{"uin":"HDFHLGP24095V032425","name":"HDFC ERGO Group Health Insurance","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425","insurer":{"slug":"hdfc-ergo-general-insurance","name":"HDFC ERGO General Insurance Company Limited","url":"https://indiainsurances.com/insurer/hdfc-ergo-general-insurance"},"line":"health","category":"group-health","category_name":"Group health","irdai_type":"Group","kind":"product","status":"active","approved_on":"2020-07-22","withdrawn_on":null,"summary":"HDFC ERGO Group Health Insurance is a group health product with both indemnity and benefit covers, where benefits apply only if opted and mentioned in the policy schedule or certificate of insurance. The base hospitalization cover has 30 day initial, 36 month pre-existing disease and 12 month specified disease waiting periods, with India-only cover unless a benefit explicitly says otherwise.","analysis":{"state":"machine","analysed_at":"2026-10-19 20:01:36.012213+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"quote-verified","value":["Plan A - Dengue Only","Plan B - Malaria Only","Plan C - Dengue Malaria Chikungunya Japanese Encephalitis Kala Azar Lymphatic Filariasis Zika"],"display":"Plan A: Dengue Only; Plan B: Malaria Only; Plan C: Dengue Malaria Chikungunya Japanese Encephalitis Kala Azar Lymphatic Filariasis Zika","note":"These plans are for the Vector Borne Disease cover.","quote":"Dengue Only ... Malaria Only ... Dengue Malaria Chikungunya Japanese Encephalitis Kala Azar Lymphatic Filariasis Zika\nOnly one plan from amongst Plan A, B, C can be opted","sources":[{"clause":null,"heading":"Plan A","page":87,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-plan-a"},{"clause":null,"heading":"Plan B","page":87,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-plan-b"},{"clause":null,"heading":"Plan C","page":87,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-plan-c"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The wording defines Policy Period by reference to the commencement and expiry dates in the Certificate of Insurance, but does not give a fixed policy term.","quote":null,"sources":[],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"Emergency cashless hospitalization: within 24 hours of emergency hospitalization. Planned cashless hospitalization: at least 72 hours prior; reimbursement claims: within 48 hours of admission or before discharge, whichever is earlier; critical illness claims: within 15 days of diagnosis or hospitalization.","display":"Emergency: within 24 hours; planned: at least 72 hours prior; reimbursement: within 48 hours of admission or before discharge; critical illness: within 15 days","note":null,"quote":"Claim Intimation Timelines | Within 24 hours of the Emergency Hospitalization | At least 72 hours prior to the planned Hospitalization | Within 48 hours of admission or before discharge from the Hospital, whichever is earlier\nClaim Intimation Timelines for Critical Illness related claims | Within 15 days of the diagnosis of Critical Illness or Hospitalization","sources":[{"clause":"1","heading":"Notification of a Claim","page":74,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-9"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Completely filled claim form, duly signed (by claimant/proposer) and stamped (by Hospital)","Government approved Photo ID & Age Proof","Copy of claim intimation letter / reference of Claim Intimation Number","Copy of the Hospital’s Registration Certificate/Hospital Registration number","Discharge Card / Day Care Summary / Transfer Summary","Final hospital bill with all deposit and final payment receipt and refund receipt(s)","Invoice with payment receipt and implant stickers for all implants used during surgeries","All previous consultation papers indicating history and treatment details","All diagnostic reports along with prescription and invoice / bill with receipt","All medicine / pharmacy bills along with prescription","MLC / FIR Copy – in Accidental cases only","Copy of Death Summary and copy of Death Certificate (in death claims only)","KYC documents and duly filled KYC form","Duly filled NEFT form with cancelled blank cheque"],"display":"Claim form, ID and age proof, intimation reference, hospital registration, discharge summary, final bills and receipts, investigation reports, prescriptions, pharmacy bills, KYC and NEFT details; MLC/FIR for accidents and death papers for death claims.","note":"The wording also lists additional documents for hospital cash, critical illness, accidental death, permanent disablement, second medical opinion and other specific covers.","quote":"i) Completely filled claim form, duly signed (by claimant/proposer) and stamped (by Hospital).\nii) Government approved Photo ID & Age Proof\niii) Copy of claim intimation letter / reference of Claim Intimation Number in the absence of main claim documents\niv) Copy of the Hospital’s Registration Certificate/Hospital Registration number in case of Hospitalization in any non-network hospital of HDFC ERGO General Insurance or certificate from Hospital authorities providing facilities available including number of beds.\nv) Discharge Card / Day Care Summary / Transfer Summary\nvi) Final hospital bill with all deposit and final payment receipt and refund receipt(s), if advance amount refunded\nvii) Invoice with payment receipt and implant stickers for all implants used during surgeries e.g. lens sticker and invoice in cataract Surgery, stent invoice and sticker in Angioplasty Surgery.\nviii) All previous consultation papers indicating history and treatment details for current Illness and advice for current hospitalization.\nix) All diagnostic reports (including imaging and laboratory) along with prescription by Medical Practitioner and invoice / bill with receipt from diagnostic centre\nx) All medicine / pharmacy bills along with prescription by Medical Practitioner\nxi) MLC / FIR Copy – in Accidental cases only\nxii) History of alcohol consumption or any intoxication certified by first treating doctor in case of accidental cases.\nxiii) Copy of Death Summary and copy of Death Certificate (in death claims only)\nxiv) Pre and Post-Operative Imaging reports\nxv) Copy of indoor case papers with nursing sheet detailing medical history of the patient, treatment details, and patient’s progress (to be submitted wherever required by the insurer).