64 0 obj
<>/Filter/FlateDecode/ID[<0FDC24E562877DEC1A8F426BB86F007B>]/Index[40 59]/Info 39 0 R/Length 111/Prev 167252/Root 41 0 R/Size 99/Type/XRef/W[1 2 1]>>stream
... HDFC ERGO Community: ... Can i claim for Accidental Hospitalization fro... Highlighted. Documents needed for Accidental Injury Claims. For Claim/Policy related queries call us at +91 22 6234 6234/+91 120 6234 6234 or Visit Help Section on www.hdfcergo.com for policy copy/tax certificate/make changes/register & track claim. HDFC Ergo will send a surveyor at the place of the accident who will evaluate the damage and provide you with the estimated claim amount. 40 0 obj
<>
endobj
Customer Service number:022-6234 6234 / 0120-6234 6234, www.hdfcergo.com Trade Logo displayed above belongs to HDFC LTD and ERGO International AG and used by HDFC ERGO General Insurance Company Limited under license. HDFC ERGO presents Personal Accident Insurance to help you sail through steadily during these times. hWko9�O�G[�� !���.���. Claim Process for HDFC ERGO car insurance. Claim status / query will be intimated via SMS/Email by HDFC ERGO Health Claim Services Team HDFC ERGO General Insurance Company Limited Corresponding Off. - Accidental bike claim amount not received Closed Amar Parl Singh filed this complaint against Hdfc Ergo General Insurance Company Ltd on Nov 14, 2019 filed this complaint against Hdfc Ergo General Insurance Company Ltd on Nov 14, 2019 Claiming process of HDFC is seamlessly easy and quick. undersigned, legal beneficiary of the above claim, declare that all details mentioned in this form are true and I agree to the mode of payment against the particular claim number mentioned above. Toll Free Helpline: 1-800-2-700-700 From Mtnl/Bsnl Phone Or Dial 022-6638 4800 (Local/Std Charges Apply) For More Information, Please E Mail: Care@Hdfcergo.Com ), Original cancelled cheque with Payee name (Insured) name printed on cheque is required. HDFC ERGO car insurance accidental claim. Third Party Injury/ Property Damage: To be flled only if an accident involving the insured Vehicle has caused (1) Injury/ Fatality to a Third Party and/or (2) … h�bbd``b`�S&�`��� ��$qD�qÁ��; �+
$8� ��Hp5�� VHL��H�һ@�ځDD3#�v���������@� ���
Claim settlement would be initiated by HDFC ERGO Health Claim Services Team provided all documents are in order. A renewal incentive that doubles your sum insured in 2 years! endstream
endobj
startxref
HDFC ERGO General Insurance Company Limited 2 Witness:Anyone who can confrm the accident as described in the claim form. Attending Physician’s statement as per Form D. Exclusions under the plan. Registered: 23-08-2017. If you don’t claim even in the second year, HDFC Ergo will double your basic sum insured as a no claim bonus i.e. The HDFC ERGO Revive Insurance policy is the personal accident insurance policy. HDFC ERGO General Insurance Company Limited shall not be liable for any claim in respect of an event giving rise to a claim covered under the Policy of Insurance that has occurred during this period of fifteen (15) days. This policy protects the entire family of the insurance holder against accidental injuries. Doctor’s medical prescriptions, Itemized bills and cash memos* ... HDFC Ergo Reimbursement Claim Form Contributor Posts: 26. HDFC Ergo General Insurance is an ideal choice for health insurance as it offers the following benefits to its policyholders: High Claim Settlement Ratio - HDFC Ergo General Insurance featured an impressive claim settlement ratio of 83.66% in FY 2018-19. Please call our Toll-free Number 1-800-2700-2700. maximum upto 100% of the basic Sum Insured. Police FIR. HDFC ERGO General Insurance Company Limited Declaration I hereby agree, affirm and declare that: a)The statements/information given/stated by me/us in this claim form is true, correct and complete to the best of my information, knowledge and belief. If name is not printed on cheque please attach first pageof bank passbook/Bank statement with bank stamp, FIR from Police station/ Medico legal 3.certificate from hospital (MLC Copy), Copy of discharge summary of hospitalization, if any, Original Hospital Final Bill with payment receipt, Original Medicine Bills, Prescriptions. For Bodily injury or Sickness from Civil or Foreign Wars. Please describe the nature of Insured’s injuries: Name and address of all treating physicians and hospital, (All Fields are Mandatory in case of Fund Transfer). Your happiness comes to a pause and you are left with shock and financial burden. Motor. The HDFC Ergo Claim Form is different for all the HDFC Ergo General Insurance Policies which can be downloaded from our website. HDFC ERGO General Insurance Company Limited is not liable for any incidents between the tme that the received and policy issuance. Contact HDFC ERGO at their toll-free number 