Health Insurance 24330 views July 29, 2019

HDFC ERGO Health Insurance

Changing lifestyle habits and increasing pollution levels have resulted in aggravating stress levels and a myriad of health problems, thus explaining the dire need to buy health insurance. As multiple health insurance companies in India offer their respective products, it is increasingly difficult for one to choose the one that would meet the necessary requirements. A look at the features and benefits of the plans by HDFC ERGO Health Insurance reveals that each plan is designed differently to cater to distinct needs. In addition, the company’s unmatched customer care service ensures that every grief or complaint is adhered to within the stipulated period.

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Why Opt for HDFC ERGO Health Insurance?

With so many health insurance plans making their presence felt among us through innovative marketing gimmicks, why should anyone prefer to pay for HDFC ERGO Health Insurance Plans? This is because of the underlying benefits offered by plans, some of which may be listed as:-

Number Of Members – HDFC ERGO Health Insurance Plans cover a maximum of four family members, including two adults and two children.

Lifelong Renewability – Worried about renewability for prolonged periods or throughout life? Fret no more as HDFC ERGO Health Insurance plans come with a lifelong renewability guarantee. This means that as opposed to logging on to the sites of various insurance companies and scanning their health plans for policy renewal, existing policyholders can apply for policy renewal throughout their lives sans unnecessary stress and financial burden due to unforeseen medical emergencies.

No Cap on Room Rent – It is always advisable to avoid buying health insurance plans that impose sub-limits on room rent. This is because the sub-limit on room rent eats into the sum insured amount, thus leaving less amount to meet medical expenses, if and when required. HDFC health plans do away with the concept of having sub-limits on room rent, which further enhances their popularity.

NCB Benefits – Policyholders not making claims on their policies are rewarded by an increased sum insured due to bonus. Also called the No Claim Bonus (NCB), HDFC ERGO health plan customers earn a five percent bonus for each claim-free year.

Pre and Post-Hospitalization Cover – Costs of treatment are not limited to that of admission in a hospital alone. The amount spent on pre- and post-hospitalization can cause a dent in your pocket, thus explaining the need to invest in a cover that takes care of both pre and post-hospitalization expenses. The health insurance plans sold by HDFC ERGO cover pre and post-hospitalization expenses for both 60 days and 90 days respectively.

Reimbursement of Expenses – The amount expended on health check-up is reimbursed on the successful completion of four claim-free years.

Minimal Waiting Period – Every health plan mandates a minimum waiting period before paying for the treatment of pre-existing illnesses. The waiting period in case of HDFC ERGO Health Insurance is four years.

Co-payment Clause – There is no co-payment clause in any of HDFC’s health plans, thus, relieving policyholders from making payment out of their pockets.

Benefits of HDFC ERGO Health Insurance

Buying health insurance has its own set of benefits. The feeling of being benefited is enhanced as customers invest in health insurance plans sold by this company. The common benefits that induce a large number of customers to pay for the company’s health insurance schemes include:-

  1. Tax benefits under Section 80D of the Income Tax Act 1961
  2. Mandated medical check-up waived off for customers aged below 45 years
  3. Zero sub-limits on room rent, hospital charges, doctors’ fees, etc.
  4. The benefit of cashless treatment due to the insurer’s extensive hospital network
  5. An additional bonus of five percent on the sum insured pursuant to every claim-free year
  6. Customers can opt for an extended two-year policy cover instead of just the one-year policy coverage
  7. Family discount to the tune of 10 percent if two or more family members are covered under the same individual health insurance policy
  8. Lifelong Renewability

How to Choose the Best Health Insurance Plan from HDFC ERGO?

Buying a health insurance plan is important. However, not all health insurance policies may serve the requirement for which they were originally bought. Before investing in any of the health plans sold by health insurance companies in India, it is important to take into account the following considerations.