\nxvi) Invoice for Vaccination and payment receipt\nxvii) KYC documents - (Ration Card/ Driving License/ Aadhar Card/ Passport /any other Government authorized identity proof of the Claimant carrying name, photograph & address) and duly filled KYC form with 1 signed across passport size coloured photograph of the Claimant ***\nxviii) Duly filled NEFT form with cancelled blank cheque (with IFSC code, A/C number, and name mentioned on cheque leaf)","sources":[{"clause":null,"heading":"List of documents for Reimbursement Claims","page":76,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-list-of-documents-for-reimbursement-claims"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The wording states settlement or rejection within 15 days from receipt of intimation. It also states settlement or rejection within 30 days from receipt of the last necessary document, or within 45 days from the last necessary document where investigation is required.","display":"15 days from intimation; also 30 days from last necessary document, or 45 days if investigation is required","note":"The policy wording contains both timelines.","quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of intimation. ... The Company shall settle or reject a claim, as the case may be, within 30 days from the date of receipt of last necessary document. ... in any case not later than 30 days from the date of receipt of last necessary document. In such cases, the Company shall settle or reject the claim within 45 days from the date of receipt of last necessary document.","sources":[{"clause":"16","heading":"Claim Settlement (provision for Penal Interest)","page":68,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-16-3"},{"clause":"3(ii)","heading":null,"page":78,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-ii-2"},{"clause":"3(iv)","heading":null,"page":78,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-iv-2"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Pre-existing diseases: excluded until 36 months","Specified diseases/procedures: excluded until 12 months","30-day waiting period for illness","Investigation & Evaluation: Code Excl04","Rest Cure, rehabilitation and respite care: Code – Excl05","Change-of-Gender treatments: Code – Excl07","Cosmetic or plastic surgery: Code – Excl08","Hazardous or Adventure Sports: Code – Excl09","Breach of Law: Code – Excl10","Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12","Maternity: Code – Excl18","War or any act of war","Any Medical treatment or hospitalization availed outside India"],"display":"Waiting-period exclusions, standard permanent exclusions such as investigation, rest cure, change of gender, cosmetic surgery, adventure sports, breach of law, alcoholism or drug abuse, maternity, plus war and outside-India treatment unless covered.","note":null,"quote":"Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. ... Expenses related to the treatment of the listed Conditions, surgeries/treatmentsshall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first Policy with us. ... Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. ... Investigation & Evaluation: Code Excl04 ... Rest Cure, rehabilitation and respite care: Code – Excl05 ... Change-of-Gender treatments: Code – Excl07: Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. ... Cosmetic or plastic surgery: Code – Excl08: Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of Medically Necessary Treatment to remove a direct and immediate health risk to the insured. ... Hazardous or Adventure Sports: Code – Excl09: Expenses related to any treatment necessitated due to participation as a professional in Hazardous or Adventure sports ... Breach of Law: Code – Excl10: Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12 ... Maternity: Code – Excl18 ... War or any act of war, invasion, act of foreign enemy ... Any Medical treatment or hospitalization availed outside India","sources":[{"clause":"A","heading":"WAITING PERIODS","page":58,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-a-3"},{"clause":null,"heading":"Surgical Procedures","page":60,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-surgical-procedures"},{"clause":"1","heading":"Investigation & Evaluation: Code Excl04","page":60,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-5"},{"clause":"2","heading":"Rest Cure, rehabilitation and respite care: Code – Excl05: Expenses related to any","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-5"},{"clause":"4","heading":"Change-of-Gender treatments","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-5"},{"clause":"5","heading":"Cosmetic or plastic surgery: Code – Excl08: Expenses for cosmetic or plastic surgery or","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-5-5"},{"clause":"6","heading":"Hazardous or Adventure Sports: Code – Excl09: Expenses related to any treatment","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-6-5"},{"clause":"7","heading":"Breach of Law: Code – Excl10: Expenses for treatment directly arising from or consequent","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-7-4"},{"clause":"9","heading":null,"page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-9-4"},{"clause":"15","heading":"Maternity: Code – Excl18","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-15-2"},{"clause":"1","heading":"War or any act of war, invasion, act of foreign enemy, (whether war be declared or not or","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-6"},{"clause":"18","heading":"Any Medical treatment or hospitalization availed outside India","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-18-2"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"First contact HDFC ERGO through the stated phone numbers or website. If the response is lacking or not satisfactory, write to the Complaints & Grievance Cell, then to the Chief Grievance Officer before approaching the Insurance Ombudsman.","display":"First contact HDFC ERGO; then Complaints & Grievance Cell; then Chief Grievance Officer","note":null,"quote":"First Point of Contact | Call us at 022 6158 2020 / 022 6234 6234/www.hdfcergo.com\nLevel 1 | For lack of a response or if the response provided does not meet your expectation, you can: 1. Write to The Complaints & Grievance Cell (C&G Cell) HDFC ERGO General Insurance Company Limited, D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai – 400078, Maharashtra 2. You can also write an email to