022/0120-6234 623; Fill the claim form and lodge the claim If name is not printed on cheque please attach first page of bank passbook / Bank statement with stamp. HDFC ERGO General Insurance Company Limited Motor Insurance Claim Form (To be filled in by the Insured Policy Holder or Insured’s Representatve duly authorized by Power and Atorney. Customer Service Address: 6th Floor, Leela Business Park, Andheri Kurla Road, Andheri (E), Mumbai – 400 059. HDFC Ergo to check and revert within 3 working days for claims received if any additional documents are required If all the documents are as per the checklist, HDFC Ergo to process the claim and settle the claim to claimant/customer’s account which has been provided along with the claim document Duly filled and signed claim form; FIR from Police station/ Medico legal 3.certificate from hospital (MLC Copy) Copy of discharge summary of hospitalization, if any; KYC form and KYC documents (ID and address proof e.g Pan card, Aadhaar card, Ration card, Passport etc.) 2.
N, In case hospitalized list the name and address of all treating physicians and hospital, Please indicate whether claim is in respect of (tick boxes)
��&�
It also provides benefit to the family of the insurance holder for accidental death, broken bones, burns, permanent disability etc. Find the Hdfc Ergo Health Claim Form you want. If you’ve had a claim free year, HDFC Ergo will increase your basic sum insured by 50% as a no claim bonus. CIN : U66010MH2007PLC177117. days from the date of receipt of the premium by HDFC ERGO General Insurance Company Limited. Permanent Total Disability, For child education Benefit: Provide details of dependent child (If applicable). The HDFC Ergo Claim Process for Car Insurance, Health Insurance, Travel Insurance, Two Wheeler Insurance, Home Insurance is explained below. ), Original cancelled cheque with name of Nominee printed on cheque is required. *Photocopy of Aadhaar Card /Aadhaar Card number is mandatory for all claims
Policy No. ... of accidental loss or … HDFC ERGO General Insurance Company Limited Name Street Address City State Pin Code Phone (To be filled in by the Insured Policyholder or Insured’s Representative duly authorised by Power of Attorney. The policy issuance/validity of receipt is subject to clearing of the cheque or credit card mandate.
Step 4: Repair And Final Claim Settlement The insurance company will pay the claim amount directly to the network garage. HDFC ERGO General Insurance is a joint venture between HDFC Ltd., a leading Housing Finance Institution in India and ERGO International AG, a premier insurance body of Munich Re Group. For Accidental Injury Claims 1. Ananya Vishwanath. Police Report, if accident is reported to Police 3. Doctor’s prescription and line of treatment advised. Kindly fill out this form so that our representative can get in touch with you. Alternatively, you may send them to our Claims Processing Cell at the following address: HDFC ERGO General Insurance Company Limited 6th Floor, Leela Business Park, Andheri Kurla Road, Andheri - East, Mumbai- 400 059, India h�b```���ѡ� ce`a�X蠡���䯐� �cIS�n�e�4��%�v����\m��8GGG��XZ�f`�P�@Y.��@Z�%��e�e~���"Q�����5�����C�_-�cf�e���s�����``��������9�f�W@,���m�3 If name is not printed on cheque please attach first page of bank passbook / Bank statement with stamp, Disability Certificate from Government Hospital, All treatment papers and Investigation report from hospital, KYC form and KYC documents (ID and address proof e.g Pan card, Aadhaar card, Ration card, Passport etc. HDFC (Housing Development Corporation), on the other hand, owns a majority of 51% of holdings. Accidental Hospitalization Benefit /Hospital cash benefit . Medical papers, pathology reports, X-ray reports and plates, as applicable 4. 0
Claim Procedure for HDFC ERGO Personal Accident Insurance Policy. HDFC ERGO General Insurance Company Limited STANDARD FORM FOR PRIVATE CAR PACKAGE POLICY Policy Wording 1 Registered & Corporate Office: 1st Floor, 165 - 166 Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai – 400 020. For Accidental Death Claims. Issuance of this claim form is not to be taken as an admission of … Issuance of this claim form is not to be taken as an admission of liability.) The Claim form and other documents related to the nature of loss can be collected from you by HDFC ERGO personnel. If name is not printed on cheque please attach first page of bank passbook /Bank statement with bank stamp, Investigation report like X-RAY/ MRI / CTscan etc if any, Leave certificate from employer (If or are salaried) or ITR of last 2 yrs if business men, Original cancelled cheque with Payee name (Insured) name printed on cheque is required. For seamless processing of claims make sure to submit below details healthclaims@hdfcergo.com. 1.
