Health Insurance 786 views July 9, 2021

Kotak Group Health Care Insurance Plan

If you are looking to offer customized health insurance coverage to your employees or group members and their dependents, think of buying the Kotak Group Health Care Insurance Plan. Kotak understands the diverse needs of the company’s requirements and offers flexible health insurance coverage accordingly. With this plan, insured members (employees or group members) remain free of worries about their financial well-being during medical emergencies.

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Before understanding this plan in detail, let’s check its salient features mentioned below.

  1. In-patient Hospitalization Cover
  2. Pre and Post-hospitalization Medical Expenses Cover
  3. Day Care Treatment Cover
  4. Domiciliary Hospitalization Cover
  5. Emergency Ambulance Cover
  6. Organ Donor Expenses Cover
  7. Daily Cash Benefit
  8. Coverage Against Home Nursing Expenses
  9. Convalescence Benefit
  10. Alternative Treatment Cover
  11. Option To Pay Premium In Installments – Monthly, Quarterly, Half-yearly or Annually
  12. A 15-day Free Look Period

You would want to know these features of the Kotak Group Health Care Insurance Plan in detail. On this page, we will let you know the same. So, read on.

Let’s Discuss the Features and Benefits of Kotak Group Health Care Insurance Plan in Detail

Kotak Group Health Care Insurance Plan provides a financial cushion to the insured members under a group against unforeseen medical conditions. Let’s understand its key features mentioned below.

In-patient Hospitalization Cover

The policy will cover the expenses for a minimum and continuous 24-hour hospitalization of the insured person’s during the policy period. Under this, the following medical expenses will get covered.

  1. Room rent and boarding charges
  2. ICU Charges
  3. Operation theatre charges
  4. Medical Practitioners fees (Including Fees Of Specialists and anesthetists treating the Insured Person;)
  5. Qualified Nurses’ charges
  6. Medicines, drugs and other allowable consumables
  7. Investigative tests or diagnostic procedures directly related to the Injury/Illness
  8. Anesthesia, blood, oxygen, etc.
  9. Surgical appliances and prosthetic devices recommended by the attending Medical Practitioner
  10. In-patient physiotherapy charges

Day Care Treatment Cover

If an illness or injury requires hospitalization of an insured member for less than 24 hours (day care treatments), the policy will also cover the expenses on such treatments. However, insured members will not get OPD treatment cover under this benefit.

Pre and Post-hospitalization Medical Expenses Cover

Once the in-claim or day care treatment claim has been accepted, you will also get coverage against expenses incurred before and after the hospitalization up to specified days.

Domiciliary Hospitalization Cover

The policy will cover the expenses incurred on the insured person’s domiciliary hospitalization (treatment taken at home, which otherwise would require a proper hospitalization) during the policy term provided the treatment should run for at least three consecutive days. The coverage amount will be up to the sum insured.

Emergency Ambulance Cover

If an insured member needs to be transported to the nearby hospital by a healthcare or ambulance service provider, the policy will cover the reasonable expenses incurred on the same. It is necessary to get the certification of the necessity of transportation by the treating medical practitioner.

Organ Donor Expenses Cover

In case of an organ transplantation procedure, Kotak Group Health Care Insurance Plan will also cover the in-patient hospitalization medical expenses incurred on the donor for harvesting the organ, up to the basic sum insured. The following expenses will not get covered under this benefit.

  1. Pre or Post-Hospitalisation Medical Expenses
  2. Costs directly or indirectly associated with the acquisition of the organ
  3. Medical treatment or complication in respect of the donor after harvesting

Optional Covers

Insured members can also enjoy the following additional covers with this group health insurance plan.

  1. Hospital Daily Cash Benefit
  2. Alternative Treatment Cover up to the sum insured
  3. Critical Illness Recuperation Benefit (Daily Allowance for Specified Days)
  4. Coverage Against Home Nursing Expenses
  5. ICU Daily Cash Benefit
  6. Convalescence Benefit (If an insured person is hospitalized for a minimum of 10 days)
  7. Accompanying Person’s Expenses
  8. Cost of Prescribed External Medical Aid
  9. Travel Expenses for Treatment (If an insured person is traveling 150 km or more from his/her residential location)
  10. OPD Expenses (Diagnostic Procedures, Pharmacy Expenses, Consultations with the Medical Practitioner, etc.)
  11. Maternity Benefits after a waiting period of 9 months
  12. OPD Dental Treatment
  13. Newborn Baby Cover with pre and post-natal care
  14. Second Opinion Cover
  15. AIDS/HIV Cover
  16. Medical Advancement Surgery Cover
  17. Hospitalization Cover only for Accidents and Critical Illnesses
  18. Vaccination Expenses

Kotak Group Health Care Insurance Plan Eligibility Criteria

Have a look at the important conditions related to the Group Health Care Insurance Policy mentioned below.

  1. The minimum entry age stands at one day.
  2. There is no limit to the maximum entry age of the insured member.

What is Not Covered under the Plan?

Insured members will not get covered against the following expenses.

  1. Routine medical, eye or ear examinations preventive health check-ups
  2. Spectacles, laser surgery for correction of refractive errors, contact lenses, hearing aids, dentures or artificial teeth
  3. Prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, crutches, etc.
  4. Personal comfort, cosmetics, convenience and hygiene-related items and services
  5. Mental Illness Treatment
  6. Weight Management Services
  7. Naturopathy treatment, acupressure, acupuncture, etc.
  8. Circumcision unless necessary for the treatment of an Illness or necessitated due to an Accident
  9. Vaccination or inoculation of any kind (Unless it is after animal bite)
  10. Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)
  11. Injury or Illness due to use, misuse or abuse of intoxicating drugs or alcohol

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