Health Insurance 138 views July 14, 2021

Kotak Health Premier Insurance Plan

Kotak Health Premier Insurance Plan provides financial protection for you and your family against medical expenses. This policy is available to persons aged between 18 and 65 years. Under this policy self, spouse, dependent children (91 days to 25 years), parents, parents in-law and siblings can be covered. You can purchase this policy on an individual or family floater basis. A family floater policy can cover a maximum of two adults and three dependent children under a single policy. Read this page further and know about the Kotak Health Premier Insurance Plan coverage.

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Kotak Health Premier Insurance Plan Base Cover

The insurer shall provide coverage against the following under this policy:

  1. Medical expenses involved in In-patient treatment, such as room rent, ICU charges, operation theatre charges, doctor’s fees, etc. if the hospitalization is for a minimum of 24 hours
  2. 405 daycare procedures 
  3. Pre & post-hospitalization medical expenses up to the specified number of days as mentioned in your policy
  4. Second E-opinion can be availed multiple times during the policy period
  5. Ambulance cover for transportation to the hospital in case of an emergency
  6. Organ donor cover for in-patient hospitalization expenses of the donor in case of an organ transplant
  7. Alternative treatments related to Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems
  8. Domiciliary hospitalization expenses, provided the same has been advised by the attending medical practitioner

Kotak Health Premier Insurance Plan Restoration Benefit

100% of the base sum insured shall be restored once in a policy year in case the same is insufficient due to previous claims. The restoration of the sum insured shall not apply to the first claim in that policy year unless the claim is related to an injury due to an accident. You can use the restored sum insured for all future claims unless it is not related to the illness for which a claim has already been made.

Note: No cumulative bonus will apply to the restored sum insured

Cumulative Bonus

You can earn a cumulative bonus of up to 50% or 100% of the sum insured based upon the plan opted by you. The cumulative bonus is available after a claim-free year at 10% per year. There will be no reduction in cumulative bonus in case of a claim.

Kotak Health Premier Insurance Plan Annual Health Check-up Benefit

The policy provides a free health check-up for each insured person above the age of 18 years. This benefit will be offered to you regardless of any claim in the policy year. Your annual health check-up will consist of the following tests:

  1. CBC
  2. MER
  3. Serum Cholesterol
  4. Serum Creatinine
  5. SGPT/SGOT
  6. ECG
  7. Random Blood Sugar

Kotak Health Premier Insurance Plan Optional Covers

The policy comes with a host of other covers that can be opted on the payment of additional premium. You can choose your additional cover from the following:

  1. Hospital Daily Cash: The insurer will pay a specified daily cash amount from day one in case the hospitalization exceeds three consecutive days
  2. Convalescence Benefit: You will receive a lump sum amount in case the hospitalization exceeds 10 consecutive days, provided the insurer has accepted the claim under in-patient treatment.
  3. Home Nursing Benefit: The insurer shall cover the services of a qualified nurse at the residence of the insured after discharge from the hospital, provided the attending medical practitioner confirms such services as being necessary.
  4. Daily Cash for Accompanying an Insured Child: The insurer will pay a specified daily cash amount from day one in case the hospitalization of an insured child extends three consecutive days.
  5. Compassionate Visit: The insurer will cover the cost of the return journey of the insured’s immediate relative from his/her place of residence to the hospital in case the hospitalization of the insured exceeds five consecutive days.
  6. Air Ambulance Cover: You will get coverage for ambulance transportation in an airplane or helicopter for emergency life-threatening situations.
  7. Maternity Covers: Under this optional cover, you’ll get three covers. First, maternity benefit where the insurer covers medical expenses for the delivery of the child or lawful termination of pregnancy, pre and post-natal expenses. Second, newborn baby cover, where the medical expenses for the newborn shall be covered. And third, vaccination expenses cover for the newborn baby till the baby completes 2 years.
  8. Critical Illness Cover: You’ll get a lump sum amount in case of the occurrence of the covered critical illnesses during the policy period.
  9. Personal Accident Cover: The insurer shall pay a lump sum amount in the event of accidental death, Permanent Total Disablement due to an accident.
  10. Cap on Room Rent: If you opt for this cover, the room rent shall be covered on a rateable proportion based on the actual and eligible room rent, provided the incurred room rent is higher than the eligible room rent.

Kotak Health Premier Insurance Plan Value Added Services

Under this policy, you can avail of the following value-added services:

  1. Online services for customers
  2. Doctor directory
  3. Doctor appointment
  4. Booking online pharmacy/diagnostics tests
  5. Health tips
  6. Home Health
  7. E-consultation
  8. Dietician/Nutritionist opinion

Note: The value-added services may attract additional charges, but the claims admissible under this section will not impact the sum insured or cumulative bonus.

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