Health Insurance

A comprehensive health insurance to protect you & your family

Keep your loved onesprotected

We look after your and your family's health, even when times are tough.

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You can insure 2 adults with age 18-65 years and 3 children with age 91 days to less than 18 years

Buy online to avail 2.5% discount on policy premium

Kotak Health Insurance Policy in 2 Minutes
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An instant policy with zero paper-work

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Quick and hassle-free claim process

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* The above data is till 31st March, 2023

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In-patient Treatment

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

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 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

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

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

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.

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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.

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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.

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Pre-existing Disease Waiting Period

Any Pre-Existing Disease will not be covered until waiting period as per Plan opted for as elapsed.

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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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Hospital Daily Cash
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It will pay a specified daily cash amount from day one in case the hospitalization extends for at least 3 consecutive days.

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Explorer Kotak Health Insurance Products

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Kotak Health Super Top-up

A top up health insurance plan that provides high health insurance coverages at affordable rates.

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Kotak Secure Shield - Critical illness insurance

With Kotak Secure Shield, you can protect yourself and your family against the expenses that come with treating 18 listed critical illnesses, without having to compromise on the quality of healthcare.

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Kotak Accident Care - Personal Accident Insurance

Personal accident policy is specially crafted to cover you and your family with a financial cushion against various events arising out of an accident.

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The perfect coverage for your dream car

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Kotak Health Super Top-up

A top up health insurance plan that provides high health insurance coverages at affordable rates.

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Kotak Secure Shield - Critical illness insurance

With Kotak Secure Shield, you can protect yourself and your family against the expenses that come with treating 18 listed critical illnesses, without having to compromise on the quality of healthcare.

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Kotak Health Insurance
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Reviews & Ratings

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We are very happy if you are satisfied with our service and products. Let's read pure reviews from customers who bought our products.

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No regrets for choosing kotak health insurance policy. Very happy to share this feed back.

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This was my first claim in last 4 years and I must say that everything went smoothly.

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Appreciate the assistance of the concerned claim teams. Also prompt action and consideration are greatly appreciated along with proper guidance.

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Health Insurance

Apply for the Kotak Health Premier policy, a comprehensive health insurance plan with attractive features and value-added benefits.

Health Insurance


What is health insurance?

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.

Why do you need a medical insurance plan?

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 –

  • Increasing illnesses

    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.

  • Expensive costs

    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.

  • Tax benefits

    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.

Health Insurance Plans by Kotak

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 planSalient 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 –

  • Inbuilt coverage benefits include inpatient treatments, day-care treatments, pre and post hospitalisation expenses, domiciliary treatments, organ cover, ambulance charges, etc.

  • Optional coverage benefits include hospital daily cash, convalescence benefit, home nursing benefit, compassionate visit, air ambulance cover, maternity cover, critical illness cover, personal accident cover, etc. as per the plan opted.

  • 10% cumulative bonus for every claim-free year. Moreover, the bonus does not reduce if you make a claim.

  • 100% restoration of the base Sum Insured if your existing Sum Insured and Cumulative Bonus is used up on a previous claim. The restored Sum Insured will be applicable for an unrelated illness and its complications.

  • Get vaccination cover for the new born baby under the optional maternity benefit as per the Sum Insured opted

  • Attractive premium discounts for adding family members on an individual basis, for choosing the multi-year tenure and for being an existing customer of Kotak Group.

  • Attractive reward points for a healthy lifestyle

  • There are plan variants to suit your needs

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 –

  • If the insured suffers from a critical illness covered under the policy, a lump sum benefit would be paid.

  • The plan allows coverage for accidental deaths and total disablements and pays a lump sum benefit in such cases too

  • The child education benefit provides financial assistance for your child’s future in the event of the Insured’s death or permanent total disability

  • In the case of loss of job due to an accidental illness or injury, the plan covers your certain number of EMIs (as specified in the policy schedule, maximum up to three) falling due in respect of the loan to ease your financial burden.

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 –

  • A lump sum benefit is paid in the case of accidental death and permanent total disablement.

  • In the case of temporary disablement, a weekly benefit is paid.

  • The plan also allows other coverage benefits like the daily cash benefit in the case of accidental hospitalisation, reimbursement for accidental hospitalisation expenses and convalescence benefit.

