Motor Insurance Claims

Health and Medical Insurance Claim Process

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

What Should be done Who Will Do it
Hospitalization
Click Here to locate nearest network hospital Policy Holder
Avail Cashless & Submission of Documents
Avail cashless at the network hospital by showing your health card and valid photo ID Policy Holder
Preauthorization
Hospital will send the cashless request to HDFC ERGO and coordinate with us for authorisation Preauthorization Form Network Hospital
At the time of Discharge & Settlement of claim
HDFC ERGO/ TPA will scrutinize all the received documents and convey the final stand on the claim HDFC ERGO
Status Update
You will receive an update through SMS/Emails on every stage of the claim on your registered mobile number or email id Track your claim HDFC ERGO
Cashless authorisation & Approval of Claim
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. HDFC ERGO & NETWORK HOSPITAL
What Should be done Who Will Do it
Hospitalization
Contact nearest Hospital Policy Holder
Claim Registration
Register the claim with us through Toll-Free 1800 2 700 700 within 7 days from the date of discharge Policy Holder
Submission of Documents
Sumbit all original documents along with duly signed claim form Policy Holder
Approval of Claim
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 HDFC ERGO
Status Update
You will be updated through SMS/Emails on every stage of the claim (You can also track the claim status yourself anytime by clicking the bitly link shared in the SMS and emails alerts ) HDFC ERGO
Settlement of claim
On receipt of complete documents, the claim would be processed and payment will be made through NEFT. HDFC ERGO
  • 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 bank6) 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

HDFC ERGO/TPA will scrutinize all the received documents and convey the decision on the claim . Please note In case of internal verification the final stand will be confirmed with 24 hours of last documents received by HDFC ERGO/TPA

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