I work with HDFC Ergo General Insurance Company that provides heath, motor, home, building, and other general insurance products. This page is about HDFC Ergo General Insurance products including health insurance. I also work with HDFC Life, which is primarily a reputed investment company that offers life insurance protection.
HDFC Ergo gives you the best experience of staying insured and making a claim when you need it.
HDFC Ergo has a high Claim Settlement Ratio (over 95%). This means the insurance company has settled most of the claims it received. Therefore, choosing HDFC ERGO health insurance can ensure financial security, especially during expensive medical procedures.
HDFC Ergo has a high Incurred Claim Ratio. The Incurred Claim Ratio for health insurance is the total amount of claims paid by the insurance company against the total premium amount received for the particular financial year.
HDFC Ergo should be your first choice for health insurance because they have a well connected network of over 13000+ hospitals where you can get “cashless” treatment. With a 48-hour notice, HDFC Ergo will ensure “cashless” facility in any hospital.
HDFC Ergo Optima Secure Health Insurance
Entry Age: 18 to 65 years for adults
Entry age: 91 days to 25 years for dependent children
Secure Benefit: From day one, you get double the coverage you choose! That is, if you chose 10 lakhs as your base cover, you will get an insurance cover worth 20 lakhs from day 1.
Restore Benefit: In addition, HDFC Ergo will restore your base cover if you exhaust that amount. That is, from day 1, you have a cover of thirty lakhs. If you chose the rider option of “unlimited restore”, your base cover will be restored unlimited times.
Plus Benefit: After the first and second years, your sum assured will get an additional 50% of the original insurance cover you chose. That is, if you chose 10 lakhs as your base cover, 5 lakhs will be added to it in the second year. Similarly, in the third year, another 5 lakhs will be added to the base cover.
With all the benefits in place, you get four times the cover you chose by the beginning of the third year!
Protect Benefit: All non-medical expenses (consummables, canteen expenses, etc.) will be covered!
Actual amount spent on ambulance and room rent will be covered
Pre-hospitalisation cover: 60 days
Post-hospitalisation cover: 180 days
Treatment at home (domicilliary treatment) will be covered if doctor permits it.
Cost of Ayurvedic treatment will be reimbursed.
Discounts on premium available if you chose Co-payment options (That is, each year, if you choose to pay the initial Rs. 25,000 or Rs. 50,000 or Rs. 100,000 of treatment costs, your premium will be get a discount of 25%, 40% and 50% respectively)
You can get further discounts if you choose to buy insurance for two years (7%) or three years (10%).
If you qualify for an interest free loan, you can pay the premium in equal monthly installments.
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Glossary
Accidental Death
Accidental Death Cover is normally available as a Rider or Inbuilt Option. Accident is a sudden, unforeseen and involuntary event caused by external, visible and violent means. Accidental Death means death by or due to a bodily injury caused by an Accident, independent of all other causes of death. Accidental Death must be caused within 180 days of any bodily injury.
Accidental Disability Rider
An optional but necessary addon. Get additional income benefits over and above your Sum Assured in the event of total permanent disability due to an Accident. In the event of Total Permanent Disability due to accident, you will be paid a regular monthly income equal to 1% of Sum Assured for a fixed period of 10 years. Disability as a result of injury or accident and is thereby rendered totally incapable of being engaged in any work or any occupation or employment for any compensation, remuneration or profit and he/she is unlikely to ever be able to do so. Alternatively, the life assured suffers an injury/accident due to which there is total and irrecoverable loss of: a. The use of two limbs; or b. The sight of both eyes; or c. The use of one limb and the sight of one eye; or d. Loss by severance of two or more limbs at or above wrists or ankles; or e. The total and irrecoverable loss of sight of one eye and loss by severance of one limb at or above wrist or ankle.
Claim settlement ratio (CSR)
An insurance company’s claim settlement ratio (CSR) refers to the number of claims successfully resolved versus the number of requests received in a given year. For example, if XYZ company receives 100 claim requests in a year and successfully settles 90 of them, its CSR is 90%. CSR acts as an indicator of their credibility.
Critical Illness
A list of illnesses are defined as critical illness. See product brochure online. Signs or Symtoms must have first commenced 90 days following date of an insurance policy.
Critical Illness Riders
HDFC Life Critical Illness Plus Rider provides a lump sum benefit on diagnosis of any one of the listed critical illnesses. The Life and CI Rebalance Option waives all future premiums after the detection of a critical illness.
Exclusions
The insurance contract specifies certain situations in which the insurance company will not honor their promise. For example, suicide is a common exclusion. If the insured person commits suicide, the company will not pay the sum assured or death benefits. Losses due to activities such as automibile racing, diving, underground activities, etc., are also excluded from coverage.
Free Look Period
The free look period is the period given to a policyholder to assess and review the policy document. He/she can terminate the policy during the free look period if they are not satisfied with its inclusion and exclusion terms which were explained at the time of purchase.
Grace Period
If you fail to pay your premium by date, your contract with the insurance company will come to an end. To prevent such a situation, you are given a grace period of 30 days from the due date every year.
Insurance
Insurance is a contract you make with an insurance company. For a certain amount you pay (that is, the premium), the insurance company undertakes to compensate you (the insured) for a loss. Also, see definition of Risk Transfer.
Life Assured
The person whose life is insured.
PPT
Policy Paying Term: The time period for paying annual premiums
PT
Policy Term: The total life of the life insurance contract
Premium
Premium is the cost of insurance. It is the amount you pay the insurance company periodically (annually) to keep yourself insured (and as seed for your investment).
Rider
Life insurance riders are contingent additional benefits over a primary policy, which come into play in case of a specific eventuality. They offer financial cover over and above basic sum assured in a life insurance policy. Even with the occurrence of the event, the life cover remains intact. This means that even if you have drawn on a particular rider, you remain eligible for the death benefit on the life insurance plan.
Risk Transfer
A good way to deal with risk is to transfer our risks to someone who is willing and capable of handling or dealing with them. This process of transferring of risk from one person to another is called insurance. Insurance, therefore, is a risk transfer mechanism.
SA
Basic Sum Assured is the amount of sum assured chosen by the policyholder
Sum Assured on Death
is the absolute amount of benefit which is guaranteed to become payable on death of the life assured in accordance with the terms and conditions of the policy or an absolute amount of benefit which is available to meet the health cover.
Sum Assured on Maturity
is the amount which is guaranteed to become payable on maturity of the policy, in accordance with the terms and conditions of the policy.