grievance@hdfcergo.com 3. Call on 18002677444 (operational Monday - Saturday 9AM to 6PM)\nLevel 2 | If you're not satisfied with the resolution or if no response was received within 15 days, you can: 1. Write to the Chief Grievance Officer HDFC ERGO General Insurance Company Limited, D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai – 400078, Maharashtra 2. You can also write an email to cgo@hdfcergo.com","sources":[{"clause":"18","heading":"Grievance Redressal Procedure","page":69,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-18-3"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"quote-verified","value":"Base Sum Insured options are INR 1,00,000 to INR 5 Cr.","display":"INR 1,00,000 to INR 5 Cr.","note":"The CIS gives this range while discussing aggregate deductible options.","quote":"Aggregate Deductible Options: INR 25,000 to INR 50,00,000 Base Sum Insured Options: INR 1,00,000 to INR 5 Cr.","sources":[{"clause":null,"heading":"Provider Network) or ‘Pre-Authorization request not raised in PPN","page":18,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-provider-network-or-pre-authorization-request-no"}],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Optional modification options in the CIS are 0 days, 7 days or 15 days.","quote":"Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. ... Initial waiting Period: 30 days for all illnesses (not applicable in case of continuous renewal or accidents) Option 1: 30 Days to 0 Days Option 2: 30 Days to 7 Days Option 3: 30 Days to 15 Days","sources":[{"clause":null,"heading":"Surgical Procedures","page":60,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-surgical-procedures"},{"clause":"Excl17(iv)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-excl17-iv"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36 months","note":"Optional modification options in the CIS reduce 3 years to 2 years, 1 year or 0 year.","quote":"Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. ... Pre-existing diseases: Covered after 36 months Option 1: 3 Years to 2 Years Option 2: 3 Years to 1 Years Option 3: 3 Years to 0 Year","sources":[{"clause":"A","heading":"WAITING PERIODS","page":58,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-a-3"},{"clause":"Excl17(iv)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-excl17-iv"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":12},"display":"12 months","note":"Optional modification options in the CIS change 1 year to 2 years or 0 years.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatmentsshall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first Policy with us. ... Specific Waiting periods (Not applicable for claims arising due to an accident): • 12 months for listed diseases/procedure Option 1: 1 Year to 2 Years Option 2: 1 Year to 0 Years","sources":[{"clause":"A","heading":"WAITING PERIODS","page":58,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-a-3"},{"clause":"Excl17(iv)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-excl17-iv"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["Non infective Arthritis","Pilonidal sinus","Diseases of gall bladder including cholecystitis","calculus diseases of Urogenital system e.g.Kidneystone,Urinary Bladder Stone","Benign tumors, cysts, nodules, polyps including breast lumps","Pancreatitis","Ulcer and erosion of stomach and duodenum","Polycystic ovarian diseases","All forms of Cirrhosis","Gastro Esophageal Reflux Disorder (GERD)","Sinusitis, Rhinitis","Perineal Abscesses","Perianal Abscesses","Skin tumors","Cataract","Fissure/fistula in anus, Haemorrhoids including Gout and rheumatism","Tonsillitis","Osteoarthritis and osteoporosis","Fibroids ( fibromyoma)","Benign Hyperplasia of Prostate","Adenoidectomy, tonsillectomy","Tympanoplasty, Mastoidectomy","Hernia","Dilatation and curettage (D&C)","Nasal concha resection","Surgery for prolapsed inter vertebral disc","Myomectomy for fibroids","Surgery of Genito urinary system","Surgery for varicose veins and varicose ulcers","Surgery on prostate","Cholecystectomy","Surgery for Perianal Abscesses","Hydrocele/Rectocele","Joint replacement surgeries","Surgery for Nasal septum deviation","Ligament, Tendon and Meniscal tear","Prolapsed Uterus","Rectal Prolapse","Endometriosis","Retinal detachment","Glaucoma","Varicocele","Hysterectomy","Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries","Nasal polypectomy"],"display":"Listed illnesses and procedures include cataract, hernia, joint replacement, gall bladder disease, genito-urinary calculus disease, fibroids, hysterectomy, varicose veins, nasal septum deviation and other listed conditions.","note":null,"quote":"Non infective Arthritis | Pilonidal sinus\nDiseases of gall bladder including cholecystitis | calculus diseases of Urogenital system e.g.Kidneystone,Urinary Bladder Stone | Benign tumors, cysts, nodules, polyps including breast lumps\nPancreatitis | Ulcer and erosion of stomach and duodenum | Polycystic ovarian diseases\nAll forms of Cirrhosis | Gastro Esophageal Reflux Disorder (GERD) | Sinusitis, Rhinitis\nPerineal Abscesses | Perianal Abscesses | Skin tumors\nCataract | Fissure/fistula in anus, Haemorrhoids including Gout and rheumatism | Tonsillitis\nOsteoarthritis and osteoporosis | Fibroids ( fibromyoma) | Benign Hyperplasia of Prostate ... Adenoidectomy, tonsillectomy | Tympanoplasty, Mastoidectomy | Hernia\nDilatation and curettage (D&C) | Nasal concha resection | Surgery for prolapsed inter vertebral disc\nMyomectomy for fibroids | Surgery of Genito urinary system | Surgery for varicose veins and varicose ulcers\nSurgery on prostate | Cholecystectomy | Surgery for Perianal Abscesses\nHydrocele/Rectocele | Joint replacement surgeries | Surgery for Nasal septum deviation\nLigament, Tendon and Meniscal tear | Prolapsed Uterus | Rectal Prolapse\nEndometriosis | Retinal detachment | Glaucoma\nVaricocele | Hysterectomy | Fissurectomy, Haemorrhoidectomy, Fistulectomy, ENT surgeries\nNasal polypectomy","sources":[{"clause":null,"heading":"Illnesses","page":59,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-illnesses"},{"clause":null,"heading":"Surgical Procedures","page":60,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-surgical-procedures"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sums insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"5","heading":"Moratorium