Finding the right health insurance provider in India is an important decision to ensure that you and your loved ones are covered in case of a health emergency.
We’ll review two of the top providers: ICICI Lombard health insurance and HDFC ERGO health insurance. Based on a review of the types of health insurance plans and the common terms of each, both providers can provide excellent coverage for the health insurance plan that is most important to you.
All information is correct at the time this article was written, so please check with each respective health insurance company before making a purchase decision to fully understand the most current information on the best health insurance plans out there, as well as all the details on medical costs, key features, and optional benefits.
About ICICI Lombard and HDFC ERGO
The general insurance company model is common around the world, and corporate partnership can allow corporations to offer complete health insurance, as well as a number of other health insurance plans and other plans, around the world.
Who Is ICICI Lombard?
The ICICI Lombard General Insurance Company Ltd. is a joint business venture between India’s ICICI Bank and Fairfax Financial Holdings, a Canadian company based in Toronto.
ICICI (Industrial Credit and Investment Corporation of India) was founded in 1994, and Fairfax Financial was founded in 1951.
What Health Policy Options Does ICICI Lombard Offer?
Options for a ICICI Lombard health insurance plan are offered alongside other plans like vehicle insurance, travel insurance, home and business insurance, crop insurance, and others.
Who Is HDFC ERGO?
The HDFC ERGO General Insurance Company is a joint business venture between India’s Housing Development Finance Corporation (HDFC) and ERGO Group, a group of insurance companies headquartered in Munich, Germany.
HDFC was founded in 1977, and the ERGO Group incorporated in 1997.
What Health Policy Options Does HDFC ERGO Offer?
HDFC ERGO health insurance is one of the main options offered by this health insurance company, in addition to vehicle and travel insurance, home and commercial insurance, rural insurance, accident insurance, and others
ICICI Lombard vs HDFC ERGO Health Insurance
ICICI Lombard and HDFC ERGO are just two of the best health insurance plans available, and there are many different kinds of plans offered by each. We’ve provided a brief summary of the key features of each plan provider.
Types of Health Policy Plans Offered by Each Health Insurance Company
Both the ICICI Lombard health insurance company and the HDFC ERGO health insurance company offer a number of different types of plans.
Be sure to do a thorough review of the policy wordings, terms, and costs of each complete health insurance plan to ensure that you receive the right coverage.
Individual and Family Plans
ICICI Lombard health insurance plans have a minimum age of 18 years for all of its insurance policies, but health insurance policy holders can add dependent family members as young as three months old. It covers key items related to hospital stays, including ambulance services and surgical care (although organ donor medical expenses are optional), as well as preventative wellness programs and doctor visits.
HDFC ERGO has the same minimum age requirements for insurance policy holders and dependent family members, but some coverage is expanded over ICICI Lombard health insurance plans. Services like cashless home healthcare, organ donor medical expenses, other related medical expenses, and mental health care expenses are covered under an HDFC ERGO health insurance policy.
Both complete health insurance plan options have terms of either one year or two years, with a lifetime renewability option.
Critical Illness Plans
ICICI Lombard health insurance plans are more limited when it comes to covering critical illnesses. It does cover nine major conditions, which would account for most emergency scenarios, and provides a basic sum benefit payment the first time a condition is diagnosed.
HDFC ERGO health insurance, on the other hand, is far more robust with its coverage of critical illnesses. It offers Silver and Platinum levels (depending on your insurance needs), and the Platinum plan covers 15 critical conditions. It also provides a lump sum payment, but covers all regular hospital medical expenses and can be renewed for life under a lifetime renewability option.
In recent years, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated that health insurance companies offer plans that cover COVID-19 in a separate specialized health insurance policy. Both ICICI Lombard and HDFC ERGO fully comply with the IRDAI’s terms on COVID-19 insurance policies.
Health Insurance Policy Age Limits by Health Insurance Company
Both ICICI Lombard health insurance and HDFC ERGO health insurance have a minimum age of 18 years old for new health insurance policy holders.
However, the maximum age is open for an insured member under ICICI Lombard health insurance plans, whereas HDFC ERGO has an upper limit of 100 years old.
Additionally, while both offer coverage for a family member on the same plan who is at least three months old (ICICI Lombard specifies 3 months, while HDFC ERGO specifies 91 days), HDFC ERGO covers family member dependents until they are 21, whereas ICICI Lombard only covers until age 20.
You may also be able to find a family floater plan that will calculate premium costs based on your entire family, rather than forcing you to pay premium costs for each family member.
Financial Terms for Each Health Insurance Company
Copays are a way to maximize your benefits while minimizing your out-of-pocket health care expenses.
