Choosing the right health insurer isn’t easy, especially when two of the biggest names, HDFC Ergo and Care Health Insurance, are often recommended side by side. Both have strong offerings, but the real question is: which one works better for you?
In this article, we break down HDFC Ergo vs Care Health Insurance across all the factors that matter; from claim performance and complaint volumes to premiums, features, and customer experience. By the end, you’ll know exactly which insurer aligns better with your health and financial needs.
HDFC Ergo Vs Care Health Insurance: Quick Overview
HDFC ERGO
HDFC ERGO General Insurance Company Limited has been operating for over two decades in India. It is promoted by HDFC Bank, one of India’s leading private sector banks, and ERGO International AG, the primary insurance entity of the Munich Re Group.
The company offers a comprehensive portfolio of general insurance solutions across retail and corporate segments and operates digitally as well as through a strong physical presence of 300 branches across the country. Within the retail segment, HDFC ERGO provides products such as motor, health, travel, home, and personal accident insurance.
In particular, the company stands out in the health insurance space with comprehensive policies, strong features, and valuable add-on options. However, most HDFC ERGO plans we’ve reviewed so far are priced higher than many of their peers.
Not sure which way to go? That’s where we come in. Ditto’s advisors will compare your options, explain the fine print, and even support you during claims — all for free. Book a free call with us and get unbiased advice before you decide.
Care Health
Care Health Insurance, formerly Religare Health Insurance, was founded in 2012. Promoted by Religare Enterprises (owned by the Burman family of Dabur Group) and backed by Kedaara Capital and other institutional investors, it is one of India’s leading standalone health insurers. The company operates digitally and through 270 branches across India.
Care focuses on customers, affordability and practical protection. It uses technology to make insurance simpler and faster, while keeping products easy to access and value-driven. Its portfolio includes health insurance, super top-up plans, personal accident cover, international travel, and critical illness protection.
Care has built trust with policyholders through competitive pricing, broad coverage, innovative add-ons, no loading charges, and a diverse product range. However, rising complaint volumes in recent years raise concerns that must be weighed when evaluating or recommending its plans.
HDFC Ergo Vs Care Health Insurance: Choosing the Right Insurer
When selecting a health insurer, it’s important to go beyond premiums and look at key performance metrics. These indicators help you understand an insurer’s reliability, financial health, and service quality. Let’s first break down the metrics and why they matter:
1) Claim Settlement Ratio (CSR)
CSR shows the percentage of claims an insurer settles. Higher is better, as it signals reliability. A CSR above 95% generally reflects strong claim-handling ability.
2) Incurred Claim Ratio (ICR)
ICR measures claims paid versus premiums collected. A healthy 50–80% range suggests balanced claim management.
3) Average Complaints Volume
This refers to complaints per 10,000 claims. Fewer complaints usually mean smoother service.
Note: Standalone health insurers like Care and Niva Bupa often report higher ratios than diversified general insurers (e.g., HDFC ERGO, ICICI Lombard, Bajaj Allianz), since their complaints are concentrated in health insurance.
4) Annual Business & Financial Strength
Insurers with healthy business numbers are usually better placed to pay claims consistently. With the industry median at ~₹1,300 crores, anything above indicates strong financial strength.
5) Network Hospitals
A wide hospital network ensures quick, cashless access during emergencies. While a 10,000+ hospital network is ideal, what matters is whether they have a strong presence in your locality.
Why These Metrics Count
These metrics help reveal whether an insurer not only collects premiums but also delivers on claims, customer satisfaction, and financial stability. Still, numbers aren’t everything. You should also weigh factors like claim process ease, customer support, digital tools, after-sales service, and whether the policy benefits suit your needs.
For a deeper understanding of the basics, check out our guide on how to choose health insurance.
Now that we know which metrics matter when choosing between HDFC Ergo vs Care Health Insurance, let’s dive into the numbers and see how the two compare with each other.
HDFC Ergo Vs Care Health Insurance: Operational Metrics Comparison (FY 2021–24)
| Company | Claim Settlement Ratio (CSR) % (Avg) | Incurred Claim Ratio (ICR) % (Avg) | Avg. Complaints per 10,000 Claims | Network Hospitals | Gross Written Premium / Annual Business (₹ Cr) (Avg) |
|---|---|---|---|---|---|
| HDFC Ergo | 98 | 86 | 7 | 13,000+ | 5,120 |
| Care Health | 90 | 59 | 36 | 11,400+ | 4,890 |
Key Insight: HDFC Ergo demonstrates better operational metrics, higher claim settlement ratio, and greater reliability and stability in claims management and customer satisfaction. Care shows relatively lower incurred claim ratio and higher complaints per claims.
HDFC Ergo vs Care Health Insurance: Key Feature Comparison
While operational metrics give us a good starting point, the real difference often lies in the product features. These are the non-negotiables that directly shape your health insurance experience.
