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Edelweiss Health Insurance

Edelweiss Health Insurance is a full-fledged health insurance plan that can cover you and your loved ones, including yourself, your dependent children, your spouse, your parents, brother, sister, your grandfather, grandmother, or anyone else with an insurable interest. Under Edelweiss Health Insurance plans, you can cover up to eight people under a single policy. The plans also cover pre and post-hospitalization medical expenses, as well as inpatient treatment for a disease, accident, or even critical illness.

Edelweiss Health Insurance is a real comrade during sick hours, with so many perks and features. This plan is appropriate for everybody, including men, women, children, seniors, and those with urgent conditions. It offers extensive coverage at a cost that isn’t prohibitively expensive.

Key Highlights

Incurred Claim Ratio114.70% (2019-20)
Equity Share Capital308 (As Of March 31, 2020)
Premium UnderwrittenRs. 146.36 Crores (2019-2020)
Solvency Ratio2.36 (March 2020)
Network Hospitals3281+
Corporate Office

5th Floor, Tower 3, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla (West), Mumbai 400 070

Awards & Achievements
  • Innovative Use Of Technology – FinTech India Innovation Awards 2021
  • Best Innovation – Finnoviti Awards 2021
  • Best Use Of Technology To Enhance Customer Experience – Customer Fest Awards 2021
  • Most Innovative Technology Initiative – Customer Fest Awards 2021
  • Innovation & Emerging Technologies – Asia Feather Awards 2021
  • Best Product Innovation – Asia Feather Awards 2021
  • Best Innovation – 8th World Auto Forum Awards 2021
  • InsureTech – India Insurance Summit & Awards 2020
  • Bronze New Product Launch – Indian Marketing Awards 2020
  • BFSI Digital Innovation – Indian Express Group 2019
  • Emerging General Insurance Company – CMO Confluence & Corporate Awards 2019
  • MINT SAP Digitalist Award – Rama – Digitalist 2018
  • SAP – Process Innovation 2018
  • SAP ACE Award 2018
Types Of Plans
  • Health Insurance Plans
    • Silver
    • Gold
    • Platinum
  • Arogya Sanjeevani Policy
  • COVID Healthcare
    • Corona Rakshak Policy
    • Corona Kavach Policy
  • Saral Suraksha Bima

Types Of Edelweiss Health Insurance Plans

1. Edelweiss Health Insurance Plan

Edelweiss Health Insurance Plan comes in three variants: Silver, Gold, and Platinum. Each plan provides comprehensive coverage to you as well as your family members against long-lasting medical problems.

Key Features:

  • Hospitalization Expenses: Each of the plans covers hospitalization expenses up to the sum insured.
  • Day Care Treatment: The plans also cover daycare treatments up to the amount of sum insured.
  • AYUSH Treatments: Treatments done under Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered under the plans.
  • Other Features:
    • No capping on ICU charges
    • Ambulance coverage
    • Domiciliary hospitalization
    • Health check-up for every claim-free year
    • Shared accommodation benefit
    • Voluntary co-payment

Eligibility:

FeaturesSilverGoldPlatinum
Sum InsuredRs. 5 LakhsRs. 20 LakhsRs. 1 Crore
Pre- & Post-Hospitalization Expenses30/60 Days60/90 Days90/180 Days
Ambulance Coverage Per HospitalizationRs. 1,500Rs. 3000Rs. 10,000
Organ Donor CoverageNot CoveredUp To Rs. 1 LakhUp To Rs. 2 Lakhs
No Claim BonusSum Insured Increases By 10% For Every Claim-Free YearSum Insured Increases By 50% For Every Claim-Free YearSum Insured Increases By 50% For Every Claim-Free Year
Maternity BenefitNot CoveredUp To Rs. 50,000Up To Rs. 2 Lakhs

2. Edelweiss Arogya Sanjeevani Policy

Visiting a hospital is usually always a costly experience. Everything from simple daycare procedures to major operations can put a strain on your finances. With the Edelweiss Arogya Sanjeevani plan, you and your family will have simple access to the medical care you need and you won’t have to break the bank.

