Kotak Health Insurance:Compare Plans, Features, Benefits

Kotak Mahindra General Insurance Company is a wholly-owned subsidiary of Kotak Mahindra Bank wherein the bank holds 100% stake in the insurance company. The company was formed in the year 2015 when it received its license from the Insurance Regulatory and Development Authority of India (IRDAI). Kotak Mahindra General Insurance Company offers different types of general insurance policies for retail and commercial customers. The company offers motor insurance plans for goods carrying, passenger-carrying and private vehicles as well as health insurance plans of different types.

Facts about Kotak Mahindra General Insurance Company

Here are some facts about the company which makes the company a reputed name –

1. The company is part of the Kotak Mahindra Group which has emerged as a reputed financial services company in India
2. Kotak Mahindra General Insurance company is spread across 13 branches in India with an employee strength of 354 professionals
3. A range of two-wheeler and car insurance policies are also offered by the company at attractive premium rates

Key features of Kotak health insurance plans

Health insurance plans offered by Kotak Mahindra General Insurance Company have the following salient features –

1. Individual, family floater, as well as group health insurance plans, are offered by Kotak
2. Kotak health insurance plans offer lifelong renewability if the plan is renewed timely
3. Claims are handled by the company internally so that you can get a quick settlement of your claims
4. You can choose from a range of indemnity oriented health insurance plans as well as fixed benefit health insurance plans

Why choose Kotak health insurance?

Here are some benefits of Kotak health insurance plans which make them an ideal choice for your health insurance requirements –

1. The company offers customised products which suit the coverage requirements of every individual
2. Kotak keeps the customer at the forefront and offers customer-friendly services
3. Digital applications and technology is applied to the processing of claims which makes claim settlement quick and easy
4. The company has tie-ups with most leading hospitals in the country so that you can avail cashless claim settlements. The company has a network of more than 4000 cashless hospitals

Health insurance plans offered by Kotak Mahindra General Insurance Company

Here is a list of Kotak health insurance plans –

1. Kotak Secure Shield Policy

   Kotak Secure Shield is a fixed benefit plan which covers critical illnesses as well as accidental contingencies. The plan also has various other inbuilt as well as optional coverage benefits which give the plan a comprehensive scope. The features of the plan are as follows –

   1. 18 types of critical illnesses and surgical procedures are covered under the plan
   2. Accidental deaths, as well as permanent and total disabilities suffered due to an accident, are covered under the plan
   3. There is also coverage for child education benefit wherein a lump sum benefit is paid in case of accidental death or disability so that the child’s education does not suffer
   4. If you have availed of a loan and you are salaried, coverage is also allowed for loss of job

   Eligibility conditions of Kotak Secure Shield Policy

   Entry age	18 years to 65 years
   Term of the plan	1 year to 3 years

2. Kotak Health Premier Plan

   This is a comprehensive health insurance plan which covers the actual medical expenses that are incurred on hospitalisation. The features of the plan are as follows –

   1. If the sum insured is used up in paying an earlier claim, the policy restores the sum insured by 100% for subsequent claims
   2. Free annual health check-ups are allowed under the plan
   3. You can avail a second medical opinion free of cost from the company’s empanelled medical practitioners
   4. If hospitalisation exceeds 3 continuous days, you also get a daily allowance per day of hospitalisation
   5. A lump sum convalescence benefit is paid if you are hospitalised for more than 10 days
   6. Coverage for home nursing benefit is available after you are discharged from the hospital
   7. Maternity and newborn baby cover are also covered under the plan
   8. There are riders available under the policy to cover critical illnesses or accidental contingencies
   9. You get a range of wellness and fitness benefits under the cover
   10. Premium discounts are also available which help in lowering the premiums

   Eligibility conditions of Kotak Health Premier Plan

   Entry age	Adults – 18 years to 65 years Children – 91 days to 25 years
   Term of the plan	1 year to 3 years
   Pre-entrance health check-ups	Depends on the age and sum insured selected
   Sum insured	Depends on the plan option selected
   No claim bonus	10% increase in the sum insured up to 50% or 100% of the original depending on the plan variant selected

3. Kotak Health Care Plan

   This is a health insurance plan which covers your medical expenses on hospitalisation and comes in two coverage variants. The salient features of the plan are as follows –

