HDFC Ergo Health Insurance Claim settlement Ratio

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There are various health insurance companies available in India. Hence, finding the best health insurance company can be a daunting task for anyone. We often buy a health insurance plan without doing research and choose a health plan that does not meet our coverage requirements. Hence, one way to find the best health insurance company available in India is to check the claim settlement ratio of health insurance companies.

Claim settlement ratio is one such aspect which tells us the claim settlement capability of an insurance company, and every health insurance company has a claim settlement ratio. The Insurance Regulatory and Development Authority of India (IRDAI) has published an annual report of all insurance companies, which contains all the information about health insurance companies such as solvency ratio, claim settlement ratio, market share, etc.

In the below article, we will discuss the HDFC Ergo claim settlement ratio in detail.

What is Claim Settlement Ratio (CSR)?

Claim Settlement Ratio (CSR) is the number of claims settled against the total number of claims filed in a financial year. For example, XYZ Company registered 1000 claims during a financial year, and it settled 950 of them, which means the claim settlement ratio of XYZ Company is 95%.

By checking the claim settlement ratio, we get to know about the claim settlement capability of the health insurance company. In simple words, the higher the Claims Settlement Ratio (CSR), the better the company can settle claims.

HDFC Ergo Claim Settlement Ratio

The below table shows the claim settlement ratio of HDFC Ergo health insurance in the year 2021-22:

HDFC Ergo Claim Settlement Ratio
Age Analysis of Number of Claims Paid (%) < 3 months 3 months to 6 months 6 months to < 1 year 1 year to < 3 years 3 years to < 5 years 5 years
Claims Settled 98.49 1.03 0.22 0.20 0.04 0.02

*The above data has been sourced from the annual report of 2021-22

HDFC Ergo Claim Settlement Process

There are two ways to file a claim under HDFC Ergo health insurance i.e. cashless claim process and reimbursement claim process. In the below section, we have mentioned both the claim processes in detail:

Cashless Claim Process

  • Intimate the HDFC Ergo health insurance about the treatment.
  • Get to the insurance desk of the hospital and show your HDFC health insurance health card.
  • Download on the HDFC Ergo health insurance pre-authorization card from the official website of the HDFC Ergo health insurance. 
  • Fill the information asked and submit the form to HDFC health insurance for verification.
  • HDFC health insurance will verify the information.
  • Once the verification is done, the insured can use a cashless treatment facility after the claim has been successfully verified and accepted. The company will take care of all the bills directly with the hospital.

Reimbursement Claim Settlement Process

  • For reimbursement claim you need to pay the treatment bill on your own first and then you can file a reimbursement claim.
  • You have to download and fill the application form and attach all the required documents.
  • Submit the form along with the documents to to the HDFC Ergo health insurance.
  • Once the documents and information is verified, the reimbursement claim amount will directly transferred to your registered bank account.

HDFC Ergo Health Insurance Contact Details

If you have any queries regarding HDFC Health Insurance plans, then you can get in touch with HDFC Health Insurance using the contact details given below:

Address: HDFC Ergo Health Insurance 1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020

Whatsapp Service Number: 8169-500-500

To Buy a New Policy: 022-6242-6242

For Claim Related Queries, Renewal Related Queries: 011-6234-6234, 0120-6234-6234

Email ID:

24x7 Contact Number: +91-120-4507250


The details, facts, or figures given here are intended solely for the reader's informational purposes and should not be relied upon for personal, medical, legal, or financial decisions. Please visit the insurer's website for the latest updates. We do not endorse any particular insurance company or insurance product provided by any insurer.