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Buying health is the most important decision you take in your lifetime. It is a financial security that protects your savings from being ruined in case of a medical emergency. With rising inflation, medical costs are at peak and having health insurance is imperative to deal with an exorbitant healthcare cost. In this regard, Kotak Mahindra health insurance comes in handy to cover you!
If you want to insure your family members separately with health insurance by Kotak Mahindra Insurance, you can add 4 adults and 4 children together. If you opt for a family floater plan, you can insure 2 adults and 3 children under a single premium. Moreover, the premiums paid are tax exempted and this policy also comes with additional benefits, apart from the basic one. Let’s delve into detail:
The policy can be availed with individual and family floater basis where you can add a maximum of 8 people together-4 adults and 4 children (in case you choose to insure your family members separately.
Incurred Claim Ratio
Kotak Mahindra health insurance comes with the following benefits and features.
Kotak Mahindra health insurance is one the famous product among the customers. Here’s why you should buy health insurance from Kotak Mahindra General Insurance:
Kotak Mahindra offers a range of health insurance products to cater to the different needs of people. This plan can be availed as individual or floater basis based on your requirement. Let’s delve into detail:
|Plan Name||Eligibility||Policy Type||Renewal age||Benefit||Policy period|
|Kotak Secure Shield||Minimum: 18 years Maximum: 65 years||Critical illness||Life-long||
||1,2 & 3 years|
|Kotak health care||Minimum: 5 years Maximum: 65 years||Individual/Floater||-||
||1,2 & 3 years|
|Kotak Accident Care||Minimum: 5 years Maximum: 65 years||Individual Accident Plan||Lifelong||
||1,2 & 3 years|
|Kotak Health Super Top Up||Individual||
||1, 2,3 years|
|Kotak Health Premier||Entry Age - 91 Days for Child and 18 Years for AdultMaximum Entry Age for Adult - 65 YearsMaximum Entry Age for Child - 25 Years||Individual/Family Floater||lifelong||
||1,2 & 3 years|
Kotak Mahindra health insurance comes with a special range of coverage, which includes:
The main exclusions of Kotak Mahindra health insurance are:
For a complete list of exclusions, kindly refer the policy document.
Sum insured is a pre-defined amount paid by the insurance company to the policyholder on payment of a regular premium. It is the amount up to which you can claim your Kotak Mahindra health insurance.
Let’s say, you own Kotak Mahindra health insurance with a sum insured of Rs. 2 lakh. During your first emergency hospitalization, you incur 80,000. In the second hospitalization, you incur 1.5 lakh. So, your total expenses come around 2.3 lakh. But the insurer will cover you for Rs. 2 lakh only and the additional expense has to be paid by you.
That’s why it is recommended to settle with a higher sum insured. However, it would mean an additional premium to avail such a higher sum insured.
Add-ons covers are to enhance the basic policy benefits where the coverage can be availed at an additional cost:
To ensure a seamless claim settlement with Kotak Mahindra, make sure you follow the below claim steps. Usually, Kotak Mahindra health insurance can be claimed under cashless and reimbursement claim
The cashless claim is where you can avail cashless healthcare services without paying single money. This facility has to be availed at a network hospital only.
When the insured avail healthcare facilities from a hospital other than the network hospital, he/she needs to pay for the hospital expenses and make a claim for the same later. This is called a reimbursement claim. In order to file a reimbursement claim
You will require furnishing the below documents while filling Kotak Mahindra health insurance claim:
Health insurance premium pays an important role while it comes to availing policy benefits. The level of cover you can avail under a health insurance policy depends on the premium you pay. Premium is the cost you pay annually, which differs from insurer to insurer. However, there are certain factors considering which your health insurance premium is calculated. They include:
In case of health insurance, the age of the person taking insurance plays an important role when it comes to calculating your premium. The younger you are, the less likely you to fall ill. This means the risk associated at your younger age is not high as compared to your old age. Hence, the insurance company charge a lower premium when you buy insurance at a young age.
The second most important aspect is the medical history of the insured. A person with any pre-existing illness or bad health record tends to pay a higher premium or vice versa. The insurer considers a person with any such condition is more susceptible to risk, so imposes higher premium.
Insurance companies charge higher premiums for a person living in a metro city that a person residing in a rural area. Because, they tend to develop an unhealthy lifestyle due to a busy lifestyle, sedentary working hours and unhealthy food habits, that eventually leads to many health complications. Moreover, the healthcare expenses are also sky-high in the metro cities than it is is a rural area. So, premiums are comparatively on the higher side.
Person with a habit of smoking will pay a higher health insurance premium. Tobacco in any of its form can cause serious diseases such as cancer. Due to its high-risk appetite, the insurer charges a higher premium.
In order to ensure the right insurance, health insurance comparison is a must. There are many insurance aggregator websites that offers suitable insurance suggestions as per your needs. You can approach such platform and compare. While comparing, keep certain things in mind or you can say some parameters such as policy coverage, claim settlement ratio of the insurer, premium, features etc. The different policy may come with different features and coverage. Without comparing them as per your requirements, you can’t land on the right deal. Moreover, the claim settlement ratio is another important aspect to consider as it indicates the capability of the insurer to settle your claim. Company with a higher claim settlement ratio is preferable. Likewise, premiums may vary from insurer to insurer. You should opt for the one that offers maximum coverage within your affordability.
