HDFC Ergo Energy Health Insurance Detailed Review

Most health insurance in India plans cater well to healthy individuals. Difficulties arise for individuals living with health conditions. Diabetes is the most common metabolic health issue among Indians. 

In India, an estimated over a hundred million people are living with diabetes. These individuals require regular health checkups, ongoing medication and a healthy lifestyle to manage the illness. Moreover, people with diabetes are more likely to develop various diabetes-induced complications, making robust health insurance coverage essential. 

In contrast, most health insurance plans deny coverage to such people for the same reason. Hence, it’s important to look for special health insurance plans for specific health requirements. And so, we’ve done a detailed review of the health insurance plan – HDFC Ergo Energy in this blog.

If you have any special requirements, you might have limited health insurance choices. This could make finding the right health insurance plan difficult. We are here to help you.

 

Book a call with us to discuss your special health insurance requirements with our expert advisors.

HDFC Ergo Energy: A Health Insurance Plan for Diabetes and Hypertension

HDFC Ergo Energy is a health insurance plan specifically designed to cater to people living with diabetes and hypertension. The plan covers diabetes and hypertension-related complications from day 1 and provides for the cost of wellness tests to manage your health. 

HDFC Ergo is a comprehensive health insurance plan that comes in two variants: Silver and Gold. The Gold variant covers the cost of wellness tests which is excluded in the Silver variant. The plan covers all other base health insurance benefits well, making it a robust health insurance plan. 

Main Benefits of HDFC Ergo Energy

No Waiting Period for Diabetes and Hypertension: HDFC Ergo Energy provides day 1 coverage for all hospitalisations arising out of diabetes and hypertension, making it a great choice for those dealing with these illnesses. 

In-patient Hospitalisation: The plan covers all medical costs of in-patient treatment up to the sum insured without any restrictions. Pre and post-hospitalisation expenses are also covered up to the sum insured for 30 and 60 days, respectively. 

Day Care Procedures: The plan provides coverage for all day care procedures without any sub-limits, making it a robust health insurance plan providing 360-degree coverage. 

Cumulative Bonus: The insurer provides a cumulative bonus of 10% of the sum insured on every renewal without a break, with a maximum bonus of 100% of the base sum insured. The bonus, once added, is not reduced when you raise a claim under your policy. 

Restoration Benefit: The plan also provides a one-time restoration benefit equal to 100% of the base sum insured on complete or partial utilisation of the sum insured and cumulative bonus. 

Other Benefits: The plan also covers organ donor harvesting expenses up to the sum insured and ambulance charges up to a maximum of Rs. 2000 per hospitalisation.

Wellness Benefits: The plan offers wellness discounts on renewal based on the results of 2 medical checkups done every policy year. The plan, under the Gold variant, covers the cost of these 2 medical checkups. However, if you choose the Silver variant, you will have to bear the cost of these medical checkups.  

Waiting Periods in HDFC Ergo Energy

Waiting Period for Specified Diseases: HDFC Ergo Energy imposes a waiting period of 24 months on a list of specified slow-growing illnesses. 

Waiting Period for Pre-Existing Conditions: There is a waiting period of 24 months for pre-existing diseases and their direct complications. However, this waiting period does not apply if the pre-existing disease is either diabetes or hypertension. The plan covers complications arising out of diabetes and hypertension from day 1.

What’s NOT Covered under HDFC Ergo Energy Health Insurance Plan?

HDFC Ergo Energy has its own shortcomings, as common health insurance benefits are not covered under this plan.

Non-Medical Expenses: HDFC Ergo Energy explicitly excludes all non-medical expenses. You have to pay for these items from your own pocket. Other regular health insurance plans usually cover the cost of non-medical items consumed during inpatient care.

All other standard medical and non-medical exclusions apply. 

Policy Conditions

HDFC Ergo has specifically designed this plan for individuals living with Diabetes or Hypertension. Any individual aged between 18 to 65 years and diagnosed with diabetes or hypertension can apply for coverage under this health insurance plan. 

Regular health insurance plans usually deny coverage to people with Type 1 diabetes. They also shy away from covering people with early detection of diabetes below the age of 35. HDFC Ergo Energy plan is meant to provide cover to such individuals.

This plan is only available to individuals aged between 18 to 65 years. It is not available on a family floater basis. So, one policy covers only one individual. 

You have multiple sum insured options from Rs. 2 Lac to Rs. 50 Lac. Both Gold and Silver variants also offer a 20% copay option.

About HDFC Ergo General Insurance

HDFC Ergo Energy is a great offering by HDFC Ergo General Insurance. The company, HDFC Ergo General Insurance, was promoted by erstwhile HDFC Limited and Ergo International AG in 2002. Post the amalgamation of HDFC Limited with HDFC Bank Limited, HDFC Ergo has become a subsidiary of HDFC Bank.

HDFC Ergo General Insurance is a leading private general insurer in India with a track record of over 2 decades.

HDFC Ergo General Insurance has one of the highest claim settlement ratios in the health insurance industry. For the financial year 2023-24, its claim settlement ratio by number of policies was 97.94% and by amount was 87.15%. However, its incurred claim ratio is also high, with the last 3 years average being 83.89%. If we look at the combined ratio, it’s more than 1, which means the insurer is spending more on claim settlement and other expenses when compared to the net premiums it is earning. In the last 3 years, its average combined ratio is 107.64%. This can be a cause of worry.

Talking about the volume of claim-related complaints, the company performs really well. In the last 3 years, the average volume of claim complaints is around 7, which is impressive. 

The insurer also has tied up with 13000+ hospitals throughout the country so you can easily avail cashless facility when required.

Should you buy HDFC Ergo Energy?

HDFC Ergo Energy is exclusively designed for individuals diagnosed with diabetes or hypertension. It’s an excellent option for those living with these conditions and seeking health insurance coverage. This plan provides coverage to people with Type 1 diabetes or those dependent on insulin.

This health insurance plan provides robust and comprehensive coverage in case of inpatient hospitalisation. The plan provides inbuilt day 1 coverage for ailments and complications arising due to diabetes or hypertension. Apart from this, it offers wellness benefits in the form of medical checkups and renewal discounts for illness control. 

However, HDFC Ergo Energy is an expensive health insurance plan. And rightly so, as it extends instant cover for diabetes and hypertension. If you are an individual with such a specific requirement and affordability is not an issue for you, give it a go. A 20% copay option makes the plan affordable. However, we recommend choosing this add-on with caution.