Zurich Kotak Claim Settlement Ratio
- Types of Claim Processes
- CSR of Zurich Kotak
- Claim Filing Process
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Updated on Apr 08, 2025 3 min read
Claim Settlement Ratio is a reliability factor showcasing your health insurer’s ability to settle claims. In a recent development, Zurich Insurance Company Ltd has completed the acquisition of a 70% stake in Kotak Mahindra General Insurance Company Limited. This development has further solidified the position of Zurich Kotak General Insurance Company (India) Limited in the market. The general health insurer has recorded 96.76% for FY 25.
Zurich Kotak General Insurance Company has recorded a claim settlement ratio of 96.76% for FY 2025.
Zurich Kotak Health Insurance Company offers two types of claims-settling processes to its customers. These are-
In this claim process the insurance company settles the medical bill directly with the hospital. This claim settlement process is most famous among the two claim settlement processes.
The company has tie-ups with most of the leading hospitals in the country where customers can avail of cashless claim settlements. The company has a network of 11,200+ cashless hospitals. Zurich Kotak General Insurance offers the benefit of cashless claims to save its policyholders from worrying about medical expenses borne by their pocket.
Zurich Kotak General Insurance Company has a simple, app-based claim process to make your experience with the customer fuss-free. You can contact the company for a claim, submit your documents, and check your claim status easily on their customer app’ Kotak Mahindra General Insurance’ and on their official website as well. Let’s go through the Zurich Kotak Health Insurance Cashless Claim process step by step.
Step 1: Customers must find a Zurich Kotak Health Insurance network hospital near them where they want to avail of the cashless treatment.
Step 2: For planned hospitalization, the customer must inform the company within 24 hours and in case of emergency hospitalization and 48 hours after the admission.
Step 3: Policyholders must show their card/policy number of the member ID provided by Zurich Kotak Health Insurance, at the insurance desk of the network hospital.
Step 4: You can get the pre-authorisation form at the hospital, and fill in all the required information. Then, the pre-authorisation form will be sent to Kotak Health Insurance Company for approval.
Step 5: After the claim details and documents are examined and reviewed Zurich Kotak Health Insurance team will inform the policyholder and hospital regarding the claim approval or rejection.
Step 6: If the claim is approved, the medical expenses will be sent to the hospital directly. But, if the claim is rejected, the policyholder will be required to pay the bills and other expenses.
In this process, the policyholders have to clear their medical expenses that are out of hospitalization from their own pocket and then raise a reimbursement claim by submitting proper medical bills and documents.
In this process, the policyholders have to clear their medical expenses that are out of hospitalization from their pocket and then raise a reimbursement claim by submitting proper medical bills and documents. A customer can file a reimbursement claim at both, network and non-network hospitals of Zurich Kotak Health Insurance Company. Here are the steps for the reimbursement claim process:
Step 1: In case of planned hospitalization, the person must inform them before 48 hours of admission.
Step 2: In case of emergency hospitalization, a person should inform Zurich Kotak Health Insurance Company within 24 hours of hospitalization.
Step 3: The policyholder must submit a claim form with all the essential documents within 30 days of discharge from the hospital.
Step 4: After reviewing the submitted documents and claim form details, the letter of approval and confirmation will be sent to the policyholder by the claim management team of Kotak Health Insurance. After verification, the claim will be settled within 15 days.
Step 5: In case of rejection, the insured individual is required to respond to the query raised by Kotak Health Insurance Company and go through the reason for rejection
Zurich Kotak Health Insurance is one of the most reliable health insurers in the country. With an impressive CSR for FY 2025 at 96.76% the insurer makes sure their customers are satisfied. Ultimately, the Zurich Kotak Health Insurance claim settlement ratio offers a key insight into the company’s performance. When making decisions about health insurance, consumers should factor in the claim settlement ratio, along with other essential factors, such as policy coverage, network hospitals, and customer service. To find out more about Zurich Kotak Health Insurance connect with PolicyX insurance experts
To cater to the different medical needs of an individual & their family, Zurich Kotak Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to Zurich Kotak Health Insurance plans explore more:
Individual
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Individual and Family Health Insurance
Zurich Kotak Health Premier is a versatile option when it comes to ensuring the health and wellness of yourself and your loved ones. Zurich ...
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Individual
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Group Health Insurance
Kotak Group Health Care insurance plan is specially designed to cater to the healthcare needs of active group members of Kotak Mahindra Bank Limited. ...
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In the case of planned hospitalization, the person must inform the hospital within 48 hours of admission.
After verification, the claim will be settled within 15 days by the company.
In case of emergency hospitalization, a person should intimate Royal Sundaram Health Insurance Company within 24 hours of hospitalization.
The policyholder must submit a claim form with all the essential documents within 30 days of discharge from the hospital.
The customer app of Kotak Health Insurance Company is ‘Kotak Mahindra General Insurance’.
The Company acquired its new name ‘’Zurich Kotak General Insurance Company (India) Limited’’ in August 2024, following Zurich Insurance Group’s 70% acquisition of Kotak Mahindra General Insurance Company Limited.
Health Premier, Secure Shield, Accident Care, and other health insurance plans are offered by Zurich Kotak General Insurance.
A claim settlement ratio is the ratio of the number of health insurance claims received against claims settled in a period.
The CSR for Zurich Kotak Health Insurance is 96.76% for FY 2025.
Zurich Insurance Company Ltd completed the acquisition of a 70% stake in Kotak Mahindra General Insurance Company Limited in June 2024.
11,200+ network hospitals are available with Zurich Kotak Health Insurance.
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Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.
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