Kotak Health Care

As people rightly say, health is wealth, which is why we have Kotak Health Care – a comprehensive health insurance plan to ensure you and your family members are always well-protected.

Key benefits

Free Health Check-Up: We understand that your health is very important, so we offer a free health check-up for every insured member above the age of 18. A considerable number of tests are covered under this free check-up, which includes: CBC, MER, Serum, Cholesterol, Serum Creatinine, SGPT /SGOT, ECG, Random Blood Sugar. Utilising the Free Health Check-Up will not affect the Base Annual Sum Insured or the Cumulative Bonus.

Ambulance Cover: If you find yourself in need of emergency ambulance services, you’re covered. The cost of transporting the insured person by a registered healthcare or ambulance service provider to a hospital for treatment of an illness or injury following an emergency will be covered, per the limits specified in your policy documents.

In-Patient Treatment: If you are hospitalised for any kind of treatment, the medical expenses incurred as a result of the hospitalisation of the insured person due to an illness or an injury for a minimum and continuous period of 24 hours will be covered.

Enhanced Protection: For better coverage, you can choose to enhance your policy by choosing from our range of add-ons that are available for an additional premium.

The Kotak Edge: When it comes to keeping your money and your life safe and secure, it pays to go with a reputed company. The Kotak Group has an illustrious history that spans over 3 decades, and is considered to be one of the most trusted brands in the country. With Kotak Health Care, your health concerns are in safe hands.

Features

Day Care Treatments: If medical expenses are incurred for specified treatments or procedures that do not require you to be hospitalised for more than 24-hours, Kotak Health Care will cover the cost of these procedures. Enjoy cover for up to 150 specified procedures and treatments. For a complete list of Day Care Treatments covered, please click here.

Cumulative Bonus: Enjoy special no-claim benefits on your policy. Receive a cumulative bonus of 10% on your Base Annual Sum Insured on renewal of your health insurance, provided there has been no claim throughout the policy period, up to a maximum of 50% of the Base Annual Sum Insured. If any claim is made under the policy after a Cumulative Bonus has been applied, then the accrued Cumulative Bonus under the policy will reduced by 10% on the commencement of the next policy year or the next renewal of the policy as applicable.

Pre-Hospitalisation Medical Expenses and Post-Hospitalisation Medical Expenses: In the event of a hospitalisation, focus only on getting better and not on the costs. Medical expenses incurred 30 days before a hospitalisation, and 60 days after a hospitalisation will be covered under Kotak Health Care.

Cashless Settlement: Whatever you location may be, use our preferred network of over 4,000+ hospitals across the country and avail of hassle-free cashless settlements.

Picking a Plan: Kotak Health Care comes to you in the form of three options; Excel, Premium and Prime. Have a look at what exactly is covered by each plan in the below table before you make your choice:

Benefits Excel Premium Prime
Base Sum Insured 2 lakhs, 3 lakhs, or 4 lakhs 5 lakhs, 10 lakhs, 15 lakhs, 20 lakhs, or 25 lakhs 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 50 lakhs, 75 lakhs, or 100 lakhs
Optional Covers (Add-Ons) Pack 1: Hospital Daily Cash + Convalescence Benefit + Donor Expenses

Pack 2: Critical Illness Cover + Double Sum Insured

Pack 3: Cap on Room Rent
Pack 1: Hospital Daily Cash + Convalescence Benefit + Donor Expenses

Pack 2: Critical Illness Cover + Double Sum Insured
Option 1: Hospital Daily Cash

Option 2: Convalescence Benefit

Option 3: Donor Expense

Option 4: Critical Illness Cover

Option 5: Double Sum Insured

Option 6: Domiciliary Hospitalisation Cover

Option 7: Alternative Treatment

Option 8: Maternity Benefit

Option 9: New Born Baby Cover

Option 10: Compassionate Visit

Option 11: Restoration of Sum Insured
Individual/Floater Individual: Available for all Sum Insured

Floater: Available for 3 lakhs and 4 lakhs only
Both Available  
Mandatory Medical Check-Ups For Individuals > 45 years  
Waiting Period: Pre-Existing Disease 4 Years (for all age groups)  
Min./Max. Entry Age Minimum 5 years & Maximum 65 years (Individual)
Minimum 91 days & Maximum 65 years (Floater)
Maximum 25 years for dependent children
 
Exit Age No Exit Age  
Policy Tenure 1, 2, & 3 years  
Relationships Covered Self, Spouse, Dependent Children, Dependent Parents  
Tax Benefit Under Sec. 80D of IT Act 1961  
Free-Look Period 15 days from the date of receipt of the policy  

Optional Covers

Choose from a range of optional add-ons that are customised to your needs, and provide you with enhanced protection. Ensure maximum protection for you and your loved ones by selecting the following add-ons that are available at an additional premium:

  • Hospital Daily Cash + Convalescence Benefit + Donor Expenses
  • Critical Illness Cover + Double Sum Insured
  • Cap on Room Rent

Register a Claim/Claim Process

Cashless Claim Process

Step 1: In case of a planned hospitalisation, take a pre-authorisation by informing us 48 hours prior to the admission

Step 2: In case of an unplanned hospitalisation, intimate to us about your claim by calling 1 800 266 4545 within 24 hours of the admission

Step 3: Use our Policy Certificate to avail of the cashless facility at any of our network hospitals

Reimbursement Process

Step 1: Intimate us by calling 1 800 266 4545 immediately on hospitalisation

Step 2: Settle bills directly with the hospital and collect all relevant documents

Step 3: Within 30 days of discharge, submit all the original documents to us

Exclusions

At Kotak Mahindra General Insurance, we value transparency above everything else. Here's a list of what we don't cover under our Kotak Health Care Policy, so we can avoid any inconvenience at the claims stage. Below is a list of our permanent exclusions, 30-days exclusions, 2-year exclusions, and 4-year exclusions:

  • Permanent Exclusions: Certain specified illnesses, procedures or treatments like routine health check-ups, dental treatments, aesthetic or cosmetic surgeries, injury or illness due to abuse of intoxicating substances, etc., are permanently excluded from the scope of coverage. For a complete list of permanent exclusions, please click here.
  • 30-Day Exclusions: This includes any illness contracted or medical expenses incurred within 30 days of commencement of the policy unless due to an accident. This exclusion doesn't apply to the renewal of a policy with us or to anyone whose policy has been accepted under the portability benefit.
  • 2-Year Exclusions: This exclusion 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. The following illnesses/medical conditions shall fall under 2-year exclusions: Cataract; Benign Prostatic Hypertrophy; Myomectomy, Hysterectomy unless because of malignancy; All types of Hernia, Hydrocele; Fissures and/or Fistula in anus, haemorrhoids/piles; Arthritis, gout, rheumatism and spinal disorders; Joint replacements unless due to accident; Sinusitis and related disorders; Stones in the urinary and biliary systems; Dilatation and curettage, Endometriosis; All types of skin and internal tumours/cysts/nodules/polyps of any kind including breast lumps unless malignant; Dialysis required for chronic renal failure; Surgery on tonsillitis, adenoids and sinuses; Gastric and duodenal erosions and ulcers; Deviated nasal septum; Varicose Veins/Varicose Ulcers.
  • 4-Year Exclusions: This exclusion applies to any pre-existing disease at the time of buying the policy. Any such pre-existing disease will not be covered for a period of 48 months of continuous coverage.

Customer Speak

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