Edelweiss Health Insurance

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Highlights

2,578+ Network Hospitals

10,449 Policies Issued

115% Incurred Claim Ratio

Lifelong Renewability

Health Checkup For Claim-Free Year

Dedicated Claim Settlement

Coronavirus (COVID-19) Cover

About Edelweiss General Insurance

Edelweiss General Insurance is a subsidiary of Edelweiss Financial Services Limited. It came into existence in 2017 with an objective to provide customers with insurance products based on actual needs and services which are swift, smooth and satisfactory. The insurer has been delivering the best insurance solutions like health insurance, motor insurance, fire insurance, engineering insurance, home insurance, loan protection, marine insurance, driver-based insurance, and commercial insurance. 

Edelweiss General Insurance takes immense pride in offering health insurance policies for individuals and families at affordable rates. The insurer abides by all the laws and regulations while processing its functions. The insurance provider has been awarded various awards such as SAP Ace Award, SAP – Process Innovation 2018, and Mint – SAP Digitalist Award 2018 for delivering the best insurance-related services to its customers and policyholders. 

How to Purchase Edelweiss Health Insurance Policy at InsuranceDekho?

Policyholders can buy different health insurance policies offered by Edelweiss Health Insurance through online and offline methods at InsuranceDekho.

Buy Edelweiss Health Insurance Policy Online at InsuranceDekho

Here are the steps to buying an Edelweiss health insurance policy at InsuranceDekho:

Step 1: Visit the website of InsuranceDekho, i.e, www.insurancedekho.com and click on the ‘Health’ tab.

Step 2: Select your Gender. Then, enter your Name and Mobile Number. You will get an OTP, please enter that.

Step 3: Select the time from the drop-down options as to when you want to buy the insurance policy. Click on ‘View Instant Quotes’ to move further.

Step 4: Select the family members you want to add in the health insurance plan and click on the ‘Continue’ button.

Step 5: Select the age of the family members you have added in the policy and click on the ‘Continue’ button.

Step 6: Enter your Email ID and City and click on the ‘Submit and View Quotes’ button. Multiple insurance plan quotes will appear as per your selections. Select the one that best suits your requirements.

Step 7: Select the policy term of the selected health insurance policy. Fill the required details and make the payment to complete the purchase process.

Buy Edelweiss Health Insurance Policy Offline at InsuranceDekho

To buy an Edelweiss health insurance plan offline at InsuranceDekho, you can get in touch with us at 7551-196-989 between 9.30 AM to 6.30 PM (Monday-Sunday).

For any assistance, you can also write to us at customersupport@insurancedekho.com.

Top Edelweiss Health Insurance Plan Types

Here are the top Edelweiss Health Insurance Plans offered for you:

1. Edelweiss Health Insurance Plan – Edelweiss Health Insurance Plan is designed with a holistic approach to cover individuals as well as families. The policy is available with three variants such as Silver Plan, Gold Plan and Platinum Plan. The minimum age and maximum age of entry under these three variants range from 3 months to no age limit with lifelong renewability option. The sum insured options of this policy starts from Rs. 1 lakh and goes up to Rs. 1 crore. The plan is available with 1 year, 2 years and 3 years of policy term with a compulsory co-payment of 20% for insured persons above 60 years. The salient benefits of this plan include Hospitalization expenses, Day care treatment, AYUSH treatment, Maternity Benefit, Hospital cash, Critical illness cover, etc.

2. Edelweiss Arogya Sanjeevani Insurance Plan – The Edelweiss Arogya Sanjeevani Insurance Plan is an affordable health scheme to offer medical coverage to more and more people. The sum insured amount of this plan ranges from Rs. 1 lakh to Rs. 5 lakh. It covers the people from 3 months up to 65 years, which can be extended with the lifetime renewability coverage. It can cover a maximum of up to 8 members that can comprise self, spouse, children, parents, parents-in-law. The plan comes with 1 year of policy term but provides various premium payment options like yearly, half-yearly, quarterly, and monthly. The policy holds several benefits such as Hospitalization expenses, Pre-hospitalisation and Post-hospitalisation expenses, Cataract treatment, AYUSH treatment, Cumulative bonus and so on.

