Edelweiss Health Insurance FAQs

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

Claim Settlement

  • 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. 

  • Does Edelweiss General Insurance accept the reimbursement claim?

    Yes, the company accepts the reimbursement claim. It reimburses by paying the entire amount that you have already paid from your pocket. In case of cashless treatment, the payment is made directly to the hospital. 

  • When do I need to inform the insurer for proper claim settlement?

    You must convey about your admission in the hospital within 48 hours for emergency hospitalisation and 72 hours prior to admission in the case of planned hospitalisation.

  • How much time do I need to spend in the hospital for requesting a claim?

    You have to stay for at least 24 hours in the hospital to ask for a successful claim settlement. In the case of daycare procedures, the hospitalisation can be less than 24 hours.

  • Where can I seek assistance for claim settlement related to Edelweiss Gneral Insurance plans?

    To seek assistance for claim settlement related to the plans of Edelweiss Tokio you can call on the toll-free number of Edelweiss General Insurance at 1800-120-00. You can also connect with the team of InsuranceDekho at 1800-120-5698.

Critical Illness

  • Does Edelweiss General Insurance provide critical illness coverage?

    Yes, Edelweiss General Insurance provides critical illness coverage, which starts from the first time you're diagnosed with a critical illness.

  • What is the name of the plan that covers critical illness under Edelweiss General Insurance?

    Gold and Platinum variants of Edelweiss Health Insurance Policy offer the coverage for critical illness.

  • What are the critical illnesses that are covered under  Edelweiss General Insurance?

    The critical illnesses which are covered under the Edelweiss General Insurance are:

    A) Coronary Artery Bypass Graft (Open Chest CABG)
    B) Myocardial Infarction (First Heart Attack of Specific Severity)
    C) Cancer of Specified Severity
    D) Stroke Resulting in Permanent Symptoms
    E) Permanent Paralysis of Limbs

  • What is the amount of sum insured offered for critical illness under the Edelweiss General Insurance?

    The sum insured for critical illness covered under the Edelweiss Health Insurance Policy increases by 50% under the Gold variant and increases by 100% under the Platinum variant.
     

  • Who all can get the coverage for critical illness under the Edelweiss General Insurance?

    Under the Gold variant of Edelweiss Health Insurance Policy, people between the age of 3 months and 65 years of age are eligible for critical illness cover, while under the Platinum variant of Edelweiss Health Insurance Policy minimum entry age is 3 months and no maximum entry age is there. 
     

Family Floater

  • Does Edelweiss General Insurance offer any family floater plan?

    Yes, Edelweiss Health Insurance Policy is the family floater plan offered under the Edelweiss General Insurance. 

  • What is the sum insured amount offered under the family floater plan of Edelweiss General Insurance?

    The sum insured ranges from Rs. 1 Lakh to Rs. 1 Crore. These amounts are divided among different variants of the plan. 

  • Do I need to go through any pre-policy medical check-up to get covered under the family floater plan?

    We will require you to undergo a pre-policy medical check-up, if you are aged 51 years or above and/or the sum insured opted is more than Rs. 20,00,000 with age more than 35 years.

  • How many family members can be covered under the family floater policy of the Edelweiss General Insurance Company?

    If you have chosen the family floater policy of this insurance company, you can cover yourself, your spouse, and up to 3 children (aged 3 months to 26 years old).

Feature

  • How much amount of ambulance cover is offered by Edelweiss health insurance?

    The maximum limits applicable per policy year under different variants of this policy, are as follows:

    Silver - Rs. 1,500 
    Gold - Rs. 3,000 
    Platinum - Rs. 10,000

  • Does Edelweiss General Insurance offer the feature of portability?

    Yes, Edelweiss General Insurance provides the portability option to its policyholders. With the help of this feature, you can easily port your plan into Edelweiss General Insurance as per the norms of IRDA, without losing any benefit in continuity. 
     

  • Does Edelweiss General Insurance cover pre and post-hospitalisation expenses?

    Yes, the Edelweiss General Insurance company covers pre and post-hospitalisation expenses:

    • 30 days pre-hospitalisation and 60 days post-hospitalisation under the Silver Plan  
    • 60 days pre-hospitalisation and 90 days post-hospitalisation under the Gold Plan
    • 90 days pre-hospitalisation and 180 days post-hospitalisation under the Platinum Plan

General Information

  • 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. 

