Kotak Health Insurance Company

Kotak General Insurance Company is a 100% subsidiary of Kotak Mahindra Bank Limited, one of the fastest-growing banks in India. The company is known for its quality customer service and innovation. The company serves the growing demands of the non-life insurance segment in the country which focuses on innovative and quality insurance products with great customer service. It offers a diverse range of products to suit the requirements of the clients.

Highlights of Kotak Health Insurance Company

Claim Settlement Ratio 97%
NCB* 50%, up to 100%* of SI
PED Waiting# 48 months
Network Hospital 7200+

Compare Top Health Plans from Kotak Health Insurance

Kotak Health Premier- Total
Kotak Health Premier- Elite
Kotak Health Premier- Edge
Features
Inpatient treatment
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Day Care Treatment
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Pre and post hospitalisation expenses
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Restoration Benefit
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Cumulative bonus
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Annual health checkup
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Ambulance Cover
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Organ Donor cover
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Features
Inpatient treatment
Day Care Treatment
Pre and post hospitalisation expenses
Restoration Benefit
Cumulative bonus
Annual health checkup
Ambulance Cover
Organ Donor cover

Awards and accolades won by Kotak Health Insurance Company

The insurance company has gained recognition at various leading international and domestic platforms. The company focuses on innovation and excellence to deliver award-winning insurance solutions to its customers.
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The company received Indian Digital Media Awards for social media campaigns in the year 2019.

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Kotak General Insurance was awarded a silver medal for best customer engagement and financial services category.

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Economic Times Brand Equity Shark Awards 2019 awarded Kotak General Insurance silver medal for best customer insight campaign.

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Kotak General Insurance is also been recognized for the best innovative product and best use of social media.

Key Highlights of Kotak Health Insurance

Key Features

Specifications

Gross written premium

Rs 1,134.09 Crores

Policies issued

31,94,507 policies issued

Number of customers

45 lakhs+ customers

Incurred claims ratio (within India)

69.50 %

Features of Kotak Health Insurance

Features

Meaning

Inpatient-hospitalization covers

If your stay in a hospital is longer than 24 hours, then the insurance company will take care of all expenses associated with hospitalization and treatment.

Pre-hospitalization cover

If you incur medical costs before you are hospitalized, the plan covers such expenses up to a specified number of days

Post-hospitalization cover

After discharge, the medical costs incurred on recovery and follow-ups are covered under the policy

Day-care cover

Medical treatments that do not require 24-hour hospitalization are called daycare treatments. Such treatments are also covered under the policy

Ambulance cover

The cost incurred on hiring an ambulance for hospitalization would be covered under the policy up to specified limits

Domiciliary cover

If you are getting treatment at home instead of a hospital, such treatments would be covered provided that a hospital bed is not available or your medical condition does not allow hospitalisation

Organ donor cover

In the case of an organ donor treatment wherein you are receiving the organ, the cost of the donor’s hospitalization and organ harvesting is covered

Free health check-ups

To ensure that you can monitor your health regularly, Kotak health plans allow free health check-ups

AYUSH cover

Kotak Health plans also cover Ayurveda, Unani, and Homeopathic practices.

Exclusions in Kotak Health Insurance

Kotak Health Insurance policy has exhaustive coverage but certain illnesses that are not covered are termed as exclusions. The list of exclusions is mentioned separately in the policy document. Listed below are some common exclusions:

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Pre-existing conditions won't be covered i.e. any disease that you already have while buying the health plan is not covered during a specified period called Pre-existing disease (PED) waiting period.

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A waiting period of two years is prescribed for some illnesses and treatments. Joint replacements, cataracts, etc., are some examples of illnesses that are excluded.

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Illnesses are not covered during the first 30 days of acquiring the plan.

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Weight loss surgery, cosmetic surgery, or any other cosmetic treatment are also excluded.

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War, nuclear threats, mutinies, revolts, and similar events cannot be claimed.

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Certain activities such as adventure sports, and hazardous and criminal activities undertaken willingly would not be entertained.

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No claim should arise from attempted suicide, cutting/harming oneself, or due to abuse of drugs or alcohol.

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HIV/AIDS or other venereal diseases are excluded from Kotak Health plans.

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Health insurance companies will not cover treatments that don't follow a doctor's prescription or are not scientifically proven.

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Congenital defects are not covered

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The claim is usually not paid for lenses, hearing aids, spectacles, or batteries for hearing aids

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Claim arising out of ionization or nuclear radiation would not be paid as it is excluded.

Health Insurance plans offered by Kotak

Kotak has a diverse portfolio of health insurance plans. Some of its most popular plans are as follows –

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Kotak Health Premier Total:

Kotak Health Premier Total is a comprehensive plan that offers a host of coverage benefits for all-inclusive coverage. The salient features of the policy are as follows:

  • Restoration benefit: You can get 100% restoration of the sum insured if your coverage is used up in any policy year and you suffer multiple claims. This allows additional coverage so that you don’t run out of the sum insured in a medical emergency.

  • Second medical opinion: You can avail of a second medical opinion, free of cost, online through the company’s panel of medical experts. The facility is available multiple times so that you get the best medical care.

  • High-sum insured:  The plan offers coverage up to Rs.2 crore so that you can opt for a high-sum insured against expensive medical costs.

  • Annual health check-ups: You can avail of free health check-ups every year to monitor your overall health.

  • Health and wellness benefits: The plan promotes healthy living and provides health risk assessment facilities besides preventive health check-ups. Furthermore, if you engage in healthy activities, you can earn health rewards which can be redeemed against non-admissible medical expenses and co-payments.

