About Kotak Health Insurance

Kotak General Insurance is a 100% subsidiary of Kotak Mahindra Bank Ltd. The company started operations in 2015 after receiving its license from IRDAI. Ever since its emergence, Kotak Insurance company has delivered various products and has established a wider presence across the country. The company offers a wide range of non-life insurance products that are designed to cater to every need of the customer, including health insurance plans, car insurance plans, and bike insurance plans.

Achievements of Kotak Health Insurance

Kotak General Insurance has received several awards and achievements over the past few years. Given below is a list of few such awards:

• Marketer company of the year by India Insurance Summit & Awards 2020
• ANA ECHO International Awards 2020, USA - Bronze, Consumer Services
• Brand Equity Shark Awards 2019 - Silver, best consumer insights campaign
• India Digital Media Awards 2019 - Silver, Special award for gender parity
• 2 Silvers in 'Best consumer engagement & Best in financial service' category by DMAi ASIA ECHO AWARDS in 2019
• 3 Bronze in 'Best use of social media, innovative use of technology & best in consumer services' category by DMAi ASIA ECHO AWARDS in 2019

Key Features of Kotak General Health Insurance

As per IRDAI, 29 companies offer health insurance products in India. Given such a wide range of health insurance companies available in the market, it is quite obvious for a customer to feel confused about which company he/she should select. To help customers overcome this problem we've compiled a list of the key features of Kotak General Insurance. Customers can go through the list to check if their requirements match with this company's services and then decide about buying a health insurance policy from the company.

**Last Updated on May, 2021

Given below is a brief explanation of these features. Let's understand them in detail.

1. Network Hospitals

   Having a health insurance policy from an insurer that provides the facility of cashless hospitalization proves to be a blessing in disguise. This is because cashless hospitalization allows policyholders to avail medical treatment in any of the network hospitals without worrying about the expenses since the hospital bills are settled by the insurance company.

   Kotak General Insurance has a long list of network hospitals where the policyholder can avail cashless treatment facility. At present, the company has partnerships with more than 4000 hospitals across the country.

   Let's have a look at the graph below to get better insights about the network hospitals offered by Kotak in comparison to top 10 companies based on network hospitals.

   Comparison between Kotak Health Insurance and other top insurance companies based on network hospital

   

2. Annual Premium

   The business reputation and market performance of any insurance provider can be determined through its annual premium. You can refer to the chart below that highlights the increase in the annual premium of Kotak Insurance Company from 2016-17 to 2019-20.

   Annual Premium of Kotak General Insurance Company from 2016- 2020

   

   **Data from IRDAI Annual Reports

3. Claim Support

   The claim support ratio is a useful parameter that shows the number of claims settled by the company during the last three months and helps in analyzing its claim settling capability. Customers are advised to opt for an insurance company that has a high claim support ratio.

   Kotak General Insurance has a claim support ratio of 98.62%. Given below is a comparison between Kotak and the top competitors based on the claim support ratio.

   Comparison of Claim Support Ratio of Kotak Health Insurance company with other top insurers

   

   **Data from IRDAI Annual Reports

4. Solvency Ratio

   Another important factor that should be considered while buying a health insurance plan is to check the financial background of the insurance company. And for this, customers should check the solvency ratio as it helps in measuring the ability of the company to meet its long-term debt obligations and other monetary commitments. As per IRDAI, all insurance companies in India are obliged to maintain a minimum solvency ratio of 1.5, and Kotak General Insurance has been able to match this criterion. At present, the solvency ratio of the company is 2.42.

   The graph given below shows the solvency ratio record of Kotak for the last 4 years. Let's have a look.

   Solvency Ratio of Kotak Health Insurance Company from 2016-17 to 2019-20

   

   **Data from IRDAI Annual Reports

Health Insurance Plans by Kotak General Health Insurance

Kotak General Insurance majorly deals in 8 types of health insurance plans to fulfill the insurance needs of a diverse range of customers. The table below provides a quick overview of these plans. Let's check.

**Last Updated on May, 2021

Let's have a detailed discussion of each of these above-listed plans.

1. Kotak Secure Shield

   Kotak Secure Shield is a critical illness insurance plan that protects you and your family against unforeseen adversities by providing financial coverage for expenses associated with a variety of illnesses (as listed in the policy).

   Key features:

   • The plan provides a personal accident benefit under which the policyholder's family members get financial coverage if the insured dies or becomes permanently disabled due to an accident.
   • In case of policyholder's demise or permanent total disability, the plan provides critical illness cover which funds the future education expenses of the insured person's child.
   • The policy also offers financial support to the insured in case he/she loses a job due to illness or accident.
   • By paying regular premiums, the insured can avail of tax benefits under section 80D of the Income Tax Act, 1961.

