Nowadays, taking a medical treatment at a good hospital, for something as small as fever, can make a hole in your pocket. And for this reason, it is important to have a health insurance cover. Taking into consideration the increasing medical inflation and growing number of health ailments, Edelweiss Health Insurance has come up with three types of health insurance plans. These plans cater to different audiences and also life-threatening diseases like cancer. Edelweiss health insurance offers three variants of its health insurance policy for its different audience. You can opt for a plan that meets most of your requirements.
Incurred Claim Ratio
Edelweiss General Insurance Company offers three types of health insurance policies that come with the following benefits:
Edelweiss Health Insurance plans are tailor-made to offer maximum protection to the insured members at an affordable price. You can purchase any of the Edelweiss health insurance plans to avail the following benefits:
Edelweiss General Insurance plans are the most comprehensive ones. There are 3 variants – Silver, Gold, and Platinum. And the sum assured limit is listed below:
|Silver Plan||Gold Plan||Platinum Plan|
|Hospitalization Expenses(Up to the Sum Insured)||Covered||Covered||Covered|
|Room Rent limit per day - Standard Single Private Room||Sum assured Rs. 3 lakh and above||No Capping||No Capping|
|No Capping on ICU charges||Covered||Covered||Covered|
|Pre and Post Hospitalization Medical Expenses(Up to the Sum Insured)||30 to 60 days||60 to 90 days||90 to 180 days|
|Day Care Treatment(Up to the Sum Insured)||Covered||Covered||Covered|
|Ambulance Cover(Per hospitalization)||Up to Rs. 1500||Up to Rs. 3000||Up to Rs. 10,000|
|Organ Donor Cover||Not Covered||Up to 1 lakh Rupees||Up to 2 lakh Rupees|
|Domiciliary Hospitalization(Up to the Sum Insured)||Covered||Covered||Covered|
|Ayush (Up to the Sum Insured)||Covered||Covered||Covered|
|No-Claim-Bonus(If you do claim, the No Claim Bonus will reduce at the same rate at which it increases in a claim-free year)||Sum Assured Increases by 10% forevery claim-free year up to amaximum of 50%||Sum Assured Increases by 50% forevery claim-free year up to amaximum of 100%||Sum Assured Increases by 50% forevery claim-free year up to amaximum of 100%|
|Health Check-Up for every claim-free year(Policyholders who are 18yrs or above)||Covered||Covered||Covered|
|Maternity Benefit||Not Covered||Up to Rs. 50,000 ( waiting period of 4- years)||Up to Rs. 2 lakhs ( waiting period of 4- years)|
|Recovery Benefit(Starts from the day of hospitalization)||Not Covered||Rs. 1,000 per day from the 11th-20th day||Rs. 1,000 per day from the 11th-20th day|
|Shared Accommodation||Rs. 800 per day ( maximum up to Rs. 4,000)||Rs.1000 per day ( maximum up to Rs. 5,000)||Rs.1200 per day ( maximum up to Rs. 6,000)|
|Critical Illness Coverage(Starts from the first time you're diagnosed with a critical illness.)||Not Covered||Sum assured amount increases by 50 percent||Sum assured amount increases by 100 percent|
|Restoration - Top it up by 100%(Top it up by 100% that is your Sum Insured doubles.)||Not Covered||Covered||Covered|
|Critical Illness Coverage(Starts from the first time you're diagnosed with a critical illness.)||Sum assured amount increases by 50 percent||Covered in the basic plan||Covered in the basic plan|
|Recharge(Top it up by 100% that is your Sum Insured doubles.||Not Covered||Covered||Covered|
|Voluntary Co-payment(This option is available for ages 60 years and below.)||10 to 20 percent||10 to 20 percent||10 to 20 percent|
The coverage provided in all the plans may vary. Some of the common inclusions of Edelweiss health insurance plans are listed below:
There are certain limitations in an Edelweiss health insurance plans. And the exclusions of Edelweiss health insurance plans are listed below:
Apart from the basic health insurance cover, you can opt for the following other optional benefits:
To avail the benefits of your Edelweiss health insurance policy it is important to notify the insurer at least 72 hours before a planned hospitalization. In the event of an emergency hospitalization, it is required to intimate the insurer within 48 hours of hospitalization or before the discharge date whichever is earlier. However, the insurer may consider delays in extreme cases along with a proof.
The process to file Edelweiss health insurance claim is defined below:
To initiate a claim you need to provide the following documents/details/information to the insurer:
To know the premium for your selected policy you can use the online health insurance premium calculator. It is one of the most convenient and cost-effective methods to calculate the premium.
All you need to do is select the plan, go to the online calculator page, enter the basic details such as sum insured amount, number of family members, geographical location, age etc.
Once you enter all the required details, you will get the premium that the insurer will charge for that particular plan.
You can consider these parameters while picking a health insurance policy –
It is quite easy and convenient to renew Edelweiss health insurance policy online. Online renewal saves both time and efforts. You can check with the insurer for any specific procedure which is followed to renew the policy online.
But before that, you need to decide if you want to continue availing the benefits from your current insurance policy or you want to upgrade it. Also, make sure that you renew your policy before the expiry date. If the policy is not renewed within the stipulated time then you will not be able to avail the continuous benefits of your policy.
Under the family floater policy, coverage is provided to you, your spouse, and up to 3 children between the age group of 3 months to 21 years.
It depends on the type of plan that you have purchased. If you buy gold or platinum plan then critical illness is covered in the basic policy. However, you can buy this as an add-on benefit with your silver plan.
Yes, you can increase your coverage benefits at the time of renewal. You can upgrade your silver health plan to a gold or platinum plan. You can also opt for optional benefits to upgrade it further.
You can pay a single premium to get coverage for 1 year, 2 years or 3 years. And the coverage is provided for lifetime with timely renewal of the plans.
Yes, you enjoy your No-claim-discount even after changing your insurance company. But make sure that you renew your policy in time or before the expiry date to avail the NCB.
Even if you lose the hard copy of your Edelweiss health insurance policy then you can refer to the soft copy that is mailed by the insurer. Or you can apply for a fresh hard copy.
Edelweiss health insurance has a great network of cashless hospitals. So, you can easily find one in your area. You can check the list of network hospitals on their official site.
You don’t need to undergo pre-medical screening before buying a policy. However, the insurer will take a call on the basis of your age, sum assured and the plan that you have opted for.
To avail the cashless services you just need to showcase your health card in any of the network hospitals where you are planning to book an appointment or take an emergency treatment.