HDFC ERGO Group Health Insurance

The insurer offers retail general insurance products like motor, health, home, travel and personal accident. In the corporate space, it offers property, marine and liability insurance products. HDFC ERGO health insurance has a wide range of health insurance products designed for individuals, families, senior citizens, and women. They also have specialised products like critical illness and super top-up health insurance.

By purchasing HDFC ERGO group health insurance from Pazcare you get best-in-class employee insurance services. With Pazcare, you can administer your HDFC ERGO group health insurance in one place using the Pazcare dashboard. Join the other 500+ HRs who use the Pazcare dashboard to manage the policy, add/delete employees, manage endorsements and many more. The employees can use Pazcare’s employee app to manage their group health insurance plan. 

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How to buy HDFC ERGO group health insurance with Pazcare?

Step 1: Visit us at Pazcare and choose group health insurance under the products drop down. 

Step 2: After going through the coverage and benefits, click on the get quote button to fill out basic information like your name, company, work email address, phone number and the number of employees in the organisation.

Step 3: Our insurance consultants will get back to you within 24 hours of submitting the form. Communicate your requirements regarding the HDFC ERGO group health insurance. This includes the sum insured, type of policy, add-ons required, etc.

Step4: Our team will get back to you with competitive quotes for HDFC ERGO group health insurance along with the other group health insurers based on the requirements you communicated.

Step 5: Once you choose the policy, say HDFC ERGO group health insurance policy, the next step is to accept the terms and conditions of the policy and pay the premium quoted.

Step 6: Once the payment is done, our team will help you with the onboarding process. Generally, an onboarding process will be done within 24 hours of your policy purchase. We will also assist you in using the Pazcare dashboard to administer your group insurance plan.

For any assistance or queries, get in touch with us at support@getpaz.com or call us directly at +91 78291 11300. Alternatively, get in touch with us on Whatsapp using +91 81973 79596.

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Why choose HDFC ERGO group health insurance as your insurance partner?

Here are the reasons why you should choose HDFC ERGO group health insurance from Pazcare. 

13,000+ cashless networks

With more than 13,000+ cashless network hospitals, HDFC ERGO group health insurance has a pan India presence. With such a huge cashless network, you can avail cashless claims for hospitalisation near your location.

‍No external TPA is involved

The claims for HDFC ERGO group health insurance are settled by the in-house claim settlement department. Hence, your claims are settled without the involvement of an external TPA.

‍24X7 support

HDFC ERGO provides 24X7 customer assistance and claim support services for its customers. The in-house claims team makes sure the claims are settled hassle-free.

‍Highly customisable plans

The HDFC ERGO group health insurance is highly customisable according to the needs of your employees. You can choose the add-ons and riders catering to the needs of your organisation.

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HDFC ERGO group health insurance claim settlement ratio

A claim settlement ratio (CSR) in health insurance is defined as the ratio between the number of claims settled to the number of claims requested in a financial year by a health insurance company.  A CSR ratio is calculated as

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HDFC ERGO group health insurance network hospitals

HDFC ERGO group health insurance have more than 13,000+ network hospitals pan India. This means availing of cashless claims for your group health insurance becomes more accessible near your geographical area.

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Claim HDFC ERGO group health insurance

HDFC ERGO group health insurance cashless claim

Make your HDFC ERGO group health insurance cashless claim using the following process.

1. Visit a network hospital

You can use the cashless claim benefit only at a network hospital. Hence, make sure you get to the nearest network hospital for treatment.

2. Verify your details

Then confirm your identity using the government photo ID like voter ID, driving license, along with the health insurance ID card or policy number, and your company ID at the network hospital.

3. Submit the pre-authorisation form

The next step is to submit the pre-authorization form to HDFC ERGO group health insurance within 24 hours of hospitalisation in case of emergency. For planned hospitalisation, submit it at least 3 days before the hospitalisation in the network hospital.

4. Review of request

After submitting the pre-authorisation form, the request for a cashless claim for your HDFC ERGO group health insurance will be reviewed by the insurer/TPA. And the same will be notified to you and the network hospital.

5. Claim settlement

Once HDFC ERGO health insurance accepts your claim request, the claim is settled directly to the network hospital according to the terms and conditions of the policy.

‍HDFC ERGO group health insurance reimbursement claim

For hospitalisations in a non-network hospital, you can go for an HDFC ERGO group health insurance reimbursement claim.

1. Intimate your insurer

Firstly, intimate your insurer about the hospitalisation within 48 hours in case of emergency and at least 3 days before planned hospitalisation

2. Settle your bills

Once you get treated at a non-network hospital, the next step to follow is to settle all your hospital bills and pharmacy bills from your pocket.

3. Collect the original documents

Once the bills are settled, collect the original copies of all the required documents to file for a reimbursement claim. 

Documents required to file HDFC ERGO group health insurance reimbursement claim

• Claim form
• Medical papers, pathology reports, X-ray reports, as applicable
• Doctor’s prescription and line of treatment suggested
• Medical bills and cash memos
• Hospital Discharge Card

4. Submit the documents

After collecting all the original documents, submit the documents via post to

‍Claim processing

Claim processing for HDFC ERGO group health insurance reimbursement claim will be done as per the terms and conditions of the policy. Once approved, the claim will be settled in your bank account. 