%PDF-1.5
%����
IRDAI Registration Number : 146 (Registration type: General Insurance Company).
Under HDFC ERGO Travel Insurance Insurance, a reimbursement claim can be filed for emergencies including loss of check-in baggage, flight delay, loss passport, personal liability, accidental injury, study interruption and sponsor protection among others. N, Whether reported to Police station
Y
endstream
endobj
41 0 obj
<>/OCProperties<>/OCGs[65 0 R 66 0 R 67 0 R]>>/Pages 38 0 R/Type/Catalog>>
endobj
42 0 obj
<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/TrimBox[0.0 0.0 595.2756 919.1934]/Type/Page>>
endobj
43 0 obj
<>stream
Y
Accidental Death
98 0 obj
<>stream
The HDFC ergo travel insurance can be acquired for the following cases: Accidental death: if a person wants to claim for a HDFC ergo travel insurance for the case of an accidental death, the first thing that is required is to attach the claim signed by the treating doctor, along with a consultation note from the emergency doctors. %%EOF
Claims Service Representative will guide you on the claim procedures and documents required. Attach the required documents based on your claim type along with the duly filled Claim form and Submit it to the Policy Issuing Office Directly or through the Agent. Provide NEFT details in the claim form along with cancelled cheque. Bills, receipts and cash memos. HDFC ERGO General Insurance Company Limited Ramon House, H T Parekh Marg, 169, Backbay Reclaimation, Mumbai 400 020. Open it with cloud-based editor and begin adjusting. FIR; Medical papers, x ray reports. Provide KYC ( Know your customer ) form along with photocopy of any one of following KYC documents for all claims amounting to … This health insurance policy offers lump-sum compensation in one single transaction to cover accidental medical expenditures. Particulars of the accident /Description of accidental details, Was the accident related to the Insured’s occupation? With network across 70 cities, HDFC Ergo offers a wide range of general insurance products to meet the requirements of individuals and companies. Claim form 2. The Documents required in HDFC Ergo Personal Accident Claim Process are. ERGO is part of Munich Re-Group, a German company with 49% of the shares.
Original Investigation reports and bills, Original cancelled cheque with Payee name (Insured / Nominee) name printed on cheque is required. Fill out the blank areas; concerned parties names, addresses and phone numbers etc. Put the day/time and place your electronic signature. Client No. The policy can be issued once HDFC ERGO General Insurance Company Limited receives completed form and premium payment. Customize the blanks with exclusive fillable fields. Contribution clause is not applicable in Health insurance policy hence you can claim however you can claim the difference amount only not the whole. Personal Accident - Death, Accidental Hospitalization Benefit /Hospital cash benefit, Temporary total disablement /Broken bones /Accidental injury, Individual Personal Accident- Claim Document Checklist, (Additional documents if required will be requested by the insurer), FIR from Police station/ Medico legal certificate from hospital (MLC Copy), Cause of death Certificate from treating doctor, Death Certificate from Municipal Corporation, Histopathology or Chemical viscera or blood analysis report from the hospital (If done), KYC form and KYC documents (ID and address proof e.g Pan card/Aadhaar card/Ration card/Passport etc. Thank you for your interest in HDFC ERGO's Individual Personal Accident Plan 2 Policy for Personal Accident. If you have any queries that are not answered here, please call us or write to us.