Period","page":65,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-5-7"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"quote-verified","value":"The insured person may port the policy to other insurers by applying at least 30 days before, but not earlier than 60 days from, the renewal date; continuity benefits in waiting periods are available if continuously covered without lapses.","display":"Can port to other insurers with waiting-period continuity credit","note":null,"quote":"The Insured Person will have the option to port the Policy to other insurers by applying to such Insurer to port the entire Policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the Policy renewal date as per IRDAI guidelines related to Portability. If such person is presently covered and has been continuously covered without any lapses under any health insurance Policy with an Indian General/Health insurer, the proposed Insured Person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on Portability.","sources":[{"clause":"9","heading":"Portability","page":66,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-9-6"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The policy says health insurance policies are renewable except on specified grounds, but it does not state lifelong renewal or no maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"No loading shall apply on renewals based on individual claims experience.","display":"No loading on renewal based on individual claims experience","note":null,"quote":"No loading shall apply on renewals based on individual claims experience ... We will not apply any additional loading on Your Policy premium at Renewal based on claim experience in Your Policy.","sources":[{"clause":"17","heading":"Renewal of Policy","page":69,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-17-3"},{"clause":"3(iii)","heading":null,"page":71,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-iii"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"quote-verified","value":["Investigation & Evaluation: Code Excl04","Rest Cure, rehabilitation and respite care: Code – Excl05","Obesity/Weight control: Code – Excl06","Change-of-Gender treatments: Code – Excl07","Cosmetic or plastic surgery: Code – Excl08","Hazardous or Adventure Sports: Code – Excl09","Breach of Law: Code – Excl10","Excluded Providers: Code – Excl11","Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12","Treatments received in health hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances that can be purchased without prescription","Expenses related to the treatment for correction of eye sight due to refractive error less than dioptres. Code – Excl15","Unproven Treatments","Sterility and Infertility: Code – Excl17","Maternity: Code – Excl18","War or any act of war","Aggregate Deductible","intentional self-injury or attempted suicide or suicide","naval, military or air force operation","Congenital external diseases, defects or anomalies","Stem cell harvesting","Circumcisions","Vaccination including inoculation and immunisations","OPD treatment","Any Medical treatment or hospitalization availed outside India","Dental treatment and surgery of any kind, unless requiring Hospitalisation","Any non allopathic treatment unless explicitly specified under a benefit/coverage in this Policy","Claims arising due to abuse or the consequences of the abuse of tobacco, intoxicants or hallucinogenic substances"],"display":"Excl04 to Excl18 standard permanent exclusions plus specific permanent exclusions including war, aggregate deductible, self-injury or suicide, military operations, congenital external anomalies, stem cell harvesting, circumcision, vaccination, OPD, outside-India treatment, dental treatment, non-allopathic treatment and abuse of tobacco or intoxicants.","note":"Other specific permanent exclusions are also listed in the wording.","quote":"Investigation & Evaluation: Code Excl04 ... Rest Cure, rehabilitation and respite care: Code – Excl05 ... Obesity/Weight control: Code – Excl06 ... Change-of-Gender treatments: Code – Excl07 ... Cosmetic or plastic surgery: Code – Excl08 ... Hazardous or Adventure Sports: Code – Excl09 ... Breach of Law: Code – Excl10 ... Excluded Providers: Code – Excl11 ... Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. Code – Excl12 ... Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. Code – Excl13 ... Dietary supplements and substances that can be purchased without prescription ... Expenses related to the treatment for correction of eye sight due to refractive error less than ... dioptres. Code – Excl15 ... Unproven Treatments– Expenses related to any unproven treatment, services and supplies ... Sterility and Infertility: Code – Excl17 ... Maternity: Code – Excl18 ... War or any act of war, invasion, act of foreign enemy ... Aggregate Deductible - We are not liable for Claims/Claim amount falling within Aggregate Deductible limit ... Any Insured Person committing or attempting to commit intentional self-injury or attempted suicide or suicide. ... Any Insured Person’s participation or involvement in naval, military or air force operation. ... Congenital external diseases, defects or anomalies, ... Stem cell harvesting. ... Circumcisions (unless necessitated by Illness or Injury and forming part of treatment). ... Vaccination including inoculation and immunisations (Except post Animal bite treatment), ... OPD treatment ... Any Medical treatment or hospitalization availed outside India ... Dental treatment and surgery of any kind, unless requiring Hospitalisation ... Any non allopathic treatment unless explicitly specified under a benefit/coverage in this Policy. ... Claims arising due to abuse or the consequences of the abuse of tobacco, intoxicants or hallucinogenic substances such as drugs and alcohol.","sources":[{"clause":"1","heading":"Investigation & Evaluation: Code Excl04","page":60,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-5"},{"clause":"2","heading":"Rest Cure, rehabilitation and respite care: Code – Excl05: Expenses related to any","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-5"},{"clause":"3","heading":"Obesity/Weight control: Code – Excl06: Expenses related to the surgical treatment of","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-5"},{"clause":"4","heading":"Change-of-Gender treatments","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-5"},{"clause":"5","heading":"Cosmetic or plastic surgery: Code – Excl08: Expenses for cosmetic or plastic surgery or","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-5-5"},{"clause":"6","heading":"Hazardous or Adventure Sports: Code – Excl09: Expenses related to any treatment","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-6-5"},{"clause":"7","heading":"Breach of Law: Code – Excl10: Expenses for treatment directly arising from or consequent","page":61,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-7-4"},{"clause":"8","heading":"Excluded Providers: Code – Excl11: Expenses incurred towards treatment in any hospital or","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-8-4"},{"clause":"9","heading":null,"page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-9-4"},{"clause":"10","heading":null,"page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-10-4"},{"clause":"11","heading":null,"page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-11-4"},{"clause":"12","heading":null,"page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-12-4"},{"clause":"Excl15","heading":"dioptres.","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-excl15"},{"clause":"13","heading":"Unproven Treatments– Expenses related to any unproven treatment, services and supplies","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-13-3"},{"clause":"14","heading":"Sterility and Infertility","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-14-4"},{"clause":"15","heading":"Maternity: Code – Excl18","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-15-2"},{"clause":"1","heading":"War or any act of war, invasion, act of foreign enemy, (whether war be declared or not or","page":62,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-6"},{"clause":"2","heading":"Aggregate Deductible - We are not liable for Claims/Claim amount falling within Aggregate","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-6"},{"clause":"3","heading":"Any Insured Person committing or attempting to commit intentional self-injury or attempted","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-6"},{"clause":"4","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-6"},{"clause":"6","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-6-6"},{"clause":"7","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-7-5"},{"clause":"9","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-9-5"},{"clause":"11","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-11-5"},{"clause":"13","heading":"OPD treatment","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-13-4"},{"clause":"18","heading":"Any Medical treatment or hospitalization availed outside India","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-18-2"},{"clause":"19","heading":"Dental treatment and surgery of any kind, unless requiring Hospitalisation","page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-19-2"},{"clause":"20","heading":null,"page":63,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-20-2"},{"clause":"25","heading":"Claims arising due to abuse or the consequences of the abuse of tobacco, intoxicants or","page":64,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-25-2"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel by giving 7 days’ written notice, and the company refunds pro-rata premium for the unexpired policy period. No refund is made where any claim has been admitted or any benefit has been availed.","display":"7 days’ written notice; pro-rata refund for unexpired period; no refund if a claim is admitted or benefit availed","note":"For instalment premium policies, the wording says future instalments for the current policy year will be adjusted in the claim amount and no refund applies during the policy year if there is an admissible claim.","quote":"The Policyholder may cancel this Policy by giving 7 days’ written notice and in such an event, the Company shall refund to the Insured a pro-rata premium for the unexpired Policy Period. ... Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where any claim has been admitted or any benefit has been availed by the Insured Person under the Policy","sources":[{"clause":"10(a)","heading":null,"page":66,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-10-a"},{"clause":"10(d)","heading":null,"page":67,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-10-d"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"All coverages and sections cover medical expenses and/or hospitalizations availed in India only, unless explicitly specified otherwise within a section or benefit.","display":"India only unless explicitly specified otherwise","note":"Some optional or other base covers state outside-India or worldwide cover.","quote":"All coverages and sections under this Policy cover medical expenses and/or hospitalizations availed in India only, unless expilcitly specified otherwise within the Coverage details of any Section / Benefit.","sources":[{"clause":"2","heading":"Geography","page":70,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-8"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"conflicting","value":{"unit":"days","amount":0},"display":"Not Applicable on Group Health Products","note":"Policy wording says free look is not applicable on group health products. CIS says: 'Free Look cancellation: You may cancel the insurance policy if you do not want it, within 30 days from the beginning of the policy.'","quote":"Not Applicable on Group Health Products ... Free Look cancellation: You may cancel the insurance policy if you do not want it, within 30 days from the beginning of the policy.","sources":[{"clause":"7","heading":"Free look period","page":66,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-7-6"},{"clause":"12(a)(iv)","heading":null,"page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-12-a-iv"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days; monthly instalments 15 days","note":"Renewal grace period is 30 days. For policies on instalment basis, half-yearly and quarterly are 30 days, monthly is 15 days.","quote":"A Grace Period of 30 days is available for Renewal of the Coverage. ... Instalment Premium Option | Grace Period applicable\nHalf Yearly | 30 days\nQuarterly | 30 days\nMonthly | 15 days","sources":[{"clause":"4","heading":"Grace Period","page":71,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-8"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"The documents define some dependants, such as dependent children, but do not state overall youngest and oldest entry ages for buying this group policy.