  1. State of health of the family members to be covered under the policy
  2. Number of family members to be covered under the health insurance plan
  3. Ability to pay the premium charges
  4. Pre-existing disorders affecting the family members
  5. Need for top-up plans to meet sudden exigencies
  6. Policy coverage period

HDFC ERGO Health Insurance Plans

HDFC ERGO Health Insurance sells not one but multiple health insurance plans, each catering to distinct needs and budgetary requirements. Some of the popular plans sold by this company include:-

HDFC ERGO Health Suraksha Policy

A basic health insurance cover available as both individual health plans and family floater health insurance policies. The minimum sum insured is Rs 3 lakhs while the maximum amount one can opt for is Rs 5 lakhs and covers all family members provided that the insured is more than three months old. Additional benefits include pre and post-hospitalization expenses, zero sub-limits on room rent, an added bonus for claim-free years, cashless hospitalization, ambulance cover, 140 daycare procedures, etc. Customers, aged below 45 years, are not subject to any medical checkup. Additionally, the policyholder can opt for maternity benefits, critical illness cover, co-payment clause, etc. Moreover, the policyholders can avail a family discount of 10 percent provided two or more family members are individually insured under the plan.

Health Suraksha Gold Policy

Augmenting the effects of an existing plan only means that the company has more to offer. This is true of Health Suraksha Gold Policy health plan that allows the option for an additional critical illness cover. This plan can be bought as both individual health insurance plans and family floater health insurance policies.

Be it those seeking individual health cover or those inclined to pay for family floater plans, the minimum sum insured is Rs 2 lakhs while the maximum health cover does not exceed Rs 10 lakhs. The individual health plans can be bought for anyone aged above three months and cover both pre and post-hospitalization expenses, zero sub-limits, NCB benefits, maternity benefits, cashless hospitalization benefit options, ambulance cover, etc. Payment of extra premium charges allows policyholders to avail additional benefits like critical illness cover, co-payment advantage, etc.

Health Suraksha Regain Policy

Expenses on the treatment of critical illnesses may exceed the amount of sum insured. Restoration of the sum insured amount may prove to be beneficial in such instances. Customers may opt for individual health plans or family health insurance plans depending on their requirements.

Salient features of individual health policies under this plan include:-

  1. The minimum sum insured is Rs 3 lakhs while the maximum amount of sum insured is Rs 10 lakhs.
  2. This plan can be bought by anyone aged above three months
  3. This plan covers both pre and post-hospitalization expenses, zero sub-limits on room rent, NCB benefits for claim-free years, cover on hospitalization expenses, ambulance cover, etc.
  4. The plan also comes with a restoration benefit facility, which means that the entire sum insured is restored to the original amount in case the same is exhausted during a particular year.

Salient features of family health plans under this plan include:-

  1. The minimum sum insured is Rs 2 lakhs and the maximum sum insured is Rs 10 lakhs.
  2. A maximum of four members is covered under this health insurance plan, i.e., two adults and two children.
  3. However, the children must be more than three months old to be covered under this policy.
  4. Additionally, pre and post-hospitalization expenses in addition to hospitalization expenses are covered while the plan also ensures zero sub-limits on room rent and NCB benefits corresponding to claim-free years.
  5. Restoration of the sum insured is the biggest benefit of buying this health insurance policy.

Health Suraksha Top-up Plus Policy

This is actually a top-up plan bought to enhance the effectiveness of the basic health insurance cover that one buys. Moreover, the benefits of this top-up plan can be availed by both individual customers and those paying for family health coverage.

Salient features of individual health policies under this plan include:-

  1. Anyone aged between five years and 65 years can buy it
  2. The minimum sum insured under this plan is Rs 2 lakhs and the maximum sum insured is Rs 10 lakhs. The deductible amounts are Rs 1 lakh and Rs 10 lakhs, respectively.
  3. This plan covers the amount spent on pre-hospitalization, hospitalization, and post-hospitalization in addition to availing the benefits of ambulance cover to its customers. Moreover, there are zero caps on room rents while patients can claim NCB benefits corresponding to claim-free years.