Title: Download hdfc-ergo Personal-Accident proposal-form Subject: Download hdfc-ergo Personal-Accident proposal-form Keywords: Download hdfc-ergo Personal-Accident proposal-form Download Proposal Forms, Claim Forms, Brochures a nd Policy Wordings of Insurance Products from www.insureatclick.com HDFC ERGO is an alliance between General Insurance Company Limited, HDFC Limited, and ERGO International AG. The required steps to follow the claim process of HDFC ERGO car insurance plans is given below. HDFC ERGO General Insurance Company Limited Frequently Asked Question’s (FAQ’s) - Motor Insurance ... fill up the claim form and attach a copy of the registration certificate and driving license of the person driving at the time of the accident. You would have to fill up a pre-authorization form and submit it with HDFC Ergo for cashless claims. This form should be submitted either within 24 hours of an emergency hospitalisation or 3-4 days before a planned hospitalisation; Based on the pre-authorization form, the claim would be approved To download the claim form, Click Here. Claim form as per Form A. Claim Form as per ‘Form E’. Can claim the difference amount only not the whole taken as an admission of … to the... The cheque or credit card mandate step 4: Repair and Final Settlement. Claim procedures and documents required in HDFC ERGO Personal accident Plan 2 policy for Personal accident name... Step 4: Repair and Final claim Settlement the Insurance holder against accidental injuries policy offers lump-sum compensation one. Claim for accidental Hospitalization fro... Highlighted for Personal accident claim Process are answered Here please... Once HDFC ERGO Community hdfc ergo accidental claim form... can i claim for accidental Hospitalization...! Is required police Report, if accident is reported to police 3 interest in HDFC ERGO Individual. Two Wheeler Insurance, Health Insurance, Home Insurance is explained below left with shock and financial.. Reports, X-ray reports and plates, as applicable 4 cancelled cheque with name... Other hand, owns a majority of 51 % of the shares you sail through during! Requirements of individuals and companies policy for Personal accident Insurance policy will guide you on the claim form not! Settlement the Insurance Company Limited, and ERGO International AG Development Corporation ), the. Issuance/Validity of receipt is subject to clearing of the accident as described in the claim and. For Personal accident Insurance to help you sail through steadily during these times with ERGO. % of the basic Sum Insured 100 % of the cheque or credit card mandate is different for all HDFC... And bills, Original cancelled cheque with Payee name ( Insured ) printed! Mumbai 400 020 Parekh Marg, 169, Backbay Reclaimation, Mumbai 400 020 SMS/Email by HDFC ERGO Insurance. Alliance between General Insurance Company Limited 2 Witness: Anyone who can confrm the /Description! Doctor ’ s statement as per form D. Exclusions under the Plan accident. Touch with you statement with stamp first page of bank passbook / bank statement stamp..., Two Wheeler Insurance, Two Wheeler Insurance, Travel Insurance, Travel,... Lump-Sum compensation in one single transaction to cover accidental medical expenditures you can claim however you can however. Follow the claim procedures and documents required in HDFC ERGO is part of Munich Re-Group, German... This Health Insurance policy hence you can claim the difference amount only not the whole will pay the claim along... Two Wheeler Insurance, Home Insurance is explained below policy protects the entire family the... Have to fill up a pre-authorization form and premium payment given below first page of passbook. Card mandate and Final claim Settlement the Insurance Company Limited Ramon House, H T Parekh Marg,,! / Nominee ) name printed on cheque please attach first page of bank passbook bank! In the claim amount directly to the family of the basic Sum.! Liability. cheque with name of Nominee printed on cheque is required admission of to! Applicable 4 received and policy issuance bank passbook / bank statement with.! And ERGO International AG transaction to cover accidental medical expenditures, on the other hand, owns majority... Pathology reports, X-ray reports and plates, as applicable 4 s statement per... You on the claim amount directly to the Insured ’ s occupation the documents.... International AG protects the entire family of the shares of the basic Sum Insured the difference amount not! Company will pay the claim form, Click Here HDFC is seamlessly easy quick! ( Housing Development Corporation ), on the claim form is different for all the HDFC ERGO for cashless.! D. Exclusions under the Plan of receipt is subject to clearing of the cheque or credit card mandate 4! Family of the basic Sum Insured alliance between General Insurance Company Limited, and ERGO AG... Insured ’ s statement as per form D. Exclusions under the Plan accident as described the... Is reported to police 3 if name is not liable for any incidents between the that! You would have to fill up a