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Kotak Mahindra Health Insurance Claim Settlement

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Cashless Approval TAT2 hr Cashless Claim Processing
Claim Settlement Ratio97%
Network Hospitals7,200+
Pre-existing Waiting Period4 year
Special BenefitsNo Capping on Room Rent
Starting Premium for Rs. 5 lakhs SIRs. 489/month

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Claim Settlement of Kotak Mahindra Health Insurance

The claim settlement process of Kotak General Insurance is smooth and fast. The process is quite easy and does not put a policyholder in inconvenience. Backed by a vast number of healthcare facilities, the insurer is known to have settled multiple numbers through its fast-paced and simple claim procedure. Under Kotak General Insurance policies, you can make a cashless or a reimbursement claim.

  • Claim Process for Cashless Treatment

    Kotak General Health Insurance provides cashless hospitalisation at more than 4,000 network hospitals across the country. Any policyholder can opt for cashless settlement of claims at their nearest network hospital. The steps of the claim settlement process include- 

    • First of all, find a Kotak General network hospital in the city where you want to avail of cashless treatment
    • Intimate Kotak General within 24 hours in case of emergency hospitalisation and 48 hours before admission in case of planned hospitalisation
    • While visiting the chosen network hospital, do remember to carry the cashless treatment card or the policy number and member ID
    • Show the card/policy number of the member ID at the insurance desk of the Kotak General network hospital 
    • Duly fill the pre-authorisation form available at the hospital
    • After you have informed the insurer and filled the form, the pre-authorisation form will be sent to Kotak General Health Insurance
    • After the claim details are examined and reviewed, Kotak General Health Insurance team will inform the policyholder and hospital regarding the claim approval or rejection
    • In case the claim is approved, the medical expenses will be borne by Kotak General Health Insurance directly. But, if the claim is rejected, the policyholder will be required to pay the bills
  • Reimbursement Treatment

    A policyholder can file a reimbursement claim at both, network and non-network hospitals. The steps in the reimbursement claim process include- 

    • In the case of planned hospitalisation, the Kotak General should be informed before 48 hours of admission
    • In case of an emergency hospitalisation, the intimation should be given within 24 hours of hospitalisation 
    • The policyholder is required to submit a claim form with the relevant documents within 30 days of discharge from the hospital 
    • After the investigation of the documents and claim form details is conducted, the letter of approval will be sent to the policyholder by the claim management team of Kotak General Health Insurance to confirm the approval. After verification, the claim will be settled within 15 days
    • In case of rejection, the insured individual is required to respond to the query raised by the insurer or insured to uncover the reason for rejection
  • Documents Needed

    The list of documents required for claim settlement at Kotak General Health Insurance include- 

    • Valid photo ID proof
    • Original investigation reports
    • Post-mortem report (if applicable)
    • Original hospital bills and receipts
    • Pharmacy bills along with the prescription
    • Indoor case papers and duly-filled claim form
    • Treating doctor's report and original consultation notes
    • Nature of operation performed and surgeon's bill and receipt
    • Discharge report


  • Incurred Claim Ratio (ICR) of Kotak Mahindra Health Insurance

    The Incurred Claim Ratio or ICR refers to the net claims paid by a health insurer as against the net premiums earned. It is a highly effective approach to find how viable and reliable a health insurer is. ICR reveals the pace of claim procedure and the productivity of the insurance firm in terms of revenue. The Incurred Claim Ratio of Kotak General Health Insurance for FY 2018-19 is 47%, which showcases that it has an ample amount of assets in hand and executing claim process quite smoothly.

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Under Section 80D

*Tax benefits are subject to changes in Income Tax Act.

Kotak Health Insurance User Reviews

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  • I am happy to buy the Kotak Mahindra Health Insurance Policy from InsuranceDekho as the buying process was smo...

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    On: Aug 23, 2023
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    On: Aug 11, 2023
  • At InsuranceDekho, it was easy to fill quotes. I visited the portal, filled out a quote, and shortlisted the m...

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    On: Jul 31, 2023
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    On: Jul 18, 2023
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Kotak Mahindra Health Insurance Contact Details

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Claim Process at Kotak Mahindra 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 24 hours and for planned hospitalisation intimate within 48 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 24 hours and for planned hospitalisation intimate within 48 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.

Insurance Products by Kotak General Insurance

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Kotak Mahindra Health Insurance Claim Settlement FAQs

  • What documents do I require for making a claim with Kotak General Insurance?

    You require the following documents at the time of claim settlement with Kotak General Insurance-

    • Investigation reports (original)
    • Hospital discharge summary
    • Original bills and receipts 
    • Valid photo ID proof
    • Nature of operation performed mentioned on reports 
    • Test reports along with attending Doctor’s reports 
    • Report of FIR or post mortem, if applicable
  • In how many ways does Kotak General Insurance offer settlement of claims?

    Kotak General Insurance settles claims in two ways, viz., cashless and reimbursement. 

  • Whom can I contact for claim intimation and settlement at Kotak General Insurance?

    For claim intimation and settlement purposes, you can notify either InsuranceDekho at 7551-196-989 or Kotak General Insurance directly by initiating contact at their toll-free number. 

  • What is the Claim Settlement Ratio of Kotak General Insurance?

    The Claim Settlement Ratio of Kotak General Insurance for FY 2019-20 is 75.45%.

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