   1. There are two plan variants called Excel and Premium
   2. Annual health check-ups are allowed under the plan free of cost
   3. There are five types of optional add-ons which you can choose from to customise the coverage and make it more comprehensive
   4. You get a premium discount if you choose a long term coverage

   Eligibility conditions of Kotak Health Care Plan

   Entry age	5 years to 65 years Dependent children can be covered under floater policies from 91 days to 25 years
   Term of the plan	1 year to 3 years
   Sum insured	INR 2 lakhs to INR 25 lakhs
   Pre-entrance health check-ups	Not required until 36 years of age
   Pre-existing waiting period	4 years

4. Kotak Accident Care Plan

   This is a personal accident insurance policy which covers the contingencies which are suffered in an accident. The salient features of the policy are as follows –

   1. The coverage is divided into two different sections of A and B
   2. Section A covers accidental death, permanent total and partial disablement and temporary total disablement
   3. Section B covers other accident-related emergencies. The coverage is allowed for daily cash benefit in case of hospitalisation following an accident, reimbursement of hospitalisation accident and a lump sum convalescence benefit if your hospitalisation exceeds 10 days
   4. There is a range of optional coverage benefits which can be taken under the plan by paying an additional premium. These benefits are carriage of a dead body, disablement improvement benefit, children’s education grant, ambulance charges and funeral costs
   5. A weekly benefit is paid in case of temporary total disablements

   Eligibility conditions of Kotak Accident Care Plan

   Entry age	5 years to 65 years
   Term of the plan	1 year to 3 years

5. Kotak Health Super Top-up Plan

   This is a super top-up health insurance plan which pays the medical expenses if they exceed the deductible. When buying the plan you have to choose a sum insured and a deductible limit. Thereafter, in a policy year, if the aggregate claims exceed the chosen deductible limit, the plan would be effective and it would pay the claims which exceed the deductible. The features of the plan are as follows –

   1. If you have existing coverage, you can buy this policy to increase the sum insured at very affordable premiums
   2. The plan is available on a floater basis covering your whole family under a single sum insured
   3. The sum insured is restored if it is exhausted in any policy year
   4. In case of accidental hospitalisation, you get covered for double the sum insured
   5. There are different plan variants with a different combination of the sum insured and deductible
   6. You also get a no claim bonus if no claims are made in the policy

   Eligibility conditions of Kotak Health Super Top-up Plan

   Term of the plan	1 year to 3 years
   No claim bonus	10% increase in the sum insured up to a maximum of 50%

6. Kotak Group Health Plans

   Now that you have seen the list of individual health insurance plans, let’s have a look at the different types of group health insurance plans which the company offers. These plans are suitable for a large group.

   The available group health plans are as follows –

   1. Kotak Group Accident Care Plan

      This is a personal accident policy for a group. The policy covers accidental death, permanent total disability, permanent partial disability, temporary total disability, fractures, burns and accidental hospitalisation

   2. Kotak Group HealthCare Plan

      This is an indemnity health plan for the members of a recognized group. The policy covers inpatient hospitalisation, costs incurred before and after hospitalisation, domiciliary treatments, daycare procedures, organ donor expenses and ambulance charges. There are optional covers too which the group can choose for its members to increase the scope of the plan. These optional covers include coverage for AYUSH treatments, daily hospital cash allowance, home nursing, lump-sum convalescence benefit, etc.

   3. Kotak Group Secure Shield Plan

      This is a fixed benefit health insurance plan which covers the group against named critical illnesses, accidental death, accidental permanent and total disablement, loss of job and an education benefit for the child of the covered member.

   4. Kotak Group Hospital Cash Plan

      This is another fixed benefit health insurance plan. This policy pays a daily cash benefit if the insured member is hospitalised for 24 hours or more. Coverage under the plan includes the accidental daily benefit, hospitalisation daily benefit, ICU daily benefit, daycare treatments benefit and surgery benefits.

   5. Kotak Group Smart Cash Plan

      This is also a fixed benefit hospital cash plan similar to Kotak Group Hospital Cash. However, the coverage under the plan varies and includes accident daily cash benefit, hospitalisation daily cash benefit, worldwide cover for the group members, ICU daily cash benefit and also AYUSH treatment benefit.

What is covered under Kotak Health Insurance plans?

