HDFC ERGO Energy Plan Explained

Are you looking for a diabetes health plan for yourself or a loved one? HDFC ERGO’s Energy Plan is one such plan that can safeguard the health and financial stability of individuals suffering from diabetes.

In this article, we will talk about the HDFC ERGO Energy Plan, its benefits, plan features, exclusions, claim process, renewal process, premium chart, and frequently asked questions.

HDFC ERGO Energy Plan

HDFC ERGO’s Energy Plan is a comprehensive plan designed to provide protection and support to individuals suffering from diabetes and hypertension. This plan offers coverage for Type 1 or Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT), or Hypertension.

HDFC ERGO’s Energy Plan is designed to help you manage your health conditions by covering medical expenses such as doctor visits, medications, inpatient treatment, health check-ups, and so on. This plan is available in two variants: the Silver Plan and the Gold Plan.

HDFC ERGO’s Energy Gold Plan comes with the added benefit of a wellness program. As part of the program, the insured individual will have access to two complete medical checks during the policy year.

Benefits of HDFC ERGO Energy Plan

Below are a few benefits that the policyholder can avail of when opting for this plan:

• In-patient Care: Along with offering comprehensive coverage, the plan will cover all hospitalization expenses arising out of diabetes and hypertension from day one of the policy period.
• Pre-hospitalisation Expenses: Expenses related to any medical treatment that occurred 30 days prior to hospitalization will be covered by this plan.
• Post-Hospitalisation Expenses: All medical expenses incurred within 60 days from the date of discharge will be covered under the plan.
• Daycare Treatments: This plan covers 150+ daycare procedures and treatments.
• Organ Donor Expenses: This plan covers medical expenses associated with the harvesting of organs from the donor for transplantation purposes.
• Ambulance Charges: This plan covers ambulance services up to Rs. 2000 per hospitalization during the policy period.
• Sum Restoration Benefit: This plan offers a 100% sum restoration benefit that automatically reinstates the sum insured once during the policy period in the event that the policyholder has exhausted their coverage limit due to hospitalization.
• HbA1C Benefit: The company will reimburse up to Rs. 750 for an HbA1C test check-up once during the policy period.
• No Claim Bonus: The company will increase the sum insured by 10% for every claim-free year, not exceeding more than 100% of the sum insured during any policy year.

Features of HDFC ERGO Energy Plan

Now, let us discuss a few key features of the HDFC ERGO Energy Plan:

• Lifetime Renew-ability: HDFC ERGO’s Energy Plan comes with a lifetime renew-ability option, which means the policyholder can renew their policy lifelong without any bar or restriction on age limit.
• Sum Insured: Both the variants, Gold and Silver Plan, have the same sum insured options, starting from Rs. 2 lakh up to Rs. 50 lakh.
• Co-payment: The plan offers the flexibility of choosing between two options: with or without a 20% co-payment. Policyholders can choose to opt for the co-payment feature based on their preferences.
• Policy tenure: The tenure of this policy is one year, and the policy can be renewed on a yearly basis.

Exclusions under the HDFC ERGO Energy Plan

Below are a few general exclusions under the HDFC ERGO Energy Plan:

• Pre-existing Conditions: Any pre-existing illnesses other than hypertension and diabetes will be covered after a waiting period of two years.
• Self-Harm: Any kind of intentional harm, like suicide, drug abuse, etc., suffered by the policyholder will not be covered under the policy.
• Sexually Transmitted Diseases: Medical expenses arising out of any STDs or venereal illnesses like AIDS, HIV, herpes, etc. will not be covered under the policy.
• Mental Disorders: The cost of treatment for any mental illnesses or psychiatric disorders such as schizophrenia, psychosis, and so on will not be covered under this plan.
• Cosmetic Procedures: Expenses arising out of any obesity treatments or cosmetic procedures will not be covered under the plan.
• Injury due to War: Any kind of injury suffered due to war, nuclear attacks, or criminal attacks will not be covered under the plan.
• Adventurous Sports: Any injuries suffered due to participation in adventurous sports like bungee jumping, rock climbing, etc. will not be covered under the plan.

How to file a claim with HDFC ERGO Energy Plan?

Follow these simple steps to file a claim with HDFC ERGO Energy plan:

There are two ways the policyholder can file a claim: Cashless and Reimbursement Claim

Cashless Claim

• Step 1: The policyholder can file a cashless claim when admitted to a network hospital of the insurer.
• Step 2: Inform the insurance company immediately about the hospitalization by contacting HDFC ERGO’s customer care claims toll-free number, i.e., 022 6234 6234 or 0120 6234 6234.
• Step 3: Always carry your cashless card and photo identification proofs.
• Step 4: Dully fill out and sign the pre-authorization form available at the TPA department in the hospital.
• Step 5: Once the pre-authorization form is received, the insurer will verify the claim.
• Step 6: HDFC ERGO will inspect all the documents and approve the claim accordingly.

Note: In the event of a claim rejection, HDFC ERGO will state the reason for the same in writing.

Reimbursement Claim

The policyholder will have to file a reimbursement claim when admitted to a non-network hospital of HDFC ERGO. Follow these simple steps to file a reimbursement claim with the insurer:

• Step 1: Get admitted to the nearest hospital and avail yourself of treatment.
• Step 2: Inform the company immediately in the event of hospitalization.
• Step 3: Post-discharge, submit all the required documents, like bills, reports, etc., to HDFC ERGO.
• Step 4: After thorough verification, the insurer will reimburse the claim amount directly to your bank account.

Documents Required

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

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

How to renew HDFC ERGO Energy Plan?

Below are the steps to renew your HDFC ERGO Energy Plan:

• Step 1: Visit the official website of the insurer, i.e., https://www.hdfcergo.com/.
• Step 2: Go to the “Renew” tab at the top-right corner of the page.
• Step 3: Select “Health Insurance.”
• Step 4: Enter your policy number, registered email address, and mobile number, and click on “Renew Now.”
• Step 5: Verify all the policy details and make the payment online. Your policy will be instantly renewed, and you will receive a confirmatory email to your registered email address.

HDFC ERGO Energy Plan Premium Table

Below is a sample premium table for the HDFC ERGO Energy Plan to give you a better understanding of policy coverage and its premium amount according to different age groups.

HDFC ERGO Energy Plan: Silver Plan (Without Co-payment Feature)

HDFC ERGO Energy Plan: Gold Plan (Without Co-payment Feature)

Learn more about the plan via the plan brochure.