HDFC Ergo Group Health Insurance

HDFC Ergo is a joint venture between HDFC Ltd, India’s premier housing finance institution and ERGO international Germany, the primary insurance entity of Munich Re Group. HDFC Ergo started its operations in the year 2002 after receiving a license from the Insurance Regulatory & Development Authority of India. Now HDFC Ergo operates in 170+ Indian cities with more than 200 branches employing nearly 10,000 employees making it one of the biggest insurance companies in terms of employee numbers. HDFC Ergo has acquired L&T general insurance company in the year 2016 post which L&T was renamed as HDFC General insurance limited after which it was amalgamated with the parent company i.e. Readmore...

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HDFC Ergo. Later in the year 2020, HDFC has acquired majority stake in Apollo Munich health insurance company and renamed as HDFC Ergo Health insurance Ltd which was later merged into the parent company i.e. HDFC Ergo. HDFC Ergo group health insurance is one of the best products in the Indian insurance market.

Key benefits of HDFC Ergo GHI

There are certain key benefits of HDFC Ergo group health insurance plans which are mentioned below

Room & Boarding expenses

The HDFC group health insurance plan pays the room and boarding expenses incurred by the insured at the time of hospitalization. These expenses would be as per the option exercised at the time of taking the policy. There are different room rent levels offered by the health insurance policy of HDFC.

Pre & Post Hospitalization

The expenses incurred by the insured before the hospitalization are known as pre hospitalization expenses and those incurred after the hospitalization are known as post hospitalization expenses. HDFC group health insurance plan pays the pre and post hospitalization expenses to the insured customer as per the number of days specified in the policy.

Domiciliary treatment expenses

HDFC group health insurance plan reimburses the medical expenses incurred by the insured customer for availing treatment at home which is known as the domiciliary treatment expenses. The domiciliary treatment expenses would be paid only for a certain number of days and the treatment should be taken only by the recommendation of the treating doctor.

Day care treatments

HDFC Ergo group health insurance provides cover for day care treatments. Day care treatments are those which can be treated within 24 hours in a hospital thereby not requiring an admission as an in-patient. Due to the advancement in technology most of the treatments are done as day care treatments which are covered by HDFC group health insurance plan.

Covid-19 cover

HDFC Ergo group health insurance plan also covers the cost incurred for the Covi-19 treatment. The cost incurred for PPE Kits, diagnostic tests etc. would be covered under the group health insurance up to a certain limit as mentioned in the policy document. The treatment for Covid-19 would be covered as per the directive from the Insurance regulatory and development authority of India which states that the covid-19 treatment should be covered under the group health insurance policies.

HDFC Ergo Advantage

Free health checkups

Health insurance policy of HDFC Ergo provides free health checkups to its customers.
The customers of HDFC Ergo group health insurance policy can avail free health checkups in any of the network hospitals on cashless basis once in every policy year.

Reimbursement of Ambulance costs

The ambulance costs incurred by the customer due to an emergency would be reimbursed by the HDFC Ergo group health insurance policy on production of the original bills.
The reimbursement would be done only up to the limit mentioned in the policy documents.
Customer needs to fill the HDFC Ergo reimbursement claim form to avail the reimbursement of ambulance costs.

Cashless network

HDFC Ergo has partnered with more than 13000 hospitals across India to provide cashless claim settlement facility to its customers.
HDFC Ergo cashless network is present all over India and customers can avail cashless facility from any of the network hospitals.
HDFC Ergo cashless network hospital list is available here.

1 Claim settled every minute

HDFC Ergo claims that the claim settlement ratio is high and they settle 1 claim per minute.
The cashless claim approval is provided by the company within 20 minutes of registering the claim and the cashless facility can be availed from any of the network hospitals available all over India.

HDFC Ergo Reimbursement Claim Process

HDFC Ergo reimbursement claim process is explained below

Step 1

The first step in the HDFC Ergo claim reimbursement process is to fill the HDFC Ergo reimbursement claim form with all the claim related details and attach the original supporting documents such as hospital bills, discharge summary etc.
The HDFC reimbursement form should be filled completely and signed by the insured customer before sending it to the insurance company for reimbursement of claim.
HDFC Ergo claim settlement ratio is more than 95% which means that most of the claims are settled by the company.

Step 2

The HDFC Ergo reimbursement claim form can be obtained online here which should be sent to the insurance company for processing.
In addition to the hospital bills, a canceled cheque leaf should be attached so that the reimbursement would be processed to that account.
HDFC claim settlement ratio is high when compared to that of its competitors. Higher the claim settlement ratio, higher the chance of your claim getting settled.
The reimbursement claim settlement should be opted only if there are no network hospitals in your area. HDFC Ergo has partnered with more than 13000 network hospitals to provide cashless claim settlement facility to its customers and this facility should be utilized by the customers for easy claim settlement.
Reimbursement claim settlement is when the customer gets treated in a non network hospital and pays the hospital bill later to claim the same from the insurance company after filling the HDFC Ergo reimbursement claim form.