What Is A Health Insurance Top-up Plan and Why Should I Buy It?

A top-up health insurance plan is framed to offer you additional medical coverage after the exhaustion of your current health insurance policy due to medical expenses incurred on hospitalisation. It is highly suggested to buy this health insurance plan to prevent any financial crisis with an extra sum insured amount subject to the deductible amount. It assists you to get the coverage for another claim in a financial year even after the threshold limit of your existing health insurance policy is crossed. 

Why Choose Edelweiss Health Insurance?

Edelweiss Health Insurance offers a range of unique offerings to its policyholders. Here are some of those:

  • Call Back Request - Policyholders and customers can request a call back to know more about the products of the insurer. They just have to fill up some details like name, mobile number, category and product to arrange a call for themselves. 
  • Coverage up to Rs. 1 Crore - The insurance provider through its health insurance plan offers the medical coverage up to Rs. 1 crore with which policyholders can combat any sort of illness or injury without any hassle. 
  • High Claim Settlement Ratio - The Edelweiss Health Insurance has managed to record an impressive claim settlement ratio of 79.82% for its first financial year. It denotes the efficiency of the insurance provider in terms of claim settlement. 
  • Awards and Recognitions - The insurer has been rewarded with different prestigious awards for its outstanding performance in the insurance industry such as SAP – Process Innovation 2018, Mint – SAP Digitalist Award 2018, and so on. 

Benefits of Edelweiss Health Insurance Plans

Here are the prominent benefits offered under the Edelweiss health insurance plans:

  • Compassionate Visit - The insurer will arrange the visit of a family member or a friend of the insured person within India if the insured person is hospitalised for more than seven consecutive days and is travelling in India without a companion.  
  • Emergency Medical Evacuation - The insurer arranges transportation under appropriate medical supervision to the nearest medical facility, capable of providing the required care within India if any adequate medical facility is not available in the vicinity of the insured person.  
  • Second Medical Opinion - The insurer will arrange for a second medical opinion for the insured person when his or her medical condition could not be accurately diagnosed by the treating doctor or if he or she seeks an additional medical opinion following a diagnosis. 
  • Restoration of Sum Insured - The insurance provider will restore 100% of the sum insured once in a policy year on the indemnity basis if the sum insured falls insufficient due to claims payable during the policy year. 
  • Lifelong Renewability - This benefit allows policyholders of the insurer to stay associated with the health insurance plan and avail its benefits for a lifetime. The benefit provides a policy renewal option without any exit age. 

Edelweiss Health Insurance Claim Settlement Ratio 

Claim Settlement Ratio (CSR) denotes the number of claims settled out of the total number of claim requests received by an insurance company. Here is the health insurance claim settlement ratio of Edelweiss Health Insurance in the last two years:

Financial Year

Claim Settlement Ratio 

FY 2017-2018

-

FY 2018-2019

79.82%

(Source: IBAI’s General Insurance Claim Insights Handbook For Policyholders - 3rd & 4th Edition)

Network Hospitals of Edelweiss Health Insurance 

The network hospitals are those hospitals, clinics or healthcare facilities, which are recognised by the insurance providing firm. The policyholders of the insurance provider are allowed to utilise the cashless treatment at network hospitals, where the insurers pay off the medical expenses of the policyholder directly to the network hospital after detailed verification. Edelweiss Health Insurance has a strong network of 2,578+ hospitals. 

Edelweiss Health Insurance Policy Terms

Edelweiss health insurance policies come with the following policy terms, which may vary from plan to plan:

Minimum Age of Entry

91 days

Maximum Age of Entry

No Limit

Policy Renewal

Lifelong renewability option is offered

Co-Payment

20% of co-payment is applicable for persons aged above 60 years

Waiting Period

A waiting period of 30 days is applicable for all illnesses, except for accidental injuries

Edelweiss Health Insurance Claim Process 

The health insurance claim process is a procedure under which the policyholder raises a request for claim against his or her medical expenses incurred from the insurance provider. A health insurance claim can be processed in two ways which are cashless claim and reimbursement claim.

