HDFC ERGO Claim Form - Pazcare

HDFC ERGO Claim Form

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HDFC ERGO claim form for group medical insurance

The HDFC ERGO claim form for your HDFC ERGO group health insurance has two parts. The HDFC Claim form part A, and the claim form part B. Part A of the HDFC claim form is filled by the insured and part B is filled in by the non-network hospital where the hospitalization was carried out.

Download the HDFC ERGO Claim Form

How to fill HDFC ERGO claim form for your group health insurance?

  1. Intimate the HDFC ERGO health insurance company about the hospitalisation. The HDFC ERGO claim form can be downloaded from the Pazcare dashboard or from https://www.hdfcergo.com/download/claim-form 
  2. Fill in your HDFC ERGO insurance policy number followed by the claim number and the TPA Id number. These details will be present on your HDFC ERGO group health insurance Id card.
  3. Mention your personal details like name, address, phone number, state, city and all the necessary details asked in your HDFC ERGO health insurance claim form.
  4. If you are covered by any other health insurance, please mention those details under the section “Details of insurance history” in your HDFC health claim form.
  5. Next, fill in the details of the insured person hospitalised and the details of the hospitalisation. This includes details like the date of admission, the reason for hospitalisation and other details in the HDFC ERGO claim form for the group health insurance policy.
  6. Fill in the details of the claim in your HDFC ERGO claim form. This includes pre and post-hospitalisation expenses, ambulance charges, etc. Also mention details of the hospitalization like if it's a domiciliary hospitalisation. Mention all the benefits applicable to your HDFC group health insurance policy according to its terms and conditions.
  7. Ensure to enclose the other required documents mentioned in your HDFC ERGO claim form. 
  8. Also, fill in the bank account details of the insured along with a cancelled cheque leaf for the HDFC ERGO reimbursement claim for your group medical cover.
  9. The HDFC ERGO claim form part B will be duly filled by the non-network hospital where the treatment was taken.

HDFC ERGO claim form filled sample 

HDFC ERGO claim form filled sample-Pazcare

HDFC ERGO reimbursement claim process for your group health insurance

After you fill out the HDFC ERGO claim form, here is how you will file for the reimbursement claim.

  1. A reimbursement claim can be filed when the insured is admitted to a non-network hospital with HDFC ERGO health insurance
  2. Make sure you collect all the necessary documents to file the HDFC ERGO reimbursement claim. This also includes all the original copies of hospital bills and a duly filled HDFC ERGO claim form.
  3. Also, make sure you have xerox copies of all the attached documents for your reference.
  4. You can submit these documents online/offline based on your convenience. 
  5. The HDFC ERGO claim status can be reviewed on the HDFC ERGO insurance website.

Download the HDFC ERGO Claim Form

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