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Claim Process – HDFC ERGO General Insurance Co. Ltd.

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4 Quick Ways to Initiate Your Claim

  • Insure claim process
    Submit Online
  • Insurer Support

    Customer Care no: 022/0120-62346234

    Email - healthclaims@hdfcergo.com

  • Submit at Nearest Branch
    Branch locator
  • Request Assistance
    Submit

Details Necessary to Intimate or Register Claim

The flowing details are required to intimate or register a claim :

  • Contact Numbers
  • You are required to furnish the following information while intimating a claim:
  • 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.

  • Emergency Cashless
  • Planned Cashless
  • Reimbursement

Points to Remember

  • Cashless is available only in network hospitals of Insurer.
  • Dully filled pre-authorization form is to be submitted along with copy of cards/policy.
  • Insurer approves part of expected expenses known as Initial approval.
  • During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.
Download Claim Form

List of Documents

Mandatory Documents

  • Copy of id card/Policy copy
  • Duly filled pre-auth form
  • KYC of insured
  • 1st consultation letter/Investigation reports (If Any)

Points to Remember

  • Cashless is available only in network hospital of Insurer.
  • Insurer should be approached well on advance, minimum 48 hrs prior to hospitalization.
  • Dully filled pre-authorization form is to be submitted along with its consultation letter.
  • Insurer approves part of expected expenses known as Initial approval. During discharge, on submission of final bill, Insurer approves final amount.
  • Care should be taken to reply to any query, if raised during the process. Unreasonable & Non medical expenses are not payable.

List of Documents

Mandatory Documents

  • Copy of id card/Policy copy
  • Duly filled pre-auth form
  • KYC of insured
  • 1st consultation letter/Investigation reports (If Any)

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

List of Documents

Documents require for claim process

  • Duly filled & signed claim form
  • Cancelled Cheque
  • 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.

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