HDFC Ergo Insurance Plans

HDFC ERGO Health Wallet

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Coverage type
Coverage amount
Date of birth
  OR age    years
* Name, Email Id & Mobile No. are required 

Key features of Health Wallet

  • It offers a wide range of coverage from of 3 lac to 50 lacs.
  • Lifetime renewal
  • Any pre-existing diseases/conditions will be covered after a waiting period of 3 years.
  • Portability
  • Grace period: A grace period of 30 days for renewing the policy is provided under this policy

HDFC ERGO Health Insurance Review

HDFC ERGO Health Insurance
HDFC ERGO Health Insurance sum insured
3 lacs − 75 lacs options available
Incurred Claims Ratio *
62.00%
HDFC ERGO Health Insurance tenure options
2 years
Claims Settlement Ratio **
85.97%
List of network hospitals
10,000+ hospitals
Number of policies issued *
1,066,395
Maximum family floater coverage
Self, Spouse + dependent (children (upto 25 yrs) + parents)
Number of lives covered *
96,05,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

HDFC ERGO Health Wallet benefits

  • What’s Included?
  • Benefits
  • Exclusions

What’s Included under HDFC ERGO Health Wallet Insurance?

  • Day Care Procedures
  • Pre-hospitalisation Cover
  • Post-hospitalisation Cover
  • Hospitalisation Expenses
  • Road Ambulance Cover
  • Organ Donor Expenses
  • Alternative Treatments (Non-Allopathic)
  • Restore Benefit
  • Domiciliary Treatment
  • Worldwide Emergency Care - Covers emergency hospitalisation expenses outside India upto the specified limithospitalisation exceeds 48 hrs.
  • Reserve Benefit

Benefits of HDFC ERGO Health Wallet Insurance

  • In-patient Treatment- Covers hospitalisation expenses for period more than 24 hrs.
  • Pre-Hospitalisation- Medical expenses incurred in 60 days before the hospitalisation or domiciliary treatment.
  • Post-Hospitalisation- Medical expenses incurred in 90 days after the hospitalisation or domiciliary treatment.
  • Day-Care Procedures- Medical expenses for day care procedures
  • Organ Donor- Medical expenses on harvesting the organ from the donor for organ transplantation
  • AYUSH Treatment - The Medical Expenses for in-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy
  • Health Check-up – At each renewal, we will pay upto the amount stated for preventive medical check-up.
  • Multiplier Benefit – 50% increase in your basic sum insured for every claim free year, subject to a maximum of 100%. In case a claim is made during a policy year, the limit under this benefit would be reduced by 50% of the basic sum insured in the following year. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.
  • Tax benefit - The premium amount paid under this policy qualifies for deduction under Section 80D of the Income Tax Act, subject to applicable tax laws.
  • Preventive health check-up benefit - Health Wallet helps to keep track of your health status by offering a preventive health check-up at renewal irrespective of claims made. However, eligibility of health check-up limit is based on Reserve Benefit sum insured.
  • Waiting period - Health Wallet comes with initial waiting period of 30 days and 2 year exclusion for specific diseases; such as Cataract, Hernia, Hysterectomy and Joint replacement. Any pre-existing diseases/conditions will be covered after a waiting period of 3 years.

HDFC ERGO Health Wallet exclusions

  • External Congenital diseases
  • Cost inferable straightforwardly or by implication to pregnancy (including voluntary termination), unsuccessful labor ((except as a result of an accident or illness)
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Drugs or treatments which are not supported by a prescription
  • Dental treatment, external aids and appliances
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens
  • Pregnancy, dental treatment, external aids,appliances.

Most of the Health Insurance Policies offered by the General Insurance companies in India have waiting periods during which certain pre existing diseases are excluded in the coverage. They are excluded for certain predefined period (number of years) before they are covered i.e. The Policy holder is expected to have continuous cover for the predefined period before the pre existing diseases are covered under the policy. Portability will ensure that these accrued benefits are transferred (without any dilution) to the new insurer at the time of renewal and porting and the consumer do not lose on these accrued benefits while opting to switch the insurer using Health Insurance Portability. The Policy holder can port the following accrued credits: General waiting period Waiting periods pertaining to the coverage of pre - existing diseases / conditions Any time bound exclusions

There is No maximum exit age for HDFC Ergo medical insurance.

A ‘Free Look Period’ is a period of 15 days from the date of receipt of the policy that a policyholder, in this case you, have to review the entire health insurance plan. If you disagree with any of the terms or conditions mentioned in the policy, you have the option of returning the policy by stating the reasons for the objection. Following this, you are entitled to a refund of the premium paid, provided no claim has been made under this mediclaim insurance policy (subject only to a deduction of the expenses incurred by the company on medical examination and the stamp duty charges). Please note that this facility is not applicable on renewal and portability cases.

List of necessary claim documents to be submitted for reimbursement are as following:
  • Claim form duly signed
  • Copy of photo id of patient
  • Hospital discharge summary
  • Operation theatre notes
  • Hospital main bill
  • Hospital break up bill
  • Investigation reports
  • Original investigation reports, X ray, MRI, CT films, HPE, ECG
  • Doctors reference slip for investigation
  • Pharmacy bills
  • MLC/ FIR report, post mortem report if applicable and conducted

Brochure

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Proposal form

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Policy wordings

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HDFC ERGO health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

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Network hospitals

HDFC ERGO Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 10,000+ Hospitals

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Health insurance benefits

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Portability

Portability Information for Mediclaim Insurance in India.


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Health insurance FAQ

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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