance?

Nowadays, good health is like a boon. With the increase in pollution, change in our lifestyle, reliability on the processed and packed food, we do not even have time to look at our habits which are directly challenging our health. After any health-related issue, we blame ourselves or different acts of carelessness by others.

We try to change everything just after one incident. But, Rome was not built in a day. Same as this idiom, your healthcare awareness that arises just in one day cannot help you in taking your good health for the long term. There is whole planning that is required for you to achieve the goal of healthy and planned medical care.

You may start drinking gallons of water daily, start eating healthy and fresh, hit the gym. But, there are various diseases which come unannounced and are unavoidable. Such disease requires the latest technology and trained specialist for treatment. It might create a big hole in the pocket of an individual.

The economic expense that arises due to medical care is so high that at times, people even take a loan for the medical treatment. Then what to do? Health insurance is the best option to choose for economic safety, peaceful assistance, and guidance for best medical treatment. Health insurance not only gives peace to you but also to your family or loved ones, who have to take care of everything when you are ill. HDFC ERGO Health Insurance policy is the best answer to ensure security cover.

HDFC Ergo has a trusted brand reputation which is trusted by millions of Indians. They have a customer base of over 75 lakhs and the brand has iAAA’ rating by ICRA indicating its highest claim paying ability capability.

  • HDFC Ergo provides 24/7 customer support along with a completely hassle-free experience which is very important.
  • HDFC Ergo has a huge list of network hospitals that offer valuable facilities like cashless treatment to the policyholders- over 10000 across India.
  • HDFC ERGO Health insurance is flexible and designed in a customized way to give the best treatment to the policyholder.

Types of HDFC ERGO Health Insurance Plans

HDFC ERGO my: health Suraksha Insurance

HDFC my: Health Suraksha Insurance is a newly launched healthcare plan. The plan aims to offer wider cover without any restrictions. It is an effective healthcare plan which takes care of all your medical needs at an affordable premium.

Variants of Plan

  • Base plan: my: health Suraksha Silver Smart Plan from HDFC ERGO has been designed by keeping the medical inflation rate in mind. The plan provides needful support to deal with the growing medical bills. Some of the key highlights of the plan are no room rent sub-limits, no limit for age at entry, with an option to add maternity coverage & critical illness cover.
  • My: health Suraksha – Gold Smart Plan: It is a simple yet effective healthcare product which aims to serve your health care needs over a decade.
  • my: health Medisure Super Top-up: This plan comes into the picture when your basic health plan is not sufficient to deal with big medical emergencies. It provides the required additional assistance in the hour of need when your basic plan’s limit meets an end. The plan ensures that you get the best cover without any restrictions and limitations.
  • My: health Suraksha – Platinum Smart Plan: This plan is rightly designed for those who want maximum coverage. It effectively reduces the high financial burden. Other benefits include maternity coverage, pre-existing disease coverage post 3 years and no restriction on entry age.

Features of the HDFC my: health Suraksha Insurance

  • It offers the facility of maximum health coverage with the best medical treatment to the policyholder.
  • HDFC my: health Suraksha Insurance covers the hospital room rent and also bears the boarding expenses of policyholder without any limitation.
  • HDFC my: health Suraksha Insurance provides pre-hospitalisation cover for 60 days. These expenses are like doctor consultant, check-ups, prescriptions, etc.
  • HDFC my: health Suraksha Insurance offers 90 days post-hospitalization expenses cover.
  • HDFC my: health Suraksha Insurance offers daycare procedures coverage under which if the policyholder is admitted even for less than 24 hours, expenses will get the cover.
  • If the policyholder requires organ donation from someone then the organ harvesting expenses caused to the donor are also covered by HDFC Health Suraksha Insurance.
  • HDFC my: health Suraksha Insurance policy pays all transportation expenses that are involved during the process of taking policyholder to the nearest hospital.
  • If the policyholder requires AYUSH treatment, in which treatment of Ayurvedic, Unani, Siddha, and Homeopathy medicines is required, it is also covered by HDFC my: health Suraksha Insurance.
  • One can avail various benefits during the tenure of the HDFC Health Suraksha Insurance. It also offers family discounts.
Eligibility 3 months to 55 years
Room rent No Sub Limits
Day care procedures 586+
Waiting period 30 days to 36 months
Renewability lifelong
Sum assured 3 lacs +

Exclusions of the HDFC Health Suraksha Insurance

  • Any injury that is caused due to any participation in adventurous activities that can give policyholder an adrenaline rush, and that may result in something hazardous is not covered under the HDFC my: health Suraksha Insurance.
  • Any self-imposed injury such as suicidal attempt, or any attempt to do the same is not covered under the HDFC my: health Suraksha Insurance.
  • HDFC Health Suraksha Insurance policy does not cover any expense that occurs during the accidents that are caused due to wars, riots, or any other terrorist act.