The actual coverage features of Kotak health insurance plans depend on the type of policy and the policy variant that you are buying. However, all indemnity oriented health insurance plans, which cover the actual medical costs, have some common coverage features. These features are as follows –

1. Pre-hospitalisation expenses

   Under this head, the expenses which lead up to the hospitalisation of the insured member are covered. These expenses can be expenses incurred on diagnostic tests, doctor’s consultations, medicines, etc. Pre hospitalisation expenses are covered for up to a specified number of days before hospitalisation.

2. Inpatient hospitalisation expenses

   This head covers the primary chunk of medical expenses which are incurred when you are an insured member is hospitalised and undergo treatments. Inpatient hospitalisation expenses are covered up to the sum insured. The different types of expenses which are covered under this head include room rent, ICU charges, doctor’s fees, surgeon’s fees, operation theatre charges, costs incurred on blood, oxygen, medicines, anaesthesia, etc.

3. Post hospitalisation expenses

   Under this head, the expenses incurred after you are discharged from the hospital are covered. These expenses are incurred on the recovery and monitoring of your health. Post hospitalisation expenses are also covered for up to a specified duration which is mentioned in the policy.

4. Daycare procedures

   There are different procedures which do not require hospitalisation for 24 or more hours because of the advancement of medical treatments. Such procedures are called daycare procedures and they are covered under Kotak health insurance plans up to the sum insured that you have selected

5. Organ donor expenses

   If you are undergoing an organ transplant surgery, the costs incurred in harvesting the organ from a donor are covered under this head. These expenses are also covered up to the sum insured.

6. Ambulance costs

   If you are transported to a hospital using an ambulance, the cost of hiring the ambulance is covered under Kotak health insurance plans. This cost is covered up to a specific limit every policy year.

7. Domiciliary treatments

   Most health insurance plans offered by Kotak also cover treatments which are taken at the insured’s home if the insured cannot be moved to the hospital or if there are no vacant hospital beds. Such home treatments are called domiciliary treatments and they are covered up to a specified limit or up to the sum insured depending on the plan.

8. AYUSH treatments

   AYUSH treatments are treatments taken using Ayurveda, Unani, Siddha or Homeopathy techniques. Such treatments are covered under some health insurance plans offered by the company.

9. Maternity cover

   This cover is available under specific Kotak health insurance plans. Under this cover, the cost of childbirth and pregnancy is covered. Coverage is allowed up to specified limits and it would be available after a specified waiting period.

10. Free health check-ups

    Kotak health insurance plans also allow free health check-ups for adult insured members. These check-ups are usually allowed every year so that you can monitor your health and take the necessary steps to lead a healthy lifestyle.

Exclusions under Kotak health insurance plans

There are certain instances in which Kotak health insurance plans do not pay a claim. These instances are called plan exclusions and they include various treatments and hospitalisations due to specified causes. A few common exclusions are as follows –

• Pre-existing illnesses are excluded from the scope of coverage for the first few policy years
• Any illness occurring within 30 or 60 days of buying the policy
• Cosmetic treatments or treatments which are not medically necessary
• Unproven or experimental treatments
• Circumcision, dental treatments, OPD costs, etc.
• Maternity treatments unless they are covered under the plan
• Illnesses or injuries suffered due to war or related perils or nuclear threats
• Illnesses or injuries due to alcohol addiction, drug abuse, participation in hazardous sports and activities, participation in criminal acts, etc.
• Self-inflicted or deliberate injuries

How to buy Kotak health insurance plans?

Kotak Mahindra General Insurance Company allows you a technologically advanced platform through which you can buy its health insurance plans online. Most Kotak health insurance plans are available for purchase online. You can visit https://www.kotakgeneralinsurance.com/ and choose to buy any of its policy online. Just choose ‘Health Insurance’ and proceed to provide the required information. The information required would be as follows –

• Type of policy that you want to buy – individual or family floater
• The members who are to be covered under the plan
• Date of birth of the insured members
• The coverage amount that you need
• Your contact details, city and state

Based on the details which you enter, the premium would be calculated and the plan options available would be displayed. You can compare and choose the plan option for yourself. You can also opt for the available add-ons and the final premium rate would be calculated. You can then buy the plan for one year or for a longer duration.

