HDFC ERGO Claim Settlement Ratio over the years

Are you planning to purchase an insurance policy offered by HDFC ERGO or are you already an existing customer? Then, it would be cognizant of you to know about the claim settlement ratio of HDFC ERGO.

Knowing the claim settlement ratio of a company can give you an accurate idea of the claim servicing temperament of an insurance company, and is an important metric that potential policyholders should keep their eye on.

In this article, we will talk in detail about:

• Meaning of Claim Settlement Ratio and its Importance
• HDFC ERGO Health Insurance Claim Settlement Ratio
• HDFC ERGO Car Insurance Claim Settlement Ratio
• How to file a claim with HDFC Ergo Health Insurance?

Meaning of Claim Settlement Ratio and its Importance

In simple terms, a claim settlement ratio means the percentage of total claims paid by the insurance provider out of the total claims reported during the financial year. A claim settlement ratio or CSR is one of the most crucial indicators to keep in mind when deciding on an insurance company as this ratio indicates how dedicated and reliable the company is in settling genuine claims.

Higher the claim settlement ratio of the insurance company, the more likely it is to settle the claims of its policyholders. The claim settlement ratio or CSR applies to all insurance-related plans and policies like term insurance, health insurance, motor insurance, and so on.

A claim settlement ratio or CSR higher than 75% is considered to be a good claim settlement ratio.  A claim settlement ratio above 90% is deemed to be an excellent ratio signifying that the company is highly efficient in settling the claims of its customers. A claim settlement ratio below 50% indicates that the insurance provider is strict in processing, assessing claims and underwriting standards.

For instance, if an insurance company  has received a total of 10,000 claims out of which it settles 8,500 claims, then the CSR of that company for that financial year is 85%.

HDFC ERGO Health Insurance Claim Settlement Ratio

HDFC Ergo has an in-house claim settlement team that is dedicated to processing and settling the claims of its customers. You can now easily register your claim with the company in a matter of minutes. The in-house claim settlement team will direct and guide you in every step of the process. Below mentioned is the claim settlement ratio (CSR) of HDFC ERGO for the following years:

HDFC ERGO Motor Insurance Claim Settlement Ratio

As mentioned earlier, the company’s in-house team provides dedicated service to its customers during the claim settlement process. The company takes up to a period of seven working days from the date of submission of all documents to process claims.

Below provided is the claim settlement ratio of HDFC ERGO Motor Insurance for the following years:

How to file a claim with HDFC ERGO Health Insurance?

Follow these simple steps laid down by us to file your claim with HDFC ERGO Health Insurance:
There are two ways a policyholder can file a claim. You can opt for a cashless or reimbursement claim process. First, let us tell you about the cashless claim process.

Cashless Claim

• Step 1: Find the nearest network hospital of the insurer to avail of treatment. The company has more than 10,000 network hospitals where you can opt for medical assistance.
• Step 2: Inform the company within 24 hours in case of an emergency or 48 hours before planned hospitalization.
• Step 3: Submit your HDFC ERGO cashless card to the insurance department in the hospital.
• Step 4: Duly fill and sign the pre-authorization form available at the hospital. The hospital will send all the documents to the insurance company for verification.
• Step 5: After thorough verification, the company will approve the claim.

Note: In case, the claim has not been approved the company will state the reasons for the same in writing.

Reimbursement Claim

The policyholder can file for a reimbursement claim when admitted to a non-network hospital of the company. In such a scenario, the policyholder will have to avail of the treatment and pay the hospital bill from his own pocket. The insurance company will then reimburse the policyholder after initiation and proper submission of documents.

Follow these simple steps laid down to initiate a reimbursement claim:

• Step 1: Get admitted to the nearest hospital and avail of treatment.
• Step 2: Inform the company within 24 hours in case of an emergency or 48 hours before planned hospitalization.
• Step 3: Post-discharge submit all the required documents like bills, reports, etc to the insurance company.
• Step 4: After thorough verification, the company will reimburse the claim amount directly into your bank account.

Documents Required

Below provided are a few important documents that you need to submit in order to file for a claim:

• Original bills
• All original test reports, x-ray scans, prescriptions, etc
• Original discharge summary
• Death certificate (if applicable)
• FIR (if applicable)
• KYC

Conclusion

It is always advisable for customers to be vigilant and check the claim settlement ratio of an insurance company before purchasing its plans. The whole purpose of buying an insurance product is to protect oneself during tough times. Therefore, it is recommended to purchase a plan from an insurance company that has a high claim settlement ratio even if the insurance company charges a marginally higher premium compared to its competitors.