  • A range of extensive benefits are available for a wider scope of coverage. Some of them include Children’s education grant, ambulance charges, funeral expenses extension, etc.

  • Choose from a tenure ranging from 1 to 3 years.

  • Lifelong renewals for continued coverage

Kotak Health Super Top-up
(UIN: KOTHLIP21162V032021)

This is a super top-up plan which helps enhance your health insurance coverage at affordable premiums.
The salient features of the policy are as follows –

  • Coverage for most medical expenses that you might incur like inpatient treatments, pre and post hospitalisation expenses, day-care treatments, organ donor cover, alternative treatments, etc.

  • Enjoy the sum assured restoration benefit which restores the sum assured if the Sum Insured and Cumulative Bonus has been used up on a previous claim

  • Get double the sum assured in the case of accidental hospitalisations

  • 10% additional sum assured as cumulative bonus if you don’t make claims

  • Family floater cover is available for your whole family

  • Choose from a long-term policy tenure going up to 3 years

Pre-policy medical check-up

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.

What is covered under health insurance policy by Kotak?

Kotak health insurance plans allow coverage for a range of medical expenses. Some of the basic coverage benefits include the following –

  • Inpatient hospitalisation

    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 and post hospitalisation

    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.

  • Ambulance cover

    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.

  • Day-care treatments

    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.

  • Organ donor cover

    If you are receiving an organ transplant, the policy would cover the cost of the donor’s hospitalisation.

  • Domiciliary expenses

    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 treatments

    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.

  • Annual health check-ups

    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

    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.

What is not covered under health insurance policy by Kotak?

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 –

  • Pre-existing waiting period

    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.

  • Initial waiting period

    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.

  • Specific waiting period

    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.

  • Other exclusions

    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.

Optional Covers of Kotak Health Premier Insurance

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 –

Advantage Plan Variant

Optional coverMeaning

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

Edge and Elite Plans

Optional coverMeaning

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

Why choose Kotak for online 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 –

  • A trusted name

    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.

  • 24/7 assistance

    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.

  • Quick claim settlements

    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.

  • Lowest complaint ratio

    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.

  • Wide variety of health insurance products

    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.

  • Easy purchases

    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

Steps to Buy Health Insurance Online from Kotak

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!

Why Buy a Medical Insurance Plan at an Early Age?

It is recommended to buy a health insurance plan at an early age. Here are some reasons why –

  • Early protection

    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.

  • Financial security

    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.

  • You can wait out the waiting period

    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.

  • Enjoy tax benefits

    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.

How to calculate health insurance premium online?

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 –

    • Your age – the premium depends on the age. Higher the age, higher would be the premium and vice-versa.
    • Number of members to be covered – if you are buying the policy for your whole family, you would have to enter the number of members to be covered and the age of each member.
    • Type of policy – in the case of covering family members, specify whether you want to buy the policy on an individual basis or a family floater basis. The premium is different for both these bases.
    • The sum insured – Choose the sum insured that you want to opt for. The sum insured determines the premium. The higher the sum insured the higher would be the premium and vice-versa.
    • Policy tenure – Health insurance plans allow longer coverage tenures going up to 3 years. The term of the policy would also determine the premium payable.
    • Optional covers – If there are optional covers under the plan and you want to add such covers with your base policy, you should specify them as well. Each optional cover has an additional premium. Based on the optional covers chosen, the premium would be determined.
    • Applicable discounts – if the plan offers premium discounts and you are eligible for the same, you can choose the discounts to reduce the overall premium outgo.

Based on the details given, the calculator would show the premium payable.

Advantages of renewing health insurance online

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 –

  • Easy

    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.

  • Instant

    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.

  • Facility of comparison

    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.

  • You can check the coverage

    The coverage details are available online. You can check the coverage of your previous plan, make changes, if required, and then renew it online.

How to file a health insurance claim at Kotak?

  • Cashless Claim

    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.

  • Re-imbursement Claim

    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/

List of Documents Required for Health Insurance Claim Reimbursement

There are certain documents which are required for health insurance claim reimbursement. These documents are as follows –

  • Health insurance claim form
  • Pre-authorization claim form in the case of cashless claims
  • Diagnostic test reports
  • Original pharmacy bills
  • Original doctor’s reports, prescriptions and hospital records
  • Identity proof of the insured
  • Police FIR in the case of accidental claims
  • Discharge summary issued by the hospital after you are discharged
  • Any other document required by the insurance company
  • Bank details of the claimant in the case of reimbursement claims

Save Tax with Health Insurance Policy

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.