Cashless Claim Process of Edelweiss Health Insurance 

When an insured person gets treated at a network hospital of his or her insurance provider, the claim is processed in a cashless manner, i.e., the insurer pays off the medical expenses directly to the hospital. 

Here are simple steps to raise a cashless claim with Edelweiss Health Insurance: 

Step 1: Intimate the Insurer
Intimate Edelweiss Health Insurance at least 72 hours prior to the admission in the hospital, in case of planned hospitalisation and within 48 hours, in case of emergency hospitalisation at 1800-12000.

Step 2: Pre-authorization Form
Show the health card issued by the company and valid photo at the insurance desk of the network hospital and get a pre-authorization form from them or from the insurer’s website. Get it duly filled and signed by the policyholders and the treating doctor and submit it to the insurance provider for approval with necessary and valid documents. 

Step 3: Verification of documents 
The claim settlement team of the insurance provider will verify the submitted form and documents. The insurer can ask the hospital or insured person to submit more information or reports during the verification process if found inadequate.

Step 4: Claim Approval
The insurance provider will confirm in writing about the authorisation or rejection of the claim request to avail cashless facility for the insured person's hospitalisation.

Step 5: Settlement of Claim
If the claim request gets approved, the insurance provider shall issue pre-authorization to the network hospital for a cashless facility and pays for the admissible claim amount. 

How to Make an Edelweiss Health Insurance Reimbursement Claim?

When a policyholder avails the medical treatment at a non-network hospital of his or her insurance provider, the claim is processed in a reimbursement manner, where the insured person or policyholder pays off the medical expenses directly to the hospital and later requests for claim with the insurance provider. 

Here are simple steps to raise a reimbursement claim request with Edelweiss Health Insurance:

Step 1: Get the Medical Treatment 
Get treated at a non-network hospital of your insurer and pay for all the hospital bills and other medical expenses. Collect all the medical bills, receipts, documents, reports, and so on. 

Step 2: Submit Relevant Documents
The insurance provider will provide relevant information and documentation in respect of all claims against the insured person’s medical expenses within 15 days of discharge from the hospital. 

Documents Required for Edelweiss Health Insurance Reimbursement Claim:

  • Duly filled and signed claim form
  • Original discharge summary from the hospital and consolidated hospital bill
  • Original payment receipt of the hospital bill with the receipt number
  • Doctor’s certificate stating the nature of operation performed and their bills and receipts
  • Original medicine bills and receipts with corresponding prescriptions
  • Copy of the First Information Report (FIR) or Post-Mortem Report, if applicable

Step 3: Verification of Documents 
The insurance provider will verify the bills, receipts, reports and documents provided by the insured person. However, if found insufficient, they can ask for some more information or reports or documents for the verification or even can reject the claim, if found the documents false or inaccurate or incomplete. 

Step 4: Claim Settlement 
On finding all the documents complete and valid, the insurance provider shall settle the claim within 30 days from the date of receipt of the last necessary document. 

Edelweiss Health Insurance Renewal Process

The renewal process keeps you connected with the health insurance plan with which you can continue to avail the benefits of Edelweiss health insurance plans. With this procedure, you can make certain modifications in your policy such as modify the sum insured, opt for add-ons, etc. 

Following are the steps to renew Edelweiss health insurance plans:

Step 1: Visit the website of Edelweiss General Insurance, i.e., www.edelweissinsurance.com. Click on the ‘Renewal’ tab and select the ‘Health’ option.

Step 2: Enter the Policy Number and Date of Birth of the Proposer, then click on the ‘Proceed’ button. 

Step 3: Review the details of health insurance plans and premium amount to proceed for the renewal

Step 4: Make payment for the amount of health insurance policy online through the payment gateway of the insurance provider.

Edelweiss Health Insurance Tax Benefits

Policyholders can avail the tax benefits up to the sum insured amount of their health insurance plans as per the section 80D of the Income Tax Act. Below are the tax benefit details which can be availed with the Edelweiss health insurance plans. 

