HDFC Ergo Optima Secure vs ICICI Lombard Elevate

Choosing between HDFC Ergo Optima Secure and ICICI Lombard Elevate can be confusing, especially since both are strong, comprehensive health insurance plans. This comparison dives deep into how the two insurers differ on reliability, coverage, premium value, add-on structures, and long-term benefits. 

We’ll also look at real performance metrics, including claim settlement ratio, complaints, incurred claim ratios, network hospital coverage, and how each plan handles key features like restoration, bonuses, room rent limits, PED benefits, maternity, and OPD. By the end, you’ll have a clear understanding of which plan aligns better with your health needs, budget, and expectations from an insurer.

Insurer Comparison: Key Insights

• The Claim Settlement Ratio (CSR) measures the percentage of claims an insurer successfully settles out of the total claims received in a given year. As clearly seen in the table above, HDFC has better and more stable settlement data over the past years. 
• The Incurred Claim Ratio (ICR) shows how much an insurer pays out in claims relative to the premiums it collects in a financial year. A healthy ICR indicates the insurer is settling claims fairly without financial strain. Both companies are in an ideal range, showing efficient claim settlement while maintaining financial stability. 
• The complaint volume indicates the number of complaints per 10,000 claims settled. Both insurers perform reasonably well here, as their numbers are significantly below the industry average of 22.65.

Both plans share several strong baseline features: no disease-wise sub-limits, zero co-payment, comprehensive daycare coverage up to the sum insured, domiciliary hospitalization cover, and AYUSH (alternative treatment) coverage. Pre-existing disease (PED) waiting periods are set at 3 years for both. Similarly, the specific illness waiting period is 2 years across both plans. 

For a complete breakdown, check out our detailed reviews of HDFC Ergo Optima Secure and ICICI Lombard Elevate.

Note: These are indicative premiums for a Delhi resident (pin code - 110001) with a ₹15 lakh sum insured, including mandatory and recommended add-ons. Your premium can change based on age, city, medical history, plan variant, and chosen add-ons.

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Ditto's Take on HDFC Ergo Optima Secure vs ICICI Lombard Elevate

Choose HDFC Ergo Optima Secure

• If you’re looking for certainty.
• The 2x sum insured from day 1, no room rent cap, built-in consumables cover, and a 96.71% CSR make it one of the most dependable health plans in the market.
• The premiums are higher, but you're paying for proven operational excellence, reliable claims settlement, and responsive customer support.
• Ideal for individuals and families who want comprehensive coverage, strong initial protection, and long-term peace of mind without piecing together add-ons.

Choose ICICI Lombard Elevate

• If you focus on flexibility and value.
• With add-ons for surrogacy, worldwide hospitalization up to ₹3Cr, bariatric surgery, and unlimited sum insured options, it's one of the most customizable plans available.
• The premiums are significantly lower, making it a strong pick for budget-conscious buyers or those with specific healthcare needs.
• However, ICICI Lombard's CSR of 84.50% and its three-year decline are a trade-off worth noting. While the plan is solid, the insurer's performance metrics trail peers like HDFC Ergo, Care, and Aditya Birla Health Insurance.