HDFC ERGO General Insurance Company Limited is made from 74:26 joint venture of India’s premier Housing Finance Institution, HDFC Limited, and the primary insurance entity of Munich Re Group, ERGO International AG. The focal point of HDFC ERGO is to provide “Right Insurance Solution” to all. Customers are provided a complete range of general insurance products ranging from Motor, Health, Travel, Home and Personal Accident in the retail space and customized products like Property, Marine and Liability Insurance in the corporate space by HDFC ERGO. With superior customer support service, constant attempt of HDFC ERGO is to improvise and cater to every need of the modern day customer. Customers get a seamless and hassle-free experience with this help.

Medical Insurance:

People can face many risks associated with either Accidents or Illnesses in their daily lives and due to this; costs associated with Hospitalization increasing day by day.

It can effect on your previous savings. As an employer, you can provide ‘Group Mediclaim Policy’ to your employees/members, which would be the finest cover for their requirement. To develop health insurance products that cut costs while maintaining superior coverage, HDFC ERGO struggles to use an innovative approach. Health Insurance Packages are modified specifically to fit the needs of the group. In a single policy, group health insurance plan provides cover to all the members. There are several advantages over buying an individual policy, which are:-

• Lower Premium Costs
• Customized Policy
• Provides Incentive for having affiliation with the group
• Cover for all members
• Cashless Claims across Network Hospitals
• Cover from Day One of member joining the group

Plan Coverage:

To suit the requirement of your group, your policy can be modified. The various covers are listed below that are generally available:

In hospitalization expenses due to Sickness or Accidents:

• Including Room, Boarding Expenses as provided by the Hospital / Nursing Home
• Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees
• Nursing Expenses
• Anesthesia, Blood, Oxygen, Operation theatre Charges, Surgical Appliances, Medicines and Drugs, Diagnostic Materials and X-Ray, Dialysis, Chemotherapy

Pre Hospitalization Expenses:

• Day Care Treatments
• Post Hospitalization Expenses
• Domiciliary Hospitalization Expenses

Premium:

• Maternity Benefit
• Inclusion of Pre Existing Disease
• Reimbursement of Cost of Health Check Up
• Family Floater to covers member’s immediate family viz. Spouse, Dependent Children, Dependent Parents etc.
• Dental Treatment
• Reimbursement of Ambulance Costs
• Cost of Spectacles, contact lenses
• Waiver of waiting period
• Waiver of First Year Exclusions

The Optional Benefits:

The premium for the policy would depend on the following parameters:-

• Size of the Group
• Benefits opted
• Profile of Members e.g. Occupation, Age, Annual Income etc

File a Claim

• To claim under the policy, call on Toll-free number 1800 2 700 700
• On the claim procedures and documents, Claims Service Representative would guide you.
• Through mail, email or fax, a claim form will be forwarded to you.
• Complete the claim form relevant to the nature of loss.
• Attach the documents mentioned against the claim type.

Documents required for Claims :-

For Accidental Injury Claims

• Claim form
• Police Report, if accident is reported to Police
• Medical papers, pathology reports, X-ray reports and plates, as applicable
• Doctor’s medical prescriptions, Itemized bills and cash memos
• Hospital Discharge Card

For Hospitalisation due to Illness/Disease

• Claim Form
• Medical papers, pathology reports, X-ray reports, as applicable
• Doctor’s prescription and line of treatment suggested
• Itemized bills and cash memos
• Hospital Discharge Card

Itemized bills must show the patient’s name, date of treatment, the type of treatment given, the diagnosis or nature of condition being treated and the Hospital/Nursing Home’s name and address.

Documents, in addition to those mentioned above maybe called for, depending on the nature of claim lodged.

You may also send the claim form with Annexure to our Claims Processing Cell at the following address:

Claims Department

HDFC ERGO General Insurance Company Limited
6 th Floor, Leela Business Park,
Andheri – Kurla Road, Andheri (East)
Mumbai – 400059