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Individual Health Insurance Plans

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Kotak Mahindra Health Insurance

Kotak Mahindra General Insurance is a complete subsidiary of Kotak Mahindra Bank Ltd, a trustworthy and famous bank of India that has promised to serve the needs of the individuals by providing different health insurance plans and securing the lives of its policyholders. Kotak Mahindra General Insurance was licensed in the year 2015 and since then it has been serving the insured faithfully. Apart from health insurance plans, it has come with a wide array of insurance policies such as motor insurance, car insurance, two-wheeler insurance, home insurance, and some more.

Key Highlights of the Company

Here is a list of key highlights.

ParametersKey facts
Incurred claim ratio (in the financial year of 2019-2020)49.22%
Number of policies sold (in the financial year of 2019-2020)31,228
Solvency Ratio (March 2020)2.13
Premium underwritten (in the financial year of 2019-2020)433.39 crores
Network Hospitals4000+
Branches across the country19 branches (as of 2020)
Awards and Recognitions
  • Marketer Company of the Year – India Insurance Summit and Awards 2020.
  • ANA ECHO International Awards 2020, USA – Bronze, Consumer Services.
  • Brand Equity Shark Awards 2019 – Silver, Special Award for Gender Parity.
    • 2 Silvers – Best Consumer Engagement and Best in Financial Service.
    • 3 Bronze – Best use of social media, innovative use of technology, and best in consumer services.

Kotak Mahindra Health Insurance Plans

This company has come up with a bundle of health insurance policies with varied benefits to cater to the needs of different individuals. Each plan helps to protect the policyholder against the medical expenses incurred to him/her due to health hazards and also provides a secure and safe life. Let us look at the below table to find out different plans offered by Kotak Mahindra.

Plan typeThe plans offered by Kotak Mahindra
Critical Illness Specific InsuranceKotak Secure Shield
Family Floater Health InsuranceKotak Health Care
Kotak Health Premier
Arogya Sanjeevani Policy
Saral Suraksha Bima
Personal Accident Insurance PolicyKotak Accident Care
Top up PlanKotak Health Super Top Up Plan
Corona Specific Insurance PlanCorona Kavach Policy
Corona Suraksha Policy

Brief description of each plan

Let’s talk about each plan for better understanding.

1. Kotak Secure Shield Plan

This type of policy is ideal for those who want to safeguard themselves and their family members against the medical expenses arising out of the treatments of critical illnesses. Apart from the critical illness benefit, this plan comes with many other advantages as Kotak Mahindra vows not to compromise with the wellness of health.

Eligibility Criteria:

Entry ageMinimum – 18 years, Maximum – 65 years
Policy period1,2,3 years
Free Look Period15 days

Key highlights of the plan:

  • If you are diagnosed with or go under any medical procedure for the first time for any pre-specified critical illnesses, the company will pay you a lump sum Sum Insured that will ease out your financial burden.
  • If the insured person suffers any permanent disability or in case of his/her sudden unfortunate demise due to an accident, the family members will receive the accident benefit on the behalf of the company.
  •  In case of sudden demise or the permanent disability of the insured person, this policy will provide child education benefits that will help the child to continue his/her study without any obstacle.
  • If the insured person loses a job and if there is any financial liability in the form of a loan, the policy will provide the loss of job benefit that is subject to a maximum limit of 3 EMI amount due against the declared loan.

2. Kotak Health Care Plan

This plan helps you and your family to stay protected against the medical expenses arising out of different diseases, illnesses, and ailments. This plan comes with three different variants – Excel, Platinum, and Prime.

Eligibility Criteria:

Minimum Entry Age

For Individuals – 5 years

For Floater – 91 days

Maximum Entry Age

For individuals – 65 years

For Floater – 65 years

For Dependent Children – 25 years

Policy term1, 2, 3 years
Sum insured

Excel – 2 lakhs, 3 lakhs, and 4 lakhs

Platinum – 5 lakhs, 10 lakhs, 15 lakhs, 20 lakhs, and 25 lakhs.

