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What Is Special About Optima Restore Policy?

HDFC ERGO Optima Restore Family Floater is a health insurance plan covering the entire family. The plan boasts of Restore and Multiplier Benefits which are unique in their nature. The facility of E-Opinion is also available which helps individuals seek a second opinion for critical illnesses. Also, a gamut of other coverage benefits is extended under this health plan

Features of HDFC ERGO Optima Restore Health Insurance Policy

Check the features and coverage of HDFC ERGO Optima Restore Health Insurance plan below:

Ambulance Charges

Upto Rs 2000 per hospitalization event

Co-pay

No co-pay

Cover Restoration

100% of cover restoration on partial or complete utilization of sum insured

Daily Cash Allowance

Rs 800 for shared accommodation, max up to 6 days, date of admission and discharge included

Day Care Procedures

All procedures covered

Treatment At Home

Covered up to Rs. 300000

HDFC ERGO Optima Restore Plan Resources

Policy Brochure

Policy Wordings

Exclusions of HDFC ERGO Optima Restore Health Insurance Policy

HDFC ERGO Optima Restore plan does not cover the following:

Ayush treatment

Maternity expenses

New born treatment

Opd expenses

Recovery allowance

Cosmetic surgery

Other Plans From HDFC ERGO

HDFC ERGO health insurance offers 4 health insurance plans. The premium of these plans starts from Rs. 1100/yr. The sum insured ranges from Rs. 3 Lakh - 75 Lakh. Details of the comprehensive coverage provided by the following 4 HDFC ERGO health insurance plans are listed below:

Calculate Optima Restore Plan Premium

Use the HDFC ERGO health insurance premium calculator to estimate your health insurance premiums.

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HDFC ERGO Claim Settlement Ratio

99.39%

HDFC ERGO

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. HDFC ERGO has a claim settlement ratio of 99.39%, as compared to the industry average of 94.21%.

HDFC ERGO Claim Process

HDFC ERGO supports both cashless claims and reimbursement claims. This section covers the information on how to check HDFC ERGO health insurance claim status, fill HDFC ERGO health insurance claim form, and the claim settlement process.

  1. Hospitalization : Find out to locate nearest network hospital
  2. Avail Cashless Hospitalization & Submission of Documents by showing your health card and valid photo ID
  3. Preauthorization: Hospital will send the cashless request to HDFC ERGO and coordinate with with Network Hospital for the Pre-authorisation form
  4. At the time of Discharge & Settlement of claim : HDFC ERGO/ TPA will scrutinize all the received documents and convey the final stand on the claim
  5. Status Update: You will receive an update through SMS/Emails at every stage of the claim on your registered mobile number or email id
  6. Cashless authorisation & Approval of Claim: Hospital shall send the final bill to HDFC ERGO for authorisation and HDFC ERGO shall scrutinize the same and give final authorization in case of approved transactions to the hospital. Any inadmissible expenses, copayments, deductions will have to be paid by Customer

  1. Hospitalisation: You need to pay the bills initially and preserve the original invoices
  2. Register A Claim: Post hospital discharge send us all your invoices and treatment documents
  3. Verification: verify your claim related invoices and treatment documents
  4. Claim Settlement: We send the approved claim amount to your bank account.

HDFC ERGO Health Insurance Renewal Process

Online Process For HDFC ERGO Health Insurance Renewal

Here are 3 quick steps to renew HDFC ERGO health insurance online

Step 1: Visit their website www.hdfcergo.com and click on "RENEW"
Step 2: Enter either your policy details, registered email id or your mobile no. and click on ‘Renew Now’ to proceed
Step 3: Make the payment for policy renewal via your preferred mode of payment


You should consider renewal as an opportunity to carefully review all policy details and make necessary adjustments as per your needs. Please note that you can renew your expired policy within 30 days from expiry date

Offline Process For HDFC ERGO Health Insurance Renewal

For the offline method of renewing your HDFC ERGO Health Policy, you can call on 022-62346234/ 0120-62346234 or visit their nearest branch.
You can also reach out to your nearest Turtlemint insurance advisor who can assist you in quick renewal of your policy. Visit www.turtlemint.com now for your HDFC ERGO health policy renewal


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