Edelweiss Health Insurance
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Edelweiss Health Insurance

Edelweiss General Insurance is one of the renowned insurance providers in the country. It has served multiple customers since 2017. It sells remarkable products across health, motor, travel, and other segments.

Its health insurance has gained the spotlight over the years. It provides comprehensive coverage for different health treatments as well as malignant diseases like cancer. With Edelweiss health insurance, you can say good-bye to financial worries at the time of a medical emergency.

Highlights

Claim Ratio (2018-19)

115%

Claim Ratio (2017-18)

70%

**Last Updated on 07-01-2021

Edelweiss Health Insurance

What are the different types of Edelweiss Health Insurance Plans?

1. Edelweiss Health Insurance Policy

It's standard health insurance, which provides comprehensive financial coverage to its customers against long-lasting medical worries. This policy is divided into three variants- silver, gold, and platinum. Let's know more about them in detail.

Eligibility:

Parameters

Silver

Gold

Platinum

Minimum entry age

3 months

Maximum entry age

65 years

65 years

No limit

Sum insured (Rs.)

1, 2, 3, 4, 5 lakhs

5, 7.5, 10, 15, 20 lakhs

15, 20, 50, 75, 100 lakhs

Policy term

1/2/3 years

Premium payment options

S1ingle

Renewal age

Lifelong

**Last Updated on 07-01-2021

Key features of the Silver Plan:

  • Hospitalization- In case the policyholder is hospitalized due to an illness/injury, the plan will look after its expenses like nursing charges, room rent, medical practitioner fees, operation theater charges, medications, ICU charges, among others.
  • Pre and post hospitalization- All the expenses incurred up to 30 days before hospitalization and up to 60 days after hospitalization are covered.
  • Day care treatments- Treatments not exceeding 24 hours of hospitalization are covered under this plan.
  • Ambulance cover- If the insured needs to be transported to the hospital due to a medical emergency, the plan will take care of its expenses (up to Rs.1,500).

Key features of the Gold Plan:

  • Pre and post hospitalization- The plan provides coverage up to 60 days before arrival at the hospital and up to 90 days after discharge from the hospital for the incurred medical expenses.
  • Ambulance cover: The plan covers the ambulance expenses (up to Rs.3,000) if the insured requires an ambulance for an emergency.
  • Organ donor expenses- The medical expenses incurred against an organ donor's inpatient treatment for harvesting an organ are covered (up to Rs.1 lakh).
  • Maternity benefit: Under this plan, maternity benefit (up to Rs.50,000) is provided for 2 deliveries and lawful termination of a pregnancy of an insured (as per policy's TnCs).

Key features of the Platinum Plan:

  • Hospital cash- The plan shells out hospital cash benefit (Rs.1,500) to the insured if the hospitalization exceeds 3 continuous days. This is applicable up to 7 days of hospitalization.
  • Pre and post hospitalization- Under this plan, pre and post hospitalization expenses are covered for 90 and 180 days respectively.
  • Ambulance coverage- In the need of an ambulance for transportation of the insured to the hospital, the plan takes care of its expenses (up to Rs.10,000).
  • Organ donor treatment- Expenses arising out of inpatient treatment of an organ donor are covered up to Rs.2 lakhs.
  • Ayush treatments- The plan will bear the expenses for any treatment taken under Unani, Ayurveda, Homeopathy, and Siddha in any government recognized hospital/institution.

2. Edelweiss COVID Healthcare

To beat COVID-19 to its core, the company has come out with two COVID-specific plans to tackle the medical expenses arising out of this deadly illness. The plans are-

  1. Corona Kavach
  2. Corona Rakshak

1. Corona Kavach Policy

The policy is designed to look after the expenses in case the insured falls ill with COVID-19. Corona Kavach can be purchased on an individual or family floater basis.

Eligibility:

Entry age

18-65 years

Sum insured (Rs.)

50,000-5 lakhs

Policy period

3.5, 6.5 & 9.5 months

**Last Updated on 07-01-2021

Key features:

  • Pre and post-hospitalization- The plan will cover any expenses incurred before hospitalization/home care treatment (up to 15 days) and after discharge from the hospital/completion of home care treatment (up to 30 days).
  • Home care treatment- If the insured undergoes treatment for COVID-19 at home after approval from the government-certified doctor, the plan is liable to cover its expenses up to 14 days.
  • Pre-policy medical check-up- Individuals up to 60 years don't have to undergo medical screening to buy this plan.
  • Daily hospital cash- The plan will pay 0.5% of the sum insured (each day) for every 24 hours of continuous hospitalization to the insured. This benefit is payable up to 15 days in a policy period.