Things to remember before buying Kotak health insurance plans

Before you buy Kotak health insurance plans, here are some factors which should be kept in mind –

1. Sum insured

   Always choose an optimal coverage level because the plan would cover the medical costs only up to the sum insured that you select. If the coverage is low, the plan would not be sufficient in covering all your medical expenses. So, ensure that you opt for a decent sum insured level for optimal coverage.

2. Affordability

   While a high sum insured level is desirable, the associated premiums should also be affordable. If you want to enjoy continued coverage you would have to renew the policy and paying very high premiums every year might prove difficult. So, when the premium is calculated, check and make sure that the premium is affordable. If the premium is high, reduce the sum insured to arrive at a suitable premium rate. The coverage can then be supplemented through the super top-up policy offered by Kotak. The policy would give you higher coverage at lower premiums.

3. Policy tenure

   Kotak health insurance plans are offered for coverage tenures of up to 3 years. Choosing a higher tenure would let you avoid the hassles of annual renewals. Moreover, a continuous tenure would also give you premium discounts. So, if you want, you can choose a continuous coverage of two or three years under your health insurance plan.

4. Members covered

   You should cover all your family members under the selected Kotak health insurance plan. if you leave any member and that member falls ill, you would have to pay the medical bills. So, protect yourself from the medical bills of any family members by insuring them under your health insurance plan.

5. Add-ons

   Kotak health insurance plans offer extensional coverage benefits called riders or add-ons. These add-ons enhance the available scope of coverage. Thus, when buying a health insurance policy, check the add-ons which the policy offers and if the add-ons are suitable for your coverage requirements, choose them for a more comprehensive scope of cover.

6. Discounts

   Kotak health insurance plans offer attractive discounts on the premiums. Look for the available discounts in the plan that you select so that the premium rates can be reduced and you can save your money.

How to renew Kotak health insurance plans?

Renewal of Kotak health insurance policies is also available online. You can visit the company’s home page and choose ‘I want to Renew my policy’. Then choose the health insurance product that you want to renew. When you do so, there would be various blank fields which you need to fill up. You need to mention the policy number of your existing plan, the mobile number registered with Kotak Mahindra General Insurance and your date of birth. Once the details are entered, you would be able to check your existing plan details. The renewal premium would also be shown. Pay the renewal premium online and the policy would be renewed instantly without any hassles.

How to make a claim under Kotak health insurance plans?

You face a claim in your health insurance policy when the contingency which is covered under the policy occurs. To make a claim, you should follow some steps and the claim would be settled. These steps are as follows –

• Inform Kotak Mahindra General Insurance Company of the claim. This intimation can be done online. You can visit the company’s home page and choose ‘I want to Register a non-motor claim’
• You can also call the company’s toll-free number 1800 266 4545 or send an email to care@kotak.com for intimating the company of your health insurance claim
• If you are taking treatments at a networked hospital, you can make a cashless claim. For this claim, a pre-authorisation form should be filled and submitted to Kotak Mahindra General Insurance Company
• The pre-authorisation form should be submitted 3-4 days before you are planning your hospitalisation. In case of emergency hospitalisation, the form should be filled and submitted within 24 hours of such hospitalisation
• Once the form is submitted, Kotak would assess your claim and approve it
• Once you receive the approval of your claim, you would be eligible to get cashless services
• You can take treatments and your medical bills would be settled by Kotak directly with the hospital at which you are being treated
• Once you are discharged from the hospital, you should fill up a claim form and submit all the required documents to complete the claim settlement process
• If you are getting treated at a non-networked hospital, you would have to bear your medical expenses yourself. Once you are discharged, the claim form should be filled and submitted and Kotak would reimburse you for the medical expenses that you have incurred

Documents required for Kotak health insurance claims

In order for you to get your claim processed and settled, a set of documents would have to be provided to Kotak. These documents include the following –

1. The claim form, filled and signed
2. Policy bond
3. Identity proof of the member being treated
4. All the hospital and medical bills in original
5. All medical reports, hospital reports and reports of diagnostic tests
6. Doctor’s prescriptions
7. Police FIR in case of accidental claims
8. Other documents as needed by Kotak

Review of Kotak health insurance

Kotak is a reputed brand name and the company offers attractive health insurance plans for its customers. The plans provide coverage for every type of medical expense and come in handy in a medical emergency. The premiums are also low and can be further reduced using discounts. Thus, Kotak health insurance plans are a good solution for your health insurance requirements.