Family Health Insurance - Kotak Health Care

As people rightly say, health is wealth, which is why we have Kotak Health Care – a comprehensive health insurance plan to ensure you and your family members are always well-protected.

Overview

‘A healthier tomorrow starts today.’ Exorbitant medical expenses often cause financial stress. As a solution to such an issue, you may invest in Kotak Health Care. Our health insurance policy allows you to undergo medical treatments without any financial constraints. You may avail of quality medical treatment and focus on speedy recovery, instead of worrying about making last-minute cash arrangements.

Steps to avail of Kotak Health Care

Availing of a health insurance is simple. All you have to do is follow the below-mentioned steps to purchase an insurance policy online.

1. Select from the various options

You may choose from the various health insurance options available, which include individual personal health insurance, entire family under one plan, or numerous family members under separate policies.

2. Select the members

You may then select the members you wish to insure. This includes self, spouse, son, daughter, or your parents.

3. Enter the date of birth

The next step is to fill the date of birth of the members you wish to insure.

4. Select the amount of insurance

You may then select the amount of insurance coverage you wish to avail of. You may determine the premium amount by using a health insurance premium calculator.

5. Enter contact details

In order to help us serve you better, enter your personal details such as your mobile number, email address, and state of residence.

6. Get a quote

While you sit back and relax, we provide you with the most suitable quote. You may then go ahead and purchase your health insurance online.

Renewing your health insurance

It is imperative to renew your policy on time to continue availing the benefits of your policy. Besides, you also avail a cumulative bonus of 10% on your Base Annual Sum Insured at the time of renewal, as long as no claim has been made throughout the policy term. You may avail of cumulative bonus up to a maximum of 50% of Base Annual Sum Insured.

By purchasing medical insurance plans for family, you must protect yourself and your family from any financial losses in case of a medical emergency. You may, therefore, purchase or renew your insurance policy at the earliest to avail of the numerous benefits the Kotak Health Care plan has to offer.

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Product UIN – KOTHLIP21071V032021

Key benefits

Health insurance takes care when one faces medical uncertainty. By investing in Kotak Health Care, you can avail the numerous benefits it has to offer. Following are the four major advantages of availing of this health care plan.

Coverage against medical bills: Both family floater health insurance plans and individual health plans provide coverage against expenses incurred on hospitalisation. This includes in-patient treatment, day care treatment, pre-hospitalization medical expenses, and ambulance expenses, among others.

In-Patient Treatment: If you are hospitalised for any kind of treatment, the medical expenses incurred as a result of the hospitalisation of the insured person due to an illness or an injury for a minimum and continuous period of 24 hours will be covered.

Health check up: Kotak Health Care plan provides the benefit of one health check-up per year at any of the network hospitals for every insured member above the age of 18 at no additional cost to you. A considerable number of tests are covered under this free check-up, which includes: CBC, MER, Serum, Cholesterol, Serum Creatinine, SGPT /SGOT, ECG, Random Blood Sugar. Utilising the Free Health Check-Up will not affect the Base Annual Sum Insured or the Cumulative Bonus.

Optional covers: You may avail comprehensive insurance coverage by opting for any of the add-ons based on the type of plan that you have opted for.

Ambulance Cover: If you find yourself in need of emergency ambulance services, you’re covered. The cost of transporting the insured person by a registered healthcare or ambulance service provider to a hospital for treatment of an illness or injury following an emergency will be covered, per the limits specified in your policy documents.

Enhanced Protection: For better coverage, you can choose to enhance your policy by choosing from our range of add-ons that are available for an additional premium.

The Kotak Edge: When it comes to keeping your money and your life safe and secure, it pays to go with a reputed company. The Kotak Group has an illustrious history that spans over 3 decades, and is considered to be one of the most trusted brands in the country. With Kotak Health Care, your health concerns are in safe hands.

Features

Day Care Treatments: If medical expenses are incurred for specified treatments or procedures that do not require you to be hospitalised for more than 24-hours, Kotak Health Care will cover the cost of these procedures. Avail cover for up to 150 specified procedures and treatments. For a complete list of Day Care Treatments covered, please refer to the policy wordings.

Cumulative Bonus: Avail special no-claim benefits on your policy. Receive a cumulative bonus of 10% on your Base Annual Sum Insured on renewal of your health insurance, provided there has been no claim throughout the policy period, up to a maximum of 50% of the Base Annual Sum Insured. If any claim is made under the policy after a Cumulative Bonus has been applied, then the accrued Cumulative Bonus under the policy will reduced by 10% on the commencement of the next policy year or the next renewal of the policy as applicable.

Pre-Hospitalisation Medical Expenses and Post-Hospitalisation Medical Expenses: In the event of a hospitalisation, focus only on getting better and not on the costs. Medical expenses incurred 30 days before a hospitalisation, and 60 days after a hospitalisation will be covered under Kotak Health Care.

Cashless benefit: Besides reimbursement of medical bills, you would also get the benefit of cashless settlement. Therefore, you need not worry about making any huge expenses, as we settle the bill directly with over 4000 hospitals in our hospital network.

