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In-patient Treatment
Medical expenses like room rent, ICU charges, operation theatre charges, doctor’s fees, etc. arising out of minimum 24 hours of hospitalization will be covered.
Day Care Treatment
Medical expenses incurred for listed 405 day care procedures will be covered which require less than 24 hours hospitalization. The complete list is available on our website www.kotakgeneral.com.
Pre and Post-Hospitalization Medical Expenses
Pre & post hospitalization medical expenses upto specified number of days Prior to admission and after discharge based on the plan opted will be covered.
Restoration Benefit
There will be a 100% restoration of the Base Sum Insured once in a policy year in case the Base Sum Insured and Cumulative bonus is insufficient as a result of previous claims in that policy year.
Cumulative Bonus
Cumulative Bonus can be earned upto 50% / 100% of the Sum Insured as per plan opted in case of a claim free year at 10% per year. There will be no reduction in Cumulative Bonus in case of a claim.
Annual Health Check-up
The policy includes one free health check-up for each Insured Person above 18 years of age for specified tests. Availing the health check-up will not impact the Base Sum Insured or the Cumulative Bonus. This will be offered regardless of any claim in the Policy.
30 Day Waiting Period
Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident. This exclusion doesn't apply if the Insured Person has Continuous Coverage for more than twelve months.
Specified disease / procedure waiting period
This 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.
Pre-existing Disease Waiting Period
Any Pre-Existing Disease will not be covered until waiting period as per Plan opted for as elapsed.
Permanent Exclusions
Treatment for Alcoholism, drug or substance abuse, Intentional self-injury, cosmetic surgery, Expenses related to any unproven treatment, Expenses related to sterility and infertility, Claims related to b
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Learn moreApply for the Kotak Health Premier policy, a comprehensive health insurance plan with attractive features and value-added benefits.
Health insurance is a coverage which safeguards against the financial implications of a medical contingency. A health insurance policy usually covers the hospital and medical bills that you might incur in the case of a covered illness or accidental injury.
There are two main types of health insurance plans – indemnity and fixed benefit health plans. Indemnity plans pay the actual medical costs that you incur in the case of a sickness or injury. Fixed benefit plans, on the other hand, pay a lump sum benefit irrespective of the actual medical costs incurred.
Indemnity health insurance plans, also called Mediclaim or medical insurance plans, are quite popular since they help you avail of cashless treatments without worrying about affordability.
A medical insurance plan has become the need of the hour because of the coverage it provides. Here are some reasons why the plan has become necessary in today’s age –
Illnesses and diseases are on the rise. Diabetes, hypertension, heart-related ailments, lifestyle conditions, etc. have become a common occurrence. These might require frequent medical attention. Alternatively, if the illness continues, it can become severe and require advanced treatments. A medical insurance plan is, thus, necessary to prevent against the financial implication of rising illnesses.
Medical treatments and hospitalisation has become expensive. A small surgery can cost lakhs of rupees and if the treatment is advanced, the medical bills might be financially draining. A medical insurance plan covers your medical expenses and allows access to quality healthcare. That is why it is a must.
You can also get tax benefits on the premiums paid for medical insurance plans. This benefit helps reduce your tax liability so that you can save money and also protect your savings against medical emergencies. Know more reasons why you need to get a medical insurance.
Kotak General Insurance offers a range of health insurance policies to suit the different needs of its customers. Some of the most popular policies of the company are as follows –
Name of the plan | Salient features |
---|---|
Kotak Health Premier (UIN:KOTHLIP23109V042223) | The comprehensive health insurance policy, Kotak Health Premier allows a range of inbuilt and optional coverage features for complete protection. The salient features of the plan are as follows –
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Kotak Secure Shield (UIN-KOTHLIP22057V052122) | This is a fixed-benefit critical illness health insurance policy which gives you financial protection in a critical illness. The features of the policy are as follows –
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Kotak Accident Care (UIN: KOTPAIP22072V042122) | This is a personal accident policy which covers accidental death, permanent total disablement, permanent partial disablement and temporary total disablement. The features of the policy are as follows –
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Kotak Health Super Top-up (UIN: KOTHLIP21162V032021) | This is a super top-up plan which helps enhance your health insurance coverage at affordable premiums.
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A pre-policy medical check-up involves health check-up of the insured members to assess their current health risks. If you opt for a high sum insured or if you are considerably old in age, you might have to undergo pre-entrance health check-ups. Alternatively, if you declare an adverse medical condition, then also the medical check-up might be required.
