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

    Toll Free - 1800-270-0700

    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.

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.

Garage List Required