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Non-instalment Premium Payment","Half Yearly","Quarterly","Daily / Monthly"],"display":"Non-instalment; Half Yearly; Quarterly; Daily / Monthly","note":null,"quote":"Non-instalment Premium Payment refers to payment of premium for the entire policy period made in advance as a single premium. ... If the Insured Person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly, as mentioned in the Policy Schedule/Certificate of Insurance ... Option 1 | Half Yearly | 30 days\nOption 2 | Quarterly | 30 days\nOption 3 | Daily / Monthly | 15 days","sources":[{"clause":"Def. 24","heading":"Non-instalment Premium Payment","page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-def-24-2"},{"clause":"11","heading":"Premium Payment in Instalments","page":67,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-11-6"}],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"quote-verified","value":["Pre-Existing Disease Waiting period Modification Option","Specified Disease / Procedure Waiting Period Modification Option","Modification of General Waiting Period","Modification of Pre and Post Hospitalization Medical Expenses","Room Rent and ICU Modification Option","Road Ambulance Modification Option","Co-Payment","Deletion of Domiciliary Hospitalization","Second Medical Opinion for Major Illness","Restore Benefit","Double Restore Benefit","Cumulative Bonus","Maternity Cover","Pre and Post Natal Expenses","Baby Cover from Day 1","Infertility Cover","Corporate Buffer","Outpatient Treatment (OPD) Cover","Aggregate Deductible","Disease Capping","Double Sum Insured for Critical Illness","Preventive Health Check Up","Air Ambulance (India only)","Air Ambulance (outside India only)","Home Healthcare","Convalescence Benefit","Protect Benefit","Inflation Protector","Compassionate Visit","Global Emergency Hospitalization Cover (outside India only)","Global Hospitalization Cover (outside India only)","Secure Benefit","Unlimited Restore Benefit","Road Ambulance Cover (outside India only)","Preferred Provider Network"],"display":"Optional covers include waiting-period modifications, room rent and ICU modification, co-payment, restore benefits, maternity, newborn, infertility, OPD, aggregate deductible, disease capping, air ambulance, home healthcare, global covers and preferred provider network.","note":"AYUSH Treatment appears under the optional-cover section, but the wording says it is no longer optional and is covered by default for inpatient care up to the hospitalization sum insured.","quote":"All coverages under Section 2.A.II. ‘Optional covers under hospitalization expenses‘ are optional in nature. ... Pre-Existing Disease Waiting period Modification Option ... Specified Disease / Procedure Waiting Period Modification Option ... Modification of General Waiting Period ... Modification of Pre and Post Hospitalization Medical Expenses ... Room Rent and ICU Modification Option ... Road Ambulance Modification Option ... Co-Payment ... Deletion of Domiciliary Hospitalization ... Second Medical Opinion for Major Illness ... Restore Benefit ... Double Restore Benefit ... Cumulative Bonus ... Maternity Cover ... Pre and Post Natal Expenses ... Baby Cover from Day 1 ... Infertility Cover ... Corporate Buffer ... Outpatient Treatment (OPD) Cover ... Aggregate Deductible ... Disease Capping ... Double Sum Insured for Critical Illness ... Preventive Health Check Up ... Air Ambulance (India only) ... Air Ambulance (outside India only) ... Home Healthcare ... Convalescence Benefit ... Protect Benefit ... Inflation Protector ... Compassionate Visit ... Global Emergency Hospitalization Cover (outside India only) ... Global Hospitalization Cover (outside India only) ... Secure Benefit ... Unlimited Restore Benefit ... Road Ambulance Cover (outside India only) ... Preferred Provider Network","sources":[{"clause":null,"heading":"II. OPTIONAL COVERS UNDER SECTION 2.A.I. ‘HOSPITALIZATION EXPENSES’ Insuring Clause","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-ii-optional-covers-under-section-2-a-i-hospitali"},{"clause":null,"heading":"1. Pre-Existing Disease Waiting period Modification Option","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-1-pre-existing-disease-waiting-period-modificati"},{"clause":null,"heading":"2. Specified Disease / Procedure Waiting Period Modification Option","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-specified-disease-procedure-waiting-period-mod"},{"clause":null,"heading":"3. Modification of General Waiting Period","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-modification-of-general-waiting-period"},{"clause":null,"heading":"4. Modification of Pre and Post Hospitalization Medical Expenses","page":21,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-modification-of-pre-and-post-hospitalization-m"},{"clause":"5","heading":"Room Rent and ICU Modification Option","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-5-2"},{"clause":"6","heading":"Road Ambulance Modification Option","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-6-2"},{"clause":"7","heading":"Co-Payment","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-7-2"},{"clause":"9","heading":"Deletion of Domiciliary Hospitalization","page":23,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-9-2"},{"clause":"10","heading":"Second Medical Opinion for Major Illness","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-10-2"},{"clause":"11","heading":"Restore Benefit","page":24,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-11-2"},{"clause":"12","heading":"Double Restore Benefit","page":25,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-12-2"},{"clause":"13","heading":"Cumulative Bonus","page":26,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-13"},{"clause":"14","heading":"Maternity Cover","page":27,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-14"},{"clause":"15","heading":"Pre and Post Natal Expenses","page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-15"},{"clause":"16","heading":"Baby Cover from Day 1","page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-16"},{"clause":"17","heading":"Infertility Cover","page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-17"},{"clause":"18","heading":"Corporate