The requirement of such check-ups depends on the underwriting guidelines of the insurance company. The test is conducted at the insurer’s networked diagnostic facility and the results are valid for 30 days. If you are eligible for a pre-policy medical check-up, the details of the medical tests and the diagnostic centre would be informed in advance.
Kotak health insurance plans allow coverage for a range of medical expenses. Some of the basic coverage benefits include the following –
This covers the medical costs incurred when you are hospitalised for 24 hours or more. The cover includes the cost of room rent, ICU charges, doctor’s fee and other hospitalisation expenses.
Pre-hospitalisation expenses are those which you incur before being hospitalised. These include doctor’s consultations, medicines, diagnostic tests, etc. Post-hospitalisation expenses are those which are incurred after you are discharged from the hospital. These also include doctor’s consultations, medicines, diagnostic tests, etc. Both these expenses are covered under Kotak health insurance plans.
Coverage is allowed for the costs incurred on hiring an ambulance to transport the insured to the hospital. Some plans allow coverage up to specified limits while some plans allow coverage for the actual expenses incurred.
Some treatments do not require 24-hour hospitalisation due to advanced procedures. These treatments are called day-care treatments and they are covered under Kotak health insurance plans.
If you are receiving an organ transplant, the policy would cover the cost of the donor’s hospitalisation.
If you are hospitalised at home either because there are no available hospital beds or because your medical condition doesn’t permit movement, such hospitalisation would be called a domiciliary hospitalisation and it would be covered under the Kotak health insurance plan.
AYUSH stands for Ayurveda, Unani, Siddha and Homeopathy. These are alternative forms of treatment which are non-allopathic. Kotak health insurance plans allow coverage for these treatments too subject to specified conditions.
You also get annual health checkups under Kotak health insurance plans. Many plans offer such check-ups every year while some plans might allow the check-up once after a specified number of years.
Cumulative bonus is a reward that you get for not making a claim in your health insurance policy. Kotak health insurance plans allow cumulative bonus in the form of sum insured enhancement after every claim-free year. The bonus keeps accumulating after every successive claim-free year up to a specified maximum limit.
Though Kotak health insurance plans are quite comprehensive, there are some instances which are not covered. These are called policy exclusions and they depend on the policy that you choose. However, some of the common policy exclusions under Kotak health insurance plans are as follows –
If you suffer from any pre-existing illness when buying a new Kotak health insurance policy, the pre-existing waiting period would apply. The pre-existing condition and medical complications arising out of it would not be covered during the specified waiting period. The waiting period would reduce with each policy year and once it is over, you can get coverage for a claim pertaining to your pre-existing conditions.
The pre-existing waiting period varies across plans. It usually ranges from 24 months to 48 months and is calculated from the coverage start date.
There is also an initial waiting period from the date of policy commencement during which illnesses and diseases are not covered. If you suffer from any illness or ailment during the initial waiting period, even if it is not pre-existing, coverage would not be allowed.
The initial waiting period may vary across policies and usually starts from 30 days.
This waiting period is applicable for specific illnesses and treatments like appendicitis, tonsillectomy, fissures, hernia, joint replacement, etc. The specified illnesses and treatments are not covered during this waiting period.
The specific waiting period varies across different Kotak health insurance policies. It usually ranges from 12 months to 48 months.
Besides the waiting period, Kotak health insurance plans do not allow coverage for the following instances –
Claims arising due to war, nuclear contamination, mutiny and related perils
Cosmetic treatments
Dental treatments, unless otherwise specified
Maternity treatments, unless otherwise covered as an inbuilt or an optional benefit
Self-inflicted injuries or attempted suicides
Illnesses or injuries suffered due to alcohol or drug addiction
Participation in hazardous or adventure sports and claims arising thereof
Participation in acts of criminal nature
Fraudulent claims, etc.
The Kotak Health Premier Insurance policy offers a range of optional coverage benefits that you can add to your policy at an extra cost.