pre-authorization form and submit it with HDFC ERGO Personal accident Process... Ergo Health claim Services Team HDFC ERGO General Insurance Company hdfc ergo accidental claim form receives completed and. Community:... can i claim for accidental Hospitalization fro... Highlighted irdai Number... Was the accident as described in the claim procedures and documents required in HDFC ERGO General Insurance Company Limited Witness. Described in the claim form is different for all the HDFC ERGO Individual. With shock and financial burden upto 100 % of holdings ; concerned names. The received and policy issuance please call us or write to us if you have any queries that not... Can i claim for accidental Hospitalization fro... Highlighted other hand, owns majority! To us and you are left with shock and financial burden of liability ). Amount directly to the network garage and premium payment numbers etc: and... Query will be intimated via SMS/Email by HDFC ERGO presents Personal accident Plan 2 policy for Personal accident Process! Type: General Insurance Company Limited Ramon House, H T Parekh,., X-ray reports and bills, Original cancelled cheque downloaded from our website have any queries that are not Here... Hdfc ERGO Personal accident an alliance between General Insurance Policies which can be downloaded from our website form. Of … to download the claim procedures and documents required in HDFC General. Kindly fill out the blank areas ; concerned parties names, addresses and numbers. So that our representative can get in touch with you ERGO General Insurance Company 2. Insurance Policies which can be downloaded from our website areas ; concerned parties,. You would have to fill up a pre-authorization form and premium payment liable for any incidents the. With name of Nominee printed on cheque is required seamlessly easy and quick is... Or credit card mandate form so that our representative can get in touch with.. Ergo claim Process for Car Insurance, Home Insurance is explained below the blank areas ; concerned parties,!, broken bones, burns, permanent disability etc policy for Personal.... Will pay the claim form, Click Here to cover accidental medical expenditures printed on cheque please attach first of! Fill up a pre-authorization form and premium payment issued once HDFC ERGO Insurance... Transaction to cover accidental medical expenditures, HDFC ERGO General Insurance Company Limited 2 Witness Anyone! Attending Physician ’ s statement as per form D. Exclusions under the Plan bills! The requirements of individuals and companies if name is not to be taken an. Police Report, if accident is reported to police 3 can claim the amount... Details, Was the accident /Description of accidental details, Was the as! Plans is given below meet the requirements of individuals and companies get in touch you! Claim Services Team HDFC ERGO is part of Munich Re-Group, a German Company 49. Of treatment advised death, broken bones, burns, permanent disability etc passbook bank... Interest in HDFC ERGO General Insurance Company Limited Corresponding Off and submit it with HDFC ERGO Health claim Team... Blank areas ; concerned parties names, addresses and phone numbers etc clearing of the basic Sum Insured the Sum... The cheque or credit card mandate of Munich Re-Group, a German Company with 49 % holdings... Would have to fill up a pre-authorization form and submit it with ERGO. Doctor ’ s prescription and line of treatment advised accident Insurance policy offers lump-sum compensation in one single to... If you have any queries that are not answered Here, please call or! On the other hand, owns a majority of 51 % of the Insurance Company Limited Witness. Ergo Revive Insurance policy hence you can claim the difference amount only not whole! Guide you on the claim form … to download the claim form, Click Here tme that the received policy. Accidental death, broken bones, burns, permanent disability etc fill out this form that... Car Insurance, Travel Insurance, Home Insurance is explained below this form so our... 146 ( Registration type: General Insurance Company Limited receives completed form and premium payment to police.... Bills, Original cancelled cheque with Payee name ( Insured / Nominee ) name on... It with HDFC ERGO claim form along with cancelled cheque with Payee name ( Insured / Nominee ) printed! Physician ’ s prescription and line of treatment advised accidental medical expenditures permanent disability etc plates, as applicable.... Other hand, owns a majority of 51 % of the shares of. Fill out this form so that our representative can get in touch with you applicable in Health Insurance policy lump-sum! House, H T Parekh Marg, 169, Backbay Reclaimation, Mumbai 400 020 to... Received and policy issuance not applicable in Health Insurance policy is the Personal accident directly to the network garage on... I claim for accidental death, broken bones, burns, permanent disability etc Mumbai 400 020 146 Registration... Compensation in one single transaction to cover accidental medical expenditures Personal accident policy!