Kotak Mahindra Group Health Insurance

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Kotak Mahindra Group Health Insurance Overview

Kotak Mahindra General insurance has designed a range of group health insurance policies to cater to the needs of employer-employee entities such as small/middle or large enterprises and non-employer-employee organisations like credit societies, banks, travel companies etc. given to the potential risks an organization is exposed to, these policies can be customized accordingly. group health insurance policies by Kotak Mahindra General Insurance are tailor-made to serve the health and accidental insurance related requirements of the employees. Let’s gather some detailed information:

Benefits & Features of Kotak Group Health Insurance

Kotak Mahindra Group Health Insurance comes with the following features and benefits that make the policy worth your investment:

  • The policy offers comprehensive cover that includes a group of people under a single policy
  • Personal accidental benefits are offered in case of an accident leading to injury, disability or death
  • Serves like a financial-shield in case of medical emergency without paying a premium
  • As the premiums are paid by the employer, it can claim tax benefits as per the provisions of Income Tax Act.
  • Instant policy renewal through Kotak Mahindra online insurance
  • The calm process is hassle-free and less time taking
  • 24x7 customer assistance
  • The insured can add his/her family as a beneficiary under a group health insurance policy.
  • The policy extends coverage to specific illnesses as well up to a certain limit.
  • No medical test is required to avail the policy and the insured is covered from day 1
  • An additional health coverage to an individual with health insurance for itself or the family
  • Certain policies may come with maternity benefits
  • it is more economical as compared to an individual health insurance
  • In many cases, pre-existing illnesses are also covered
  • Employees are not denied to be the insured basis on their age or past medical history

Why buy Group Health Insurance from Kotak Mahindra

Kotak Mahindra group health insurance is one of the famous products among insurance seekers. Here’s why you should buy group health insurance from Kotak Mahindra General Insurance:

  • Kotak Mahindra is a subsidiary of one of the leading baking enterprises, Kotak Mahindra Bank Ltd. So, the genuineness of the insurer is highly assured.
  • The insurance products offered by the insurer are capable of serving the various needs of the people with different requirements.
  • You can avail round-the-clock claim assistance
  • Cashless services can be availed at network hospitals throughout India

Types of Kotak Mahindra Health Insurance

Kota Mahindra General Insurance comes with a variety of group health insurance policies to serve the interest of both employers and employees. Here are the types of Kotak Mahindra Group Health Insurance:

  • Kotak Group Accident Care: Group Accident Care is specially designed for organisations to cover their employees for the rising risk of unforeseen accidents. The policy can be purchased at an affordable premium and ensure comprehensive protection to the group members against death or disability arising from an accident.
  • Kotak Group Health Care: this policy offers customized health insurance coverage to the employer to cover its employees and their respective dependents. The rising healthcare cost has become a matter of concern for the companies irrespective of small or large one. To retain the tales, benefits like serves in a great way to motivate the employees. This policy serves the health insurance interest of a group of members by helping the person to face the financial strain without thinking of breaking their banks. The policy covers the hospitalisation expenses resulting from an accident or illness. The policy comes with additional benefits such as alternative treatment cost, daily cash, home nursing, convalescence benefit etc.
  • Kotak Group Secure Shield: Kotak Group Secure Shield is a specific illness plan under which a lump sum benefit is offered towards treating a critical illness. The policy also comes with an additional benefit where a lump sum is provided in case of disability or death of a person due to an accident. This can be taken by the bank or financial institution to cover the loan liability of its customers in case of death /disability.
  • Kotak Group Accident Protect: this is a comprehensive policy taken by the employer to keep its employees secured against the financial burden arising due to an accidental disability or death. The policy serves the needs of its family in case of an accidental demise or disability leading to loss of employment.
  • Kotak Group Hospital Cash: this policy is similar to regular daily cash benefit policy; the only differences is it covers a group of people from the same organization or entity. A fixed amount is paid during hospitalisation, apart from the medical cost. This policy comes in handy to cover the medical and non-medical expenses that are not covered by regular health insurance, by utilizing the given amount towards that purpose. 
  • Kotak Group Smart Cash: Kotak Group Smart Cash policy also offers a fixed amount during hospitalization up to certain days, in addition to the medical expenses. However, the coverage is slightly different, where the benefits can be availed worldwide with this policy. this policy also comes in handy in covering the expenses that are not included under a regular health insurance plan.