Prime – 10 lakhs, 15 lakhs, 20 lakhs, 25 lakhs, 50 lakhs, 75 lakhs, and 100 lakhs.

Key highlights of the plan:

  • This plan offers hospital daily cash benefits, donor expenses benefits, and convalescence benefits.
  • On the renewal of the policy, you can avail of a cumulative bonus benefit on every claim-free year that is subject to 10% of the sum insured and up to a maximum limit of 50% of the sum insured.
  •  Critical illness cover is available with the policy.
  • You can also avail of the facility of free health check-ups in the network hospitals of the company if the insured member is above 18 years of age.

3. Kotak Health Premier

It is a comprehensive health insurance policy that not only safeguards you from medical expenses but also offers you rewards and value-added benefits to ensure you always remain protected.

Eligibility Criteria:

Entry age

Minimum entry age – For child: 91 days

For adults – 18 years

Maximum entry age – For dependent child: 25 years

For adults – 65 years

Exit ageNo upper limit
Policy period1, 2, 3 years

Key highlights of the plan:

  • This plan offers cover for medical expenses like ICU charges, room rent, operation theatre charges, doctor fees, and many more only for the hospitalization of a minimum of 24 hours.
  • 405 day care procedures are covered under this plan that requires less than 24 hours of hospitalization.
  • One can avail of the facility of a second E-opinion on medical conditions multiple times within the policy period.
  • This plan covers up road ambulance cover, organ donor benefit, AYUSH treatment cover, domiciliary hospitalization cover.
  • Maternity cover, newborn baby cover, and vaccination cover are available but all three covers have to be taken altogether.

4. Kotak Arogya Sanjeevani Policy

It is a standard health policy that provides protection to the individual and to the family at an affordable premium rate.

Eligibility Criteria:

Entry age

Adults – 18 years to 65 years

Dependent children – 3 months to 25 years

Policy period1 year
Sum insuredRs. 50,000 to 10 lakhs

Key highlights of the plan:

  • Under this policy inpatient hospitalization and daycare expenses are covered up to the sum insured that is subject to the sub-limits of the company.
  • Road ambulance charge for emergency medical transportation from one hospital to another is provided up to Rs. 2000 per hospitalization.
  • AYUSH treatment cover is available with the policy.
  • A fixed co-payment of 5% is applicable for all claims and ages in this policy.

5. Kotak Saral Suraksha Bima

Eligibility Criteria:

Entry age

Adults – 18 years to 70 years

Dependent children – 3 months to 25 years

Policy year1 year
Sum insured2.5 lakhs to 1 crore

Key highlights of the plan:

  • If the insured person meets an accident and he/she dies within 12 months of that accident due to the same, this policy offers a benefit equal to 100% of the sum insured.
  • Due to an accident, if the insured faces permanent total disability within 12 months of that accident during the policy period, a benefit equal to 100% of the sum insured will be offered by the policy.
  •  Different optional covers like temporary total disablement, education grant benefit, and coverage for hospitalization expenses due to an accident are available under this policy.

6. Kotak Accident Care

This plan is specially designed to provide you financial protection against the different medical expenses if you face any accident. This plan offers a wide array of benefits and you can also customize the plan according to your requirements.

Eligibility Criteria:

Entry age5 years to 65 years
Policy year1, 2, 3 years
RenewabilityLifelong renewals

Key highlights of the plan:

  • If the insured person faces any unforeseen unfortunate demise or permanent total disability or permanent partial disability or temporary total disability due to an accident, this policy offers a lump sum amount to cover the loss.
  • Accidental hospital daily cash benefit is available with the policy that offers a fixed amount on a daily basis during the period of hospitalization.
  • The policy provides a convalescence benefit that offers a fixed sum of Rs. 10,000 for the hospitalization for continuous 10 days.
  • This plan comes with a bundle of optional covers from which you can choose according to your convenience. Such covers are carriage of the dead body, children’s educational grant, ambulance charges, funeral extension expenses, and a few more.