2. Corona Rakshak Policy

If the insured is diagnosed with COVID-19 and requires uninterrupted hospitalization for at least 72 hours, this plan provides 100% insurance coverage. It should be detected from a government authorized diagnostic centre.

Eligibility:

Entry age

18-65 years

Sum insured (Rs.)

50,000-2.5 lakhs

Policy period

3.5, 6.5 & 9.5 months

Waiting period

15 days

**Last Updated on 07-01-2021

3. Edelweiss Arogya Sanjeevani Policy

Hospital costs are reaching new heights. Everything from simple daycare procedures to hospitalization can damage your wallet. With the Arogya Sanjeevani plan, you can get comprehensive health coverage and protect your savings account.

Eligibility:

Entry age

18-65 years

Sum insured (Rs.)

1-5 lakhs

Member covered

8

Premium payment options

Annually, half-yearly, quarterly and monthly

**Last Updated on 07-01-2021

Key features:

  • Hospitalization costs- If you are hospitalized for at least 24 hours, coverage will be provided up to the sum insured. The plan also includes coverage for day care treatment procedures.
  • Pre and post-hospitalization costs- All the related expenses incurred before admission and after discharge from the hospital are covered up to 30 and 60 days respectively.
  • Cataract treatments- If your eye(s) needs cataract treatment, the plan will take care of its expenses (Rs.40,000 or up to 25% of SI per eye).
  • Cumulative bonus- In case you don't claim in a policy year, your sum insured will increase by 5% (maximum 50%).

What are the general exceptions under Edelweiss Health Insurance Plans?

Below are the general exceptions, which apply to Edelweiss Health Insurance plans. Let's have a look:

  • All hazardous activities.
  • Oral chemotherapy.
  • AIDS/HIV treatment.
  • The cost of contact lenses, spectacles, hearing aids, eye and ear examinations, dentures, laser surgery, dentures, and other similar external devices.
  • Plastic surgery or cosmeceutical surgery.
  • Treatments undertaken by unauthorized hospitals/doctors.

Why is Edelweiss General an ideal choice for health insurance purchase?

Edelweiss Health Insurance plans are tailored to meet the health care needs of its customers. Whether you are a victim of COVID-19 or need regular medical assistance, the company offers a separate health plan for each of them. The claim process is straightforward, and the policyholders are notified at every step of the way.

How to buy Edelweiss Health Insurance Plans?

To provide utmost comfort to its customers, Edelweiss has come up with an easy process to buy its health plans. Here is the process.

  • Visit the official website of Edelweiss General and tap on 'Health Insurance'.
  • Enter the details in the 'Get Quote' tab.
  • Choose the plan of your choice, customize its details (if needed) and pay the premium.
  • After payment of the premium, the policy document will be sent to your registered mail id.

If you don't wish to buy online, just visit the nearest branch of the company for a health insurance purchase.

To know more about the plan, get in touch (1800-4200-269) with the experts of PolicyX.com.

How to file a claim for Edelweiss Health Insurance Plans?

To avoid any confusion, the company asks its customers to perform a 3-step claim process. Let's take a look at it.

Claim intimation: Whether it's a planned or emergency hospitalization, just inform the company (call at 1800 12000) about the same.

Submission of documents: Submit all the necessary documents like medical records, discharge summary, claim form, etc. to the company within the deadline.

Claim decision: If you opt for cashless hospitalization, Edelweiss will directly pay the hospital (if the claim is approved). In the case of reimbursement, the company will transfer the amount to the registered bank amount.

For any queries, mail at support[at]edelweissinsurance[dot]com

Documents Required For Edelweiss Health Insurance Claim

  • Correctly signed & filled claim form
  • Medical research reports
  • Pre-authorization request
  • Medical reference slip
  • Copy of Patient Photo ID Card (Hospital Verified)
  • Discharge document from the hospital
  • Operation Theater Reports
  • Chemist bills
  • Hospital bills
  • Others requested by the company

FAQ's

1. Does Kotak Health Premier offer maternity cover?

Yes, the plan offers maternity cover, provided all the below 3 covers are taken together.

  • Maternity Benefit
  • New Born Baby Cover
  • Vaccination Expenses

2. Does Kotak General offer a free look period in its health plans?

Yes, as per the IRDAI guidelines, a policyholder has the option to return the original policy within 15 days from the date of receipt of the policy.

3. What documents do I need to submit for a reimbursement claim?

The following documents are required for the processing of reimbursement claims:

  • Duly filled and signed claim form.
  • All the hospital bills and receipts of the chemist, medical practitioner, prescriptions, etc. (in original).
  • Discharge card from the hospital.
  • All original medical investigation reports.
  • NEFT and KYC details of the claimant.
  • Others requested by the company.

Page updated on 07-01-2021