HDFC ERGO Health Insurance Claim Settlement

In case of hospitalization, intimation should be provided to the Company immediately and not later than 7 days In all other cases, the company must be informed of any event or occurrence that may give rise to a claim under this Policy at least 7 days prior to any consequent treatment, consultation or procedure being taken and the Company should pre-authorise such treatment, consultation or procedure. Any documentation and information requested to establish the circumstances of the claim, its quantum or the Company’s liability for the claim, should be submitted within 15 days of our request or discharge from Hospital or completion of treatment, whichever is earlier.

Cashless Service: Seeking Pre-Authorization

  • The policyholder has to fill the pre-authorization form present at the hospital’s insurance/ TPA Desk
  • Then Policyholder has to share the same through email or fax.
  • You will receive an approval letter from the claim management team. Claim Management team can cross questioning with you to recheck it.
  • In case of rejection, the policyholder can go for the reimbursement claim.

Reimbursement Claim: Claim Submission

  • The policyholder has to fill the required forms appropriately and submitted the same along with the required documents, according to the policy terms and conditions.
  • Necessary documents may include discharge summary, prescriptions, and bills, etc. as per the requirements of the insurance policy.
  • You will receive an approval letter by the claim management team.
  • In case of any rejection the reasons will be communicated by the team.

Documents Required for HDFC ERGO Health Insurance

Claim settlement process of HDFC ERGO Health Insurance Policies is quite simple and it requires some general documents like

  • Duly filled Claim Form
  • Original documents associated with discharge
  • KYC details – ID, Age and Address Proof.
  • Original bills with a detailed breakup, original invoices with prescriptions and payment receipts.
  • NEFT details for payment: Cancelled cheque: KYC form along with a photocopy of any one KYC document (e.g. Aadhaar card, passport, driving license, voter ID, etc.).

Review of HDFC ERGO Health Insurance

Whatever you choose for yourself and your loved ones, trust is the basic key to it. Trust is the strongest factor that redefines the relations of customer and insurer at HDFC ERGO. HDFC ERGO Health Insurance consistently strives to make insurance easier, and affordable for the customer. HDFC ERGO Health Insurance plans offer comprehensive coverage at affordable premium prices to the policyholder and they have more than 10000 network hospitals all over India. These hospitals offer significant features like cashless hospitalization, a great number of health claim benefits and flexible payment modes. These health insurance plans are highly recommended and preferable by the young generation because of changing lifestyle and increasing disease. Without a good health insurance policy, expensive medical treatment charges may burn a hole in the pocket of the common man.

HDFC ERGO Health Insurance assists during the hour of need. Instant assistance is offered to the customer. HDFC ERGO Health Insurance provides 24×7 customer care to the policyholder and they have a dedicated claims approval team, which ensures constant support in times of need. No doubt, claims refers to the most important stage of any health insurance policy. HDFC always tries to offer a seamless process.


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Any expenses incurred for inpatient treatment taken under Ayurvedic, Unnani, Siddha or Homeopathy stream of medicine is covered under AYUSH benefits in HDFC ERGO Health Suraksha.

A health card is like a mini-policy document that helps you avail cashless treatment in the network hospitals. It also contains the contact details of the in-house claim service team and comes really handy in case of a medical emergency

It is very important to have a health insurance policy nowadays. HDFC ERGO health insurance plans provide comprehensive coverage to the insured and the family. The HDFC ERGO Health Insurance policy offers affordable health insurance plans with the cashless benefit at over 5000 hospitals all over India. Additional features are flexible payment options, pre and post hesitation, day care cover, enhanced NCB (No Claim Bonus), and so forth.

It is very simple to pay HDFC ERGO Health Insurance policy premium. Premium payments are accepted in the following three modes:

  • Auto-deduction from your bank account
  • In the form of cash or cheque deposit
  • Online payment by credit card, debit card or by net banking.

There is no maximum age limit for HDFC ERGO Health Insurance policy entry. While the minimum age to apply for the HDFC ERGO Health Insurance policy is 91 days.

HDFC ERGO offers a variety of health insurance plans which are designed specifically for individuals, families, and senior citizens. They also offer top-up insurance plans and critical illness insurance plans. There are 3 categories of plans which include Health Suraksha, my: health Medisure, and Critical Illness.

For your HDFC ERGO Health Insurance policy Insurance premium can be made via online payment mode or cash payment mode.

Cash payment can be made at the nearest HDFC ERGO branch office. Online payment can be made through the insurer’s website using net banking, debit card or credit card.