Fwd: HDFC ERGO Knowledge Portal
Official Knowledge Repository for HDFC ERGO Retail Health Renewals, Customer Support, Calling Scripts, and Quality Audit Standards. Access complete one-pagers, bilingual pitch scripts, premium rate matrices, and 100-mark compliance parameters.
Operational Quick Links
Optima Secure (2026)
FlagshipRevolutionary 4X coverage: Secure Benefit (2X Day-1), Plus Benefit (100% bonus), Restore Benefit, and Protect Benefit (68 Non-medical items covered).
Optima Restore (2026)
Most PopularAutomatic restoration after 1st claim, 50% Multiplier bonus up to 100%, Stay Active discount (up to 8% for steps), and optional 10%/20% Co-Pay discounts.
Koti Suraksha (PA)
High SI Covermy:health Personal Accident shield from ₹10 Lakhs to ₹5 Crores. Covers accidental death, comatose, temporary total disability (TTD), broken bones & hospital cash.
Renewal Script & Add-On Pitches
Interactive PrompterStandardized agent flow for retail renewals, including greeting within 5s, mandatory recording disclaimer, upgrade pitching (3L/5L to 10L+), deductibles, and moratorium advantage.
Quality Audit Parameters (100 Marks)
Strict Compliance5 Core evaluation sections based on the corporate audit sheet. Includes 5 Fatal Breaches that immediately lead to 0% call score (Third Party verification, Call recording disclaimer, etc.).
Crucial Customer Retention Advantage: Moratorium Period (5 Years)
Why Timely Renewal Without Break Is Non-Negotiable: After 5 continuous claim-free renewal years, the policy enters a statutory moratorium period. Beyond this milestone, no claim can ever be rejected on grounds of non-disclosure of past medical conditions (except proven fraud). Explain to customers that every uninterrupted renewal secures lifetime claim invulnerability!
HDFC ERGO Product One-Pagers (2026)
Optima Secure (2026 Edition)
Eligibility & Family Structure
| Basic Sum Insured | ₹5L, 10L, 15L, 20L, 25L, 50L, 1 Cr, 2 Cr |
| Tenure & Discount | 1 Year, 2 Year (6% off), 3 Year (8% off) |
| Age Limit | Adults: 18 - Lifetime | Child: 91 Days - 25 Years |
| Family Floater | Max 6 members (Up to 4 adults or 6 children) |
| Individual Plan | Max 6 members (Self, spouse, parents, siblings, in-laws, grandparents, grandchild) |
| Optional Riders | Wellbeing, IPA, Unlimited Restore, Hospital Daily Cash, Critical Illness |
Core 4X Benefits Breakdown
- Secure Benefit: Additional 100% Sum Insured available right from Day 1. Effectively doubles your cover without waiting!
- Plus Benefit: 50% bonus on Basic SI for every policy year irrespective of claims (max up to 100%). Cover increases even after claims!
- Restore Benefit: 100% SI reloaded automatically after 1st claim in the policy year.
- Protect Benefit: 68 listed non-medical consumables (gloves, masks, kits, PPE) covered up to SI. Zero out-of-pocket medical bill deductions!
Clinical & Treatment Coverage
Aggregate Deductible Discount Grid (Optima Secure)
| Deductible Amount | Base SI < 25 Lakhs (Discount %) | Base SI ≥ 25 Lakhs and Above (Discount %) |
|---|---|---|
| ₹25,000 | 22.5% | 15.0% |
| ₹50,000 | 40.0% | 30.0% |
| ₹1,00,000 (1 Lakh) | 50.0% | 40.0% |
| ₹3,00,000 (3 Lakh) | 65.0% | 55.0% |
| ₹5,00,000 (5 Lakh) | Not Available | 62.0% |
| ₹10,00,000 (10 Lakh) | Not Available | 80.45% |
| ₹20,00,000 (20 Lakh) | Not Available | 88.0% (For SI ≥ 50 Lakhs) |
| ₹25,00,000 (25 Lakh) | Not Available | 90.0% (For SI ≥ 50 Lakhs) |
Optima Restore (2026 Edition)
| Basic Sum Insured | ₹3L, 5L, 10L, 15L, 20L, 25L, 50L, 1 Crore |
| Tenure & Discount | 1 Year, 2 Year (6% off), 3 Year (8% off) |
| Age Limit | Adults: 18 - 65 Years | Child: 91 Days - 25 Years |
| Optional Co-Payment | 10% Co-Pay (10% Discount) or 20% Co-Pay (20% Discount) |
