HDFC ERGO Group Health Insurance

HDFC ERGO offers a comprehensive range of group health and group medical insurance plans for all types of companies in India. HDFC ERGO is the second-largest private sector insurance group in India. The insurer has an extensive suite of health insurance products for critical illness, diabetes care, health plans for women, family floater, top-up/super top-up and more.
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Key Statistics of HDFC ERGO General Insurance Company
GHI Premiums
₹1,009 crores
FY 2021
GHI lives insured
53 lakhs
FY 2020
Health lives insured
1.72 crores
FY 2020
Claims Processed
1,67,673
FY 2020
Claims Settlement Ratio
86.52%
FY 2020
Claims Settled within 3 months
86.42%
FY 2020
*Source - IRDAI and IBAI annual reports  **GMC - Group Medical Cover
***Claims Settlement Ratio (CSR) is the percentage of claims settled by the insurance company against the no. of claims obtained in a financial year. A high claim settlement ratio indicates the good financial health of the insurance group.
GHI Premiums
₹1,009 crores
FY 2021
GHI lives insured
53 lakhs
FY 2020
Health lives insured
1.72 crores
FY 2020
Claims Processed
1,67,673
FY 2020
Claims Settlement Ratio
86.52%
FY 2020
Claims Settled within 3 months
86.42%
FY 2020
Awards and Recognitions
Excellence in Financial Reporting
ICAI Awards 2015-16
Top Projects in India
SKOCH Order-of-Merit
Best Customer Experience Award of the Year
Financial Sector
CMS Outstanding Affiliate World
ICAI Awards 2015-16
iAAA rating
ICRA
Best Insurance Company in Private Sector
General 2014
Gold Shield
ICAI Awards 2012-13
HR Excellence
Technology award 2012
Excellence in Financial Reporting
ICAI Awards 2015-16
Top Projects in India
SKOCH Order-of-Merit
Best Customer Experience Award of the Year
Financial Sector
iAAA rating
ICRA
iAAA rating
ICRA
Best Insurance Company in Private Sector
General 2014
Gold Shield
ICAI Awards 2012-13
HR Excellence
Technology award 2012

What is Group Health Insurance?

Working in a company can help you get a lot of benefits. One such is group health insurancecover for you and your entire family. You need not think about purchasing a group insurance scheme because your employer sponsors it. Yes, the cost of buying and administering group insurance lies in the hands of your employer. With group medical cover, you can live and work stress-free without needing to think about the financial obligation arising out of emergency hospitalisation. Plus, HDFC ERGO comes with online health plans that offer complete customisation options.
Highlights  of HDFC ERGO Group Health Insurance
Excellent cashless claims service
More than 1.5 crore happy customers
Wide network of 10,000 plus hospitals across India
Industry experience of more than 20 years
Average customer rating of 4.5/5
A highly trusted brand of the insurance sector in India

Standard Benefits Offered by HDFC ERGO Group Health Insurance

Here is a comprehensive summary of the HDFC ERGO Group Health Insurance Plan. The features mentioned below can be customised as per your organization’s requirements.
Feature
Type of cover
Average customer rating of 4.5/5
Employees as well as their spouse, children, and parents
Hospitalization expenses due to accident and sickness are covered (inpatient hospitalization)
Sum Insured
Depends on the size of the organization
What is covered?
Room rent, boarding expenses, nursing home expenses
Fees for the surgeon, doctor, nurse, medical practitioner, consultant and more
Medical requirements for blood, oxygen, anaesthesia, OT charges, drugs, medicines, diagnostic materials, etc.
Chemotherapy, dialysis
Surgical appliances such as needles, gloves, IV, etc.
Pre/post hospitalization expenses
Yes
Day care treatment
Yes
Domiciliary hospitalization
Yes
Add-on Benefits Offered by HDFC ERGO Group Health Insurance
Add-ons
Maternity benefit options
Any type of pre-existing diseases
Reimbursement for the cost of health check-up
Family floater option - spouse, dependent children and dependent parents
Treatment for dental disorders
Expenses related to spectacles, contact lenses
Waiver of the waiting period
Waiver of 1st-year exclusions
Reimbursement for ambulance travel to the hospital
Please note that Plum has collated and presented this data for informational purposes only and at a particular point in time. Plum does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer. The final terms, conditions, and premiums may vary depending upon factors including group size, age, location, and applicable taxes.