The optional covers depend on the plan variant that you choose and are as follows –
Optional cover | Meaning |
---|---|
Home Nursing Benefit | Under this cover the cost of hiring a nurse is covered after you are discharged after treatment |
Daily Cash for Accompanying an Insured Child | If an insured minor child is admitted to a hospital, the optional cover would pay a daily cash allowance for the accompanying adult |
Compassionate Visit | The cost of return journey is paid for an immediate family member/ relative for travelling to the Hospital where the Insured Person is hospitalized |
Critical Illness Cover (Available for Age 18 years and above) | The optional cover has a list of 18 illnesses. If the insured suffers any of the covered illness, a lump sum benefit is paid |
Personal Accident Cover | It covers accidental death and permanent total disability. In either of these occurrences, a lump sum benefit is paid. |
Cap on room rent | If you choose a capping on room rent, you can claim a premium discount |
Optional cover | Meaning |
---|---|
Compassionate Visit | The cost of return journey is paid for an immediate family member/ relative for travelling to the Hospital where the Insured Person is hospitalized |
Maternity Benefit* (with 3 years waiting period) | This optional cover allows coverage for maternity-related expenses incurred on childbirth and pre and post-natal care. |
Newborn Baby Cover* (with 3 year waiting period) | Medical Expenses incurred on the Hospitalization of the Insured Person’s New Born Baby is covered |
Vaccination Expenses* (with 3 year waiting period) | The vaccination expenses of the new born baby are covered under the maternity benefit as per the Sum Insured opted |
Air Ambulance Cover | The add-on covers the cost of hiring an air ambulance for hospitalisations |
Critical Illness Cover (Available for Age 18 years and above) | The optional cover has a list of 18 illnesses. If the insured suffers any of the covered illness, a lump sum benefit is paid |
Personal Accident Cover | It covers accidental death and permanent total disability. In either of these occurrences, a lump sum benefit is paid. |
Learn more about how to choose proper coverage for health insurance
Kotak offers a range of online health insurance plans to match your coverage needs. The plans are comprehensive in their scope of coverage and are available at affordable premiums. Here are some reasons why you can choose Kotak for buying an online health insurance policy –
Kotak General Insurance is a part of the famed Kotak Group which has more than 30 years of experience in the industry. Spanning a range of financial services, the Kotak Group is reliable and has a wide customer base.
You might need assistance in buying a suitable health plan or at the time of claims. Kotak offers round-the-clock assistance for all your queries and needs. You can connect with the company at your convenience and get the solution for your queries.
Kotak has consistently settled customer claims to help you in times of need. Kotak health insurance plans have a high claim settlement ratio which fosters trust in the company.
Kotak keeps its customers at the forefront and seeks to solve their grievances at the earliest. That is why the company enjoys the lowest complaint ratio in the insurance industry.
Get a complete solution for your health insurance needs with Kotak. Choose from indemnity or fixed benefit plans for complete financial protection. Kotak offers hospitalisation cover plans as well as specialised coverage options like super top-up health plans, personal accident health plans, etc.
Buying a Kotak health insurance plan is quite simple and convenient. You can buy the plans online or offline. For offline purchases, you can meet the company’s representative or visit the nearest branch. For online purchases you can simply visit the website, choose the plan that you want, fill an online application form and pay the required premiums.
The online mode offers quick purchase so that you can enjoy coverage at the earliest.
Know more benefits & reasons why you should buy health insurance online
It's time to make health your priority. Opt Kotak Health Premier Plan, which is a comprehensive health insurance plan that provides all-around protection in just a few steps. Apply for the health plan as listed below:
Step 1: Click on the "Get a Quote" button on the Kotak Health Insurance Page.
Step 2: Fill in your family details such as number of adults, number of kids, Mobile Number, etc.
Step 3: Select Suitable Plan
Step 4: Make the payment online.
It's that simple!
It is recommended to buy a health insurance plan at an early age. Here are some reasons why –
The sooner you buy a medical insurance plan, the sooner you get covered against medical contingencies. Even when you are young and healthy, you might suffer sudden illnesses or injuries which are not age-related. The COVID pandemic is a classic example.
In such cases, buying a health plan early would give you the coverage that you need to pay for your medical bills.
A health insurance plan offers financial security by promising the coverage. When you are covered, you find it easy to meet your medical bills without disturbing your financial savings or the monthly budget. The health plan also allows access to quality healthcare facilities.
Buying early gives you the financial security from an early age. As you secure your finances against medical emergencies, you can plan for your other financial goals without worrying about unexpected outcomes.
Health insurance plans have different types of waiting periods during which coverage for specified illnesses and medical conditions is not available.
When you are young, you might not suffer from the health conditions excluded during the waiting period. So, when you buy the plan early, you can wait out the waiting period so that when the illnesses do strike, you can enjoy complete protection.
