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HDFC ERGO General Insurance Company Limited my:health Personal Accident Insurance Proposal Form Application No. FOR OFFICE USE ONLY Branch Code:Intermediary Code*:Intermediary Location Code :Intermediary

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How to fill out my health personal accident

01

Gather all necessary personal information such as name, address, contact details, and policy number.

02

Fill out the sections related to your medical history, current health status, and any previous accidents or illnesses.

03

Provide details on the type of coverage you are seeking and any additional benefits you might want to include.

04

Review the form for completeness and accuracy before submitting it to your insurance provider.

Who needs my health personal accident?

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Anyone who wants financial protection in case of a health-related accident or illness.

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Individuals who have dependents and want to ensure their medical expenses are covered in case of an emergency.

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What is my health personal accident?

Your health personal accident provides coverage for medical expenses and loss of income in the event of an accident.

Who is required to file my health personal accident?

You or your designated representative are required to file your health personal accident claim.

How to fill out my health personal accident?

You can fill out your health personal accident claim form online or by submitting a paper form to your insurance provider.

What is the purpose of my health personal accident?

The purpose of your health personal accident is to provide financial protection in case of an accident resulting in medical expenses or loss of income.

What information must be reported on my health personal accident?

You must report details of the accident, medical treatments received, and any loss of income due to the accident on your health personal accident form.

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