Kotak Mahindra Health Insurance

About Kotak Mahindra Health Insurance

Kotak Mahindra Health Insurance Company has established itself as one of the most reliable insurance providers today. Being a 100% subsidiary of Kotak Mahindra Bank Ltd. gives it the reputation it needs to continue being one of the foremost providers in the country. Kotak Mahindra offers a range of plans covering health insurance, critical illnesses, families, and accident insurance. This variety ensures that they can give their customers the best chance at financial security.

Kotak Health Insurance has over 4000 network hospitals at which they can provide cashless facilities. Headquartered in Mumbai, they maintain a 55.47% claim settlement ratio through their in-house claim settlement team. The lack of Third-Party Administrators also makes them more approachable to their customers. Combining this with their expert and efficient customer care alleviates any possible stress their clients may have during their insurance experience.

The range of Kotak Mahindra Health Insurance Plans are:

Kotak Secure Shield Health Insurance
Kotak Health Care Insurance
Kotak Accident Care Insurance
Kotak Health Premier Insurance
Kotak Health Super Top-Up Insurance

Let’s look at each Kotak Mahindra Health Insurance policy in detail.

Kotak Secure Shield Health Insurance

Entry Age: 18-65
Policy Term: 1-3 years
Sum Assured: Rs.5-10 lakhs
Coverage: 18 different critical illnesses

Other benefits:

Offers child education benefit
Additional personal accident policy coverage with accidental death and disability benefits.
Loss of job benefit

Kotak Health Care Insurance

Entry Age: 5-65 years
Policy Term: 1-3 years
Sum Assured: Rs.2-4 lakhs (Excel); Rs.5-25 lakhs (Premier)
Pre and Post-Hospitalisation: 30 and 60 days, respectively.

Other benefits:

Ambulance Cover: Rs.1500
Free health checkup every policy year.
Cumulative bonus: 10% on your Base Annual Sum Insured on renewal of this Policy every claim-free year, up to a maximum of 50%

Kotak Accident Care Insurance

Entry Age: 5-65 years
Policy Term: 1-3 years
Convalescence Benefit: Rs. 10,000 upon hospitalisation
Renewability: Lifelong

Other benefits:

Coverage: Accidental death; Permanent total disablement; Permanent partial disablement; Temporary total disablement.
Daily hospital cash benefit.
Temporary total disablement has a weekly benefit.

Kotak Health Premier Insurance

Entry Age: 18-65 years (Adults); 91 days - 25 years (Child)
Policy Term: 1-3 years
Sum Insured: Rs.3-25 lakhs
Waiting Period: Depending on the chosen plan.

Other benefits:

Coverage for road and air ambulance offered for the entire family under this plan.
Discounts offered during renewal between policy terms.
Maternity Benefit: Covers 2 deliveries during the policy term.

Kotak Health Super Top-Up Insurance

Policy Term: 1-3 years
Sum Assured: Wide range offered.
Deductible Amount: Depending on the sum insured.

Other benefits:

Coverage offered for the entire family under this single plan.
Wide variety of coverage options available depending on your needs.
Tax benefits offered under Section 80(D) of the Income Tax Act, 1961.

The Advantages of Choosing Kotak Medical Insurance

With numerous positive reviews speaking to their expertise, Kotak Mahindra is evidently a good insurance option. Their plans are comprehensive, offering several benefits. Their family health insurance options, especially, involve significant advantages. What are the advantages associated with Kotak Mahindra Health Insurance?

4000+ network hospitals allowing for cashless hospitalisation makes them very desirable. There is no worrying about covering treatment costs yourself.
Kotak Mahindra Family Health Insurance, in particular, offers comprehensive coverage for up to 8 members - 4 adults and 4 children. This kind of coverage indicates a larger trend of Kotak’s dedication to ensuring their clients remain financially secure no matter who faces a medical crisis.
They offer coverage for in-patient and OPD procedures.
You can visit their website and renew your Kotak mediclaim policy instantly with easy premium payment procedures.
They provide 24*7 insurance assistance and prompt claim settlement so that their clients get the best insurance experience.
Their policies are customisable depending on your needs through riders. The policies are also portable between insurance providers. This ensures that you get maximum coverage for lower premiums since you have a base sum in place and only need to pay a slightly higher premium for increased coverage.
There are various discounts that you can avail during your policy term for claim-free years, adding deductibles etc. These measures also reduce your premium.
The premiums you pay under Kotak Mahindra Health Insurance plans are deductible under Section 80(D) of the Income Tax Act.

How Your Kotak Health Insurance Premium is Calculated

Premiums are what you pay between policy terms to renew your insurance. Different providers use different methods to calculate insurance. Kotak Mahindra uses well thought out parameters to determine your premium. By allowing you to calculate your premium, they give you an idea of how much your insurance plan costs you in the long run.

The guidelines along which Kotak Mahindra calculates your insurance:

Your Age: The younger you are or your family members are, the less likely you are to fall ill. Therefore, Kotak Mahindra charges a higher or lower premium depending on your age.
Current Health Status: Customers with pre-existing illnesses or bad health records tend to have higher premiums.
Your Location and Medical History: Your environment, where you live, where you work etc. determine your premium, too. Depending on your medical history and family history, you may need riders for better coverage, which then affects your premium.
Sum insured You Need: The higher the sum insured, the greater your premium.
The Type of Policy You Want to Buy: Individual and family floater policies have different premiums.

Kotak Medical Insurance Claim Process

Like their peers, Kotak Mahindra offers cashless claim process and reimbursement-based claim processes. Depending on whether or not you are admitted into a network or non-network hospital, you need to choose which form to fill. Their claim settlement ratio of 55.74% speaks to their precision and the necessity for accurate insurance documents. You need to ensure that your claim is not rejected because you did not have the necessary documents. How do you file claims under each process?

Cashless Claims

Make sure you are at a Kotak Mahindra network hospital.
In case of emergency hospitalisation, inform Kotak Mahindra within 24 hours. Intimate them 48 hours in advance during planned hospitalisation.
Always carry your cashless treatment card or your policy number and member ID when filing for a cashless claim at a network hospital.
Show your card or give them your policy number at the Kotak network hospital’s insurance desk.
Fill in the pre-authorisation form.
The hospital will then send the form to Kotak General for verification.
After reviewing the claim, Kotak General will inform you and the hospital about whether your claim has been verified or rejected.
Upon approval, Kotak Mahindra will directly settle the bills with the hospital. If the claim is rejected, you need to pay the bills.

Reimbursement Claims

In case of emergency hospitalisation, inform Kotak Mahindra within 24 hours. Intimate them 48 hours in advance during planned hospitalisation.
Submit a claim form along with your discharge papers and any other relevant documents within 30 days of discharge from the hospital to Kotak Mahindra.
After a close examination, you will receive a letter of approval from Kotak Mahindra Health Insurance. Within 15 days from verification, the Kotak Mahindra settles the claim.
If rejected, Kotak Mahindra may have queries for you which you are required to answer. Alternatively, you can demand the reason for claim rejection.

In order to make a valid claim, you need the following documents:

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

For any further questions regarding the claim process, Cover360’s experts are at your service! Our specialists ensure that you have all the necessary documents to make a successful claim. Just call our 24*7 customer service helpline and let us walk you through the process!