| Multiplier Bonus | 50% SI bonus every year (irrespective of claims), max up to 100% |
Stay Active Step Target Discount (Upon Renewal)
- 5,000 steps/day or below: 0% Discount
- 5,001 to 8,000 steps/day: 2% Renewal Discount
- 8,001 to 10,000 steps/day: 5% Renewal Discount
- Above 10,000 steps/day: 8% Renewal Discount
Aggregate Deductible Grid (Optima Restore)
| Deductible Amount | Base SI ≤ 20 Lakhs | Base SI > 20 Lakhs |
|---|---|---|
| ₹25,000 | 22.5% Discount | 15.0% Discount |
| ₹50,000 | 40.0% Discount | 30.0% Discount |
| ₹1,00,000 (1 Lakh) | 50.0% Discount | 40.0% Discount |
Health Wallet
| Basic Sum Insured | ₹3L, 5L, 10L, 15L, 20L, 25L, 50 Lakhs |
| Policy Tenure | 1 Year |
| Reserve Benefit | ₹5,000 to ₹25,000 (Credited as per SI grid) |
| Multiplier Bonus | 50% SI bonus every year, max up to 100% |
| Recovery Benefit | ₹10,000 lump sum for hospitalization exceeding 10 continuous days |
| Worldwide Emergency | 50% of SI (Max ₹20 Lakhs, reimbursement basis) |
Reserve Benefit Grid (OPD / Pharmacy Wallet)
| Deductible Option | 3L | 5L | 10L | 15L | 20L | 25L | 50L |
|---|---|---|---|---|---|---|---|
| No Deductible | ₹5,000 | ₹5,000 | ₹10,000 | ₹10,000 | ₹15,000 | ₹20,000 | ₹25,000 |
| 2 Lakh Ded. | ₹5,000 | ₹5,000 | ₹10,000 | ₹10,000 | ₹15,000 | ₹20,000 | ₹25,000 |
| 3 Lakh Ded. | N/A | ₹5,000 | ₹5,000 | ₹10,000 | ₹10,000 | ₹15,000 | ₹15,000 |
| 5 Lakh Ded. | N/A | N/A | ₹5,000 | ₹10,000 | ₹10,000 | ₹15,000 | ₹15,000 |
| 10 Lakh Ded. | N/A | N/A | N/A | N/A | ₹10,000 | ₹15,000 | ₹15,000 |
my:health Koti Suraksha (Personal Accident: 10L to 5 Crore)
Comprehensive coverage including Accidental Death, Disappearance, Comatose Benefit, Permanent Disability (PTD+PPD Table D), Temporary Total Disability (TTD), Burns, Broken Bones, Parental Care, Dependent Child Education, and Hospital Cash.
| Sum Insured (SI) | 1 Yr Premium (incl. GST) | 2 Yr Premium (incl. GST) | 3 Yr Premium (incl. GST) | TTD Benefit (Per Week, max 104 wks) | Child Education Benefit | Hospital Cash (30 Days) |
|---|---|---|---|---|---|---|
| ₹10 Lakhs | ₹3,611 | ₹6,680 | ₹9,747 | ₹10,000/week | ₹1,00,000 | ₹3,000/day |
| ₹25 Lakhs | ₹6,531 | ₹12,080 | ₹17,629 | ₹25,000/week | ₹2,50,000 | ₹3,000/day |
| ₹50 Lakhs | ₹11,395 | ₹21,080 | ₹30,763 | ₹50,000/week | ₹5,00,000 | ₹3,000/day |
| ₹1 Crore | ₹21,172 | ₹39,168 | ₹57,162 | ₹1,00,000/week | ₹10,00,000 | ₹3,000/day |
| ₹2 Crore | ₹32,730 | ₹60,550 | ₹88,370 | ₹1,00,000/week | ₹20,00,000 | ₹5,000/day |
| ₹3 Crore | ₹44,140 | ₹81,659 | ₹1,19,179 | ₹1,00,000/week | ₹30,00,000 | ₹5,000/day |
| ₹4 Crore | ₹55,551 | ₹1,02,769 | ₹1,49,987 | ₹1,00,000/week | ₹40,00,000 | ₹5,000/day |
| ₹5 Crore | ₹66,961 | ₹1,23,879 | ₹1,80,796 | ₹1,00,000/week | ₹50,00,000 | ₹5,000/day |
Energy (Diabetes & HTN)
Chronic CareSpecialized coverage for Individuals with Type 1/Type 2 Diabetes and Hypertension. Day-1 complication coverage, 182 Day care procedures, and HbA1c tests covered up to ₹750 twice a year!
• Wellness Discount: Up to 25% renewal discount based on BMI, Cholesterol ratio, and tests!
Easy Health (Std / Excl)
TraditionalClassic dual-tier health plan. Standard (1L to 15L) and Exclusive (3L to 50L). Cumulative bonus of 10%/year up to 100%. Maternity benefit in Exclusive variant up to ₹50,000.
• Shared Room: ₹500 - ₹1,000/day
• Accompanying Child: Up to ₹800/day
Medisure Super Top-Up
Service SLACost-effective top-up with aggregate deductibles (₹4L or ₹5L). High sum insured up to ₹20 Lakhs with IRDAI-backed service guarantee!
Retail Tele-Calling Scripts & Pitching
1. Master Health Policy Renewal Script (Word Approved)
Mandatory Script
Greeting & Intro:
"Good Morning / Good Afternoon / Good Evening. This is Rahul Sharma, I am calling on behalf of HDFC Ergo General Insurance Company Limited. Am I speaking with Mr. Rajesh Verma?"