Here's how HDFC ERGO is better with Plum

Complete digital experience
From cashless claims to digital health IDs, and much more, go digital with Plum.
Cover for businesses of all sizes
Get the best online group health insurance for teams and companies of all sizes.
Scales as you expand your team
Add or remove employees and medical benefits as you scale.
Doctor on call
Get teleconsultations from our expert doctors along with advice on medical and general health.
Plum Wellness
Get access to corporate wellness programmes for your employees.
Insurance on WhatsApp
Start a claim, download your eHealth card, check policy details, and much more on WhatsApp.
Single dashboard
Be it employer or employee, desktop or mobile, check your insurance plan & health benefits dashboard anywhere.
Track your claims
Know how your team is utilizing their employee benefits and medical coverage.
Get Started

How Does Plum Work?

Open
app.plumhq.com
to access your insurance
Select
Open WhatsApp
and continue to chat
Click on use
my insurance button
on the dashboard
Open
app.plumhq.com
to access your insurance
Click on use
my insurance button
on the dashboard
Select
Open WhatsApp
and continue to chat

Documents Required for Claims Process

The documentation depends on the type of claims process you have chosen - Cashless or Reimbursement.
Reimbursement Claims
Cashless Claims
Completely filled  claim application form for reimbursement process with employee id and group policy details
All original bills related to medical treatment
Payment receipts done manually
Discharge certificate
If you have taken implants, the invoice has to be submitted
Doctor’s prescription
Nurses/attending physicians notes
KYC details for deposit transfer - NEFT/IFSC/Bank Statement
FIR or police certificate or post mortem report  in case of accident/death
Claims application form
Cashless claims application form - you can get this from the TPA desk at the hospital
Health card or health id or policy number
Id proof - PAN & Aadhaar is mandatory
Medical bills and daily treatment summary
Reimbursement claim
Cashless claim
Completely filled  claim application form for reimbursement process with employee id and group policy details
All original bills related to medical treatment
Payment receipts done manually
Discharge certificate
If you have taken implants, the invoice has to be submitted
Doctor’s prescription
Nurses/attending physicians notes
KYC details for deposit transfer - NEFT/IFSC/Bank Statement
FIR or police certificate or post mortem report  in case of accident/death
Claims application form
Cashless claims application form - you can get this from the TPA desk at the hospital
Health card or health id or policy number
Id proof - PAN & Aadhaar is mandatory
Medical bills and daily treatment summary

Here’s why you will love Plum

With Plum, get complete access to your insurance plan on WhatsApp
Check your healthcare benefits
Intimate your claim
Read what’s covered and not covered
Select other health benefits
Download your Digital health ID Card
See daycare treatment list

Frequently asked 
questions

What is natural death in insurance?

Death occurring due to natural causes such as old age or sickness. This includes critical illness as well.

What type of death is not covered in insurance?

Your health plan will not cover death that is classified as unnatural. Example - Death by suicide, substance abuse, criminal activity, negligence and more.

Can I include my children in HDFC ERGO group insurance?

Yes, you can include your children, spouse and parents in HDFC ERGO group insurance cover.

What are the advantages and benefits of HDFC ERGO health insurance?

There are multiple benefits of having an HDFC ERGO health insurance policy. Here is to name a few:
Cover all of your family members (up to 4 members), option for lifelong renewal for an individual health plan, group cover is applicable till you are part of the organisation, option of cashless and reimbursement claims settlement, the company has a good high claim settlement ratio along with an IAAA rating from ICRA.

What is a non-network hospital?

A non-network hospital is a health institution that is not included in the insurers' list of network hospitals for cashless treatment. You can only avail of reimbursement facilities in such hospitals.