Kotak Mahindra Group Health Insurance Plan Table

Plan Name

Type of Plan

Benefit &Features

Kotak Group Accident Care

 

Group Accidental Plan

  • Accidental Death
  • Permanent Total Disablement (PTD)
  • Permanent Partial Disablement (PPD)
  • Temporary Total Disablement (TTD)
  • Accidental Hospitalization
  • Broken Bones/ Burns Benefit

 

Kotak Group Health Care

Regular group health plan

  • In-patient Treatment
  • Pre-hospitalisation Medical Expenses
  • Post-hospitalisation Medical Expenses
  • Day Care Treatment
  • Domiciliary Hospitalisation
  • Emergency Ambulance
  • Donor Expenses
  • alternative treatment cost
  • daily cash allowance
  • home nursing
  •  convalescence benefit

 

Kotak Group Secure Shield

Critical Illness Plan

  • Critical Illness
  • Accidental death/ Accidental Permanent Total Disablement (PTD) due to the accident
  • Loss of Job
  • Child Education cover

Group Accident Protect

Accidental Plan

  • Accidental Death
  • Permanent Total Disablement (PTD)
  • Permanent Partial Disablement (PPD)
  • Temporary Total Disablement (TTD)
  • Accidental Hospitalisation

 

Kotak Group Hospital Cash

Hospital Cash Plan

  • Hospital Daily Cash Benefit
  • Accident Daily Cash Benefit
  • ICU Daily Cash Benefit
  • Surgery Benefit
  • Day Care Procedure Benefit

 

Kotak Group Smart Cash

Cash Benefit Plan

  • Hospital Daily Cash Benefit
  • Accident Daily Cash Benefit
  • ICU Daily Cash Benefit
  • Worldwide Cover
  • Alternative Treatment Benefit

 

 

Kotak Mahindra Group Health Insurance Inclusions

The common exclusions of Kotak Mahindra Group health insurance include:

  • Accidental hospitalisation expenses cover including pre and post hospitalisation expenses
  • Emergency ambulance cover up to a certain fixed amount
  • The insured is covered for domiciliary expenses
  • Personal accident cover in case of accidental death/disability/injury leading to loss of income
  • ICU daily cash benefit
  • Critical or specific illness cover (plan specific)
  • Surgery benefit
  • Accident daily cash allowance, hospital daily cash allowance
  • Donor expense cover
  • Alternative treatment expenses cover
  • Home nursing expenses
  • Convalescence benefit cover

Kotak Mahindra Group Health Insurance Exclusions

Whether you’re an employer or employee, a closer look towards Kotak Mahindra group health insurance exclusion and policy document is required. If an employee is not informed about these exclusions, it may lead to misunderstanding on the grounds of breach of trust on the employer. As there is no fixed list of exclusions and it may vary from insurer to insurer, some of the common exclusions you can consider are:

  • Sub-limit: The coverage under group health insurance can be limited due to the sub-limit Moreover, it is a master policy for a group of people, which may lack customization.
  • Duration of Employment: The policy covers you until the time you are with the organisation. Any claim made after leaving the organisation will be rejected by default.
  • No cover for AYUSH treatments: The policy doesn’t cover treatment expenses incurred in naturopathy, homoeopathy, Ayurveda, Unani, immunizations etc. It also doesn’t cover the expenses incurred towards cosmetic surgery/plastic surgery.
  • Other Exclusions: apart from the above the other exclusions include:
    • Intentional injury, suicide or attempt to suicide
    • Injuries caused due to any involvement in criminal activity
    • Accident occurs while driving without the influence of alcohol or drugs
    • While driving without a valid driving license
    • AIDS or HIV treatment is not covered
    • Natural death or disability are excluded
    • Some coverage may not be extended towards the family

For the complete list of exclusion, kindly refer the policy document.