This super top-up policy works as an extension of the existing health insurance plan to provide the insured person additional adequate benefits to keep him/her protected. It enables the policyholder to avail of larger coverage and multiple benefits at an affordable premium rate.

Eligibility Criteria:

Long term cover2 years and 3 years
Tax benefitAvailable
Pre-hospitalization medical expenses coverUp to 30 days
Post-hospitalization medical expenses coverUp to 60 days

Key highlights of the plan:

  • Road ambulance cover for the emergency transportation from one hospital to another is available with this policy up to Rs. 2000 per hospitalization.
  • 405 daycare treatment expenses and organ donor costs are covered by the policy.
  • AYUSH treatment cover is available that is subject to a maximum limit of Rs. 50,000.
  • The policy offers an additional sum insured over and above the base sum insured to provide coverage for the inpatient hospitalization expenses arising out of an accident that is subject to a maximum limit of 40 lakhs.

8. Kotak Corona Kavach Policy

In the face of the global pandemic, Kotak Mahindra has included Corona Kavach Policy to protect those individuals who are diagnosed positive of Covid-19 and need treatments for that in order to fight against the contagious coronavirus.

Eligibility Criteria:

Entry age

Adults – 18 years to 65 years

Dependent children – 1 day to 25 years

Policy period3.5 months, 6.5 months, and 9.5 months
Pre-hospitalization medical expenses cover15 days
Post-hospitalization medical expenses cover30 days
Sum insuredRs. 50,000 to 55 lakhs

Key highlights of the policy:

  • Hospitalization expenses arising out of the medical treatments of Covid-19 on positive diagnosis are covered by this policy. The insured has to do the diagnostic test in any government or government-authorized center and the duration of the hospitalization should be at least 24 hours.
  • AYUSH and road ambulance cover is available with the policy.
  • Home care treatment expenses are taken care of by the policy up to a maximum limit of 14 days.
  • One can avail of the facility of hospital daily cash (optional benefit), subject to a maximum limit of 14 days during a policy period for each insured person. In this case, he/she will be paid 5% of the sum insured per day for every 24 hours of continuous hospitalization due to the treatment of Covid-19.

9. Kotak Corona Rakshak Policy

It is also a standard corona-specific policy that offers a lump sum amount on the diagnosis or treatment for Covid-19.

Eligibility Criteria:

Entry age18 years to 65 years
Waiting period15 days
Policy period3.5 months, 6.5 months, and 9.5 months
Sum insuredRs. 50,000 to 2.5 lakhs

Key highlights of the policy:

  • If the insured person is diagnosed positive for Covid-19 from any government or government-authorized center and requires a continuous hospitalization for at least 72 for the same, the company pays a lump sum amount that is equal to 100% of the sum insured.
  • Once the lump sum amount is paid, the policy will be terminated automatically.
  • Lifelong renewability, portability, and migration are not available with this policy.

Why should Kotak Mahindra be your no.1 choice for health insurance?

As the market is filled with different health insurance companies, it has become difficult to find a suitable and proper health insurance company that can fit your needs. But, if you can keep in your mind a few parameters while choosing a health insurer, your job will be easier. And, after evaluating all the potential parameters, it has been found that Kotak Mahindra Health Insurance can be the ideal one for you. Let us find out the reasons briefly.

