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About Kotak Health Insurance

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.


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

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

Kotak Claim Settlement Ratio

98.82%

Kotak

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Kotak has a claim settlement ratio of 98.82%, as compared to the industry average of 94.21%.

Kotak Health Insurance Plans Overview

Kotak health insurance offers 4 health insurance plans. The premium of these plans starts from Rs. 1391/yr. The sum insured ranges from Rs. 2 Lakh - 25 Lakh. Details of the comprehensive coverage provided by the following 4 Kotak health insurance plans are listed below:

Kotak Accident Care Plan

Starting Premium- ₹ 5,459/yr

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
    • Section A covers accidental death, permanent total and partial disablement and temporary total disablement
    • 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
  2. 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
  3. A weekly benefit is paid in case of temporary total disablements

Eligible Age

5 years - 65 years

PED Waiting Period

4 years

Coverage

NA

NCB

NA

Kotak Health Care Plan

Starting Premium- ₹ 2,943/yr

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

Eligible Age

91 days - 65 years

PED Waiting Period

4 years

Coverage

2 Lakh - 25 Lakh

NCB

10% increase in cover;max upto 50%

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 hospitalMaternity and newborn baby cover are also covered under the plan
  7. There are riders available under the policy to cover critical illnesses or accidental contingencies
  8. You get a range of wellness and fitness benefits under the cover
  9. Premium discounts are also available which help in lowering the premiums

Eligible Age

91 days - 65 years

PED Waiting Period

NA

Coverage

NA

NCB

10% increase in cover;max upto 100%

Kotak Top-up Plans

Kotak health insurance provides 1 top-up plan. The premium of these top-up plans start from Rs. 5,136/yr. The sum insured ranges from Rs. 3 Lakh - 40 Lakh. Kotak top-up plans provide enhanced coverage and added protection for your well-being. Explore the details of each Kotak top-up insurance policy below:

Kotak Health Super Topup Plan

Starting Premium- ₹ 5,136/yr

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

Eligible Age

18 years - 80 years

PED Waiting Period

2 years

Coverage

3 Lakh - 40 Lakh

NCB

10% increase in cover;max upto 50%

Top Features From Kotak Health Plans

Key features of Kotak health insurance plans

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

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

  • The company offers customised products which suit the coverage requirements of every individual
  • Kotak keeps the customer at the forefront and offers customer-friendly services
  • Digital applications and technology is applied to the processing of claims which makes claim settlement quick and easy
  • 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

What is covered under Kotak Health Insurance plans?

  • 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.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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 Across Kotak Health 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

Kotak Premium Calculator

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Kotak Customer Care

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Kotak Claim Process

Kotak supports both cashless claims and reimbursement claims. This section covers the information on how to check Kotak health insurance claim status, fill Kotak health insurance claim form, and the claim settlement process.

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

  1. 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’
  2. 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
  3. 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
  4. 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
  5. Once the form is submitted, Kotak would assess your claim and approve it
  6. Once you receive the approval of your claim, you would be eligible to get cashless services
  7. You can take treatments and your medical bills would be settled by Kotak directly with the hospital at which you are being treated
  8. 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

Kotak Health Insurance Renewal Process

Kotak Health Insurance Policy Online Renewal Process

Renew your Kotak health insurance policy conveniently by following these steps:

Step 1: Visit the official website https://www.kotakgeneral.com
Step 2: Select Renewal from the main menu
Step 3: Select the type of Kotak health insurance policy to initiate the online renewal process
Step 4: Enter the necessary details, including the policy number, mobile number, and date of birth, and click on 'Submit’ to proceed with premium payment
Step 5: Upon successful payment, your policy will be renewed, and you will receive an email confirming the renewal

Kotak Health Insurance Policy Renewal - Offline Process

Kotak Mahindra Health Insurance ensures a seamless renewal experience for its customers, offering the convenience of offline renewal

To opt for offline renewal contact Kotak at the toll-free number 1800-266-4545 and communicate your renewal requirements

Alternatively, you can visit the nearest branch of Kotak Health Insurance for a quick and hassle-free policy renewal

FAQs

Kotak health insurance plans allow you premium discounts for buying the policy for 2 or 3 continuous years and paying the premium at one go. There is another discount for covering two or more family members under the same policy. Moreover, under some plans, you can also find a premium discount if you have any other insurance policy offered by Kotak.

The cost of pre-entrance health check-ups is borne by the proposer himself/herself. Thereafter, if the policy is accepted by Kotak and it is issued, 50% or 100% of the costs incurred would be reimbursed by the insurance company.

Pre-existing conditions or illnesses are those health-related complications which the insured already suffers from at the time of buying a fresh policy. Since the insured has an illness at the time of buying the policy, such illness is called a pre-existing illness and it is excluded from coverage for the first 2 to 4 policy years depending on the plan that you select.
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