Health insurance plans also allow tax benefits. You can reduce your tax liability by claiming a deduction on the health insurance premium paid. When you buy early, you can enjoy tax benefits from an early age for efficient tax planning.
Kotak allows you to calculate your health insurance premium online. The process is simple and requires some simple steps. You can use the premium calculator to check the premium online.
Here’s how you can calculate your health insurance premium online –
Open the premium calculator and furnish your details.
The details include the following –
Based on the details given, the calculator would show the premium payable.
Your health insurance policy comes for a specified tenure. Once the tenure expires, you should renew the policy for uninterrupted coverage. Health insurance plans allow lifelong renewals and you can renew the policy online.
Here are the advantages of renewing the coverage online –
Renewing online is easy. You simply have to visit the insurer’s website, enter your policy number and other verification details and check the policy status. Then you can choose the renewal option, pay the renewal premium and the policy would be renewed easily.
You don’t have to visit the insurer’s branch office or search for the representative of the company for renewing. The process is simple and can be done from the comfort of your home or office.
The online renewal process is instant. You don’t have to wait for hours or days. Just choose the policy details and pay the renewal premium online. The policy gets renewed without delay. This is particularly helpful if your health plan is near its expiry date as you don’t have to lapse the coverage with instant renewals.
On renewing online, you can compare the other health insurance plans and see which offers a comprehensive scope of coverage at competitive rates of premium. You can compare and switch to another policy if it offers better coverage at attractive rates.
The coverage details are available online. You can check the coverage of your previous plan, make changes, if required, and then renew it online.
Take a pre-authorization in case of a planned hospitalization by informing us 48 hours prior to admission.
In case of unplanned hospitalization, intimate us about your claim by calling 1800 266 4545 within 24 hours of admission.
Visit any of our network hospitals & use our Policy Certificate to avail cashless facility.
Intimate us by calling 1800 266 4545 immediately on hospitalization. Settle bills directly in the hospital & collect all relevant documents. Submit all original documents to us within 30 days of discharge. List of applicable documents is available on our website: https://www.kotakgeneral.com/
There are certain documents which are required for health insurance claim reimbursement. These documents are as follows –
As mentioned earlier, a health insurance policy helps in saving taxes. The premium paid towards the health plan can reduce your taxable income and, consequently, your tax liability.
You can pick an indemnity or a fixed-benefit health insurance plan and the premium would enjoy the aforementioned tax benefits. Moreover, for the optional add-ons selected, the additional premium paid also qualifies for a deduction under Section 80D up to the specified limits. Know more about tax deductions on health insurance.
A health insurance policy can have some technical terms that might confuse you. So, here are some important terms and their meaning to simplify the health insurance concept –
Terms | Meaning |
---|---|
Room rent limit | This is the maximum room rent that the health insurance policy would cover. The room rent limit may be different for normal hospitalisation and ICU admission |
Proportionate deduction | If you choose a room whose rent exceeds the allowed limit, the concept of proportionate deduction would apply. The inpatient hospitalisation claim for room rent would be reduced in the proportion of the allowed limit vis-à-vis the actual rent. For instance, say the allowed room rent limit is Rs.5000 and the room you chose has a rent of Rs.10,000. If the total hospitalisation claim is Rs.50,000, a claim of Rs.25,000 would be paid since your actual room rent exceeded the allowed limit by 50% |
Compulsory deductible | This is the portion of claim that you have to pay out of your pocket in each instance of claim. Compulsory deductible is applicable in some coverage features. For instance, the plan might allow coverage for domiciliary hospitalisation only after 3 days. So, the expenses incurred in the first 3 days would be treated as a compulsory deductible. |
Consumables | Consumables are one-time use items whose cost is not usually covered under health insurance plans. Common examples include bandages, masks, gloves, etc. |
Preferred Provider Network | Preferred provider network is the network of selected hospitals with which the insurance company has a tie-up. If you get admitted in any hospital within the network, you will get a cashless treatment |
Pre-existing illness/disease | A pre-existing illness/ disease is a medical condition that you already suffer from when you are buying a fresh health insurance policy. Common examples include diabetes, hypertension, asthma, etc. |
Pre-policy medical check-up | A pre-policy medical check-up is a health check-up conducted before the health insurance policy is issued. Insurance companies ask for such check-ups if the insured’s age exceeds a preferred limit and/or you choose a higher sum insured |