Compliance Disclaimer (FATAL Parameter):
"This call is being recorded for internal Training and Quality Purposes."
Purpose of Call & Policy Details:
"This call is regarding your health policy renewal. As you are our valued customer, this call has been made before the due date of your policy. Your policy is Optima Secure Floater plan, policy's Sum Insured amount is 5 Lakh, the premium for your policy is Rs 22,000, and the policy's Due Date is 15/10/2026. Would request you to kindly renew your policy so that you can continue using your health policy hassle-free."
Payment Mode Probing:
"May I know when you will renew your policy? Which mode will you pay by: Online or Cheque?"
• If Cheque: "Sir/Madam, would like to suggest digital payments to lessen your burden of submitting a cheque. Digital payment is immediate and your policy copy proof will be received instantly."
• If Online: "Sir/Madam, we will share the link through our website payment mode. Appreciate your decision to renew well before time!"
Closing & Feedback:
"Would you like to get any further information regarding the renewal of your policy? Sir/Madam, hope the information provided has been satisfactory. Kindly let us know if you have any further queries. If not, please feel free to share your valuable inputs so we can improve our services. Thank you for your precious time, have a wonderful day ahead!"
Dual-Language Pitching Cards (English & Hinglish)
Deductible Option - Smart Savings on Premium
Sum Insured Upgrade - Move from 3L/5L to 10L & Beyond
Must-Have Riders - Unlimited Restore, Wellbeing & PA
• Unlimited Restore: Refills your sum insured unlimited times in a policy year, no matter how many claims are made.
• Optima Well-being: Offers preventive health check-ups, wellness sessions, and lifestyle rewards.
• Personal Accident Cover: Provides substantial extra financial payout in case of accidental injuries or mishaps."
Auto Renewal Mandate (AR Mandate)
PDO Script (Website Visitor Drop-Out Follow-Up)
Website Drop-Off
Opening & Purpose:
"Good Morning / Afternoon / Evening Sir/Madam, this is Rahul Sharma calling on behalf of HDFC ERGO General Insurance Company Limited. Am I speaking with Mr. Rajesh Verma? This call is being recorded for internal Training and Quality Purpose. Is this a convenient time to talk? We noticed that you visited our website recently. May I know if there is any renewal-related query? We will be happy to assist you."
Here App Promotion Closure:
"Sir/Madam, would also like to inform you that HDFC ERGO has launched the Here App which you can download from Google Play Store or Apple App Store. You can view your policy details, check e-Challan, calculate your BMI, track fitness activities, and manage claims seamlessly. Thank you for your valuable time, have a wonderful day ahead!"
Retail Renewal Calling Flow & Objection Handling
Call Opening & Greeting (Within 5 Seconds)
Greet the customer promptly without casual slang (No 'Hi' / 'Hello' / 'Hey'). Introduce agent name, employee code, and HDFC ERGO General Insurance Co. Ltd. Perform Right Party Contact (RPC) confirmation.
Seek Permission & Pitch Mandatory Disclaimer
Check if it is a convenient time to speak. State clearly: "This call is being recorded for internal Training and Quality Purpose." (Non-negotiable compliance rule).
State Purpose of Call & Due Date Reminder
Explain that the call is for advance renewal. Quote the exact Plan Name, Sum Insured amount, Premium amount (with GST), and the due date.
Payment Commitment & Probing
Probe whether the customer is ready to renew: ask for mode of payment (Online vs Cheque). Guide to digital online link to avoid manual cheque collection delays.
Objection Handling & Proactive Pitching
If customer hesitates or asks for callback: probe reason for non-payment. Pitch value-enhancing upgrades: Deductibles (savings), Sum Insured Upgrade (inflation safety), Riders (Unlimited Restore / Wellbeing), Auto Renewal Mandate, and Here App.
Professional Call Closing & Feedback
Offer further assistance, seek customer satisfaction/feedback, and close with the approved polite sign-off verbiage.
Quality Audit & Compliance Scorecard
Interactive Rate Cards & Premium Calculators
Koti Suraksha PA Rate Card
PA CalculatorDeductible Discount Finder
Discount MatrixEnergy Wellness Score Rater
Diabetes RewardsSide-by-Side Product Comparison Matrix
Feature BenchmarkMoratorium Period Advantage & Here App Services
The Moratorium Advantage (5 Continuous Claim-Free Years)
Statutory ProtectionIn Indian health insurance regulations, after completing 5 continuous policy years without a break, the policy enters into the Moratorium Period.
How to Pitch to the Customer:
- Lifetime Peace of Mind: Even if any health condition was missed unintentionally during initial policy inception, the claim is 100% protected.
- Exclusive Loyalty Shield: This protection cannot be purchased by a new customer with money—it is exclusively earned through renewal continuity.
- Future-Proofing: Skipping or delaying renewal resets this vital timeline, causing irreparable loss of claim security!
HDFC ERGO Here App Features
Digital EcosystemThe Here App is HDFC ERGO's all-in-one digital companion for health and motor policyholders available on Android Play Store and Apple App Store.