Situations

Premium Paid

Deduction under Section 80D of the Income Tax Act

Self, Family, Children

Parents

When Policyholder and Parents are below 60 years

Rs. 25,000

Rs. 25,000

Rs. 50,000

When Policyholder and family members are below 60 years with parents above 60 years

Rs. 25,000

Rs. 50,000

Rs. 75,000

When Policyholder, family members and parents are above 60 years

Rs. 50,000

Rs. 50,000

Rs. 1,00,000

Members of HUF

Rs. 25,000

Rs. 25,000

Rs. 25,000

Non-resident Individuals

Rs. 25,000

Rs. 25,000

Rs. 25,000

Edelweiss Health Insurance Premium Calculator

The premium of health insurance plans can be influenced by some factors, the understanding of which can help you select a relevant health insurance plan. Here are some of the factors that can affect the premium of Edelweiss health insurance plans:

  • Age - Young people are charged with lower premiums in comparison to older people as the former are less susceptible to illnesses than the latter. 
  • Profession - People who work at places filled with hazardous substances, radiation, chemicals etc., have to pay higher premiums than those who work at the place with less or negligible risk like school.
  • Family Medical History - If the family of a policyholder holds certain medical ailments, then their premiums may be higher than those who belong to a family with a healthy background.
  • Harmful Substances - People who have a habit to smoke, drink, chew or consume alcohol, tobacco or any other injurious substance are charged with higher premiums as compared to those with healthy habits and lifestyle.  
  • Sum Insured - The more the sum insured will be, the higher the premium amount will be because a high sum insured amount enhances the compensation amount that the insurance provider has to bear. 

What All Is Covered Under Edelweiss Health Insurance Policies?

Policyholders can avail the below inclusions under the Edelweiss health insurance plans:

  • In-patient Hospitalisation Expenses - It is the coverage for medical expenses incurred on the treatment of injuries or illnesses that require hospitalisation for at least 24 hours. The coverage may comprise doctor’s fees, medicine costs, medical test costs, etc.
  • Day Care Treatment - The insurer offers compensation for medical expenses incurred on day care treatment or procedures that do not require more than 24 hours due to technological advancement. The insurance provider covers 388-day care procedures. 
  • Organ Donor Cover - The benefit provides compensation for the medical expenses incurred for an organ donor’s in-patient treatment for the harvesting of the donated organ up to maximum Rs. 2 lakh. 
  • AYUSH Treatment - It refers to the coverage for the medical expenses incurred on the treatment of an insured person under Ayurveda, Unani, Siddha and Homeopathy (AYUSH) through in-patient hospitalisation in a government hospital or and/or accredited by Quality Council of India/National Accreditation Board on Health. 
  • Maternity Benefit - It gives coverage for the delivery of a child limited to maximum 2 deliveries and medically necessary and lawful termination of pregnancy of an insured person of above 18 years after completion of a waiting period of 48 months of continuous coverage. 

What All Is Not Covered Under Edelweiss Health Insurance Policies?

Policyholders can not avail the below exclusions under Edelweiss health insurance plans:

  • Acupressure Treatment - Any treatment related to acupressure, acupuncture, magnetic and such other therapies will not be covered by the insurance provider. 
  • Warlike Incidents - Medical expenses incurred on the treatment of injuries or illnesses sustained due to war, warlike occurrence, invasion, acts of foreign enemies, civil war, etc., are not covered by the insurer. 
  • Self-Inflicting Actions - Treatment costs of injuries or illnesses suffered due to the act of self-destruction or self-inflicted, attempted suicide or suicide will not be covered. 
  • Hair Fall Treatments - No coverage is offered for alopecia wigs and/or toupee and all hair or hair fall treatment and products by the insurance provider to its policyholders. 
  • Sex Change Operations - The insurance provider will not cover any treatment or surgery for change of sex or gender reassignments including any complication arising from these treatments.

All the inclusions and exclusions mentioned-above may vary from plan to plan offered by the Edelweiss Health Insurance.

 

Edelweiss Health Insurance Plan List

Name of PlanSum Insured
Edelweiss Health InsuranceMin: 3 Months; Max: No Limit1 Lakh Get Quotes Now
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years1 Lakh - 5 Lakh Get Quotes Now
Corona Kavach PolicyMin: 1 Day; Max: 65 Years50,000 - 5 lakh Get Quotes Now

Claim Process at Edelweiss Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate 72 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 48 hours and for planned hospitalisation intimate 72 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

Edelweiss Health Insurance User Reviews

  • Quality has no boundaries

    Family Health Optima is an excellent plan . 