Salient features of family health plans under this plan include:-

  1. Being a family health insurance plan, it covers costs of treatment of most of the family members.
  2. The minimum and maximum sum insured amount is Rs 2 lakhs and Rs 10 lakh respectively, while the deductible amounts continue to be in the range of Rs 1 lakh and Rs 5 lakhs
  3. Not more than four members can be covered under the policy. The insured must not be less than five years old nor exceed 65 years of age.
  4. This plan also avails its customers the basic pre and post-hospitalization cover, zero sub-limits on room rent, NCB benefits corresponding to claim-free years, ambulance cover, etc.

Critical Illness Silver Policy

Though there are multiple health insurance plans being sold in India, there is an ardent need to have a critical illness cover in place. This plan promises a lump sum cover in the event of the insured being diagnosed with some chronic disorder. The minimum sum insured is Rs 1 lakh while the maximum amount of sum insured is Rs 50 lakhs for policyholders aged between five years and 65 years. As opposed to health insurance policies where the cover amount is paid only after the insured’s hospitalization and subsequent treatment, the insured is paid in a lump sum on being diagnosed with any of the critical illnesses included in the list.

Critical Illness Gold Policy

This is just an advanced version of the Critical Illness Silver Policy with most of the conditions remaining the same barring a few. Apart from the critical illnesses covered under this plan, this policy also secures cover against added critical health problems like aorta graft surgery, primary pulmonary arterial hypertension, and heart valve replacement.

Critical Illness Platinum Policy

Not much different from the Critical Illness Silver Policy and the Critical Illness Gold Policy, this plan ensures that its customers are paid in a lump sum the entire amount of sum insured in the event of critical health problems like Benign Tumor, Parkinson’s disease, Alzheimer’s disease, and end-stage liver disease. Other critical health problems include Heart Attack, Multiple Sclerosis, Stroke Cancer, Major Organ Transplantation, Coronary Artery Bypass Surgery, Paralysis, Kidney failure, Aorta Graft Surgery, Primary Pulmonary Arterial Hypertension, Heart Valve Replacement, etc.

Personal Accident Insurance Policy

Death or permanent disability due to accident may result in loss of income. This calls for the need to have such a health plan in place that can look after the interests of your family members and make up for the loss of income in your absence or infirmity. Depending on the choice of cover opted and the premium charges paid, the sum insured amount may range from Rs 2.5 lakhs to Rs 15 lakh for individuals aged below 65 years.

Health Medisure Classic Insurance

Parents need your attention and continued medical support. This plan ensures that you have a plan in place that would take costs of the costs of your parents’ treatment. The plan does not mandate any entry or upper age limit and can be renewed for one’s entire life. Moreover, the insured gets an additional 5 percent bonus corresponding to each claim-free year. The insured paying for this plan can also opt for an add-on rider to ensure a double amount of the original sum insured.

Health Medisure Super Top Up Insurance

This is more of a top-up plan designed to enhance the effectiveness of the Health Medisure Classic Insurance cover. In addition to the benefits one can avail on the basic classic insurance cover, the insured can avail the benefit of an additional sum insured against the aggregate deductible amount in lieu of nominal premium charges.

Some essential features of this plan include:-

  1. Lifelong renewability of the plan
  2. Zero medical tests for policyholders aged below 55 years
  3. Fixed premium charges from the day the insured turns 61 years old
  4. The insured gets a five percent discount on the policy is taken for two years and 10 percent family discount in the event of addition of two or three family members under individual health insurance plans.
  5. Efficient customer care service resulting in effective response within six hours of receiving the cashless claim.
  6. Pre-hospitalization and post-hospitalization cover available for 30 days and 60 days, respectively.

What Sets HDFC ERGO Health Insurance Plans Apart From Others?

