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HDFC ERGO Critical Illness Gold is a critical illness benefit variant designed to provide financial support after an eligible diagnosis of a covered serious illness. The policy can pay a lump sum up to the sum insured when the diagnosis or procedure satisfies the applicable policy definition and claim conditions. Gold lists 11 specified critical illnesses, including heart attack, cancer, kidney failure, stroke and selected major surgical procedures. Compared with Silver, the Gold list includes three additional conditions: aorta graft surgery, primary pulmonary arterial hypertension and open-heart replacement or repair of heart valves. The actual sum insured, premium, eligibility and claim requirements must be confirmed in the current policy wording and issued schedule.
11 specified critical illnesses with lump-sum benefit subject to policy terms
Gold provides a broader list of specified conditions than Silver, but the number of illnesses alone should not determine a purchase. Each condition has a contractual medical definition, and a diagnosis does not automatically qualify for payment. This is a benefit policy intended to pay a lump sum for an eligible claim rather than reimburse every hospital bill. Review the waiting period, survival condition, exclusions, sum insured and available premium before purchasing. The official product information lists a 90-day waiting period and a 30-day survival condition; confirm these against the policy wording applicable to the policy being purchased.
HDFC ERGO
Key Insights
Founded
2002
HDFC ERGO was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
98.2% CSR, calculated as a 3-year average
HDFC ERGO settles 98.2% of all claims it receives, demonstrating strong credibility.
Contact Details
1800-2677-444
Headquarters: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai - 400 059, Maharashtra, India.
The policy pays the applicable sum insured on the first diagnosis of a covered critical illness, subject to policy terms.
The payout can help meet medical treatment and related expenses.
The payout can help with recuperation and rehabilitation-related costs.
The payout can help manage loss of income during illness and recovery.
The lump sum can help with household commitments and debts.
A 90-day initial waiting period applies, subject to policy terms and exceptions. A survival period also applies after diagnosis; verify the duration stated in the issued policy schedule.
Initial Waiting Period
Claims are subject to the policy waiting-period clause and applicable exceptions in the policy wording.
Survival Period
The insured must survive the applicable period after diagnosis as specified in the policy wording and policy schedule. Confirm the applicable duration for the issued policy.
Conditions or treatments that the policy clearly says it will not cover.
A 90-day initial waiting period applies, subject to the policy terms and applicable exceptions. A survival period after diagnosis also applies; the required duration is as specified in your policy schedule (15 or 30 days). Each illness must meet its specific policy definition.
Insurer
HDFC ERGO plans and claim process
The referenced policy wording lists 11 specified critical illnesses under Gold. Each claim must satisfy the applicable policy definition.
Gold adds Aorta Graft Surgery, Primary (idiopathic) Pulmonary Arterial Hypertension and Open Heart Replacement or Repair of Heart Valves to the eight Silver conditions.
An eligible claim may pay a lump sum up to the sum insured, subject to policy conditions and claim requirements.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official HDFC ERGO website before purchasing.
Official Website
hdfcergo.com
Visit the official HDFC ERGO website for plan brochures, premium quotes and policy services.
The aforementioned ratios have been averaged over three years (FY24-FY26)
The official product information lists a 90-day waiting period. Confirm the applicable wording and commencement rules in the current policy documents.
The official product information lists a 30-day survival condition after first diagnosis. Refer to the applicable policy wording for details.
Premium depends on the insurer quote and relevant applicant and cover details. Confirm the current premium directly with HDFC ERGO.
The sum insured is the amount selected and recorded in the issued policy schedule. Confirm available options with HDFC ERGO.
No. Critical illness benefit insurance and comprehensive hospitalisation insurance serve different purposes.