Below, we’ve compared the flagship plans of both insurers: HDFC Ergo Optima Secure and Care Supreme, to see how they stack up against each other.
| Feature / Parameter | HDFC ERGO Optima Secure | Care Health Insurance Care Supreme | Key Insights |
|---|---|---|---|
| Entry Age | Adults: 18+, No max (up to 99 years) | Adults: 18+, Lifelong renewability | Both offer entry up to 99 years and lifelong renewability |
| Dependent Children Age | 91 days to 25 years | 90 days to 24 years | Comparable child coverage |
| Sum Insured (SI) Options | ₹5L to ₹2Cr | ₹5L to ₹1Cr | Optima Secure offers higher max coverage |
| Policy Tenure | 1 / 2 / 3 years | 1 / 2 / 3 years | Similar tenure options |
| Coverage Options | Individual, Family Floater (Max 4A 6C) | Individual, Family Floater (max 2 adults + 2 children) | Both offer family floater with HDFC allowing more members to be covered |
| Co-Payment | No | No | No co-payment applicable for both |
| Room Rent Restrictions | No | No | No restrictions on room rent |
| Disease-wise Sub-limits | No | No | Both do not impose disease-wise sub-limits |
| Pre & Post Hospitalization | 60 days pre, 180 days post | 60 days pre, 180 days post | Identical pre/post hospitalization cover |
| Day Care & Modern Treatments | Covered upto Sum Insured (SI) | Covered upto Sum Insured | Both cover modern treatments |
| Domiciliary | Covered up to SI | Covered up to SI | Included in both plans |
| AYUSH Treatment | Covered up to SI | Covered up to SI | Covered by both |
| Bonus | 50% increase per year up to 100% of base SI (regardless of claims) | 50% increase up to 100% of base SI; cumulative bonus options to boost bonus by 100% up to 500% or unlimited accumulation | Both offer attractive bonuses regardless of claims made; Care Supreme has add-on |
| Restoration / Recharge Benefit | 100% once a year; add-on for unlimited restoration | Unlimited automatic recharge on partial/complete exhaustion | Care Supreme offers unlimited restoration as default |
| Waiting Periods | 30 days initial, 2 years specific illness, 3 years pre-existing illness | 30 days initial, 2 years specific illness, 3 years pre-existing illness | Same standard waiting periods |
| Road Ambulance Cover | Covered up to SI | Up to ₹10,000 (<15L SI) / full SI for ≥15L | Care Supreme limits cover based on SI amount |
| Air Ambulance Cover | Covered up to ₹5L | Covered up to ₹5L | Both provide up to ₹5L air ambulance cover |
| Additional Benefits / Riders | Parenthood rider (maternity), Unlimited restore add-on, Aggregate deductible, Optima Wellbeing (doctor visits & wellness), ABCD Chronic Care (PED WP reduction), Hospital Cash | Cumulative Bonus Super/Booster, Claim Shield, Claim Shield Plus, Wellness Benefit, Instant Cover/Plus, OPD Care, Be Fit | Both have add-on options for customization, Care wins in this regard |
| Maternity Coverage | Via Parenthood Rider (₹50K to ₹2L coverage) | Not available | Maternity coverage not included in the base plan of both. |
HDFC Ergo vs Care Health Insurance: Popular Plans
Both HDFC Ergo and Care Health Insurance offer a wide range of health insurance products catering to different needs and budgets. Below is a quick list of popular HDFC Ergo and Care plans, from base plans to top-ups.
HDFC Ergo
- Optima Secure
- Optima Super Secure
- Optima Secure Global Plus
- Optima Energy Silver
- Medisure Super Top-up
Care Health
HDFC Ergo vs Care Health Insurance: Premium Comparison
Price is often the first thing that comes to mind when choosing a health insurance plan. So we've put together a premium comparison of HDFC ERGO vs Care Health Insurance and have highlighted their most recommended plans across age groups to give you a clear view of how costs vary.
HDFC Ergo Health Insurance: Premium Comparison (₹15 Lakh Sum Insured, Delhi)
| Plan | Single (28 yrs) | Couple (32 & 35 yrs) | Seniors (62 & 60 yrs) | Riders / Add-ons |
|---|---|---|---|---|
| Optima Secure | ₹17,293/yr (Add-ons: ₹86) |
₹27,003/yr (Add-ons: ₹135) |
₹87,584 (Add-ons: ₹438) |
Unlimited Restore |
| Plan | Single (28 yrs) | Couple (35 & 32 yrs) | Seniors (62 & 60 yrs) | Riders / Add-ons |
|---|---|---|---|---|
| Care Supreme | ₹15,217/yr (Add-ons: ₹2,911) |
₹21,340/yr (Add-ons: ₹4,492) |
₹76,535/yr (Add-ons: ₹18,007) |
Cumulative Bonus Super, Claim Shield, Annual Health Checkup |
Note: The premiums listed reflect only the base plan cost and exclude cost of any add-ons or riders.
