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HDFC Ergo Health Insurance Plans

HDFC ERGO General Insurance Co. Ltd.

HDFC ERGO is a 51:49 joint venture between HDFC Ltd and ERGO, which is the primary insurance entity of the Munich Re Group of Germany. HDFC ERGO, the 3rd largest Private General Insurer with a 6.2% market share, offers products like Motor, Health, Travel, Home, Personal Accident and Cyber Insurance in the retail space and customized products like Property, Marine and Liability Insurance in the corporate space through its network of 203 branches spread across 170 cities and a wide distribution network

  • Branches - 200+
  • Cities-170+
  • TEmployee - 7000+

Awards and Recognition

  • ICAI Awards 2015-16 (For Excellence in Financial Reporting ) -
    HDFC ERGO has been presented an award by ICAI for Excellence in Financial Reporting 2015- 16 under Category IV. It is the 2nd consecutive year, the 4th time in our journey, that we have been awarded for excellence in financial reporting. It is the only award presented in the non - life category this year.
  • SKOCH Order-of-Merit ((for Claims Survey Management (CMS) for qualifying amongst the Top 100-projects in India ) -
    This SKOCH order of merit is awarded to the “Top 100 Projects in India”. The projects are selected by a Jury of eminent experts and the Secretariat of SKOCH from a large number of nominations and presentations. HDFC ERGO’s Claim Survey Management, was conferred “SKOCH Order-of-Merit” at the 46th Skoch Summit.
  • Best Customer Experience Award of the Year (Financial Sector) -
    This award recognises the efforts undertaken by an organisation in the area of customer service & customer experience to improve customer relationships and building long term profitability. The primary parameters considered for this award were; initiatives taken to simplify customer service processes, use of automation to deliver superior customer experience and ROI delivered through the changes.
  • ICAI Awards 2014-15 (For Excellence in Financial Reporting Annual Report under the Category III – Insurance Sector ) -
    The award jury comprised of eminent personalities from regulators & industry experts and was headed by Shri M. Damodaran, Former Chairman of Securities and Exchange Board of India (SEBI). The parameters for evaluation were on the basis of degree of compliance with accounting standards, statutory guidelines and other relevant pronouncements, in each category. Based on the rigorous evaluation process, out of 175 participants, 12 awards were given; and HDFC ERGO General Insurance Company Limited was the only one to receive the Gold Shield. We are proud to receive this Gold Shield again after FY 2012-13.
  • iAAA rating ( by ICRA ) -
    The Company has been rated iAAA by ICRA (an associate of Moody’s Investors Service) indicating highest claim paying ability. This rating denotes company’s fundamentally strong position and prospect of meeting policyholder obligations as the best. The rating takes into account the company’s strong parentage, its leadership position amongst the private sector general insurers in the country, balanced and diversified portfolio, prudent underwriting practice and reinsurance strategy.
  • Best Insurance Company in Private Sector -
    General 2014 (by the World HRD Congress at ABP NEWS - Banking, Financial Services & Insurance Awards) - This award underlines the best-of-the-best practices of the BFSI Industry based on the strategy, security, customer service, and the future technology challenges and innovations.The award has been selected basis customer poll and analysis by a bench of jury.
  • Best General Insurance Company in India 2014 (by International Alternative Investment Review (IAIR)) -
    The event was organized by The Excellence in Global Economy (4th Edition), Hongkong on 28th Feb'14. This award was based on an independent survey and was analyzed considering the Leadership, Innovative Services & ability to be responsive to the customers' needs with a dynamic approach & a variety of products.
  • Gold Shield ICAI Awards 2012-13 (for Excellence in Financial Reporting) -
    HDFC ERGO has been awarded Gold Shield ICAI Awards for Excellence in Financial Reporting for the year 2012-13 under the Category III – Insurance Sector by Institute of Chartered Accountants of India (ICAI). The award has been selected by the panel of judges on the basis of degree of compliance with the Accounting Standards, Statutory Guidelines and other relevant pronouncements. Mr. T. S. Vijayan, Chairman, IRDA was the Chairman of the Jury committee for the award.