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	18 years	65 years
   Renewal Age	Life-long renewals
   Policy Period	1, 2 & 3 years

   **Last Updated on May, 2021

2. Kotak Health Care

   Kotak Health Care is a comprehensive health insurance plan that ensures you and your family are financially protected against medical emergencies. The plan comes in three variants- Excel, Platinum & Prime.

   Key Features:

   • Customers can ensure maximum protection by selecting the following optional covers:
   • Hospital Daily Cash + Convalescence Benefit + Donor Expenses
   • Critical Illness Cover + Double Sum Insured
   • Cap on Room Rent
   • The plan covers pre and post-hospitalization expenses up to 30 & 60 days respectively.
   • With every claim-free year, avail of a cumulative bonus of 10% on your base annual sum insured (up to 50% of base SI) on renewal of the policy.
   • The policy also offers the benefit of free health check-ups per year at any of the network hospitals for every insured member above 18 years of age.

   Eligibility Criteria:

   Criteria	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
   Minimum Entry Age	Individual- 5 years Floater- 91 days
   Maximum Entry Age	Individual- 65 years Floater- 65 years Dependent Children- 25 years
   Policy Term Period	1, 2, & 3 years

   **Last Updated on May, 2021

3. Kotak Accident Care

   The policy is specially designed to cover you and your family in case of an accidental injury, disability, or death.

   Key Features:

   • Grab an accidental hospital daily cash benefit, where a claimant will get a fixed sum on a daily basis (during hospitalization) to cover the miscellaneous expenses.
   • One can avail of a convalescence benefit, under which the company pays a fixed sum of Rs.10,000 on hospitalization for a minimum of 10 continuous days.
   • As an optional cover, the policy looks after the expense incurred during the transportation of the body of the deceased from the place of death to the place of residence

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	5 years	65 years
   Renewal Age	Life-long renewals
   Policy Period	1, 2 & 3 years

   **Last Updated on May, 2021

4. Kotak Super Top-up

   With the Kotak Super Top-up plan, you can enhance your health insurance coverage at affordable rates. In other words, the plan offers additional coverage to the policyholder to meet his/her medical expenses.

   Key Features:

   • The plan offers restoration benefits up to 100% of the sum insured for claims due to unrelated illness in a policy year.
   • Ambulance expenses incurred for taking the insured to the hospital are covered (up to Rs.2,000/hospitalization) by the plan.
   • The plan covers (up to Rs.50,000) medical expenses arising during the treatments taken under Ayurveda, Unani, Siddha, among others.

   Benefits	Availability
   Long Term Cover	2 & 3 years
   Tax Benefits	Available

   **Last Updated on May, 2021

5. Kotak Health Premier

   Kotak Health Premier is a comprehensive health insurance plan that forms a financial bubble around you and your family against rising medical expenses. The plan offers rewards and value-added benefits to help you stay fit.

   Key Features:

   • The plan looks after the treatment expenses of listed 405 daycare procedures, which require less than 24 hours of hospitalization.
   • Go for an annual health check-up (for specified tests) once every policy year, without paying any charges. The insured must be above 18 years of age.
   • Avail of multiple second e-opinions on medical conditions in a policy year.

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	91 Days for Child 18 Years for Adult	25 years for Child 65 years for Adult
   Renewal Age	Life-long renewals
   Policy Period	1, 2 & 3 years

   **Last Updated on May, 2021

6. Arogya Sanjeevani Policy

   Arogya Sanjeevani policy from Kotak General Insurance is a standard individual health insurance plan that offers medical coverage to individuals and their families at affordable premiums.

   Key Features:

   • The plan offers pre & post-hospitalization coverage up to 30 & 60 days respectively.
   • If the insured wants to undergo cataract treatment of one eye, the plan covers (Rs.40,000 or 25% of SI, whichever is less) its expenses.
   • The plan also covers ambulance charges up to Rs.2000 per hospitalization.

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	18 years	65 years
   Sum Insured Amount	Rs. 1 lakh	Rs. 5 lakhs
   Policy Period	1 year

   **Last Updated on May, 2021

7. Corona Kavach Policy

   Corona Kavach policy is a standard individual health insurance policy that protects you against hospitalization expenses that occur due to COVID-19.

   Key Features:

   • Pre-hospitalization and post-hospitalization expenses (up to 15 and 30 days) are covered.
   • The plan offers coverage against the expenses incurred on the road ambulance service, home care treatment (maximum of 14 days during the policy period), and AYUSH treatments.
   • The plan offers daily hospital cash benefits (0.5% of the sum insured) for every 24 hours of continuous hospitalization for treatment of COVID. This is payable for a maximum 15-day period.