Health Insurance Terms You Need to Know about

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.

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Health Insurance - Frequently Asked Questions

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 –

  • Arogya Sanjeevani Policy – This is a standardized health insurance policy issued in accordance with IRDAI guidelines. The policy offers affordable cover for the basic medical expenses that you might incur.
  • Indemnity health insurance – This policy covers the hospitalisation and other medical expenses that you incur. The policy has a wide scope of coverage and covers the specified medical costs that you have incurred up to specified limits.
  • Personal accident insurance – This policy covers accidental deaths and disablements. This is a fixed benefit policy which pays a lump sum benefit in claim.
  • Critical illness insurance – The policy covers specific illnesses and pays a lump sum benefit of the insured suffers from any covered illness.
  • Top up health insurance - This policy supplements an existing cover at affordable premium rates.

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:

  • In-patient treatment costs
  • Day care treatments
  • Pre and post-hospitalization expenses
  • Ambulance cover
  • Free health check at any network provider
  • Organ donor treatments
  • Domiciliary treatments
  • AYUSH treatments

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:

  • Age – Higher the age, the higher is the insurance premium
  • Pre-existing illness- People suffering from pre-existing illnesses like blood pressure and diabetes need to pay higher premiums
  • Smoker or Non-smoker- Individuals who smoke need to pay higher insurance premiums than Non-smokers
  • Sum assured – higher the sum assured, higher would be the premium payable
  • Policy tenure – if you choose long-term tenures and pay a lump sum premium, the premium would be higher. However, you might enjoy long-term discounts which would reduce the overall premium payable.
  • Add-ons selected – If you opt for optional add-ons and riders, the premium would be higher since each add-ons or optional cover requires an additional premium.
  • Available premium discounts – if there are premium discounts that you can claim, the premium would be lower.

If you are planning to do renewal of health insurance online, simply follow the below steps:

  • Visit https://www.kotakgeneral.com/renewal
  • Select the health insurance policy to initiate the online renewal process
  • Enter the necessary details, including the policy number, mobile number, and date of birth, and click on 'Submit.'

Here’s the process for making a health insurance claim -

Cashless claim

  • To avail this facility, you need to ensure that the treatment is being taken at the empanelled hospital listed in the insurance policy document
  • Approach the hospital 48 hours prior to hospitalization
  • Produce the pre-hospitalization form along with an identity proof and medical documents at the cashless deck in the hospital
  • In case of an emergency, you need to visit the cashless deck at the hospital within 24 hours of hospitalization
  • Submit the ID proof along with the medical documents
  • Once the cashless claim is approved, you will be required to pay the deductibles.

Reimbursement claim

  • In case the hospital is not listed in-network list, you can opt for a reimbursement facility:
  • Get in touch with us at 1800 266 4545 or care@kotak.com
  • Submit all the original hospital bills, and discharge documents along with the reimbursement claim.
  • Post verification, the claim will be settled within 15 days

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:

  • Compare multiple health insurance policies to find a policy which offers the coverage features that you need and is comprehensive
  • Check for the cashless network hospitals – the wider the better
  • Check for the exclusions of the health policy – the lesser the better
  • Look for the claim settlement ratio – the higher the better
  • Pre-existing illness cover – check how soon pre-existing illnesses are getting covered. The sooner, the better
  • Know about add-on covers so that you can choose the relevant ones
  • Choose a trusted brand for a hassle-free claim experience

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:

  • Age of the insured policyholder
  • Type of health plan
  • Sum assured
  • Lifestyle choices
  • Add-on covers
  • Pre-existing diseases
  • Family medical history
  • Number of family members being covered
  • Geographical location etc.

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:

  • Call on 1800 266 4545 or mail us at care@kotak.com
  • Collect the reimbursement form from the hospital
  • After the discharge, submit the claim form to the insurance company along with the original copy of hospital bills, discharge report & other payment receipts
  • Post verification, the insurance company may approve or disapprove the claim
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