Is there a mandatory out-of-pocket expense clause under the Energy Silver With Copay plan?

Yes, as indicated by the plan variant, a mandatory 20% co-payment applies to all valid medical claims, requiring the policyholder to share that specific percentage of the total hospitalization expenses while the insurer handles the remaining balance.

Are there any room rent caps or limits enforced during an inpatient hospital stay?

No, Energy Silver does not impose any sub-limits or capping on room rent or Intensive Care Unit (ICU) charges, granting you full freedom to choose any category of available hospital room up to your annual sum insured limit.

How does the waiting period affect my coverage?

The HDFC ERGO Energy Silver With Co-Pay plan has a 30-day general waiting period and a 48-month waiting period for pre-existing conditions.

What if I don’t use my health insurance benefits for the entire year?

If no claims are made in a policy year, you may receive a No Claim Bonus, increasing your sum insured for future coverage.

Does the HDFC ERGO Energy Silver With Co-Pay plan cover treatment abroad?

The plan covers treatments only within India and does not include international medical expenses under its standard coverage.

What is the standard waiting period requirement for other pre-existing diseases under this plan?

For pre-existing medical conditions other than diabetes and hypertension (such as thyroid or cardiovascular issues), a standard waiting period of 24 months of continuous coverage must be served before related treatment claims become eligible.

OneAssure

Health Insurance

HDFC ERGO

Energy Silver With Copay

HDFC ERGO Energy Silver Plan

Experience India's most trusted health insurance with HDFC ERGO Health Insurance. Get instant cashless treatment at 15000 network hospitals with sum insured up to ₹50 lakhs.

95

Claim Settlement Ratio

15000

Network Hospitals

9.4

Customer Rating

Policy Brochure

Get a Quote

95

Claim Settlement Ratio

15000

Network Hospitals

9.4

Customer Rating

Policy Brochure

Our Verdict

Expert Review: HDFC ERGO Health Insurance

Final Verdict

HDFC ERGO Energy Silver With Co-Pay offers coverage for diabetes and hypertension with wellness benefits and a No Claim Bonus. Ideal for cost-conscious individuals, but the 20% co-payment increases out-of-pocket expenses.

About

About HDFC ERGO Health Insurance

HDFC ERGO Energy Silver With Co-Pay is a specialized health insurance plan designed for individuals with diabetes and hypertension. It covers hospitalization expenses, pre- and post-hospitalization costs, and daycare treatments. The plan includes an annual health check-up, wellness coaching, and a wellness discount based on healthy lifestyle choices. A co-payment clause applies, requiring the policyholder to share a percentage of claim costs. Additionally, it offers a No Claim Bonus, enhancing coverage for claim-free years, ensuring comprehensive financial protection.

HDFC ERGO Energy Silver With Co-Pay is a specialized health insurance plan designed for individuals with diabetes and hypertension. It covers hospitalization expenses, pre- and post-hospitalization costs, and daycare treatments. The plan includes an annual health check-up, wellness coaching, and a wellness discount based on healthy lifestyle choices. A co-payment clause applies, requiring the policyholder to share a percentage of claim costs. Additionally, it offers a No Claim Bonus, enhancing coverage for claim-free years, ensuring...

Testimonials

Real People. Real Relief

These are the moments that show what we really do. We don't sell you a policy. We stand by you when it matters most.

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Mumbai, Maharashtra

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Mumbai, Maharashtra

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

Bengaluru, Karnataka

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

Jaipur, Rajasthan

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

West Bengal

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Inclusions and Exclusions

Inclusions and Exclusions of HDFC ERGO Insurance Company Limited

ICU Charges

No restriction on ICU room rent

Disease-wise sublimits

No

Co-payment

Available as an option

Restoration Benefit

Yes, your sum insured restores to 100% each time you make a claim in a policy year, for both related and unrelated illnesses

Cumulative Bonus

Your sum insured increases by 10% every year, maximum up to 100%

Room Rent

All room categories are covered

Consumable Cover

Yes

Initial Waiting Period

30 days

Specific Waiting Period

2 years

PED Waiting Period

2 years

Modern Treatment

Hospital expenses for listed advanced treatments are covered up to your full sum insured during the policy period

Annual Health Checkup

Health check-up is available twice every policy year, from day 1 of the policy

Daycare Treatment

Covers medical expenses for treatments not requiring 24-hour hospitalization, up to your annual sum insured

AYUSH Treatment

Covers AYUSH treatment expenses up to your annual sum insured during the policy period

Pre-Hospitalisation

You get cover for medical tests and doctor visits up to 30 days before hospitalisation, if your main claim is approved

Post-Hospitalisation

You get cover for medical bills up to 60 days after discharge, including physiotherapy if your doctor prescribes it

Outpatient Department Cover (OPD Expense)

OPD expense is not included

Deductible Option

Not available

Cashless Healthcare Providers

15,000+ Healthcare Providers

Coverage Options

Available coverage options: ₹2L, 3L, 5L, 10L, 20L, 25L, 50L

Maternity Cover

Not available

Claim Settlement Ratio

95%

ICU Charges

No restriction on ICU room rent

Disease-wise sublimits

No

Co-payment

Available as an option

Exclusions

Any pre-existing diseases (other than diabetes and hypertension) not covered during the waiting period.
Expenses related to self-inflicted injuries, suicide, or attempted suicide.
Treatment for alcohol or drug abuse, including rehabilitation programs.
Any illness or injury arising from war, terrorism, or civil unrest.
Injuries or conditions resulting from participation in hazardous sports or activities.

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About the company

HDFC Ltd., India’s top financial services company, and ERGO International, part of Munich Re Group of Germany. The company offers a wide range of insurance products, including health, motor, travel, home, and commercial insurance. In health insurance, HDFC ERGO is known for flexible plans, large coverage options, and easy claim processes. It has a wide hospital network across the country for cashless treatments. The company also provides modern services like wellness programs, online claim filing, and round-the-clock support. HDFC ERGO is trusted by millions of customers for its reliable service and transparent policies. With strong financial backing and global expertise,...

HDFC Ltd., India’s top financial services company, and ERGO International, part of Munich Re Group of Germany. The company offers a wide range of insurance products, including health, motor, travel, home, and commercial insurance. In health insurance, HDFC ERGO is known for flexible plans, large coverage options, and easy claim processes. It has a wide hospital network across the country for cashless treatments. The company also provides modern services like wellness programs, online claim filing,...