  • 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. 

  • How to avail the cashless facility provided by the Edelweiss General Insurance company?

    To enjoy the cashless facility, you need to show the health card issued by the insurer at the network hospital. For any help, you can contact InsuranceDekho at 1800-1205-698.

  • 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.

Help to Buy

  • 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.

  • What is the toll-free customer care number of Edelweiss General Insurance?

    The 24x7 toll-free customer helpline number of Edelweiss General Insurance is 1800-1200-0.

  • 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.

Individual

  • How many members can get covered under the individual plan of Edelweiss General Insurance?

    Maximum 8 members can be covered under a single Individual type of policy.

  • Which relations are allowed to get covered under the individual plan?

    The relations that get covered under the individual plan comprise self, spouse, dependent children and dependent parents and dependent parents-in-law, brother, sister, grandmother and grandfather or any other relationship having an insurable interest.

  • Is there any discount available on the purchase of an individual plan?

    Yes, a 5% discount is offered if two or more family members are covered in an individual policy.

Kids

  • What is the age criteria of kids to get covered under the plans of Edelweiss General Insurance?

    The coverage is offered to a child (natural or legally adopted), who is unmarried, aged more than 90 days and less than 26 years, financially dependent on the primary insured or proposer and does not have his / her independent sources of income.

     

  • Is there any specific plan for kids offered by Edelweiss General Insurance?

    No, Edelweiss General Insurance doesn’t provide any specific health insurance policy for kids but offer the coverage for kids under its family and individual plans. 

  • How many kids can be added under a single premium under the Edelweiss General Insurance?

    Under a family floater policy of Edelweiss General Insurance, additional child (up to maximum 3 children) can be added under a single premium.

Maternity

  • Does Edelweiss General Insurance provide maternity benefits under its plan?

    Yes, the maternity benefit is available under the Gold plan and Platinum plan of Edelweiss General Health Insurance. 

  • What is the waiting period to avail the maternity benefits under the plan of Edelweiss General Insurance?

    The waiting period of 48 months is applied to avail the maternity benefits under the family floater plan of Edelweiss General Insurance. 

  • What is the amount of coverage provided for the maternity expenses?

    A maternity cover is offered for up to Rs. 50,000 under the Gold variant and for up to Rs. 2 Lakh under the Platinum variant of Edelweiss Health Insurance Policy. 

  • Does any expense related to medical termination of pregnancy covered under the Edelweiss General Insurance?

    No, maternity expenses incurred in connection with the voluntary medical termination of pregnancy during the first 12 weeks from the date of conception shall not be admissible under the benefit of maternity.
     

Parents

  • Can I earn tax benefits by purchasing a health plan from Edelweiss General Insurance?

    Yes, you become eligible to earn tax benefits on buying a health insurance policy for your parents under Section 80D of the Income Tax Act.

  • Will my parents get the domiciliary hospitalisation option under the plan of Edelweiss General Insurance?

    Yes, Edelweiss General Insurance offers the option of domiciliary hospitalisation for your parents under its family floater policy.

  • What is the maximum entry age of parents under the plan of Edelweiss General Insurance?

    The entry age of parents depends on the variants of the Edelweiss Health Insurance Policy. The Silver and Gold variant offers entry up to 65 years of age with lifelong renewability, while Platinum variant offers the entry for parents to any age.
     

Plan Coverage

  • Does Edelweiss General Insurance provide the coverage for daycare procedures to its customers?

    Yes, daycare procedures up to the limit of sum insured are covered under Edelweiss General Insurance.

  • Does Edelweiss General Insurance offer a cover for Ayush treatment?

    Yes, Edelweiss General Insurance gives the coverage for Ayush treatment and procedures up to the sum insured.

  • Does Edelweiss General Insurance cover pre and post-hospitalisation expenses?

