Claim process

    For seamless processing of claims make sure to submit below details at healthclaims@hdfcergo.com

  • Provide NEFT details in the claim form along with cancelled cheque
  • Provide KYC ( Know your customer ) form along with photocopy of any one of following KYC documents for all claims amounting to Rs 1 lakh and above. For KYC Form Click Here
  • KYC Documents: Aadhaar Card, Passport, Driving Licence Voter ID, etc
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Step 1. Hospitalization

Who Will Do it : Policy Holder
What Should be done? Click Here to locate nearest network hospital

Step 2. Avail Cashless & Submission of Documents

Who Will Do it : Policy Holder
What Should be done? Avail cashless at the network hospital by showing your health card and valid photo ID

Step 3. Preauthorization

Who Will Do it : Network Hospital
What Should be done? Hospital will send the cashless request to HDFC ERGO and coordinate with us for authorisation Pre-authorisation form.

Step 4. At the time of Discharge & Settlement of claim

Who Will Do it : HDFC ERGO
What Should be done? HDFC ERGO/ TPA will scrutinize all the received documents and convey the final stand on the claim.

Step 5. Status Update

Who Will Do it : HDFC ERGO
What Should be done? You will receive an update through SMS/Emails on every stage of the claim on your registered mobile number or email id.

Step 6.Cashless authorisation & Approval of Claim

Who will do it: HDFC ERGO & Network Hospital
What should be done? Hospital shall send the final bill to HDFC ERGO for authorisation and HDFC ERGO shall scrutinise the same and give final authorisation in case of approved transcations to the hospital. Any inadmissible expenses, copayments, deductions will have to be paid by you.

Step 1. Hospitalization

Who Will Do it : Policy Holder
What Should be done? Contact nearest Hospital

Step 2. Claim Registration

Who will do it : Policy Holder
What should be done?To register your claim, fill the claim form and send to us with required documents to below address : Click Here for claim form HDFC ERGO General Insurance Company Ltd 5th Floor, Tower 1, Stellar IT Park, C-25, Sector-62, Noida 201301 State : Uttar Pradesh , City : Noida Pin Code : 201301

Step 3. Approval of Claim

Who will do it: HDFC ERGO
What should be done? HDFC ERGO will scrutinize all documents and approve the claim. In case additional information or documents are required, HDFC ERGO will call for the same and upon satisfactory receipt of all necessary documents the claim will be settled by HDFC ERGO

Step 4. Status Update

Who will do it:HDFC ERGO
What Should be done? You will be updated through SMS/Emails on every stage of the claim 

Step 5. Settlement of claim

Who will do it: HDFC ERGO
What should be done? On receipt of complete documents, the claim would be processed and payment will be made through NEFT.

Document Check List

List of documents needed for registering claim

  • Duly filled and signed Claim Form with HDFC Ergo policy number Claim Form
  • Original Discharge Summary
  • Original final bill with detailed breakup,payment receipt and,original pharmacy invoices supported by prescriptions
  • Original Investigation reports (eg. blood reports, X-Ray, etc)
  • Implant sticker/invoice, if used (eg. for stent in angioplasty, lens cataract, etc.)
  • Past Treatment documents, if any
  • In cases of Accident, Medico Legal Certificate (MLC) or FIR
  • Other relevant documents, if any
  • NEFT details for payment: Cancelled cheque in the name of the Proposer or passbook copy attested by bank For all claims amounting 1 lakh and above: KYC form along with photocopy of any one KYC document (eg. aadhar card, passport, driving license, voter ID, etc)
  • For all claims amounting 1 lakh and above: KYC form along with photocopy of any one KYC document (eg. aadhar card, passport, driving license, voter ID, etc) KYC Form
Awards & Recognition
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