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Kotak Health Premier- Elite:

Kotak Health Pioneer Elite is one of the variants of Kotak Health Premier which comes with protection plus value-added benefits and rewards to help you stay healthy and fit. The plan offers various benefits which are in addition to the benefits offered in Kotak Health in your total plan. Salient Features of the plan are as follows:

  • Compassionate Visit: Compassionate Visit pays for the cost incurred by an immediate relative of the insured in traveling from the place of residence to the hospital.

  • Maternity benefit: Medical expenses for the delivery of a child are also covered. It also covers expenses for the lawful termination of a child. A maximum of two deliveries is available across all policy years. Maternity benefit has a waiting period of three years during which no benefit would be payable.

  • Newborn Baby Cover: All the medical expenses incurred on your newborn baby would also be covered after a waiting period of three years.

  • Vaccination Expenses: Vaccination expenses for your newborn baby from childbirth till the child attains two years are also covered only if you take the maternity benefit, newborn baby cover, and vaccination cover together.

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Kotak Health Premier- Edge:

Kotak Health Premier Edge is one of the three variants of Health Premier. The plan provides an extensive range of covers which includes the covers mentioned in Health Premier Elite and Total plan. Other highlights are:

  • Air Ambulance Cover: You might need to travel from one city to another for medical treatment in emergencies. Your health plan covers the expenses for ambulance transportation in a helicopter or airplane for life-threatening or other emergencies.

  • Critical Illness Cover: Critical Illness covers pay a lump sum if the insured is diagnosed with a covered critical illness. The benefit would be payable over and above the sum insured in the plan. Health Premier Edge covers 18 critical illnesses listed in the policy document.

  • Personal Accident Cover: Personal Accident Cover includes accidental death or permanent total disablement suffered by the insured. A lump sum amount would be payable which is above the base sum insured in the plan.

Eligibility conditions

Minimum entry age

18 years for adults and 91 days for children

Maximum entry age

65 years for adults and 25 years for children

Sum insured

INR 2 lakh – INR 20 lakh

Policy term

1 year – 3 years

Policy Type

Individual/Family plan

Number of family members covered

2 adults, 3 dependent children

Renewability

Lifetime renewability

Waiting period (Initial waiting period)

30 days

Waiting period (PED)

36 months

How to buy Kotak Health Insurance Plan?

Go to the official portal of Kotak Health Insurance. Go to “Health Insurance”. Answer a few questions about the policy seeker and submit to get quote.

Or visit the Paybima portal and select Health Insurance from the options available.

1

Visit the Paybima homepage and click on the ‘Health Insurance’ tab in the dropdown menu.

2

Fill in your required details and request a callback.

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A Paybima representative will help you buy the most suitable plan.

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You may also reach us at 1800 267 67 67 from 10 AM to 7 PM, or

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You can visit a Paybima branch near you.

The process of renewing Kotak Health Insurance Policy

How to File a Kotak Health Insurance Claim?

To submit a claim for your health insurance policy. The steps are as follows:

1
Identifying network hospitals:

The company offers great benefits to its customers to make a claim either through a cashless or reimbursement facility. For cashless claims, you will have to locate the nearest network hospital with which the company has a tie-up and get admitted to the same. You can locate a network hospital through the website of Kotak General Insurance.

2
Admission:

Get admitted to the networked hospital by showing your ID card and health card.

3
Fill out the pre-authorization form:

The pre-authorization form is necessary if you want your cashless claim to be approved. You can either download the form from the company’s website and fill it out or obtain a hard copy from the insurance desk of the network hospital. Fill in all required fields correctly and completely to get your claim processed faster. You should fill out and submit this form three to four days before your hospitalization. You can also submit the pre-authorization form within 24 hours of your hospitalization only in case of emergency admissions.

4
Cashless approval:

Insurers approve cashless facilities based on pre authorised claim forms. After assessing the form, the company approves the claim and intimates the same to the hospital which would begin your treatment. Once your claim has been approved, you will not be required to pay anything. The company will directly settle all the hospital bills.

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Reimbursement Claim Facility:

If you want to get your claim settled on a reimbursement basis or if a cashless claim has been rejected, then you will have to pay all your bills related to illness and then submit the original bills after discharge to the company. The company will assess your claim and approve the treatment cost. Upon approval, the amount will be credited to your bank account. PayBima is committed to making sure that your claim gets settled quickly and smoothly. You can contact us via email at [email protected] or call 1800 2676767 for any kind of claim-related assistance. Some documents are required to be submitted along with the claim form to enable the company to assess your claim.

The list of documents required to settle an insurance claim includes the following:
 

  • A valid form of identification such as a PAN Card, Aadhaar Card, Passport, etc.

  • Duly filled and signed claim form

  • For planned hospitalization, submit a doctor’s prescription suggesting hospitalization

  • Pre-authorization form

  • All original bills such as medical bills, screening bills, hospital bills, hospital reports, etc.

  • Consultation notes and prescriptions

  • Bank account details to credit the amount of reimbursement claims

Guaranteed Claim Support

When you buy or renew a health insurance plan from us, we guide at every step till your claim is settled.

Start your claim process with us to get our support

Review of Kotak Health Insurance Company

At Kotak General Insurance, comprehensive health insurance policies ensure to take care of yourself and your family in all emergencies and illnesses. Other highlights of Kotak health plans are as follows:

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Kotak General Insurance provides customer-centric services and customized products to ensure that the variant needs of customers are fulfilled.

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Kotak General Insurance provides an efficient claim handling process and has a high claim settlement ratio of 98% as of 30th September 2021.

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Kotak health plans also provide coverage of 18 types of critical illnesses which helps you to get 360-degree coverage at affordable rates.

Sahi Advice,
Sahi Insurance

If you have any questions on how to choose the best insurance plan, you can connect with our IRDAI certified insurance advisors.

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