    Yes, the Edelweiss General Insurance company covers pre and post-hospitalisation expenses:

    • 30 days pre-hospitalisation and 60 days post-hospitalisation under the Silver Plan  
    • 60 days pre-hospitalisation and 90 days post-hospitalisation under the Gold Plan
    • 90 days pre-hospitalisation and 180 days post-hospitalisation under the Platinum Plan

Portability

  • Can I port into Edelweiss General Insurance anytime within the policy year?

    No, you can apply for the portability feature only at the time of renewal.

  • How can I apply for portability into Edelweiss General Insurance?

    If you need to port into Edelweiss General Insurance from any other insurer, you are required to apply with product details and claim details of your health insurance plan, at least 45 days before the expiry date of the policy.

  • Does Edelweiss General Insurance offer the feature of portability?

    Yes, Edelweiss General Insurance provides the portability option to its policyholders. With the help of this feature, you can easily port your plan into Edelweiss General Insurance as per the norms of IRDA, without losing any benefit in continuity. 
     

Premium

  • What is the minimum premium amount of Edelweiss General Insurance plans?

    The starting premium amount of Edelweiss General Insurance plans is Rs. 4,424* per year. *The premium amount changes from time to time.

  • What are the elements which determine the amount of premium?

    Factors that determine the value of premium of Edelweiss General Insurance plans are as follows:

    a) Gender
    b) Sum insured
    c) Policy term
    d) Age of insured
    e) Number of members
    f) Medical history

  • Does Edelweiss General Insurance offer any discount on the premium amount to its customers?

    Yes, on opting for voluntary co-payment option the eligible insured members can avail discount on premium.

  • How can I make the payment of the premium of an Edelweiss Health Insurance Policy?

    You can make the payment of your premium through different payment modes such as cash, cheque, credit or debit cards or through digital payment gateways.

  • Will I get payment acknowledgement from Edelweiss General Insurance after paying the premium?

    Yes, policyholders are provided with a payment acknowledgement from the insurer on their registered email address. This acknowledgement serves as a proof of the premium paid. 

Senior Citizen

  • Can senior citizens get coverage under the Edelweiss General Insurance?

    Yes, senior citizens can get covered under the Edelweiss General Insurance.

  • What is the sum insured amount offered for the senior citizens? 

    The sum insured offered for the senior citizens under the Edelweiss Health Insurance Policy depends on different variants such as up to Rs. 5 Lakh under Silver variant, up to Rs. 20 Lakh under Gold variant and up to Rs. 1 Crore under Platinum variant.  
     

  • What is the maximum entry age for senior citizens under Edelweiss Health Insurance?

    The maximum entry age for senior citizens under Silver and Gold variant is 65 years, whereas under Platinum variant there is no entry age bar.

Tax Benefit

  • What is the highest limit of premium up to which senior citizens can avail the tax benefits? 

    Rs. 50,000 is the highest premium amount up to which senior citizens are waived off from tax. 

  • What should be the mode of payment to gain the tax benefit on the premium of Edelweiss Health Insurance Policy?

    To gain the tax benefit on the premium of Edelweiss Health Insurance Policy, the policyholders need to pay their premium through any mode of payment other than cash. 

  • What is the maximum tax limit on the premium amount of Edelweiss health insurance plans?

    The tax limit is Rs. 25,000 if a proposer is below 60 years of age, whereas if the proposer less than 60 years of age buys a health insurance policy for a senior citizen then the tax limit increases to Rs. 30,000.

Woman

  • Can a woman customer get a health check-up for every claim-free year? 

    Yes, women policyholders are provided with the option of health check-up for every claim-free year under the Edelweiss General Insurance. 

  • What is the maximum age of entry for women to get enrolled in any plan of Edelweiss General Insurance?

    The maximum age of entry for women in the Edelweiss Health Insurance Policy is 65 years under the Silver and Gold variants, while for Platinum variant there is no maximum entry age limit.

  • Does any policy under Edelweiss General Insurance offer the coverage for newborn baby hospitalisation expenses for women?

    Yes, the Edelweiss Health Insurance Policy offers the coverage for newborn baby hospitalisation expenses for its women customers. 

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
Corona Rakshak Policy Min: 18 Years; Max: 65 Years50,000 - 2.5 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...

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    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...

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    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...

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    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...

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    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...

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    J
    Jigyasa Purohit
    On: May 27, 2020 | Views

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