Buffer","page":28,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-18"},{"clause":"19","heading":"Outpatient Treatment (OPD) Cover","page":29,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-19"},{"clause":"20","heading":"Aggregate Deductible","page":29,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-20"},{"clause":"21","heading":"Disease Capping","page":30,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-21"},{"clause":"22","heading":"Double Sum Insured for Critical Illness","page":31,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-22"},{"clause":"23","heading":"Preventive Health Check Up","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-23"},{"clause":"24","heading":"Air Ambulance (India only)","page":32,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-24"},{"clause":"25","heading":"Air Ambulance (outside India only)","page":33,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-25"},{"clause":"26","heading":"Home Healthcare","page":33,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-26"},{"clause":"27","heading":"Convalescence Benefit","page":34,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-27"},{"clause":"28","heading":"Protect Benefit","page":34,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-28"},{"clause":"29","heading":"Inflation Protector","page":35,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-29"},{"clause":"30","heading":"Compassionate Visit","page":35,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-30"},{"clause":"31","heading":"Global Emergency Hospitalization Cover (outside India only)","page":36,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-31"},{"clause":"32","heading":"Global Hospitalization Cover (outside India only)","page":37,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-32"},{"clause":"33","heading":"Secure Benefit","page":38,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-33"},{"clause":null,"heading":"Specific Conditions applicable to Unlimited Restore Benefit","page":39,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-specific-conditions-applicable-to-unlimited-rest"},{"clause":null,"heading":"35. Road Ambulance Cover (outside India only)","page":40,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-35-road-ambulance-cover-outside-india-only"},{"clause":null,"heading":"36. Preferred Provider Network Special conditions applicable to this section","page":40,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-36-preferred-provider-network-special-conditions"}],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For instalment premium policies, coverage is available during the grace period. For non-instalment premium payment, coverage is not available for the period for which no premium is received; any illness, disease or condition contracted during the grace period will not be covered and will be treated as pre-existing diseases.","display":"Instalments: covered during grace period; non-instalment: no cover for unpaid period","note":null,"quote":"Any Illness, disease or condition contracted during Grace Period will not be covered and will be treated as Pre-existing diseases. ... If premium is paid in instalments then coverage will be available during the grace period also. (Note: In case of non-instalment premium payment, coverage shall not be available for the period for which no premium is received).","sources":[{"clause":"4","heading":"Grace Period","page":71,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-4-8"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"Daily room limit, if any.","status":"quote-verified","value":"Room rent and boarding charges are covered at actuals unless specified otherwise in the Policy Schedule or Certificate of Insurance. If the Room Rent and ICU Modification Option is availed, room rent, ICU limits and/or room category apply as mentioned in the schedule or certificate.","display":"At actuals unless specified otherwise in the Policy Schedule / Certificate of Insurance","note":"The CIS lists multiple optional room rent restriction options.","quote":"Room Rent and boarding charges at actuals (unless specified otherwise in the Policy Schedule / Certificate of Insurance) ... On availing this option, Room Rent and ICU limits and/or type of room category applicable under Section 2.A.I.a. shall be modified to the extent as mentioned in the Policy Schedule / Certificate of Insurance.","sources":[{"clause":null,"heading":"COVERS UNDER HOSPITALIZATION EXPENSES","page":19,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-covers-under-hospitalization-expenses"},{"clause":"5","heading":"Room Rent and ICU Modification Option","page":22,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-5-2"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Childbirth cover and any waiting period.","status":"quote-verified","value":"Maternity expenses are covered only if Maternity Cover is opted. The cover is limited to the amount specified in the Policy Schedule or Certificate of Insurance and has an additional waiting period of 48 months unless otherwise specified there.","display":"Optional maternity cover; 48 months waiting period unless specified otherwise","note":null,"quote":"We will indemnify Maternity Expenses incurred by the Insured Person under Section 2.A.I.a,incurred during the Policy Year. ... Indemification of Maternity Expenses under this benefit shall be covered only upto the limit specified against this cover in the Policy Schedule / Certificate of Insurance. ... An additional waiting period of 48 months (unless specified otherwise in the Policy Schedule / Certificate of Insurance against this cover) starting from the date of commencement of this Cover under this Policy shall apply for all Claims under Maternity Cover.","sources":[{"clause":"14","heading":"Maternity Cover","page":27,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-14"},{"clause":null,"heading":"Specific Conditions applicable to Maternity Cover","page":27,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-specific-conditions-applicable-to-maternity-cove"}],"law":[]},{"key":"ped_cover_group","label":"Pre-existing diseases","section":"Waiting periods","meaning":"Whether pre-existing diseases are covered from day one for the group.","status":"quote-verified","value":"Pre-existing diseases are not covered from day one by default; PED treatment and direct complications are excluded until 36 months of