# HDFC ERGO Group Health Insurance

HDFC ERGO offers a comprehensive range of group health and group medical insurance plans for all types of companies in India. HDFC ERGO is the second-largest private sector insurance group in India.

The insurer has an extensive suite of health insurance products for critical illness, diabetes care, health plans for women, family floater, top-up/super top-up and more.

## Key statistics of ICICI Lombard general insurance company

| Statistic                                     | Value        | Year  |
|-----------------------------------------------|--------------|-------|
| GHI Premiums                                  | ₹1,009 cr    | FY 2021 |
| GHI lives insured                             | 53 lakhs     | FY 2020 |
| Health lives insured                          | 1.72 crs     | FY 2020 |
| Health claims Processed                       | 1,67,673     | FY 2020 |
| Health claims settlement ratio                | 86.52%       | FY 2020 |
| Health claims settled within 3 months        | 86.42%       | FY 2020 |

*Source - IRDAI and IBAI annual reports*

### Awards and recognitions

**Excellence in Financial Reporting**  
ICAI Awards 2015-16

**Top Projects in India**  
ICAI Awards 2015-16

**Best Customer Experience Award of the Year**  
Financial Sector

**CMS Outstanding Affiliate World**  
ICAI Awards 2015-16

**Best Insurance Company in Private Sector**  
General 2014

**Gold Shield**  
ICAI Awards 2015-16

**iAAA Rating**  
ICRA

**HR Excellence**  
Technology Award 2012

### What is group health insurance?

Group health insurance provides cover for you and your family without the financial burden of purchasing a group insurance scheme, as your employer sponsors it. It alleviates concerns over emergency hospitalization costs.

#### Highlights of Group Care Insurance

- Excellent cashless claims service

- More than 1.5 crore happy customers

- Wide network of 10,000 plus hospitals across India

- Industry experience of more than 20 years

- Average customer rating of 4.5/5

- A highly trusted brand in the insurance sector in India

### Standard benefits offered by HDFC ERGO group health insurance

| Feature                      | Detail                                                                                                       |
|------------------------------|--------------------------------------------------------------------------------------------------------------|
| Who is covered?              | Employees, their spouse, children, and parents.                                                            |
| What is covered?             | Room rent, boarding expenses, nursing home expenses; fees for medical practitioners.                        |
| Sum Insured                  | Depends on the size of the organization.                                                                    |
| Hospitalization cover        | Pre and post hospitalization charges, daycare treatments, and domiciliary hospitalization are covered.

### Additional benefits offered by HDFC ERGO group health insurance

- Maternity benefit options
- Coverage for pre-existing diseases
- Reimbursement for health check-up costs
- Family floater option for spouse, dependent children, and dependent parents
- Treatment for dental disorders
- Expenses related to spectacles and contact lenses
- Waiver of waiting periods and exclusions
- Reimbursement for ambulance travel to the hospital

### Here's how HDFC ERGO is better with Plum

- Complete digital experience
- Cashless process for treatments at network hospitals
- Scales with team expansion
- Access to teleconsultations and wellness programs
- Insurance management via WhatsApp
- Single dashboard for benefits tracking

### Documents required for claims process

- Claim application form (Cashless or Reimbursement)  
- Original bills related to medical treatment  
- Discharge certificate  
- Doctor’s prescription  
- ID proof (PAN & Aadhaar mandatory)

#### Frequently Asked Questions

**Can I add or remove members after the initial setup?**  
Super top-up allows additional coverage for family with certain critical illnesses.

**How are premiums calculated for additions?**  
You can add new employees or dependents. Changes can be performed via the Plum dashboard.

**Can an employee convert the group plan to an individual plan if they leave the company?**  
No, the policy doesn’t cover same-sex or unmarried couples.