Contact us at support@pazcare.com for 24X7 claim assistance for your employees. Alternatively, you can call us at +91 78291 11300.

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HDFC ERGO group health insurance renewal process

Renew your HDFC ERGO group health insurance with Pazcare using the following steps.

‍Step 1: Visit us at https://pazcare.com/ and submit a basic form that requires your name, company name, number of employees, work email address and phone number.

Step 2: After submitting the form our group health insurance consultants will contact you for the following documents.

• Active data of employees - name, age, gender, details of dependents (as per the type of policy)
• Claim analysis report
• Claim dump report from the insurer/TPA
• Policy copy

Step 3: If you wish to choose additional add-ons to your existing HDFC ERGO group health insurance policy like dental insurance riders, maternity insurance riders communicate your requirements. With Pazcare, you can also choose additional health and wellness add-ons like wellness and therapy sessions, unlimited doctor consultations, comprehensive check-ups, and many more to your HDFC ERGO group health insurance. 

Step 4: We will get back to you with the competitive quotes for your HDFC ERGO group health insurance.  Based on the history of claims and the additional riders and add-ons you choose, the group health insurance premium may vary from the previous financial year.

Step 5: Then agree to the terms and conditions of the policy and proceed with paying the premium for the HDFC ERGO group health insurance policy. The policy is usually valid for a year after the renewal.

Step 6: In case, purchasing your HDFC ERGO group health insurance for the first time with Pazcare, within 24 hours the onboarding process will be carried out. 

We make sure that your HDFC ERGO group health insurance administration experience is seamless using our Pazcare dashboard. Your employees can access their HDFC ERGO group health insurance plan using Pazcare’s employee app which is available on both the app store and the play store. 

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HDFC ERGO group health insurance premiums

Your HDFC ERGO group health insurance premium is calculated based on factors like 

‍Claims history

For HDFC ERGO group health insurance policy renewal, the claim history is also considered to calculate the premium for that financial year. If the number of claims requested in the previous financial year is higher, then the premium to be paid for the policy will increase during the renewal.

‍Riders and add-ons 

In case you opt for riders and add-ons like maternity insurance riders, dental insurance riders along with the existing HDFC ERGO group health insurance policy then your group health insurance premium will increase.

‍Sum insured

Sum insured is known as the maximum amount that an insurance company will pay in case of any hospitalisation in a financial year. If your hospitalization expenses cross the sum insured, the policyholder pays the remaining amount from his/her pocket. So the group health insurance premiums are higher for a higher sum insured.

‍Type of group health insurance plan opted

There are 3 types of group health insurance plans available. They are employee only (E), employee+spouse+children (ESC) and employee+spouse+children+parents (ESCP) plans. As the number of people covered in the ESCP plan is more than that of E only plan, the cost of the premium will be much higher.

‍Average age

The HDFC ERGO group health insurance premium is also calculated based on the average age of the people insured. The higher the average age, the higher will be the premium. This is due to the fact that the risks associated with the younger age group are lesser than that of the older age group.

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What is covered under your HDFC ERGO group health insurance?

Your HDFC ERGO group health insurance is custom-made according to the needs of your organisation. Here is what your policy covers.

‍Day care treatment coverage

The HDFC ERGO group health insurance policy covers your daycare treatment expenses, which require less than 24 hours of hospitalisation.

‍Pre and post-hospitalisation expenses

All your pre and post-hospitalisation expenses are covered in your HDFC ERGO group health insurance according to the terms mentioned in the policy wording.

‍Cover for covid-19

Your HDFC ERGO group health insurance covers hospitalisation expenses for covid-19. However, home quarantine expenses are not covered in the policy.

‍In-hospitalisation expenses

In-hospitalisation expenses due to sickness or due to accidents are covered in the HDFC ERGO group health insurance. These include nursing expenses, room rent, doctor fees, and many more.

‍Optional benefits

Optional benefits like Maternity benefits, the inclusion of pre-existing disease, reimbursement of the cost of health check-ups, and dental treatment expenses can be covered by opting for additional riders to the existing policy.

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What is not covered under your HDFC ERGO group health insurance?

Your HDFC ERGO group health insurance policy will not cover expenses related to 

‍Cosmetic treatment expenses

Expenses related to cosmetic treatments like plastic surgery, liposuction, and botox are not generally covered in the HDFC ERGO group health insurance plan.

‍Gender-changing surgeries

Coverage for gender-changing treatments or surgeries is excluded from the HDFC ERGO group health insurance policy.

‍Self-harm injuries

Injuries and hospitalisations due to suicide or any other self-harm activities are not covered in your policy.

‍Treatments for substance abuse

Treatment and hospitalisation expenses due to substance abuse like drugs or alcohol are not covered in the HDFC ERGO group health insurance.

‍Injuries due to war

Any hospitalisations due to injuries sustained due to wars and its treatment expenses are not covered in your HDFC group health insurance policy.