Buying Kotak Mahindra health insurance is easy. You can either choose the online or offline mode. After comparing the various plans available online, if you find Kotak Mahindra suitable for you, you can visit the official website of the insurer and follow the below options
If you don’t want to buy online, you can approach an agent and get the details of Kotak Mahindra health insurance plans. Complete the formalities with him/her and pay the premium by cheque. Moreover, you can directly visit the insurer’s office and buy a plan.
Without renewing your Kotak Mahindra health insurance timely, you can’t avail the policy benefits continuously. In the advent of the internet, most of the health insurers avail their products easily available online, with this renewing health insurance becomes more convenient. While renewing the policy, you can stay with the existing insurer or switch to another. So, if you are not satisfied with your current insurer and want to switch to Kotak Mahindra, this is the time. The best part of porting your policy is you don’t have to serve the waiting period all over again. All insurance company is authorised to provide the portability facility as per the guidelines of IRDA.
Health insurance renewal online is the most convenient and fastest process of renewing your policy. nowadays policy renewal with Kotak Mahindra General Insurance can be ensured in just a 4 simple steps:
Renewing your Kotak Mahindra health insurance on time is very important. However, the insurance provider will certainly send a renewal notification but they are not obliged. It’s your responsibility to keep a track of your policy and renew it on time. Usually, it is recommended to renew 15 days before the actual due date. However, in case you miss the date, the insurer will offer a 15 days grace period within which Kotak Mahindra health insurance needs to be renewed to avoid a lapsed policy. However, by adhering certain renewal tips, you can ensure a safe policy experience:
Ans: Cashless health care services under Kotak Mahindra health insurance can only be availed at network hospitals. Network hospital means the hospitals that are associated with the insurer, where one can avail healthcare facility free of cost. Under a network hospital, you can avail the treatment across the country. The list of network hospital is attached in the policy document. In case of an emergency refer this list and approach the hospital that is in your vicinity.
Ans: Pre-authorisation form is an essential document to avail cashless service. By filing this form you can request for availing the cashless benefit. This needs to be filled and duly signed by the attending doctor and submitted to the TPA/insurance help desk in the hospital. Upon approval from the insurer, you can avail treatment without worrying about the expenses.
Ans: You will require the following documents to apply for cashless healthcare services:
Ans: Yes, policy benefits can be availed in this case under the reimbursement clause, where you pay the hospital bills on your own and register a reimbursement claim. You will need to submit the original hospital bills along with the duly filled claim form. The insurer will reimburse the money if the claim meets the requirements.
Ans: Kotak Mahindra health insurance comes in handy while covering hospitalisation expenses arising out of an accidental or illness claim. Usually, the policy covers in-patient expenses including room rent, nursing expenses, doctor’s consultation fee, ICU rent, OT rent, medicine, blood, oxygen, x-ray or other test, OPD, Daycare etc. Depending on the plan expenses such as Second E-opinion, ambulance cover, organ donor cover, alternative treatment, domiciliary hospitalisation, Hospital daily cash, convalescence benefit, air ambulance, home nursing etc. are also covered.
Q6. Under which condition my cashless claim can be rejected?
Ans: You cashless claim may get rejected by the insurer under following grounds:
Ans: Probability is that the hospitalisation expenses exceed the total sum insured. In such a case, the hospital authority will request the insurer to increase the approved amount in case of the hour of need. The insurance company will access the request and additional approval will be given applying terms and conditions. It also depends on the availability of sum insured or if they can offer this much.
Ans: In order to ensure a fast and smooth claim, it is essential to inform the insurer immediately. In case of a planned hospitalisation 48 hours of the window prior to the hospitalization is a must to inform the insurer, while in case of emergency hospitalization, the insurer needs to be informed within 24 hours of hospitalisation. A pre-authorization form is required in both the cases seeking permission for cashless services. The incurred expenses will be directly settled with the hospital authority if the insurer approves the cashless benefit.
To intimate a claim you can call on the toll-free number at 18002664545 from 8 am to 8 pm. You can also write to them at care[@]kotak[.]com.
Ans: You will have to provide the following information at the time of intimating a claim under Kotak Mahindra health insurance:
Ans: The claim form duly filled and signed by the insured along with the supporting documents should be submitted positively within 30 days from the date of discharge.
Ans: Pre and post hospitalization benefit is also covered by Kotak Mahindra health insurance, where the insured is cover for a fixed day for availing treatment pre and post hospitalization and the expenses are on the insurance company. The pre-hospitalisation claim documents need to be sent to the insurer with 15 days from the date of discharge. While post hospitalization documents have to be submitted with 30 days from the date of completion of treatment. Usually, health insurers come with a fixed period for covering pre and post hospitalization cover like 30 days and 90 days respectively. However, it may vary from insurer to insurer. You will require to submit the hospital bills along with the claim form in both the cases.
Ans: To claim under reimbursement claim, you’ll need to submit the following documents:
Ans: In case of a double claim, you’ll need to submit the original documents to one of the insurance provider. Once the claim is settled, you will need to collect the certified true copies of the document accompanying with a settlement letter. Submit the same documents to another insurance to complete your claim.
Ans: Reimbursement Claim: the insurer takes 15 days of time to proceed with this kind of claims from the receipt of supporting documents. Documentation includes the submission of all medical documents starting from the doctor’s report on the ailment to the bills along with the receipts in original.
Cashless Claims: The process is initiated within 6 working hours from the receipt of details. It includes the pre-authorisation letter, information regarding diagnosis, estimated hospitalisation expense, duration of stay, pre-existing illness if any, pre-admission prescription if any, medical report. The claim form should be duly signed by the insurer and the attending doctor.