Health Insurance

Kotak Health Insurance – Plans to Suit Your Needs

By Vikas Chandra Das
16 November 2022, 3:18 PM

Health insurance is almost a necessity. Despite India being a medical tourism destination, the cost of quality health care is beyond the reach of the majority of Indians unless protected by health insurance. There are several service providers offering health insurance plans, each with individual pricing and individual offerings. With limited budgets and so much on offer, choosing a plan requires time and effort if one has to select the plan that suits his or her needs most.

This blog details some of the comprehensive health insurance plans offered by Kotak General Insurance:

Kotak Health Care

Variants and Coverage: This comes in 3 variants - Excel, Premier and Prime. While Excel Plan offers coverage of INR 2 Lakhs to INR 4 Lakhs, the Premium offers coverage of INR 5 Lakhs to INR 25 Lakhs. Kotak Health Care Prime offers coverage of INR 5 to INR 100 Lakhs.

The main features are as follows:

Premiums

In the case of Excel, the premium for coverage of INR 400,000 when the age of entry is 91 days, is tagged at INR 3872/-. This goes up to INR 56,788/- when the age of entry is 80 years. Premiums for the Prime variant range from INR 5730/- to INR 84,076/- for coverage of INR 10,00,000/-. 

Coverage is provided for in-patient hospitalisation of 24 hours or more along with coverage of pre and post-hospitalisation expenses up to 30 and 60 days respectively. Several day care procedures are also treated.

Free Health Check-up: Any person above the age of 18 is entitled to one free health check-up per year, irrespective of whether a claim has been made or not

Cumulative Bonus: The sum insured (SI) is increased every year by 5% at the time of renewal, up to a maximum of 50%. This will only happen if there is no claim made during the entire policy period

Cashless Treatment: This is offered in the 4000+ network hospitals

Family Floater Plans: The policy can be availed as a family floater plan in Premium and Prime variants. The family floater option is only available for Excel plan if coverage is INR 3 lakhs and above. Persons considered family are spouse, dependent children up to the age of 25 and dependent parents.

Age of Entry: This is 4 years to 65 years in the case of individual plans with a lifetime renewability option. For family floater plans, the age of entry is 91 days.

Special Features of Prime: Prime Health Care Plan has several optional features not available on the excel and Premium variants. This includes domiciliary hospitalisation, coverage of AYUSH treatment, maternity benefits, coverage of newborn babies, as well as restoration of SI.

Policy Tenure: Individuals can choose a policy tenure of one, two or three years. The two-year tenure provides a 5% discount on premiums and the three-year tenure provides a discount of 10%

Free Look Period: All three variants have a free look period of 15 days

Grace Period: This is 30 days

Exclusions

Hospitalisation expenses arising out of war, acts of terror, radiation or contamination due to nuclear activity, STD and AIDS, attempts at self-destruction all are permanently excluded from the scope of the policy. 

Pre-existing diseases have a waiting period of 48 months before treatment expenses are eligible for coverage.

Hospitalisation due to conditions such as hernia, fissures, fistula, arthritis, gout etc. have a two year waiting period.

Most other conditions have a waiting period of 30 days, except for treatment due to accidents.

Kotak Secure Shield: This is a critical illness policy that covers 18 critical illnesses. On being diagnosed, one will receive a lump sum payment which may be used for any expenses the insured chooses - whether to pay medical bills or remodel a home necessitated by a disability. In addition, this plan provides the following

Personal Accident Benefit:  A lump sum provided in case of death of the insured to the family members

Child Education Benefit: In case of death or permanent disability as a result of which the insured cannot work again, there is a provision of coverage of educational expenses of the child. 

Illnesses Covered: These include cancer of specified severity, kidney failure, benign brain tumour, multiple sclerosis, permanent paralysis of the limbs, major organ transplant, coma, third-degree burns, deafness, loss of speech etc.

Premiums: The premiums start at INR 1391/- for a SI of INR 500,000/- along with a child education benefit of INR 50,000/-. There is an option to double this coverage. Premiums increase with age and amount of coverage.

Arogya Sanjeevani Policy

Coverage: This offers coverage from INR 50,000/- to INR 10,00,000/.

Premiums: Premiums start at INR 2,830 for a coverage of INR 50,000 (for age of entry = 18) and go up to INR 7587 for a coverage of INR 10,00,000/- for the same age of entry

Coverage is provided for in-patient hospitalisation of 24 hours or more along with coverage of pre and post-hospitalisation expenses up to 30 and 60 days respectively in AYUSH Hospitals

Cumulative Bonus is provided.

Co-payment: a 5% co-payment is necessary.

Family Floater Plans: The policy can be availed as a family floater plan. 

Exclusions: Permanent exclusions include change of gender treatment, expenses due to participation in hazardous sports, cosmetic surgery, among others

Free Look Period: There is a free look period of 15 days

Kotak Health Super Top Up

This top up plan of Kotak works like other top up plans offered by health insurance service providers. It becomes active once the SI or the coverage available against the basic health insurance plan is exhausted. Permanent and other temporary exclusions are similar to those of the basic health insurance. The plan offers coverage at a comparatively lesser premium compared to basic health insurance plans.

Kotak offers several different plans from which one can choose according to the budget and the need. To cut costs, one may opt for a basic health care plan along with a top up plan. As one gets older, getting a critical illness add-on cover is a good option.

FAQs
1. What are daycare procedures?

These are procedures that do not require overnight hospitalisation. Notable examples include cataract surgery, chemotherapy, dialysis, etc.

2. What is the restoration of SI?

When one exhausts the SI during a policy period, the insurer again makes an amount equivalent to the original sum assured available for use during the same policy term.

3. What is a free look period?

This is a period of usually 15 to 30 days, when one may scrutinize the policy document received and return it to the insurer who will refund the premium amount paid, after deducting any costs incurred till then.

4. What is domiciliary hospitalisation?

When hospitalisation is required but a person cannot be admitted due to the lack of beds or his/her condition does not permit movement to a hospital, and is treated at home as a result, it is called domiciliary hospitalisation.

5. What is the grace period?

Once the policy term is over, if for some reason the insured is unable to renew the policy on time, a further time of 15 to 30 days is provided as grace. Payment during this period will allow the policy to be treated as continued without a break.

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