Zurich Kotak Claim Settlement Ratio
  • Types of Claim Processes
  • CSR of Zurich Kotak
  • Claim Filing Process
Zurich Kotak Claim Settlement Ratio
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Simran Kaur Vij
Written By:
Simran

Simran Kaur Vij

Health and Term Insurance

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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Reviewed By:
Anchita Bhattacharyya

Anchita Bhattacharyya

Health, Term & Life Insurance

Anchita has over 6 years of experience in content marketing, insurance, and healthcare sectors. Her motto to make health and term insurance simple for our readers has proven to make insurance lingos simple and easy to understand by our readers.

Zurich Kotak Health Insurance Claim Settlement Ratio

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 Claim Settlement Ratio

Zurich Kotak General Insurance Company has recorded a claim settlement ratio of 96.76% for FY 2025.

Types of Claims by Zurich Kotak Health Insurance Company

Zurich Kotak Health Insurance Company offers two types of claims-settling processes to its customers. These are-

  • Cashless Claims
  • Reimbursement Claims

Cashless Claims

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.

Zurich Kotak Health Insurance Cashless Claims

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.

Process of Filing a Zurich Kotak Health Insurance Cashless Claim

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.

Reimbursement Claims

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.

Zurich Kotak Health Insurance Reimbursement Claims

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

Conclusion 

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 

 

Explore other Zurich Kotak Health Insurance

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

It's insurance against adversities caused due to accidents. The Union Minister of Road Transport and Highways, Nitin Gadkari, revealed that over 4.8...

Unique Features

  • AD PTD & PPD Covers
  • Children’s Education Grant
  • Lifestyle Modification Cover

Zurich Kotak Group Accident Protect Plan (Pros)

Zurich Kotak Group Accident Protect Plan
  • Accident Cover
  • Accidental Death
  • Disability Cover

Zurich Kotak Group Accident Protect Plan (Cons)

Zurich Kotak Group Accident Protect Plan
  • Adventure Sports
  • Illegal activities
  • Obesity Treatments

Zurich Kotak Group Accident Protect Plan (Other Benefits)

Zurich Kotak Group Accident Protect Plan
  • Permanent Total Disability
  • Partial Disability
  • Children education

Zurich Kotak Group Accident Protect Plan (Eligibility Criteria)

Zurich Kotak Group Accident Protect Plan
  • Min Age: 5 Years
  • Max Age: 65 Years
  • Sum Insured: 25 L
  • Initial Waiting Period: NA

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 ...

Unique Features

  • Comprehensive coverage
  • Value added benefits
  • Customizable plans

Zurich Kotak Health Premier Plan (Pros)

Zurich Kotak Health Premier Plan
  • In-patient treatment
  • daycare treatment
  • ambulance cover
  • restoration benefit

Zurich Kotak Health Premier Plan (Cons)

Zurich Kotak Health Premier Plan
  • Global coverage
  • modern treatment
  • IVF cover
  • Adventure sports

Zurich Kotak Health Premier Plan (Other Benefits)

Zurich Kotak Health Premier Plan
  • maternity benefit
  • cumulative bonus
  • compassionate travel
  • vaccination

Zurich Kotak Health Premier Plan (Eligibility Criteria)

Zurich Kotak Health Premier Plan
  • Entry age 18 years (min) - 65 years (max)
  • SI 2 Lakh to 2 Crore
  • Initial waiting period 30 days
  • Policy period 1/2/3 years

Individual

Out of 1.35 million deaths happening in road crashes, almost 93% of the accidental deaths occur in averagely developed countries like India. We're not...

Unique Features

  • Funeral expenses extensions
  • Children’s education grant
  • Lifelong renewability

Zurich Kotak Accident Care Plan (Pros)

Zurich Kotak Accident Care Plan
  • Children education grant
  • Dead remains transportation
  • Convalescence benefit
  • Accident daily cash benefit

Zurich Kotak Accident Care Plan (Cons)

Zurich Kotak Accident Care Plan
  • Room rent charges
  • Pre and post-hospitalization
  • Mental disorders
  • Self-inflicted injury

Zurich Kotak Accident Care Plan (Other Benefits)

Zurich Kotak Accident Care Plan
  • Ambulance charges
  • Accidental death
  • TTD PTD PPD cover

Zurich Kotak Accident Care Plan (Eligibility Criteria)

Zurich Kotak Accident Care Plan
  • Entry Age 5 to 65 years
  • Sum Insured NA
  • Policy term 1/2/3 years
  • Waiting period NA

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. ...

Unique Features

  • Domiciliary treatment cover
  • Get wellness benefits
  • Optional covers available

Zurich Kotak Group Health Care Policy (Pros)

Zurich Kotak Group Health Care Policy
  • Domiciliary hospitalization
  • Daycare procedures
  • Donor expenses
  • In-patient treatment care

Zurich Kotak Group Health Care Policy (Cons)

Zurich Kotak Group Health Care Policy
  • Obesity treatment unavailable
  • Breach of law
  • Cosmetic surgery
  • Maternity not covered

Zurich Kotak Group Health Care Policy (Other Benefits)

Zurich Kotak Group Health Care Policy
  • Room rent capping
  • AYUSH cover
  • Wellness benefits

Zurich Kotak Group Health Care Policy (Eligibility Criteria)

Zurich Kotak Group Health Care Policy
  • Entry age - 18 -55 Years
  • SI - 3/4/5 Lakhs
  • Plan type- Individual
  • Waiting Period - 30 days

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Zurich Kotak Claim Settlement Ratio: FAQs

1. When should we inform the insurance company about the planned hospitalization?

In the case of planned hospitalization, the person must inform the hospital within 48 hours of admission.

2. How long does it take to settle the claim after document verification?

After verification, the claim will be settled within 15 days by the company.

3. When should we inform the hospital about emergency hospitalization?

In case of emergency hospitalization, a person should intimate Royal Sundaram Health Insurance Company within 24 hours of hospitalization.

4. By when the policyholder should submit his documents after being discharged from the hospital?

The policyholder must submit a claim form with all the essential documents within 30 days of discharge from the hospital.

5. What is the name of the customer app of Kotak Mahindra Health Insurance Company?

The customer app of Kotak Health Insurance Company is ‘Kotak Mahindra General Insurance’.

6. When did Kotak Mahindra get renamed as Zurich Kotak 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.

7. What are some new health insurance policies offered by Zurich Kotak General Insurance?

Health Premier, Secure Shield, Accident Care, and other health insurance plans are offered by Zurich Kotak General Insurance.

8. What is a claim settlement ratio?

A claim settlement ratio is the ratio of the number of health insurance claims received against claims settled in a period.

9. What is the latest CSR for Zurich Kotak Health Insurance?

The CSR for Zurich Kotak Health Insurance is 96.76% for FY 2025.

10. When did Kotak Health Insurance become Zurich Kotak Health Insurance?

Zurich Insurance Company Ltd completed the acquisition of a 70% stake in Kotak Mahindra General Insurance Company Limited in June 2024.

11. How many network hospitals are available with Zurich Kotak Health Insurance?

11,200+ network hospitals are available with Zurich Kotak Health Insurance.

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Simran Kaur Vij

Written By: Simran Kaur Vij

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.