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Group Insurance 659 views July 12, 2021
Kotak Group Smart Cash – Micro Insurance Plan is designed for the employees of an organization or company. Under this policy, the insured person (employee) shall receive a daily cash benefit in case of hospitalization during the policy period. Under this policy, you can also include your spouse, children, parents, siblings, parents in-law, son in-law, daughter in-law, brother in-law and sister in-law. You should declare the list of covered members at the beginning of the policy period as no change would be accepted afterward. Read this page further and know more about the Kotak Group Smart Cash – Micro Insurance Plan benefits.
Table of Contents
Kotak Group Smart Cash – Micro Insurance Plan Base Cover
You can opt for the following benefits under this policy:
- Hospital Daily Cash Benefit: The insured person will receive a daily cash amount as specified in the policy schedule for each completed day of hospitalization as an in-patient.
- Accident Daily Cash Benefit: The insurer will pay the daily cash amount as specified in the policy schedule for each completed day of hospitalization as an in-patient. This benefit is payable to the insured only if the hospitalization occurs due to an accident.
- ICU Daily Cash Benefit: In case the insured person is hospitalized in an ICU during the policy period, the insurer will pay the daily cash amount as specified in the policy schedule.
Note: If the policyholder (employer) opts for the base cover Accident Daily Cash Benefit, payout under ICU Daily Cash Benefit will be restricted to the hospitalization in an ICU following an injury due to an accident. The policyholder can opt for any one, two or all the base covers.
Kotak Group Smart Cash – Micro Insurance Plan Optional Covers
The policyholder can opt for the following covers by paying an extra premium for the same.
- Convalescence Benefit: The insurer will pay the sum insured as specified in the policy schedule against this benefit if the insured person is admitted to a hospital for a period as specified in the policy schedule. You can avail of the benefit under this optional cover only once during the policy year. This benefit applies to this policy on an individual basis irrespective of the type of policy.
- Companion Benefit: You’ll receive a daily cash amount as specified in the policy schedule against this benefit for accompanying a person at the Hospital/Nursing Home for each completed day of hospitalization. The companion will include your spouse, children, siblings and parents.
- Joint Hospitalization: The insurer will pay the sum insured as specified in the policy schedule in a lump sum if two or more insured persons are hospitalized. You’ll receive this benefit only once during the policy year.
- Parent Accommodation: You’ll get a daily cash amount for every completed hospitalization during this policy period, provided the insured person hospitalized is a child aged 12 years or below.
- Day Care Procedure Benefit: If you undergo a Day Care Procedure as an in-patient, the insurer will pay a sum insured as specified in the policy schedule. This benefit is applicable on an individual basis irrespective of the type of policy.
- Surgery Benefit: In case you undergo a surgery/surgical procedure, the insurer will pay a sum insured as stated in the policy schedule. This benefit is payable only once during the policy year.
- Accidental Hospitalisation Benefit: If you suffer an injury due to an accident, the insurer shall cover the in-patient hospitalization expenses up to the limit as specified against this benefit. The hospitalization should be of minimum and continuous period of 24 hours and advised by the Medical Practitioner
- Broken Bones: A percentage of the sum insured shall be payable if the insured person sustains broken bones due to an accident. Check out the table below to know about it:
| Type of Broken Broken | % of the Sum Insured |
|---|---|
| Compound fracture of the skull with damage to the brain tissue | 100 |
| Compound fracture of the skull without damage to the brain tissue | 75 |
| All other skull fractures | 50 |
| Fractures of hip or pelvis - Multiple fractures (at least one compound & one complete) | 100 |
| All other compound fractures of hip or pelvis | 50 |
| Multiple fractures of hip or pelvis at least one complete | 30 |
| All other fractures of the hip or pelvis | 20 |
| Fracture of thigh or heel - multiple fractures (at least one compound & one complete) | 50 |
| Fracture of thigh or heel all other compound fractures | 40 |
| Fracture of thigh or heel - multiple fractures (at least one complete) | 30 |
| Fracture of thigh or heel - all other fractures | 20 |
| Fracture of Lower Leg, Clavicle, Ankle, Elbow, Upper or Lower Arm (including wrist, but excluding Colles-type fracture) - Multiple fractures (one compound & one complete), all other compound fractures, multiple fractures, at least one complete and all other fractures | 40, 30, 20 and 12 |
| Fractures of Lower Jaw - multiple fractures (one compound & one complete), all other compound fractures, multiple fractures (one complete) and all other fractures | 30, 20, 16 and 8 |
| Fractures of Shoulder Blade, Kneecap, Sternum, Hand (excluding fingers and wrist), Foot (excluding toes and heel) - all compound fractures and All other fractures | 20 and 10 |
| Colles type fracture to the lower arm - compound and other | 20 and 10 |
| Fractures of Spinal Column (Vertebrae but excluding coccyx) - all compression fractures, all spinous, transverse process or pedicle fractures and all other vertebral fractures | 50, 30 and 20 |
| Fractures of Rib or Ribs, Cheekbone, Coccyx, Upper Jaw, Nose, Toe and toes, finger or fingers - multiple fractures (one compound & one complete), all other compound fractures, multiple fractures, at least one complete and all other fractures | 16, 12, 8 and 4 |
Note: If you suffer a fracture that is not specified in the table above, the insurer’s medical advisors will determine the amount payable, if any
- Burns: If an insured person sustains burns directly due to an accident, the insurer will pay a percentage of the sum insured as specified in the policy schedule
- Maternity Benefit: A daily cash amount is payable for the delivery of the insured person’s child or medically necessary and lawful termination of pregnancy.
- New Born Baby Benefit: The insurer will pay a daily cash amount as specified in the policy schedule for each completed day of the hospitalization of the insured’s newborn baby.
- AYUSH Treatment Benefit: You can receive AYUSH treatment during this policy period, provided the treatment is administered by a medical practitioner.
- Worldwide Cover: You’ll receive a daily cash amount for each completed hospitalization outside India.
- Personal Accident Benefit: Under this cover, you’ll get coverage against accidental death and Permanent Total Disablement (PTD) caused by an accident during the policy period.
- Critical Illness Benefit: If you are first diagnosed to be suffering from any of the covered critical illnesses as specified in the policy schedule, the insurer will pay a sum insured.
Note: Critical illness must be diagnosed within 90 days of the commencement of the first policy period.
Free Look Period
A 15-day free look period starts from the date of receipt of the policy document to review the terms and conditions of the policy. You can return the policy if the terms and conditions aren’t acceptable. On such cancellation, you’ll be entitled to a refund of the paid premium less any expenses incurred on medical examination and stamp duty charges, provided you haven’t filed a claim during the free look period. If the risk has already commenced and the option of return of the policy is exercised by you, a deduction towards the proportionate risk premium for the period the on cover shall be provided. Where only a part of the insurance coverage has commenced, such proportionate premium commensurates with the insurance coverage during the free look period.