Kotak Mahindra Group Health Insurance Sum Insured

Group health insurance sum insured is pre-decided at the time of buying a plan, up to which the insurer indemnifies the claim. Every sum insured is subject to a definite premium without which one can’t avail the policy benefits.

Let’s say you own Kotak Mahindra Group Health Insurance of Rs. 5 lakh. During your first hospitalisation due to an accident, you claim the insurance for medical expenses Rs. 70,000. While in your second-time hospitalization, you incur 1.5 lakh. Your total expense is 2.2 lakh, which is paid by the insurer. Now you can claim the policy for remaining Rs. 2.8 lakh, up to which the insurer will pay and anything above that will be borne by you.

Usually, the sum insured for Kotak Group health insurance is decided based on the size of the group and the coverage offered. However, it is recommended to opt for a higher sum insured to cover maximum hospitalisation and enjoy tax benefit.

Kotak Mahindra Group Health Insurance Claim

The process of registering Kotak Mahindra Group health insurance claim is similar to that of any other health insurance policy. You can either opt for the cashless facility at a network hospital, in which case the submission of the claim settlement related documents will be done by the hospital and you avail the treatment free of cost. If not pay the hospital bills on own and get the claim amount reimbursed by submitting all the required documents to the insurer. To ensure a smooth claim settlement with Kotak Mahindra group health insurance, ensure the following steps:

1. Cashless Claim:

  • Step 1: Filling a pre-authorisation letter is required in case of a planned hospitalisation followed by intimating the insurance company before 48 hours of hospitalization. You can approach the employer for the same, while the formalities are done by the HR by informing the insurer. In case of emergency hospitalisation, the insurer has to be updated within 24 hours of hospitalization, followed by filling a pre-authorisation letter and submit with the insurance help desk in the hospital.
  • Step 2: Seek the treatment free of cost after the insurer approves the request
  • Step 3: the claim is settled by paying for the incurred expenses directly to the hospital authority.

2. Reimbursement Claim

If you avail the healthcare expenses from a non-registered hospital with the insurer, the claim process comes under reimbursement claim. In order to ensure a claim under this category, follow the below steps:

Step 1: Intimate the insurer by calling on the toll-free number 1 800 266 4545, immediately on the hospitalization or inform your employer

Step: Pay the hospital bills initially and register a claim under the reimbursement process. Keep the original bills and attached along with the claim form.

Step 3: You’ll have to claim under the reimbursement clause within a particular time frame. The insurer will settle the incurred amount after verifying the documents, by transferring the money to the registered bank account number

Documents Required for Claims

  • Duly filled the claim form
  • Discharge certificate from the hospital
  • Hospital bills duly stamped and signed by the concerned authority
  • Medicine bills
  • Police FIR in case of an accident
  • Attending doctor’s report
  • The insurer may ask for other relevant documents

How to Calculate Kotak Group Health Insurance Premium?

The premium calculation of a group health insurance is quite different from individual health insurance. The premiums, benefits, coverage, deductibles are usually based on certain factors including:

  • The size of the group or number of employees covered
  • The type of coverage needed
  • Amount of sum insured required
  • Employer’s prior claim history
  • An employer’s prior claims history

However, the premiums are borne by the employers, against which a tax benefit is payable.

How to Compare Kotak Mahindra Group Health Insurance?

Without comparing health insurance, you can’t land on the right deal. Here comes online policy comparison into the picture that suggests adequate plans as per your insurance needs. You can approach any of the insurance aggregator websites online and compare the various group health insurance offered by the different insurers with the one offered by Kotak Mahindra.

