Health Insurance

Medical/health insurance is an insurance policy designed to cover medical expenses arising due to unforeseen illnesses or injuries. The health insurance policy covers hospitalisation expenses and other medical costs that you might incur depending on the coverage offered under the plan.

There are different types of health insurance plans available in India. These include the following –

• Indemnity health insurance – This policy covers the hospitalisation and other medical expenses that you incur. The policy has a wide scope of coverage and covers the specified medical costs that you have incurred up to specified limits.

• Personal accident insurance – This policy covers accidental deaths and disablements. This is a fixed benefit policy which pays a lump sum benefit in claim.

• Critical illness insurance – The policy covers specific illnesses and pays a lump sum benefit of the insured suffers from any covered illness.

• Top up health insurance - This policy supplements an existing cover at affordable premium rates.

With the growing medical inflation, a robust health insurance plan for your family helps meet any medical emergencies. Apart from the coverage, health insurance plans also help in getting access to enhanced medical facilities without depleting your savings. Also know about the consequences of not having a health insurance plans.

Coverage under health insurance plans depend on the type of policy that you choose and the coverage that it provides. Health insurance plans offered by Zurich Kotak General Insurance cover the following common healthcare expenses:

• In-patient treatment costs

• Day care treatments

• Pre and post-hospitalization expenses

• Ambulance cover

• Organ donor cover

• Domiciliary hospitalisation

• AYUSH

If you buy a health plan for your parents and pay the premium, the premium paid would qualify as a deduction under Section 80D. The limit of deduction is Rs.25,000 if your parents are below 60 years of age. For senior citizen parents, the limit increases to Rs.50,000.

You can enjoy countless benefits if you buy a health insurance plan at an early age. A few of the advantages are:

Lesser exclusions in a health insurance policy:

Health insurance companies impose exclusions on pre-existing illnesses or diseases that you have already suffered, which is likely to be less at a younger age. Thus, when you buy the plan at a young age, you are likely to be healthy and enjoy a comprehensive scope of protection.

No health check-up:

Undergoing a health check-up might not be required if you are young.

Waiting out the waiting period

Health plans have different waiting periods for different illnesses. When you are young, you might be healthy. As such, you can wait out the waiting period so that when you might develop illnesses, the policy would allow coverage from Day 1.

Tax benefits

You can also enjoy tax benefits on the premium paid for the health plan and save taxes.

Know more about the tax benefits of health insurance

Here are a few factors that affect the health insurance premium:

• Age – Higher the age, the higher is the insurance premium

• Pre-existing illness- People suffering from pre-existing illnesses like blood pressure and diabetes need to pay higher premiums

• Smoker or non-smoker- Individuals who smoke need to pay higher insurance premiums than Non-smokers

• Sum insured – higher the sum insured, higher would be the premium payable

• Policy tenure – if you choose long-term tenures and pay a lump sum premium, the premium would be higher. However, you might enjoy long-term discounts which would reduce the overall premium payable.

• Add-ons selected – If you opt for optional add-ons and riders, the premium would be higher since each add-ons or optional cover requires an additional premium.

• Available premium discounts – if there are premium discounts that you can claim, the premium would be lower.

If you are planning to do renewal of health insurance online, simply follow the below steps:

• Visit https://www.zurichkotak.com/renewal

• Select the health insurance policy to initiate the online renewal process

• Enter the necessary details, including the policy number, mobile number, and date of birth, and click on 'Submit.'

Here’s the process for making a health insurance claim -

Cashless claim

• To avail this facility, you need to ensure that the treatment is being taken at the empanelled hospital listed in the insurance policy document

• Approach the hospital 48 hours prior to hospitalization

• Produce the pre-hospitalization form along with an identity proof and medical documents at the cashless deck in the hospital

• In case of an emergency, you need to visit the cashless deck at the hospital within 24 hours of hospitalization

• Submit the ID proof along with the medical documents

• Once the cashless claim is approved, you will be required to pay the deductibles.

Reimbursement claim

• In case the hospital is not listed in-network list, you can opt for a reimbursement facility:

• Get in touch with us at 1800-2120 or care@zurichkotak.com

• Submit all the original hospital bills, and discharge documents along with the reimbursement claim.

• Post verification, the claim will be settled within 15 days

Know about the various ways to make a health insurance claim

To select the right health insurance cover, here are a few things you should keep in mind:

• Compare multiple health insurance policies to find a policy which offers the coverage features that you need and is comprehensive

• Check for the cashless network hospitals – the wider the better

• Check for the exclusions of the health policy – the lesser the better

• Look for the claim settlement ratio – the higher the better

• Pre-existing illness cover – check how soon pre-existing illnesses are getting covered. The sooner, the better

• Know about add-on covers so that you can choose the relevant ones

• Choose a trusted brand for a hassle-free claim experience

For instance, if you are searching for a health insurance that covers life-threatening diseases, then you can opt for Shield Secure to protect you and your family.

While buying the policy, the cost of the premium is often the most important thing you may evaluate. While calculating health insurance premiums, a lot of factors are taken into consideration; these include:

• Age of the insured policyholder

• Type of health plan

• Sum assured

• Lifestyle choices

• Add-on covers

• Pre-existing diseases

• Family medical history

• Number of family members being covered

• Geographical location etc.

Yes. You have the flexibility to add more people to the existing health insurance policy. However, the health insurance premium also increases with the inclusion of a new member.

Children of any age can be included in the health insurance policy right from the day they are born, typically in retail health policies children are covered from 91 days and up to 25 years.

The requirement of a medical examination depends on your age, sum insured and the policy that you choose. Some plans might require a medical check-up while others might not. However, if you are older and/or if you are opting for a high sum insured, the medical examination usually becomes necessary before the coverage is granted.

If you or any member of your family is admitted to a non-network hospital, you can raise cashless anywhere request the request subject to feasibility in the non-network hospital for reimbursement of the hospital expenses. Health insurance policyholders at Zurich Kotak General Insurance can initiate the process in the following way:

• Call on 1800-2120 or mail us at care@zurichkotak.com

• Collect the reimbursement form from the hospital

• After the discharge, submit the claim form to the insurance company along with the original copy of hospital bills, discharge report & other payment receipts

• Post verification, the insurance company may approve or disapprove the claim