  • Network hospitals – As you know that for availing of the cashless facility, you need to get admitted to a network hospital of the company, the number of network hospitals has become a primary parameter. Additionally, you cannot cover a wide distance at the time of a medical emergency. Kotak Mahindra has more than 4000 network hospitals all over India. That not only enables you to find a network hospital in your vicinity but also gives you an opportunity to find a good hospital to get the best facilities.
  • Types of policies – Kotak Mahindra has come up with a wide range of health policies to suit the varied needs of individuals. Under this company, you can not only protect yourself and your family against the financial expenses arising out of different health hazards but also safeguard your family from different 18 critical illnesses, accidents and Covid-19 with many other extended benefits. Under Kotak Mahindra, you will get a number of options of health plans to choose from according to your convenience.
  • Annual premium – the amount of market share denotes the strength of the company to handle the financial situations. According to the IRDA Annual Report, the premium underwritten in the financial year of 2019-2020 by this company is 433.39 crores which is a handsome amount in respect to the other health insurers. Therefore, once you buy a health policy from Kotak Mahindra, you remain safe and secure.
  • Claim settlement ratio – We purchase health plans to avail of the benefits when it is most needed. So, the claim settlement ratio reflects the likability of your claims to be settled. As per the IRDA Annual Report, the claim settlement ratio of Kotak Mahindra is 49.22% in the financial year of 2019-2020, which is quite good and makes this company a reliable one. 
  • Network system – As of September 2020, Kotak Mahindra Health Insurance has 19 branches spread across PAN India and 793 employees along with a wide number of licensed individual agents and corporate agents. So, you can find this company easily within your vicinity and purchase any insurance plan smoothly. 
  • Solvency ratio – The solvency ratio stands for the capability of the company to meet its long-term financial obligations. If the ratio is high, that means the company is potential enough to pay off the lump sum claim amount. According to the IRDA Annual Report, the solvency ratio of Kotak Mahindra is 2.13 as of March 2020, which is higher than many other health insurers. So, this company must be there on your bucket list.
  • Customer support – To get connected with this company, you are provided with a number of options. It has a toll-free number and you can also email them. Their customer service is 24×7 open for you. So, whenever you need, Kotak Mahindra is right beside you.

How to purchase health insurance from Kotak Mahindra?

You can buy a health plan from Kotak Mahindra both online and offline according to your preference.

Online process:

If you want to purchase the health plan online, follow the below-mentioned steps.

  • Go to their official website and click on the ‘health Insurance’ option.
  • Then you have to put certain personal details such as for whom you want to buy, family members to be insured, date of birth and some more and then submit the form.
  • After that, you need to select your desired health plan. You can also customize the plan according to your requirements if this option is available.
  • The premium details will be displayed before you.
  • Make the payment of the premium amount.
  • Upon successful payment, the policy details will be mailed to your registered email ID.

Offline process:

If you are more comfortable with the offline buying process, visit the company’s nearest branch and their experts will guide you seamlessly throughout the buying process.

You can also contact one of their registered agents or brokers to purchase a health plan easily.

If you need any help with buying a health plan, you can call their customer service, they will guide you through the entire buying process effortlessly.

You can renew your health product online at any time by following the below-mentioned easy steps.

  • At first, go to their official website and on the right side of the page, there will be a ‘Renewal’ option. Click on that.
  • Then you have to select a product (insurance plan) for renewing and submit.
  • After that, you need to put certain details such as policy number, mobile number, date of birth.
  • After putting in all the required details submit the form.
  • The renewal amount will be displayed on the screen. Pay the amount.
  • Upon successful payment, the confirmation message will be sent to your registered mobile number or email ID.

Apart from this, you can also call the customer service of the company, to get assistance from the experts of the company throughout the renewal process.

Premium calculation for Kotak Mahindra Health Insurance

Depending on the sum insured and the premium amount paid for that, you can avail of the benefits of the policy. So, it is important to know how to calculate the premium. Follow the below-mentioned steps to know the process.

  • Go to the official website of the company and click on the ‘Health Insurance’ tab.
  • Provide the details as required such as type of the policy, the number of the members to be insured, sum insured, personal details, date of birth, etc.
  • After that, click on the ‘Submit’ option.
  • The premium amount based upon your given details will be displayed to you.

For better understanding, let us take an example. Mr. Kapoor has opted for Kotak Secure Shield Plan for himself only. He is a 36 years old businessman. Let’s find out how much he has to pay as premiums for different sum insured amounts.