Key Features

  • Cataract Treatment: 25% of the sum insured will be provided by the company to the policyholder for every policy year. This amount can be used for cataract treatment, in case you require it.
  • AYUSH Treatment: The plan covers the expenses of treatment under Yoga, Ayurveda, Unani, Siddha, and Homeopathy systems.
  • Hospitalization Expenses: In case you are hospitalized for 24 hours, you will have coverage up to the sum insured.
  • Other Features:
    • Pre- and post-hospitalization expenses
    • Daily room rent expenses
    • Pre-existing disease cover
    • Cumulative bonus
    • Co-pay clause
Eligibility

For Children: 3 Months To 18 Years

For Adults: 25 To 65 Years

Maximum Number Of Members Covered8
Sum InsuredRs. 1 Lakh To Rs. 5 Lakhs
Cataract Treatment Cover25% Of SI
Cumulative BonusSum Insured Will Increase By 5% For Every Claim-Free Year
Co-Pay5% Co-Pay Is Mandatory On Every Claim

3. Edelweiss COVID Healthcare Plan

In order to provide financial assistance in the unprecedented times of COVID-19, Edelweiss has come up with two COVID healthcare plans: Corona Kavach Policy and Corona Rakshak Policy.

Corona Kavach Policy

In case the insured person falls ill due to COVID-19, Corona Kavach Policy will take care of the expenses arising out of the illness. This plan can be purchased either on an individual or family basis.

Key Features:

  • COVID Hospitalization Expenses: In case the insured is hospitalized due to COVID-19, the company will look after the expenses.
  • Pre- & Post-Hospitalization Expenses: Expenses occurring before and after the hospitalization of the insured person will be covered under the policy.
  • AYUSH Treatment: In case the insured person has to undergo treatment of Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems, the expenses will be covered by the company.
  • Homecare Treatment: In case the insured person undergoes COVID-19 treatment at home, the company will cover the expenses for up to 14 days.
  • Daily Hospital Cash: The plan will pay a significant amount of cash in case of continuous hospitalization every 24 hours.
Eligibility

Minimum Age: 18 Years

Maximum Age: 65 Years

Sum InsuredRs. 50,000 To Rs. 5 Lakhs
Premium DiscountMaximum Of 25%
Policy Period3.5/6.5/9.5 Months

Corona Rakshak Policy

The Edelweiss Corona Rakshak Policy is a low-cost health insurance plan that protects your health during COVID-19.

Key Features:

  • Lump-Sum Benefit: If you are diagnosed with COVID-19 and need to be hospitalized for at least 72 hours, the policy will pay you a lump sum benefit equivalent to 100% of the sum insured if you are diagnosed at a government-approved diagnostic center.
  • Waiting Period: A 15-day waiting time will be necessary before you can receive policy benefits. The waiting time will be computed from the policy’s inception date.
  • Non-Renewable: Edelweiss Corona Rakshak Policy is a non-renewable short-term health insurance policy. The coverage will be terminated once the benefit has been used.
Eligibility

Minimum Age: 18 Years

Maximum Age: 65 Years

Sum InsuredFrom Rs. 50,000 To Rs. 2.5 Lakhs
Policy Tenure3.5/6.5/9.5 Months

4. Edelweiss Saral Suraksha Bima

You could be permanently crippled or worse if you are injured in an accident. You can plan for the unexpected with the Edelweiss Saral Suraksha Bima plan, which will protect your family and their finances against such medical exigencies.

Key Features:

  • Accidental Death: The nominee of the insured person will receive 100% of the sum insured in case of accidental death of the insured person.
  • Permanent Total Disablement: The insured person will receive 100% of the sum insured in case he/she is left with permanent total disability.
  • Permanent Partial Disablement: The insured person will receive a specific percentage of the sum insured in case he/she is left with permanent partial disability.
  • Additional Coverage: The plan also provides additional coverage to the insured person, such as:
    • Temporary total disablement
    • Accidental hospital costs
    • Education grant
Sum InsuredRs. 2,50,000 To Rs. 1,00,00,000
Eligibility

For Children: 3 Months To 35 Years

For Adults: 18 To 70 Years

Policy Period1 Year
For Accidental Death100% Of SI
For Permanent Total Disablement100% Of SI
Family Discount5%
Renewal Discount5%

Why Should You Bank On Health Insurance Plans From Edelweiss?

  1. 3281+ Network Hospitals: Edelweiss has more than 3281 network hospitals, where the insured members can avail cashless facilities. While Edelweiss benefits the insured by charging a lower charge to network hospitals, the hospitals benefit by receiving more patients through the health insurance company’s network.

    So, there is no need to worry about making financial arrangements at the last minute. The Edelweiss pays the hospital bills directly, relieving the insured of the financial burden. Furthermore, the insured person receives the medical treatment he or she desires without sacrificing its quality.
  1. Healthy Solvency Ratio: A solvency ratio is a critical indicator for determining an organization’s capacity to meet debt and other obligations.