continuous coverage. An optional modification can reduce the 3 year waiting period to 2 years, 1 year or 0 year if opted.","display":"No by default: covered after 36 months; optional modification can be 0 year","note":"Day-one PED cover is available only if the applicable modification option is selected and shown in the schedule or certificate.","quote":"Expenses related to the treatment of a pre-existing disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with insurer. ... Pre-existing diseases: Covered after 36 months Option 1: 3 Years to 2 Years Option 2: 3 Years to 1 Years Option 3: 3 Years to 0 Year","sources":[{"clause":"A","heading":"WAITING PERIODS","page":58,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-a-3"},{"clause":"Excl17(iv)","heading":null,"page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-excl17-iv"}],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available only at HDFC ERGO network providers, where the insurer pays the network provider directly to the extent pre-authorization is approved.","display":"Cashless at network providers; insurer pays the network provider directly to the pre-authorized extent","note":null,"quote":"Cashless Facility means a facility extended by the insurer to the insured where the payments, of the costs of treatment undergone by the insured in accordance with the policy terms and conditions, are directly made to the Network Provider by the insurer to the extent pre-authorization is approved. ... Cashless facility can be availed only at Our Network Provider.","sources":[{"clause":"Def. 5","heading":"Cashless Facility","page":3,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-def-5"},{"clause":"2","heading":"Conditions for obtaining Cashless facility","page":78,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-2-9"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claim related queries, intimation and submission of claim documents are handled through HDFC ERGO General Insurance contact channels.","display":"HDFC ERGO General Insurance","note":"The definitions mention insurer or TPA for notification/network arrangements, but the claim contact section names HDFC ERGO General Insurance.","quote":"For any claim related query, intimation of claim and submission of claim related documents, You can contact HDFC ERGO General Insurance through:\n- Website | : www.hdfcergo.com\n- Claim Intimation : healthclaims@hdfcergo.com\n- Customer Service No. 022-62346234 / 0120- 62346234\n- Courier | : Claims Department,\nHDFC ERGO General Insurance Co. Ltd.","sources":[{"clause":"3(viii)","heading":null,"page":79,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-3-viii"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Family Floater","note":null,"quote":"Family Floater means a Policy described as such in the Policy Schedule where under You and Your Dependents (Spouse, dependent children, dependent parents/parents in laws) named in the Policy Schedule are insured under this Policy as at the Commencement Date on floater Sum Insured basis. ... Floater Sum Insured-Where all members under the policy have a single sum insured limit which may be utilized by any or all members","sources":[{"clause":"Def. 19","heading":"Family Floater","page":10,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324#c-def-19-2"},{"clause":"Row 4","heading":"Sum Insured","page":1,"url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289#c-row-4"}],"law":[]}],"documents":[{"kind":"wording","label":"HDFC ERGO Group Health Insurance (for policies with Period of Insurance starting 30-Oct-2024 onwards)","pages":87,"fetched_at":"2026-10-17 19:38:40+00","source_url":"https://customer-portal-assets.hdfcergo.com/assets/v2/docs/default-source/downloads/policy-wordings/health/group-health-insurance/group-health-insurance---pw-100009864323.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6324"},{"kind":"wording","label":"HDFC Group Health Insurance","pages":41,"fetched_at":"2026-10-17 19:42:10+00","source_url":"https://customer-portal-assets.hdfcergo.com/documents/hdfc-group-health-insurance-pw-96104533042.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6443"},{"kind":"wording","label":"HDFC Group Health Insurance (IRDAI copy)","pages":34,"fetched_at":"2026-10-20 01:51:27+00","source_url":"https://irdai.gov.in/documents/37343/931203/HDFHLGP21116V012021_2020-2021.pdf/30f99454-74a9-f6d2-b7bd-22094aecbc0f?version=1.1&t=1668581020873&download=true","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/27518"},{"kind":"prospectus","label":"HDFC Group Health Insurance","pages":23,"fetched_at":"2026-10-17 19:41:38+00","source_url":"https://customer-portal-assets.hdfcergo.com/assets/v2/docs/default-source/downloads/prospectus/health/hdfc-group-health-insurance-prospectus-9884540259.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6424"},{"kind":"cis","label":"HDFC ERGO Group Health Insurance","pages":22,"fetched_at":"2026-10-17 19:37:39+00","source_url":"https://customer-portal-assets.hdfcergo.com/assets/v2/docs/default-source/downloads/cis/hdfc-ergo-group-health-insurance/hdfc-ergo-group-health-insurance-11394297777.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6289"},{"kind":"cis","label":"HDFC Group Health Insurance","pages":10,"fetched_at":"2026-10-17 19:41:25+00","source_url":"https://customer-portal-assets.hdfcergo.com/assets/v2/docs/default-source/downloads/cis/hdfc-group-health-insurance/PDF240-673514453276.pdf","url":"https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425/document/6417"}],"versions":[{"uin":"HDFHLGP21116V012021","version":null,"approved_on":null},{"uin":"HDFHLGP24095V032425","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"HDFC ERGO General Insurance official website","url":"https://www.hdfcergo.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claim intimation and process","url":"https://www.hdfcergo.com/claim/register-bike-insurance-claim/cashless-claims","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal","url":"https://www.hdfcergo.com/customer-voice/grievances","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renew car insurance","url":"https://www.hdfcergo.com/renew-car-insurance","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"HDFC ERGO Group Health Insurance (UIN HDFHLGP24095V032425), IndiaInsurances, https://indiainsurances.com/policy/hdfc-ergo-general-insurance/hdfc-ergo-group-health-insurance-hdfhlgp24095v032425"}