Sum insuredAge of the insurerPolicy typeZone/stateAnnual Premium Amount
10 lakhs36IndividualKolkata, West BengalRs. 3836.14
5 lakhsRs.1918.07

How to file a claim for Kotak Mahindra health insurance?

Kotak Mahindra offers you two methods to file your claim – Cashless settlement and Reimbursement claim settlement. Keep an eye on the below-mentioned steps to know about the claim procedure for both.

Cashless claim settlement process:

  • For availing of the cashless claim facility, you need to get admitted to a network hospital of the company.
  • For pre-planned hospitalization, you must inform the hospital 48 hours prior to the hospitalization. There you need to submit a duly filled and signed pre-authorization claim form along with your valid ID proof and other required medical documents. 
  • For emergency hospitalization, go to the cashless desk of the hospital and submit the duly filled and signed pre-authorization form along with ID proof and other necessary medical documents at least within 24 hours of the hospitalization.
  • The hospital will contact the company for the approval of the treatment.
  • The company will evaluate your claim and if approved, Kotak Mahindra will settle the claim amount directly with the hospital.
  • If the cashless claim is not approved, you have to pay all the bills and then you can apply for a reimbursement claim.

Necessary documents for a cashless claim:

  • Health card of the policyholder
  • Valid photo ID proof
  • Original policy document
  • All the pre-hospital documents of medical records, reports, and prescriptions.
  • Any other document if required.

Reimbursement claim process

  • If you have received treatments in a non-network hospital, you can file for reimbursement.
  • Inform the hospital about the event of hospitalization at or you can also call on 1800-266-4545 for the same.
  • You need to settle all the bills of the hospitals and collect and preserve all the documents.
  • Submit all the required documents along with the duly filled and signed claim form within 30 days from the discharge from the hospital.
  • The company will evaluate and verify your claim. Remember, do not provide any wrong information to the company and co-operate with the same.
  • If the claim is approved, the amount will be settled within 15 days by the company.

Required documents for reimbursement claim:

  • Duly filled and signed authorization form.
  • Policy document
  • Pan card of the policyholder
  • Valid address proof and ID proof with 2 passport size recent photographs.
  • Hospitals discharge certificates, certificates of other doctors, surgeons.
  • Original medical investigation report or the survey report.
  • Valid details of the disease or ailment.
  • All the prescriptions, pharmacy, hospital, medical bills are in their original form.
  • Canceled cheque, copy of bank passbook/statement.
  • Any other document if demanded by the company.

Address for health claims (TPA details):

Family Health Plan Insurance TPA Limited

Srinilaya – Cyber Spazio, Suite # 101,102,109&110

Ground Floor,Road No. 2, Banjara Hills

Hyderabad: 500034

Telangana, India

Frequently Asked Questions

In that scenario, the hospital will raise a request to the company to increase the approved amount during the period of treatment. This request will be assessed by Kotak Mahindra and the additional approval is subject to the policy’s terms and conditions and the availability of the sum insured.

For cashless claims, the company takes only 6 hours after receiving the complete documents and details to convey their opinion. For the reimbursement claim, after receiving the complete documents, the company starts the processing within 15 days.

In this scenario, you have to submit the original documents of one of the companies. Once the claim is settled, you need to obtain certified original copies of documents along with a settlement letter. Then you need to submit the same to the other insurer for the claim.

Yes, you can avail of the tax benefits on the amount of the premium for Kotak Mahindra Health Insurance Policies under Section 80D of the Income Tax Act.

No. you can file the claim as many times as you want but that should not exceed the sum insured.
Yes, you have to bear the expenses first. Then, if the policy is accepted by the company and issued, then 50% or 100% of the incurred expenses will be taken care of by Kotak Mahindra.

Under this circumstance, the waiting period is 48 months only if the policy is continued without any break.

Under this circumstance, the waiting period is 48 months only if the policy is continued without any break.

Yes, a legally adopted child can be covered under this policy.
Yes, a legally adopted child can be covered under this policy.

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