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	18 years	65 years
   Sum Insured Amount	Rs. 50,000	Rs. 5,00,000
   Policy Period	3.5 months, 6.5 months, and 9.5 months

   **Last Updated on May, 2021

8. Corona Rakshak Policy

   Corona Rakshak is a standard individual health insurance policy that provides a lump-sum benefit to the insured if detected with COVID-19 (by a government-authorized diagnostic centre). To avail of policy benefits, a minimum continuous period of 72 hours is required.

   Key Features:

   • The plan offers a lump-sum benefit equal to 100% of the sum insured amount upon positive diagnosis of the insured person for COVID infection.
   • This policy gives a special discount of 5% to the employees of Kotak Group.

   Eligibility Criteria:

   Criteria	Minimum	Maximum
   Entry age	18 years	65 years
   Sum Insured Amount	Rs. 50,000	Rs. 2,50,000
   Policy Period	3.5 months, 6.5 months, and 9.5 months

   **Last Updated on May, 2021

Exclusions of Health Insurance Plans by Kotak General Insurance

Below is a list of few general exclusions applicable under Kotak Health Insurance plans. To get more details about plan-specific exclusions, refer to its policy document.

• Any injury due to war, invasion, an act of a foreign enemy, hostilities, etc.
• Usage, consumption, or abuse of drugs or alcohol.
• Self-destruction or self-inflicted injury.
• Sexually transmitted disease.

How To Buy Kotak Health Insurance?

There are two methods by which customers can purchase Kotak health insurance plans. These methods include buying the plan from either:

• Kotak company's online portal or the nearest branch,
• Through third-party intermediaries like agents and brokers.

Here is a step by step guide for buying the plan online:

• Visit the website of Kotak General Insurance.
• Click on the 'Health Insurance' icon.
• Enter the personal details and submit the form.
• Select your preferred plan and customize it.
• Check the premium details.
• Make an online payment of the premium amount.

Once the payment is done, the policy details will be mailed to your registered email address.

You can also buy it from PolicyX.com. Here are the steps you can follow:

• Fill in the details in the 'Calculate Premium' form.
• The next page will show all the available plans. Choose the best Kotak health plan and click on 'Buy Now'.
• Pay the premium and your policy document will be shared with you on your registered email.

How To File Kotak Health Insurance Claim?

It is important to have knowledge about the claim process of the insurer so that the customer can avoid any stress during a medical emergency. Below is the complete guide that tells how customers can file claims for their Kotak health insurance policy. Let's have a look.

Cashless Claim

If you are admitted to one of Kotak General's network hospitals, you have to follow the below steps-

• In case of planned hospitalization, intimate the company 48 hours before the hospitalization.
• In case of an emergency, visit the cashless helpdesk of the hospital within 24 hours of hospitalization.
• Submit the pre-authorization form, along with the photo identity and health card copies at the hospital desk.
• The hospital will then contact the company for treatment approval.
• If approved, the company will settle all the bills and expenses of your treatment.

Reimbursement Claim

You have the option to get yourself treated at a non-network hospital, and file for reimbursement with the following steps:

• Inform (via care[at]kotak[dot]com or 1800 266 4545) the insurance company at the earliest.
• Settle all the bills and collect the necessary documents before you leave the hospital.
• Submit the documents and the claim form to the company within 30 days of discharge.
• Once the verification is done, the company will settle your claim within 15 days.

Documents Required for Filing Claim

For Cashless claim:

• Health card of the insured
• All pre-hospital medical papers, reports, and prescriptions
• Commencement of the ailment
• Policy copy
• Photo ID proof (PAN card, passport, election ID, employee ID, driving license)

For Reimbursement claim:

• Claim form duly filled and signed by the insured and attending doctor
• All treatment papers of current ailment mentioning first symptoms and date of occurrence of the ailment, previous treatment papers.
• Discharge card from the hospital
• Original medical investigation reports
• Original bills from the hospital, chemist, or medical practitioner supported by prescriptions
• Cancelled cheque, copy of bank passbook/statement, and PAN card of the policyholder
• Address proof, ID proof, and 2 recent passport size photographs

The claim documents, duly completed, should be submitted at the following address as early as possible, but no later than 30 days from the date of discharge (in case of reimbursement).

Health claims department address:

Family Health Plan Insurance TPA Limited, Srinilaya - Cyber Spazio, Suite # 101,102,109 & 110,

Ground Floor, Road No. 2, Banjara Hills, Hyderabad: 500034, Telangana, India.

Contact Details Of Kotak General Insurance

Corporate Office Address: 8th Floor, Zone IV, Kotak Infinity, Bldg. 21, Infinity IT Park, Off WEH, Gen. AK Vaidya Marg, Dindoshi, Malad (E), Mumbai - 400097. India

Telephone: 1800 266 4545 (Toll-free)

E-Mail: care[at]kotak[dot]com