Health plans offered by ICICI Lombard and HDFC ERGO have health plans that require no copays.
No-Claim Bonus Options
This claim bonus is paid out at your next premium if you have no claims on your health insurance.
It’s a great way to recoup some of the costs of healthcare if you didn’t take advantage of your health insurance policy coverage.
ICICI Lombard health plans tend to be more restrictive on their claim bonus terms: some plans only offer a 10% cashback claim bonus, increasing in intervals to up to 50% of your plan’s value.
HDFC ERGO, on the other hand, starts at a 50% cashback claim bonus, and some health plans even let you recover up to 100% of your health insurance policy premium costs.
Claim Settlement Time
Settling an insurance claim quickly not only provides much-needed financial support to the customer; it also allows the health insurance company to deliver excellent service and retain its members.
Providing quick insurance claim settlements can also be critical in an emergency situation.
HDFC ERGO has relatively brief settlement times of 20 minutes for cashless claims. However, ICICI Lombard prides itself on processing an average of 3.5 claims every minute.
ICICI Lombard clearly has the capacity to handle more claims, but also handles them much more quickly on average.
Online Customer Service Options
Since many customers prefer to do business with their particular policy online, providing essential services like purchase, policy renewal, claim settlement, and live chat are crucial to keeping health insurance companies successful in a highly competitive market.
Both ICICI Lombard and HDFC ERGO offer all of these customer service options.
Network Hospitals and Coverage Options
The number of covered network hospitals is important when choosing a healthcare plan, since you’ll want to make sure you have enough network hospitals in your area that will accept your health insurance plan.
Additionally, you should think about whether your hospital room rent charges are covered, what procedures are covered, and whether you can use your health insurance to pay for outpatient procedures.
ICICI Lombard health insurance has a range of more than 6500 network hospitals, while HDFC ERGO health insurance has a range of more than 12,000 network hospitals. On this point, HDFC ERGO has far better coverage.
Hospital Charges Covered
For emergency ambulance services, HDFC ERGO also edges out ICICI Lombard by covering up to ₹2000 instead of only ₹1500.
ICICI Lombard fully covers hospitalization expenses, while HDFC ERGO will bill your health insurance based on the actual medical costs incurred. In this way, ICICI Lombard provides slightly broader coverage and terms that favor the patient.
HDFC ERGO covers slightly more days for hospital stays than ICICI Lombard (150 days vs. 144 days).
Additionally, HDFC ERGO offers two times more coverage in pre hospitalization expenses (which includes any medical test required for admission or treatment plans), as well as triple the post hospitalization expenses.
Coverage is reimbursed based on actual expenses incurred, but HDFC ERGO covers 60 days of pre hospitalization expenses and 180 days of post hospitalization expenses, while ICICI Lombard only covers 30 days of pre hospitalization expenses and 60 days of post hospitalization expenses.
The maternity add on covers costs related to maternity and birth hospital visits. If you do not have this rider included, you will pay these costs out of your own pocket.
The maternity benefit is not offered by some HDFC ERGO health insurance plans, while ICICI Lombard health insurance plans cover these charges within defined limits.
Outpatient care is not covered by some HDFC ERGO health plans, while most ICICI Lombard health insurance plans can cover up to ₹5,000 in medical costs for these procedures annually.
Other Key Differences
Pre Existing Disease
Some health policies will restrict the amount of coverage available for those who have a pre existing disease. In these cases, most insurance provider options will impose a waiting period before they will cover costs for those treatments.
ICICI Lombard has a waiting period of only two years on pre-existing illnesses for some plans, while those offered by HDFC ERGO force their members to wait at least three years in most cases.
Coverage for domiciliary care, or home-based health care, can be essential for those who have at-home nursing expenses, or who require care at an assisted living facility. ICICI Lombard health insurance plans typically cover these nursing expenses, while HDFC ERGO plans do not.
AYUSH treatments are a blanket term used to cover alternative treatments and therapies outside of conventional medicine. Many of these are ancient in origin and are still practiced by many segments of society to this day.
The term AYUSH is an acronym that includes the following concepts:
- Ayurveda (a holistic approach to healthcare with ancient roots)
- Yoga and naturopathy (a combination of physical exercises and spiritual realignment)
- Unani (a pseudoscientific approach with religious roots)
- Siddha (based around the belief in a balanced equilibrium of several “humours” that make up the human body)
- Homeopathy (the belief that substances that cause diseases in healthy people will cure them in sick people).
AYUSH treatments are covered by both ICICI Lombard health insurance and HDFC ERGO health insurance, although ICICI Lombard plans tend to be broader in accepting these kinds of treatment plans.