HDFC ERGO General Insurance
A joint venture between HDFC and ERGO International, HDFC ERGO is India's third-largest private general insurer. Their health insurance portfolio benefits from strong brand trust and a vast distribution network. The Optima Secure plan has become a benchmark product in the industry.
Claim Settlement
88.2%
Network Hospitals
13,100
Incurred Claim Ratio
71.8%
Claims Difficulty
Medium
Overview
Key Strengths
- Strong brand trust from HDFC parentage
- Optima Secure — widely regarded as a benchmark health plan
- 13,100+ network hospitals with multi-city coverage
- Robust digital infrastructure for policy management and claims
- Wide product range including micro and group health products
Key Weaknesses
- Being a general insurer, health is one of many lines — less specialised focus
- Claims process can involve more documentation than standalone health insurers
- Room rent sub-limits exist on certain plan variants
- Renewal premium hikes have been notable in recent years
Top Plans
Optima Secure
Sum Insured
5L - 50L
Starting Premium
7,200/yr*
*Premium for 30-year-old, individual plan, base variant
My:Health Suraksha
Sum Insured
3L - 25L
Starting Premium
5,800/yr*
*Premium for 30-year-old, individual plan, base variant
Optima Restore
Sum Insured
5L - 50L
Starting Premium
8,900/yr*
*Premium for 30-year-old, individual plan, base variant
Claims Data
Claim Settlement Ratio
Some documentation requirements, occasional follow-ups
The claim settlement ratio indicates the percentage of claims settled out of total claims received. A higher ratio means the insurer pays out more claims. Industry average is approximately 85%.
Incurred Claim Ratio
71.8%
HealthyThe incurred claim ratio measures total claims paid versus premiums earned. A ratio near 60-80% is considered healthy. Above 100% means the insurer is paying more in claims than it collects in premiums.
Source: IRDAI Annual Report FY2024-25
Network Hospitals
13,100
empanelled hospitalsNetwork hospitals are where you can avail cashless treatment. A larger network means more choices and convenience across cities. The industry leader has approximately 14,000+ hospitals. Always verify if your preferred hospital is in-network before hospitalisation.
Gotcha Alerts
These are policy fine-print items that can catch you off guard at claim time. We surface them upfront so you can make informed decisions.
Proportionate deduction clause on room upgrades
If you opt for a room costing more than the eligible limit, deductions apply proportionately to the ENTIRE bill — not just the room rent difference. A 20% room upgrade can result in 20% deduction on surgery, medicines, and doctor fees.
Source: Optima Secure, Clause 6.3 — Proportionate Deduction
Restore benefit resets only for unrelated illness
The restore benefit (sum insured top-up after exhaustion) only activates for a completely unrelated illness. If your follow-up hospitalisation is linked to the original condition, restore does not apply.
Source: Optima Restore, Section 2.8 — Restore Benefit Terms
Compare with other insurers
See how HDFC ERGO General Insurance stacks up against competitors on coverage, pricing, and claims experience.