Claim Process - HDFC ERGO General Insurance

  1. Intimation
  2. Availing Treatment
  3. Compilation / Submission of Claim File

How to intimate health claim with HDFC ERGO General Insurance

Planned Treatment - At least 48 Hrs prior to hospitalization
Emergency Treatment - Within 24 Hrs of hospitalization
E-Mail
healthclaims@hdfcergo.com
Register Claim Online
Claim Helpline
1800-2700-700
Nearest Branch

Details required for Registration/ Intimation of Claim

To Register claim by calling/FAX on above contact point, you will need to provide the following information to the customer support executive:-
  • You are required to furnish the following information while intimating a claim:
  • Contact Numbers
  • Policy Number (as on the Health Card/Policy Schedule)
  • Name of insured person who is hospitalized
  • Nature of disease / illness / injury
  • Date & time in case of accident/ Injury, commencement date of symptom of disease in case of illness
Once the claim is registered, the customer support executive will provide you with a Claim Reference/Intimation Number.

Points to Remember

  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  •  The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  •  Unreasonable & Non medical expenses are not payable.
  • Every claim should be intimated & file should be submitted within time, as non adherence can lead to delay in claim settlement.
  •  The claim is decisioned only when all required & necessary documents are submitted.
  • NEFT & KYC details should be updated with the Insurer for easier & faster claim settlement.
  • Pre hospitalization expenses may be claimed along with main hospitalization expenses.
  •  Unreasonable & Non medical expenses are not payable.

 

The claim file has to be submitted at the below mentioned addresses within 15 days of discharge.

 

The claim file has to be submitted at the below mentioned addresses within 15 days of discharge.
Courier Address
HCS - Noida, HDFC ERGO General Insurance Co. Ltd., 5th floor, Tower 1, Steller IT Park, C-25, Sector-62, Noida - 201301 OR HCS - Chennai, HDFC ERGO General Insurance Co. Ltd., 6th floor, MBC Tower, Old no. 90, New no. 199, Luz Church Road, Mylapore, Chennai - 600 004




List of Documents

Documents require for claim process

  • Duly filled & signed claim form
  • All hospital bills in original including final hospital bill (with bill number signed & stamped by the hospital) with itemized bill & original receipts
  • Discharge card or discharge summary (original) or death certificate in case of death (in hospital)
  • All original investigation reports & medicine bills with doctor’s prescription.
  • Follow-up advice or letter for line of treatment after discharge from hospital from doctor.
  • In case the hospital is not registered, please get letters on the hospital letterhead mentioning the number of beds and availability of doctors and nurses round the clock.
  • In case of non-network hospital, you may have to get the hospital and doctor’s registration number in hospital letterhead and get the same signed and stamped by the hospital, if required.

Process of Claim

01
The treatment is to be intimated within prescribed timelines
02
Post completion of treatment, documents are to be collected from hospital during discharge.
03
The claim file is to be prepared with ref to check list, (The claim form part B is to be filled by hospital)
06
Post receiving of all required info, the claim will be processed within 30 days.
05
HDFC Ergo will inform about any deficiency within 7 days.
04
Duly filled claim forms along with all necessary documents are to be submitted within prescribed timelines.
07
If the claim is approved, amount will be transferred within 30 days.
08
If the claim is rejected, letter with details are to be shared with Insured.
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