    P
    PRANAB KUMAR MOHANTY
    On: Jun 27, 2020 | Views
  • Very supportive team at Insurance Dekho

    I wanted to buy Edelweiss Arogya Sanjeevani Policy for which I got in touch with the customer care executives at InsuranceDekho. They supported me in ...

    Read More
    C
    Chinansha Jain
    On: Jun 03, 2020 | Views
  • Amazing service

    InsuranceDekho offered me amazing services last week when I purchased the Edelweiss Arogya Sanjeevani Policy from them. It was an easy process and the...

    Read More
    R
    Rahul Jain
    On: Jun 02, 2020 | Views
  • Best plan ever

    The Edelweiss Arogya Sanjeevani Policy is not only a standard plan that is easy to understand but an affordable plan too. I got my family of 5 covered...

    Read More
    J
    Jasmeet Kaur
    On: Jun 02, 2020 | Views
  • Highly recommended policy

    I recommend Edelweiss Arogya Sanjeevani Policy to all my friends and family members who are looking out for an economical health insurance plan during...

    Read More
    N
    Nishchay Yadav
    On: Jun 02, 2020 | Views
  • Easy buying procedure

    The team at InsuranceDekho helped me a lot in buying this plan online. All I did was talk to the executives and they guided me about the process. I as...

    Read More
    P
    Praful Goel
    On: Jun 02, 2020 | Views
  • Allows you to pay in installments

    I was happy to buy Edelweiss Arogya Sanjeevani Policy as it allowed me to pay the premium in instalments. They had options of monthly, quarterly, half...

    Read More
    V
    Vijay Vaish
    On: Jun 02, 2020 | Views
  • Knowledgeable team at InsuranceDekho

    I was searching for a comprehensive health insurance plan for myself for which I contacted the customer executives at InsuranceDekho. They suggested E...

    Read More
    A
    Atishay Jain
    On: Jun 01, 2020 | Views
  • Highly Impressed!!

    I am very much impressed with the dedication of the employees at insurancedekho.com. I have bought Edelweiss health insurance for me and my spouse bec...

    Read More
    S
    Sumit Singh
    On: May 29, 2020 | Views
  • Many benefits under my plan

    I purchased Arogya Sanjeevani policy by Edelweiss from InsuranceDekho recently for my family. I was the Proposer for the plan and got my 4 members cov...

    Read More
    J
    Jigyasa Purohit
    On: May 27, 2020 | Views

Latest Edelweiss Health Insurance News

Edelweiss Health Insurance Contact Details

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Edelweiss Health Insurance FAQs

  • What is the age criteria to buy health policies at Edelweiss General Insurance?

    The minimum entry age for Silver, Gold and Platinum plan is 3 months. The maximum entry age for the Silver and Gold plans is 65 years. No entry age bar for the Platinum plan. 

  • Why should I buy an Edelweiss Health Insurance policy?

    There are several benefits that make Edelweiss health insurance policy worth buying:

    • It provides wide coverage at low premiums
    • Sum insured can be restored up to 100%
    • Cover for critical illnesses
    • There is an option of midterm inclusion of an applicant in case of marriage or a child is born
    • No matter which health insurance variant you buy, you can avail the benefits of Medical Monitoring, Medical Referral, Medical Repatriation, Second Medical Opinion, Compassionate Visit, etc.
  • How many claims does Edelweiss health insurance allow to make in a year?

    There is no rule that sets the number of claims you can make in a policy year. However, the number of claims should not exceed the limit of the sum insured. 

  • How to buy and apply for Edelweiss General Insurance Health policy?

    You’re able to buy and apply for any Edelweiss General Insurance Insurance Policy online from the official website of Edelweiss General Insurance or through online broker InsuranceDekho by calling toll-free number 1800-120-5698.

  • Is pre-policy medical health check-up facility available at Edelweiss Health Insurance?

    Yes, there is a facility to go for a health check-up. Edelweiss General Insurance provides health check-up for every claim-free year provided that the policyholder is 18 years old or above. 

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