How to Buy Kotak Mahindra Group Health Insurance

If you want to cover your employees with a comprehensive group cover, then Kotak Mahindra group health insurance can be an ideal deal. You can buy the policy either online or offline. To buy online:

  • Just visit the official website of the insurer
  • Browse over the health insurance plan
  • Go to the ‘Get Quote’ option
  • Buy the policy by paying the premiums online.

If buying offline, you can approach a reliable broker to brief the policy and do the paperwork for you. Or you can directly visit the branch office and buy the plan by paying the premium. However, large organizations have tie-ups with insurers, where the concerned person visits the office to do the formalities.

How to Renew Kotak Group Health Insurance

To know about the renewal process kindly refers to the official website of the insurer.


Kotak Mahindra Group Health Insurance FAQ

Q1. What’re the common advantages of Kotak Mahindra Group Health Insurance?

The common advantages of group health insurance offered by Kotak Mahindra include:

  • The policy can be availed at a lower premium than individual health insurance.
  • It comes in handy to cover maternity expenses (optional)
  • There is no waiting period to serve and employers are covered from the day 1
  • No pre-policy health check-up is required to avail the policy

Q2. What if I leave the organization? Does Kotak Mahindra group health insurance cover me either?

Kotak Mahindra Group Health insurance only active until the time you are with the organization. The policy ceases when you resign or leave the organization. However, group health insurance can be transferred to an individual plan, if the insured wants.

Q3. How is Kotak Mahindra Group health insurance different from individual health insurance?

You can find out from its name, that a group health insurance caters to the needs of a group of the people, while an individual plan is for an individual. Apart from this, individual plans come with a separate renewal option, while group health insurance has only one renewal date. Moreover, premiums are paid by the employer (s) in case of group health insurance, where it is not the same if it is an individual plan.

Q4. How does Kotak Mahindra Group Health Insurance work?

The basic of Kotak group health insurance is that a master policy is issued against a single premium where a group of employees are covered for medical expenses. Under this policy, the inclusions and exclusions or terms and conditions are the same for every member of the group. When a claim arises, the insured can avail cashless or reimbursement services.

Q5. What are the major exclusions on Kotak Mahindra Group Health Insurance?

The policy doesn’t include the below conditions:

  • If the accident or injury happens due to the consumption of alcohol, drugs or intoxic substances
  • The insurance policy would not cover the insured if he/she doesn’t carry a valid DL in case of an accident
  • Any claim arising for treatment other than allopathic such as Ayurveda, Unani, Naturopathy, homoeopathy
  • The member and his family are not covered in case he/she resigns
  • Some coverage are not extended to the insured family such as group personal accident cover, where the insured is covered for disability or death.

Q6. Does Kotak Mahindra group health Insurance offers coverage to specific illnesses?

Yes, Kotak Group Secure Shield policy is designed to cover critical illness or other specific illness, where a lump sum amount is paid towards the treatment of an illness.

Q7. Why do employers offer group health insurance?

The motive behind offering group health insurance is to retain the talent and motivate them to be more productive, These policies considered under employees benefit schemes where the policy benefits are extended to a group of people from the same organisation.

Q8. How is an employer health insurance plan suitable in terms of premium?

These policies come with lower premiums, hence suitable for both large and small organization. However, the lower premium at times leads to the exclusion of several conditions.

Q9. How does co-payment clause work under a group health insurance policy?

As plan with co-payment never seems beneficial to the insured, as with this clause, the insurer cut their costs and the insured has to pay a fixed amount of total claim.

Q 10. What are the benefits to be availed by the employer while offering group health insurance to its employees?

The employer apart from retaining its talent can also earn tax benefits. The premiums paid towards Kotak Mahindra group health insurance are eligible for tax benefits as per the Income Tax Act 1988.

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