    As per IRDAI, it is mandatory for all insurers to maintain a healthy solvency ratio of 1.5. When talking about Edelweiss, the company has a solvency ratio of 2.36, as of March 2020. Thus, we can say that Edelweiss has a positive net worth and has a sustainable debt load.
  1. Lifelong Renewability: The plans of Edelweiss have the option of being renewed for a lifetime. With the lifetime renewability provision, the insured can assure that the policy can be renewed indefinitely, regardless of age or other restrictions. The benefit of lifetime renewability relieves financial stress for senior citizens in the event of a medical emergency.
  1. 24/7 Quick Customer Support: You can call Edelweiss toll-free number at any time to solve your query. Moreover, the company also allows customers to connect at support@edelweissinsurance.com.
  1. Fast & Easy Process: Whether you wish to purchase a health insurance plan or you wish to file a claim, Edelweiss has made it all easy and fast for the customers. The purchasing and claiming process is so smooth that the customers feel like it is just a piece of cake.

How To Calculate The Premium For Edelweiss Health Insurance Plans?

Edelweiss calculates the premium of its health insurance plans through the below-listed process.

  1. Visit the official website of Edelweiss.
  2. Click on the icon at the top right corner and then click on “Products”.
  3. Click on “Health Insurance” under the “Products” tab.
  4. Enter all the necessary details under the “Get Quote” tab and then click on “Get Quote”.
  5. The premium amount will be displayed on the screen as per the sum insured option you have chosen.

Here are the sample premium prices.

AgeNumber Of KidsCoveragePremium Amount
29 Years13 Lakhs
  • Silver: Rs. 7277.65
  • Gold: Rs. 12, 310.35
28 Years110 Lakhs
  • Gold: Rs. 15,098.10
  • Platinum: Rs. 21,602.85
27 Years220 Lakhs
  • Gold: Rs. 24,235.72
  • Platinum: Rs. 30,430.72

What’s The Buying Process Of Edelweiss Health Insurance Plans?

ONLINE METHOD

  1. Visit the official website of Edelweiss Health Insurance.

  2. Click on ‘Health Insurance’.

  3. Enter the details and click on “Get Quote”.

  4. A number of plans will be displayed to you on the screen. Choose any one suitable plan and pay the premium.

  5. Once you are done with your payment, your policy details will be sent to you at your registered mail address.

OFFLINE METHOD

  1. Pay a visit to the branch or phone the toll-free number.

  2. The company’s customer executive will assist you in determining an appropriate plan for you.

  3. Submit all required paperwork.

  4. Make the premium payment.

  5. That’s all there is to it! An original copy of your policy will now be sent to you.

How To Settle Claims For Edelweiss Health Insurance Plans?

CASHLESS CLAIM

  1. Informing The Company: No matter whether it is planned hospitalization or emergency hospitalization, inform the insurance company as soon as possible.

  2. Submit Documents: Now, you need to submit all the essential documents, such as discharge summary, claim form, etc. to the insurance provider.

  3. Verification: Once submitted, your documents will be verified by the company.

  4. Claim Settlement: Now, the company will directly pay the hospital for your expenses.

REIMBURSEMENT CLAIM

  1. Inform The Company: You can either call at the toll-free number of the company or you can pay a visit to the branch office of Edelweiss.

  2. Submit Documents: Submit all the essential documents to the insurance company, such as invoices, doctor’s reports, etc.

  3. Analysis & Verification: The insurance company will then analyze your case and verify your documents for approval.

  4. Settling The Claim: Once approved, Edelweiss Insurance company will then reimburse a specific amount to the registered bank account of the insured person.

Frequently Asked Questions

1. How can I contact Edelweiss Health Insurance company?

You can either call them at their toll-free number 1800 12000 or landline number 022 423 12000. You can also contact the company by mailing at support@edelweissinsurance .com.

2. How many claims can you make with Edelweiss health insurance in a year?

There is no limit to how many claims you can file in a policy year. The number of claims, however, should not exceed the sum insured limit.

3. Does Edelweiss Health Insurance offer a pre-policy medical health check-up?

Yes, there is a place where you can get a health check-up. If the policyholder is 18 years old or older, Edelweiss General Insurance will provide a health check-up after each claim-free year.

4. Does Edelweiss General Insurance offer a portability feature?

Yes, Edelweiss General Insurance offers policyholders the option of portability. With this tool, you may effortlessly migrate your plan into Edelweiss General Insurance in accordance with IRDA regulations, without losing any continuity benefits.

5. When do I need to notify the insurer so that the claim can be properly settled?

In the case of emergency hospitalization, you must notify the hospital within 48 hours, and in the case of a scheduled hospitalization, you must notify the hospital 72 hours in advance.