Co-payment | Co-payment is short for compulsory payment. This is like a deductible wherein a part of the claim is payable by you while the insurance company pays the rest of the claim. For instance, if there is a co-pay of 20% and the claim amount is Rs.1 lakh, you have to pay Rs.20,000 out of your pockets while the insurance company would pay the remaining Rs.80,000. Co-payment is usually applied for senior citizens, for getting treatments in cities that fall under higher zones, etc. |
Sum insured restoration/recharge/reinstatement | Some health insurance policies offer the benefit of restoration/recharge/reinstatement of the sum insured. In simple terms, restoration means reallocating the sum insured when the Sum Insured and accrued bonus has been exhausted on previous claims. The feature comes in useful if you have incurred multiple claims in the same policy year and the previous claims have used up the sum insured. In such cases, the sum insured is refilled to allow coverage for subsequent claims. |
Individual vs family floater policy | Under an individual policy, each member of your family enjoys an independent sum insured. The member can make a claim up to the sum insured allocated to him/her. The claim would not affect the sum insured allotted to other members. A family floater policy provides a consolidated sum insured to all family members who can use it jointly or independently. Each member can make a claim up to the overall sum insured of the family floater policy. However, once a member claims, the sum insured for other members reduces. |
Of course, you may have more questions related to health insurance, so scroll down and find your question answered!
Medical/ Health insurance is an insurance policy designed to cover medical expenses arising due to unforeseen illnesses or injuries. The health insurance policy covers hospitalisation expenses and other medical costs that you might incur depending on the coverage offered under the plan.
There are different types of health insurance plans available in India. These include the following –
With the growing medical inflation, a robust health insurance plan for your family helps meet any medical exigencies. Apart from the coverage, health insurance plans also help in getting access to enhanced medical facilities without depleting your savings. Also know about the consequences of not having a health insurance plans.
Coverage under health insurance plans depend on the type of policy that you choose and the coverage that it provides. Health insurance plans at Kotak cover the following common healthcare expenses:
If you buy a health plan for your parents and pay the premium, the premium paid would qualify as a deduction under Section 80D. The limit of deduction is Rs.25,000 if your parents are below 60 years of age. For senior citizen parents, the limit increases to Rs.50,000.
You can enjoy umpteen benefits if you buy a health insurance plan at an early age. A few of the advantages are:
Lesser exclusions in a health insurance policy:
Health insurance companies impose exclusions on pre-existing illnesses or diseases that you have already suffered, which is likely to be less at a younger age. Thus, when you buy the plan young, you are likely to be healthy and enjoy a comprehensive scope of protection.
No health check-up:
Undergoing a health check-up might not be required if you are young.
Waiting out the waiting period
Health plans have different waiting periods for different illnesses. When you are young, you might be healthy. As such, you can wait out the waiting period so that when you might develop illnesses, the policy would allow coverage from Day 1.
Tax benefits
You can also enjoy tax benefits on the premium paid for the health plan and save taxes.
Know more about the tax benefits of health insurance
YWhat are the health insurance eligibility criteria?
Here are a few factors that affect the health insurance premium:
If you are planning to do renewal of health insurance online, simply follow the below steps:
Here’s the process for making a health insurance claim -
Cashless claim
Reimbursement claim
Know about the various ways to make a health insurance claim
To select the right health insurance cover, here are a few things you should keep in mind:
For instance, if you are searching for a health insurance that covers life-threatening diseases, then you can opt for Kotak Shield Secure to protect you and your family.
While buying the policy, the cost of the premium is often the most important thing you may evaluate. While calculating health insurance premiums, a lot of factors are taken into consideration; these include:
Yes. You have the flexibility to add more people to the existing health insurance policy. However, the health insurance premium also increases with the inclusion of a new member.
Children of any age can be included in the health insurance policy right from the day they are born. For instance, if you have purchased Kotak Heath Care Policy, you can include your child (up to 25 years) in the existing policy.
The requirement of a medical examination depends on your age, sum insured and the policy that you choose. Some plans might require a medical check-up while others might not. However, if you are older and/or if you are opting for a high sum insured, the medical examination usually becomes necessary before the coverage is granted.
If you or any member of your family is admitted to a non-network hospital, you can request the insurance company for reimbursement of the hospital expenses. Health insurance policyholders at Kotak General Insurance can initiate the process in the following way: