Kotak Mahindra Health Insurance FAQs

Kotak Mahindra Health Insurance

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Highlights

4,000+ Network Hospitals

3,49,931 Policies Issued

47% Incurred Claim Ratio

Lifelong Renewability

55.74% Claim Settlement Ratio

In-House Claim Settlement

Claim Settlement

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

    The claim settlement ratio of Kotak General Insurance for the year ended March 31, 2018 is 55.74%.

  • 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 1800 120 5698 or Kotak General Insurance directly by initiating contact at their toll-free number. 

Critical Illness

  • Does Kotak General Insurance offer critical illness cover?

    Yes, Kotak General Insurance provides comprehensive coverage for 18 types of critical illnesses under its Kotak Secure Shield policy.

  • How many critical illnesses are covered by Kotak General Insurance?

    Kotak General Insurance provides cover for 18 listed critical illnesses to the customers. 

  • When should I intimate the company in case of a critical illness?

    You must inform the company within 10 days of first occurrence or diagnosis of a critical illness. 

  • When am I required to submit relevant documents in case of critical illness?

    You are required to submit all the relevant documents within 30 days. 

  • Under which health insurance plans does Kotak General Insurance offer critical illness cover to the customers?

    Kotak General Insurance provides critical illness cover under its health insurance plan named Kotak Secure Shield Policy. It also provides critical illness covers as an add on benefit under health insurance plans named Kotak Health Premier and Kotak Health Care.

Family Floater

  • Is there any add-on benefit offered by Kotak General Insurance under its family floater health insurance plan?

    Yes. Kotak General Insurance offers the following add-on benefits under its family floater health insurance plan-

    • Hospital daily cash
    • Convalescence benefit
    • Donor expenses
    • Critical illness cover
    • Double sum insured
    • Cap on room rent 

  • Who all can be covered under a family floater health insurance plan offered by Kotak General Insurance?

    The following members can be covered under a family floater health insurance plan by Kotak General Insurance-

    • Proposer
    • Spouse
    • Dependent children
    • Dependent parents

  • Are daycare procedures covered under the family floater heath insurance plan offered by Kotak General Insurance?

    Yes. Kotak General Insurance provides cover for up to 150 day care procedures under its family floater health insurance plan. 

Feature

  • Do the health insurance policies offered by Kotak General Insurance provide lifetime renewability benefit to the policyholders?

    Yes. The health insurance policies offered by Kotak General Insurance provide lifetime renewability benefit to the policyholders.

  • For how many days does Kotak General Insurance provide free-look period to the policyholders?

    A free-look period of 15 days from the date of receipt of the policy is provided by Kotak General Insurance to the policyholders. 

  • What is the policy tenure offered by Kotak General Insurance for its health insurance plans?

    The health insurance plans offered by Kotak General Insurance are provided for policy tenure of 1 year, 2 years, and 3 years. 

General Information

  • How many network hospitals are covered under Kotak General Insurance?

    Kotak General Insurance has a wide base of 4000+ well-equipped network hospitals. 

  • How many policies did Kotak General Insurance issue in the previous year?

    According to the annual report of IRDAI, Kotak General Insurance issued 27,203 policies in the year 2017-2018. 

  • What is the Incurred Claim Ratio (ICR) of Kotak General Insurance?

    As per the Annual Report of the IRDAI, the ICR of Kotak General Insurance is 48.21%. The ICR of a company changes from time to time. 

  • What is the address of Kotak General Insurance?

    The correspondence address of Kotak General Insurance is -

    8th Floor, Zone IV, Kotak Infinity, Bldg. 21, Infinity IT Park, Off WEH, Gen. AK Vaidya Marg, Dindoshi, Malad (E), Mumbai – 400097

  • What are the health insurance policies offered by Kotak General Insurance?

    Under its health category, Kotak General Insurance offers plans such as Kotak Secure Shield, Kotak Health Premier, Kotak Health Care, Kotak Accident Care, and Kotak Health Super Top Up. 

Help to Buy

  • Why should I buy a health insurance policy from Kotak General Insurance?

    Kotak General Insurance is an ideal choice for both, individuals as well as families that wish to invest in health insurance without breaking their bank. Reasons that make the insurer different than the others include customer-centric operations, customised products & services, digitally enabled processes, efficient claims handling, strong management practices, team of experienced professionals, and others. Talking specifically about policies, the insurer provides comprehensive coverage against the expenses of medical treatment in case of medical emergencies, and that too at a low premium.

     

  • How to buy and apply for Kotak Mahindra health insurance policy?

    To apply for and purchase a Kotak Mahindra health insurance policy online, you can either visit the official website of Kotak General Insurance or www.insurancedekho.com. If possible, you can also visit the nearest branch of Kotak General Insurance and uncover more about different policies offered and learn about their purchase in a detailed manner.

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

    The toll-free number of Kotak General Insurance is 1800 266 4545. 

  • Why should I share my contact details with the company?

    The company requires your contact details to share important information about the policy with you. The company is able to serve you better if your contact details are there in its records. 

  • How can I get in touch with Kotak General Insurance?

    You can get in touch with Kotak General Insurance by calling them on their toll-free number-1800 266 4545. You can even write to them at care@kotak.com.

  • What are the documents required by the company if we buy a health insurance policy from them?

    Typically, Kotak General Insurance does not ask you to submit any document to purchase health insurance online. If the company feels that analysing your health is required, then the company may ask you for a few documents.

Individual

  • For how many days are the pre and post-hospitalisation expenses covered under the individual plan offered by Kotak General Insurance?

    The individual plan offered by Kotak General Insurance covers 30 days pre-hospitalisation and 60 days post-hospitalisation expenses. 

  • What is the policy tenure offered under individual health insurance plan by Kotak General Insurance?

    The individual health insurance plan by Kotak General Insurance can be purchased for a policy tenure of 1 year, 2 years, and 3 years. 

  • Will I get any discount if I buy an individual plan from Kotak General Insurance for a tenure of 2 years?

    Yes. The company offers a discount of 5% if you purchase the individual plan for a tenure of 2 years and 10% if you purchase it for 3 years.  

Kids

  • Is there any limit on the ambulance charges covered under health insurance plans for kids?

    Yes. Ambulance charges are covered for up to Rs. 1,500 under health insurance plans for kids. 

  • What are the sum insured options for children under health insurance plans by Kotak General Insurance?

    Children can be covered under health insurance plans by Kotak General Insurance with the sum insured options ranging from Rs. 2 Lakh to Rs. 25 Lakh. 

  • What is the entry age under health insurance plans for kids offered by Kotak General Insurance?

    Dependent children can be covered if aged between 91 days to 25 years under floater plan offered by Kotak General Insurance. 

Maternity

  • Does Kotak General Insurance offer maternity benefits to the women?

    Yes. Kotak General Insurance offers maternity benefits under its health insurance plan named Kotak Health Premier.

  • What are the maternity benefits provided by Kotak General Insurance under its health insurance plans?

    Maternity benefits include medical expenses for the delivery of insured’s child or lawful termination of pregnancy, cover for up to two deliveries, and pre and post-natal expenses.

  • Is the newborn baby cover provided by Kotak General Insurance under its health insurance plans for women?

    Yes. Women-centric health insurance plans by Kotak General Insurance cover medical expenses incurred on the insured individual’s newborn baby. 

Parents

  • What are the sum insured options available for parents under health insurance plans offered by Kotak General Insurance?

    Parents are provided with the following sum insured options under health insurance plans by Kotak General Insurance-Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 10 Lakh, Rs. 15 Lakh, Rs. 20 Lakh, and Rs. 25 Lakh. 

  • Is there any waiting period for the pre-existing diseases for parents under health insurance plans offered by Kotak General Insurance?

    Yes. There is a waiting period of 4 years for pre-existing diseases for parents under health insurance plans offered by Kotak General Insurance. 

  • Is there any dedicated support team to address the queries of senior citizens?

    Yes. Kotak General Insurance has a separate channel for addressing claims and grievances of the senior citizens. You can drop a mail at seniorcitizen@kotak.com. 

Plan Coverage

  • What medical expenses are covered under health insurance plans offered by Kotak General Insurance?

    Health insurance policies offered by Kotak General Insurance provide cover for the following medical expenses-

    • Hospital expenses (room, boarding, and nursing charges)
    • Fee of Surgeon, Anesthetist, Nurse, Specialists
    • Expenses related to diagnostic tests, blood, oxygen, medicines and drugs, etc.

  • For how many days are the pre and post-hospitalisation expenses covered under health insurance policies offered by Kotak General Insurance?

    Kotak General Insurance provides pre and post-hospitalisation cover for 30 days and 60 days respectively under its health insurance plans. 

  • Is ambulance cover provided under health insurance plans by Kotak General Insurance?

    Yes. Kotak General Insurance provides cover for ambulance services under its health insurance plans. 

Portability

  • What do you mean by health insurance portability?

    Health insurance portability is a right that an insured person gets to transfer the credit gained when he/she ports from one health insurance policy to another. 

  • When can I port my health insurance plan from one to another?

    You can make a request to the health insurance company for health insurance portability at the time when your policy is due for renewal. 

  • Will I get my accumulated credits if I port from one health insurance policy to another?

    Yes. The credits that you have earned for the pre-existing conditions and time-bound exclusions will be transferred to your new policy, but only if you had maintained your previous policy without a break. 

Premium

  • How is the premium calculated for health insurance policies offered by Kotak General Insurance?

    The premium for health insurance policies offered by Kotak General Insurance is calculated on the basis of several factors. Some of these are-Age, Pre-existing health condition, Sum insured chosen, Policy tenure opted etc. 

  • Does the sum insured have any impact on my premium?

    Yes. The higher the sum insured you opt for, the higher premium you are required to pay. 

  • Will I get the refund of premium in case I cancel my policy?

    If you cancel your Kotak General Insurance policy, then the premium for the period at stake will be retained and you will get refund for the balance. However, if a claim is notified or settled under a policy, then no refund will be made.  

  • How should I pay my health insurance premium to avail tax benefit?

    You can pay in any mode other than cash to avail tax benefits on the premium paid for health insurance plans offered by Kotak General Insurance. 

  • Will I get tax benefit if I purchase health insurance from Kotak General Insurance?

    Yes. The premiums paid for health insurance plans offered by Kotak General Insurance qualify for tax deduction under Section 80D of the Income Tax Act 1961.

  • What is the starting range of premium for health insurance policies offered by Kotak General?

    The premiums for health insurance policies by Kotak General Insurance start at Rs. 4143*. *The premium amount is subject to change from time-to-time. 

Senior Citizen

  • What is the maximum entry age for senior citizens under health insurance policies offered by Kotak General Insurance?

    The maximum entry age for the senior citizens under health insurance policies offered by Kotak General Insurance is 65 years. 

  • Is there any dedicated support team to address the queries of senior citizens?

    Yes. Kotak General Insurance has a separate channel for addressing claims and grievances of the senior citizens. You can drop a mail at seniorcitizen@kotak.com. 

Tax Benefit

  • Do you get any tax benefit on buying a health insurance policy from Kotak General Insurance?

    Yes! When you buy a health insurance policy from Kotak General Insurance, you get tax benefits under Section 80D of the Income Tax Act, 1961.

     

  • Under which Section am I eligible for tax benefits on the premium paid for health insurance plans by Kotak General Insurance?

    The premium paid for health insurance plans by Kotak General Insurance is eligible for tax benefits under Section 80D of the Income Tax Act, 1961. 

  • How should I pay my health insurance premium to avail tax benefit?

    You can pay in any mode other than cash to avail tax benefits on the premium paid for health insurance plans offered by Kotak General Insurance. 

Top-up

  • Does Kotak General Insurance provide any super top-up plan to the customers?

    Yes. Kotak General Insurance provides a super top-up plan by the name of Kotak Health Super Top-up.

  • What are the benefits of buying a super top-up health insurance plan from Kotak General Insurance?

    Given below are some of the advantages of purchasing a super top-up plan from Kotak General Insurance-

    • 100% restoration of the sum insured
    • Cover for 30 days pre-hospitalisation expenses 
    • Cover for 60 days post-hospitalisation expenses
    • Cover for up to 405 daycare procedures
    • Provision of the double sum insured in case of hospitalisation due to an accident

  • What are the health insurance policies offered by Kotak General Insurance?

    Under its health category, Kotak General Insurance offers plans such as Kotak Secure Shield, Kotak Health Premier, Kotak Health Care, Kotak Accident Care, and Kotak Health Super Top Up. 

  • What are the exclusions under the super top-up plan offered by Kotak General Insurance?

    Given below are the exclusions under the super top-up plan offered by Kotak General Insurance-

    • Dental treatment and surgeries
    • Acupressure and other such therapies
    • Vaccination or inoculation
    • Any cosmetic surgery, etc.
    • Any injury caused due to war, etc.
    • Any injury caused due to an intention of self-harm

Woman

  • Are there special benefits offered to women under health insurance plans offered by Kotak General Insurance?

    Yes. Kotak General Insurance provides the following benefits to women under its women-centric health insurance plans-

    • Maternity benefit
    • Newborn baby cover
    • Vaccination expenses 

  • Is there any limit on the number of deliveries covered by women-centric health insurance plans by Kotak General Insurance?

    Yes. Up to 2 deliveries are covered across all policy years under women-centric health insurance plans offered by Kotak General Insurance.  

  • What is an ideal sum insured for women?

    Your preference for the sum insured should depend on your age and number of family members you need to get insurance for, along with yourself. If you are young and have less or no dependents, then you should go for a lower sum insured. However, if you have dependent parents and children, then you must opt for a higher sum insured. 

Kotak Mahindra Health Insurance Plan List

Name of PlanSum Insured
Kotak Health Care Min: 91 Days; Max: 65 Years2 Lakh Get Quotes Now
Kotak Secure ShieldMin: 18 Years; Max: 65 Years5 Lakh Get Quotes Now
Kotak Health PremierMin: 91 Days; Max: 65 Years3 Lakh Get Quotes Now

Kotak Mahindra Health Insurance Top Up List

Name of PlanSum Insured
Kotak Health Super Top UpMin: 91 Days; Max: 65 Years3 Lakh Get Quotes Now

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.

Kotak Mahindra Health Insurance User Reviews

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