Brand reputation is one factor that explains why customers prefer to pay for HDFC ERGO Health Insurance Plans above everything else. The company’s massive customer base exceeding 75 lakh people and the “iAAA rating” by Investment Information and Credit Rating Agency (ICRA) explains why this company has always been at the forefront when it comes to introducing new plans or modifying the old to improve on their efficacy.

  1. A well-organized and efficient customer care service to take care of customer grievances and complaints during any time of the day.
  2. The benefit of cashless hospitalization due to the company’s huge network of more than 6000 hospitals in its network.
  3. Multiple health plans under its banner. Most plans are customized, which means every customer avails what he or she seeks while buying the health insurance policy.

Claim Settlement Process of HDFC ERGO Health Insurance

Every health insurance company including HDFC ERGO Health Insurance allows its customers to either opt for cashless settlement or seek reimbursement of the claims made on the health insurance policy. To ensure the benefit of cashless settlement, it is important that the insured seeks treatment in one of the hospitals or medical treatment centers listed in the insurance company’s network. However, before undergoing the treatment that has been decided pursuant to a reliable medical opinion, the insured has to first seek authorization from the health insurance company and fill in necessary details in the prescribed form. In the event of emergency hospitalization, the insured has to submit the health card to the hospital at the time of admission. Even for reimbursement of claims made due to treatment at a hospital that is outside the network list, it is important that the policyholder informs the insurance company in accordance with the prescribed terms and conditions.

To ensure an easy and hassle-free claim settlement process of their health plans, policyholders have to submit certain necessary documents. These include:-

  1. Know Your Customer (KYC) details. These include ID, proof of age and address
  2. A canceled cheque of the bank to which the insured wants the reimbursement amount to be credited
  3. HDFC ERGO claim form duly filled in with all details and signed by the insured
  4. Original discharge summary
  5. Original bills of treatment received from the hospital, chemists and doctors’ prescriptions
  6. Original reports including X-rays, blood reports, etc.
  7. Implant sticker/invoice, if used, to treat patients with amputation or being treated for cataract
  8. A copy of the FIR lodged at the nearest police station in case of hospitalization due to accident or instances of road rage.

HDFC ERGO Health Insurance Renewal

To continue enjoying benefits, you need to pay the renewal premium of HDFC ERGO Health Insurance on time. You can do so online too. Here’s how you can do it there.

  • Visit the official website of HDFC ERGO Health Insurance
  • Click on ‘Renew’
  • Enter your policy number/date of birth/mobile number
  • Click on the ‘Renew Now’ button
  • The premium amount and different payment options – netbanking, debit/credit card, UPI – will appear on your screen
  • Choose the option you want to make the payment with
  • Once the payment is made successfully, you will receive both SMS and email notifications confirming the same
  • You will get a renewed policy on your email too


Can I buy HDFC Health Insurance online?

The answer is “Yes”. HDFC ERGO Health Insurance believes in the power of technology and leverages the same for maximum benefit to its customers. Customers may either log on to the health insurance company’s site to buy health insurance or log on to some insurance web aggregator portal to compare the company’s plans and choose accordingly.

How to evaluate the premium charges of the health insurance policy I wish to buy from HDFC ERGO Health Insurance?

Almost every insurance company including HDFC ERGO Health Insurance has a premium calculator published on its site. Since there are myriad factors affecting health insurance premiums, it helps to use the online premium calculator given on the company’s site. The customer has to submit details including name, age and other details of family members, etc. before clicking on the “Submit” button. After the details are submitted, the customer will find the premium charges listed corresponding to the health insurance policy they have chosen to pay for.

How do I view the list of hospitals where I may avail cashless treatment?

Simply log on to the company’s website and click on the cashless facility hospital locator. This will open to a list of hospitals in your vicinity where you may seek treatment using the cashless facility option.

How do I check if my HDFC ERGO Health Insurance policy has lapsed?

To check the current policy status, you may visit the HDFC ERGO site. Log on to the site with your ID and Password. Once you are logged in to the site, you will be able to view the policy details including the expiry date and the current policy status.

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