Picking a Plan: Kotak Health Care comes to you in the form of three options; Excel, Premium and Prime. Have a look at what exactly is covered by each plan in the below table before you make your choice:

Benefits Excel Premium Prime
Base Sum Insured 2 lakhs, 3 lakhs, or 4 lakhs 5 lakhs, 10 lakhs, 15 lakhs, 20 lakhs, or 25 lakhs 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 50 lakhs, 75 lakhs, or 100 lakhs
Optional Covers (Add-Ons) Pack 1: Hospital Daily Cash + Convalescence Benefit + Donor Expenses

Pack 2: Critical Illness Cover + Double Sum Insured
Hospitalization due to Accident

Pack 3: Cap on Room Rent
Pack 1: Hospital Daily Cash + Convalescence Benefit + Donor Expenses

Pack 2: Critical Illness Cover + Double Sum Insured
Hospitalization due to Accident
Option 1: Hospital Daily Cash

Option 2: Convalescence Benefit

Option 3: Donor Expense

Option 4: Critical Illness Cover

Option 5: Double Sum Insured
Hospitalization due to Accident

Option 6: Domiciliary Hospitalisation Cover

Option 7: Alternative Treatment

Option 8: Maternity Benefit

Option 9: New Born Baby Cover

Option 10: Compassionate Visit

Option 11: Restoration of Sum Insured
Individual/Floater Individual: Available for all Sum Insured

Floater: Available for 3 lakhs and 4 lakhs only
Both Available  
Waiting Period: Pre-Existing Disease 4 Years (for all age groups)  
Min./Max. Entry Age Minimum 5 years & Maximum 65 years (Individual)
Minimum 91 days & Maximum 65 years (Floater)
Maximum 25 years for dependent children
 
Exit Age No Exit Age
(Lifetime Renewability)
 
Policy Tenure 1, 2, & 3 years  
Relationships Covered Self, Spouse, Dependent Children, Dependent Parents  
Tax Benefit Under Sec. 80D of IT Act 1961  
Free-Look Period 15 days from the date of receipt of the policy  

Optional Covers

Choose from a range of optional add-ons that are customised to your needs, and provide you with enhanced protection. Ensure maximum protection for you and your loved ones by selecting the following add-ons that are available at an additional premium:

Excel Plan

  • Hospital Daily Cash (INR 500 per day for minimum 3 days of hospitalization subject to maximum of 10 days)
  • Convalescence Benefit- INR 10,000 (minimum hospitalisation of 10 days)
  • Donor Expenses (up to Base Annual Sum Insured)
  • Critical Illness Cover (Additional Sum Insured equivalent to Base Annual Sum Insured)
  • Double Sum Insured for Hospitalization due to Accident (Additional Sum Insured equivalent to Base Annual Sum Insured)
  • Cap on Room Rent (1% of annual sum insured in case of stay in Non ICU; 2% of annual sum insured in case of stay in ICU)

Premium Plan

  • Hospital Daily Cash (INR 500 per day for minimum 3 days of hospitalization subject to maximum of 10 days)
  • Convalescence Benefit- INR 10,000 (minimum hospitalisation of 10 days)
  • Donor Expenses (up to Base Annual Sum Insured)
  • Critical Illness Cover (Additional Sum Insured of INR 5 lacs)
  • Double Sum Insured for Hospitalization due to Accident (Additional Sum Insured equivalent to Base Annual Sum Insured)

Register a Claim/Claim Process

Cashless Claim Process

Step 1: In case of a planned hospitalisation, take a pre-authorisation by informing us 48 hours prior to the admission

Step 2: In case of an unplanned hospitalisation, intimate to us about your claim by calling 1 800 266 4545 within 24 hours of the admission

Step 3: Use our Policy Certificate to avail of the cashless facility at any of our network hospitals

Reimbursement Process

Step 1: Intimate us by calling 1 800 266 4545 immediately on hospitalisation

Step 2: Settle bills directly with the hospital and collect all relevant documents

Step 3: Within 30 days of discharge, submit all the original documents to us

Waiting Period/Exclusions

At Kotak Mahindra General Insurance, we value transparency above everything else. Here's a list of what we don't cover under our Kotak Health Care Policy, so we can avoid any inconvenience at the claims stage. Below is a list of our permanent exclusions and waiting periods:

  • Permanent Exclusions: Certain specified illnesses, procedures or treatments like routine health check-ups, dental treatments, cosmetic or plastic surgery, treatment for alcoholism, drug or substance abuse, etc., are permanently excluded from the scope of coverage. For a complete list of permanent exclusions, please refer to the policy wordings.
  • 30-Day Waiting Period: This includes expenses related to the treatment of any illness within 30 days from the first policy commencement date unless due to an accident. This exclusion doesn't apply if the Insured Person has continuous coverage for more than 12 months.
  • Specified disease/ procedure waiting period: This exclusion includes medical expenses incurred for certain specified illnesses or conditions like Hernia, Fissures/Fistula, Arthritis, Gout etc. during the first 2 consecutive years of the commencement of the policy. The following illnesses/medical conditions shall fall under 2-year exclusions: Cataract; Benign Prostatic Hypertrophy; Myomectomy, Hysterectomy unless because of malignancy; All types of Hernia, Hydrocele; Fissures and/or Fistula in anus, haemorrhoids/piles; Arthritis, gout, rheumatism and spinal disorders; Joint replacements unless due to accident; Sinusitis and related disorders; Stones in the urinary and biliary systems; Dilatation and curettage, Endometriosis; All types of skin and internal tumours/cysts/nodules/polyps of any kind including breast lumps unless malignant; Dialysis required for chronic renal failure; Surgery on tonsillitis, adenoids and sinuses; Gastric and duodenal erosions and ulcers; Deviated nasal septum; Varicose Veins/Varicose Ulcers.
  • Pre-existing Diseases waiting period: This exclusion applies to any pre-existing disease at the time of buying the policy. Any expenses related to the treatment of a pre-existing Disease (PED) and its direct complications will not be covered for a period of 48 months of continuous coverage. If the Insured Person is continuously covered without any break as defined under the portability norms of the extant IRDAI (Health Insurance) Regulations, then waiting period for the same would be reduced to the extent of prior coverage.

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