Key Insight: Care Supreme is lighter on the pocket for young individuals and couples, but its add-ons raise the overall cost. HDFC Ergo’s Optima Secure, while priced slightly higher upfront, offers stronger in-built benefits (like unlimited restore) with minimal add-on expenses. For seniors, HDFC Ergo tends to provide steadier pricing, whereas Care’s premiums rise more sharply.
Who Should Choose HDFC Ergo vs Care Health Insurance
Picking between HDFC Ergo Vs Care Health Insurance isn’t just about premiums. It’s about how they handle claims, the kind of experience you’ll have as a customer, and the flexibility their plans give you. The right choice really comes down to which insurer fits your needs better.
Performance and Operational Metrics
As we have already discussed above, HDFC Ergo demonstrates stronger operational performance, higher claim settlement reliability, and better customer satisfaction. Care, while having a lower incurred claim ratio and more complaints per claim, focuses on cost-effective, flexible health insurance plans.
Claim Processing and Customer Experience
HDFC Ergo and Care Health Insurance both focus on streamlined claim processes, but with some notable differences.
- HDFC Ergo is known for its quick, in-house claim settlement team, which means individual policy claims are not handled by a third-party administrator (TPA). This can lead to faster approvals.
Customer reviews generally highlight a hassle-free and efficient process that shows the company's responsiveness and transparency. Also its claims process includes pre-approved cashless treatments for chronic patients that supports smoother hospital visits. - Care Health Insurance is also lauded for its customer-centric approach and in-house claim settlement. Customer feedback often highlights the ease of the claim process. However, their complaint volume is slightly higher.
In Ditto’s own experience working with Care, overall service has been fairly decent. The company's focus on a wide range of customer needs, including specific plans for chronic conditions, riders to reduce waiting period, and gym memberships, contributes to a positive overall experience.
Range of Offerings and Features
Both HDFC Ergo and Care Health Insurance provide a wide spectrum of health insurance solutions that cater to individuals, families, and senior citizens. HDFC Ergo emphasizes breadth of coverage, long-term value, and operational reliability. This makes it appealing for those who prioritize stability and smooth claim experiences. Care Health Insurance, on the other hand, focuses on affordability, flexible design, and innovative add-ons that appeal strongly to younger customers and cost-conscious buyers.
In terms of pricing approach, HDFC ERGO is generally positioned on the higher side. This higher pricing reflects its focus on offering comprehensive benefits and reliable service. In contrast, Care aims to balance cost with flexibility and offers more budget-friendly options that can be customized through riders.
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HDFC Ergo vs Care Health Insurance: Conclusion
When it comes to picking between HDFC Ergo Vs Care Health Insurance, the decision isn't about which insurer is better as both bring their own strengths to the table. The right choice comes down to your priorities. HDFC Ergo is ideal for individuals and families who prioritize reliability, stability, and operational excellence in their insurer.
Care Health Insurance is better suited for customers who want affordable coverage with innovative, customizable benefits for pre-existing conditions. Its valuable add-ons and competitive pricing make it a popular choice for families.
Not sure which way to go? That’s where we come in. Ditto’s advisors will compare your options, explain the fine print, and even support you during claims — all for free. Book a free call with us and get unbiased advice before you decide.
Frequently Asked Question
Which insurer has a better claim settlement ratio?
HDFC Ergo has a higher average claim settlement ratio of 98%, compared to Care Health’s 90%- indicates more reliable claims payment.
Does HDFC Ergo charge co-payment for seniors?
No, generally both insurers do not apply copay in their flagship plans but if you do not qualify for these due to underwriting reasons, you may have to settle for plans with copay because some coverage is still better than nothing.
Can the waiting period for pre-existing diseases be reduced?
Yes, both insurers let you reduce the waiting period for pre-existing diseases. HDFC Ergo’s Optima Secure offers the ABCD Chronic Care add-on with a 30-day cover for conditions like diabetes, hypertension, asthma, and cholesterol. Care Supreme from Care Health provides the Instant Cover rider for 30-day coverage of select PEDs and a PED Modification rider to cut the wait from 36 months to 1–2 years.
Does Care Health Insurance offer better maternity benefits compared to HDFC Ergo?
Care Health Insurance and HDFC Ergo both offer maternity benefits, but neither has a very extensive maternity portfolio. Care Health provides maternity coverage through its Care Joy plan, which is designed specifically for maternity needs with a relatively shorter waiting period. HDFC Ergo, on the other hand, offers maternity benefits via parenthood rider attached to plans like Optima Secure but excludes coverage for new born.
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