What is the E-Opinion Facility Provided by HDFC ERGO?

Apollo Munich is a health insurance company that has merged with HDFC ERGO lately. The company, rebranded as HDFC ERGO post the merger, provides various health insurance plans to customers so that they can lead a healthy and worry-free life. Under HDFC ERGO health insurance plan, an E-Opinion facility is available through which the insured can seek medical advice from the company’s panel doctor in respect of a critical illness. In an E-Opinion, a second doctor other than the patient current doctor reviews the medical records and provides an opinion about the illness and its treatment. If the second doctor has any doubts related to the current treatment, they can question the patient’s attending doctor treatment as well. With an E-Opinion, the insured person can know whether the current treatment is being beneficial to him or not. Read the page below to know more about theHDFC ERGO E-Opinion facility.

How to Request for E-Opinion at HDFC ERGO?

If you are insured under any of the HDFC ERGO health insurance plans that provide the E-Opinion facility, you can fill the Claim Form [E-Opinion] and seek the same without any hassle. Under the Claim Form [E-Opinion], you need to mention the following –

1. Policy Number
2. HDFC ERGO Health Insurance Ltd. Member ID
3. Name of the Policyholder (in the name upon which the policy is issued)
4. Details of the Insured Person (in respect of whose claim is made) such as the name of the insured person, relationship with the policyholder, date of birth or age, occupation, current residential address and contact details (that include telephone, mobile and email)
5. After that, select the Critical Illness for which you are claiming E-Opinion
6. Enter the details of the critical illness clinical symptoms
7. Provide names and contact details of all doctors whom you have consulted regarding the critical illness
8. Submit all the copies of previous consultations
9. Submit the details of previous hospitalizations along with the discharge summary, if any
10. Details of investigation and reports if any investigation is made regarding the critical illness
11. Tick Yes/No if you are suffering from any of the following currently – Hypertension, Diabetes, Heart Disease and any other chronic ailment.
12. Enter the number of documents submitted including the claim form
13. Status of your current clinical diagnosis
14. Current treatment and medication details
15. Enter the illness for which you seek E-Opinion

When the Claim Form [E-Opinion] is duly filled, submit the same along with the copy of all medical reports including investigation reports and discharge summary, if any, at the HDFC ERGO office. After that, you need to select the doctor from whom you would prefer to take the second opinion from the company’s panel. To check out the list of panel doctors, you can visit the HDFC ERGO website or call the 24X7 toll-free number.

What is the Procedure to Seek an E-Opinion at HDFC ERGO?

On receipt of the complete set of documents and the duly filled claim form, the company will arrange a second opinion from the medical practitioner you select from the list. And the second opinion will be sent to you directly by the concerned medical practitioner. This E-Opinion facility can be availed only once in a policy year.

Which HDFC ERGO Health Insurance Policies Provide E-Opinion Facility?

You can get the E-Opinion facility if you purchase any of the following HDFC ERGO Health Insurance Plans –

1. HDFC ERGO Health Plan
2. HDFC ERGO Health On
3. HDFC Ergo Optima Vital
4. HDFC Ergo Easy Health
5. HDFC Ergo Optima Restore

Important Notes

When you request for an E-Opinion at HDFC ERGO, you agree to the following

1. It is entirely your decision to take an E-opinion from the medical practitioner of the HDFC ERGO panel
2. The company won’t provide E-opinion or make any representation of the adequacy or accuracy of the same
3. The company will take no responsibility for any actual or alleged errors, omissions or representations in any E-opinion