Key Advantages and Features

  • The whole family, adults and children, can be covered under the same plan
  • Customers get reimbursed for the expenses of routine medical check-ups, subject to conditions
  • There is no co-pay clause in the policy wordings
  • There is no cap on the hospital room rent
  • HDFCERGO hospital list for cashless claims support is 10,000+ strong
  • No-claim bonus is issued to the customers for every claim-free year
  • HDFCERGO general insurance renewal and premium payment can be done online easily
  • All the insurance policies can be bought for a term of 1, 2 & 3 years
  • Customers get lifetime renewal with all the plans

Plans And Details

The health insurance plans by HDFCERGO are divided into two categories, indemnity and lump-sum benefit. The indemnity insurance pays according to the cost incurred and can be claimed multiple times while lump-sum pays the whole sum insured at once.

HDFCERGO My: Health Suraksha - a plan for individuals and families to cover all the necessary expenditures during medical procedures.

Entry Age eligibility

  • Adult
  • Minimum Entry Age - 18 Years
  • Maximum Entry Age - Lifetime
  • Child
  • Minimum Entry Age - 91 days
  • Maximum Entry Age - 25 years

Sum Assured (in Rupees)

  • 5, 7.5, 10, 15, 20, 25, 50 & 75L

Coverage

  • Two adults and two children can be covered under the family floater plan
  • In-patient hospitalization, 586 day-care procedures and domiciliary treatments are covered.
  • Pre-hospitalisation and post-hospitalisation expenses are covered for 60 and 180 days respectively.
  • AYUSH benefit is also provided in the policy
  • Emergency ambulance charges and organ donor expenses are also reimbursed

More benefits

  • Voluntary co-pay discounts and family discounts are applied to the premium
  • 10% for every claim free year upto 100% of basic cover

Extra details

  • Health check-up is necessary only for applicants above 45 years
  • Coverage for pre-existing conditions begins after 3 years

HDFCERGO My health Critical Illness

a policy in 2 variants, silver and platinum, to protect financial aspects during medical emergencies

Entry age eligibility

  • Minimum - 18 years
  • Maximum - 65 years

Sum assured (in Rupees)

  • 2.5, 5, 7.5 or 10 lakhs

Coverage

  • Silver plan - covers eight critical illnesses
  • Platinum plan - covers 15 critical illnesses
  • Lump sum is paid 30 days after diagnosis if the insured person survives until them

More benefits

  • Customers can avail tax exemption under the section 80D
  • 50% of the expenses towards medical tests are reimbursed

Extra details

  • Company applies a waiting period of 3 months after the policy begins before a claim can be made
  • You can buy this policy online with minimum paperwork

My:health Critical Illness Add on

  • Multiple optional plans to cover - 9/12/ 15/ 18/ 25/ 40/ 51 Critical Illnesses
  • 90 days waiting period shall apply from the commencement of the policy period to all claims under the policy
  • 7 days survival period shall be apply from the date of occurrence of illness, medical event or surgical procedure.

my:health Hospital Cash Benefit Add on

Provides a daily cash benefit for admissible hospitalization of Insured person

  • Hospital cash allowance for every 24 hrs. Hospitalisation in a regular hospital room, maximum upto 30 days
  • 2 times of the base hospital cash benefit, for hospitalisation in ICU

HDFCERGO my: health Super-Top-Up

customers can buy this policy to get extra financial coverage

Entry age eligibility

  • Minimum - 18 years for adults and three months for children
  • Maximum - 65 years for adults and 23 years for children

Sum assured (in Rupees)

  • 3, 5, 6, 7, 8, 10, 11, 12, 15, 16 or 20 lakhs

Coverage

  • In-patient treatment, expenses related to hospitalisation, etc. are covered
  • Day-care treatment cover and pre-existing diseases cover are also included
  • The company offers a free-look period of 15 days
  • The company guarantees processing of every cashless claim is within 6 hours

More benefits

  • The customers have the option of choosing their desired deductible amount ranging from 2 to 5 lakhs
  • The premium rate is low as this plan is designed to be bought alongside another medical insurance policy
  • Premium paid can be claimed in the section 80D for tax benefit

Extra benefits

  • Pre-policy check-up is required for applicants aged more than 55 years
  • Co-payment of 10% is necessary for policyholders above 80 years of age