Kotak General Super Top Up Insurance

Kotak General Super Top Up Insurance

Buy Kotak General Super Top Up Insurance plan

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With Kotak Health Super Top Up, a top up health insurance plan you can get higher health insurance coverage at affordable rates. The Super Top Up policy works alongside the basic health insurance policy and enhances it to provide a larger coverage at a much lower premium. The initial expenses (called deductible) can be covered under your existing policy (personal or corporate) or borne by you. Once this deductible amount is crossed, Super Top Up Insurance becomes active and pays the excess amount. This means, you can still opt for our health insurance top up plan even if you don’t have any existing health insurance.

Kotak General Health Insurance Review

Kotak General Health Care Insurance
Kotak General Insurance sum insured
2 lac - 25 lacs
Incurred Claims Ratio *
47.00%
Kotak General Insurance tenure options
1 or 2 years options available
Claims Settlement Ratio **
100.00%
List of network hospitals
3900+ hospitals
Number of policies issued *
349,931
Maximum family floater coverage
Self, Spouse + dependent children + parents
Number of lives covered *
4,39,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Kotak General Super Top Up Insurance benefits

  • Key Benefits
  • Exclusions

Key Benefits

Following are the key benefits you get with our super top up health insurance plan Sum Insured Options : ₹ 3lacs to ₹25 lacs

In Patient Treatment : Covers medical expenses arising out of minimum 24hrs of hospitalization

Day Care Treatment : Covers medical expenses arising out of listed 405 day care procedures

Pre & Post Hospitalization : Covers upto 30 days of pre & upto 60 days of post hospitalization medical expenses

Ambulance Cover : Covers ambulance expenses of upto INR 2000 per hospitalization

Organ Donor Cover : Covers hospitalization expenses of the donor in case of an organ transplant

Alternative Treatment : Covers medical expenses arising out of treatments related to Ayurveda, Unani, Sidha, etc. upto INR 50,000/-

Restoration of Sum Insured : 100% restoration of the sum insured for claims due to unrelated illness in a Policy year

Double Sum Insured for Hospitalization due to Accident : Additional sum insured over & above base sum insured to cover in-patient hospitalization expenses in the event of an accident subject to maximum payout of 40 lacs

Cumulative Bonus : 10% additional annual sum insured for every claim free year upto a maximum of 50%

Exclusions of Kotak General Super Top Up Insurance

Below is a list of our permanent exclusions, 30-days exclusions, 2-year exclusions, and 4-year exclusions:
  • Permanent Exclusions: Certain specified illnesses, procedures or treatments like routine health check-ups, dental treatments, aesthetic or cosmetic surgeries, injury or illness due to abuse of intoxicating substances, etc., are permanently excluded from the scope of coverage.
  • 30-Day Exclusions: This includes any illness contracted or medical expenses incurred within 30 days of commencement of the policy unless due to an accident. This exclusion doesn't apply to the renewal of a policy with us or to anyone whose policy has been accepted under the portability benefit.
  • 2-Year Exclusions: This exclusion includes medical expenses incurred for certain specified illnesses or conditions like Hernia, Fissures/Fistula, Arthritis, Gout etc. during the first 2 consecutive years of the commencement of the policy. The following illnesses/medical conditions shall fall under 2-year exclusions: Cataract; Benign Prostatic Hypertrophy; Myomectomy, Hysterectomy unless because of malignancy; All types of Hernia, Hydrocele; Fissures and/or Fistula in anus, haemorrhoids/piles; Arthritis, gout, rheumatism and spinal disorders; Joint replacements unless due to accident; Sinusitis and related disorders; Stones in the urinary and biliary systems; Dilatation and curettage, Endometriosis; All types of skin and internal tumours/cysts/nodules/polyps of any kind including breast lumps unless malignant; Dialysis required for chronic renal failure; Surgery on tonsillitis, adenoids and sinuses; Gastric and duodenal erosions and ulcers; Deviated nasal septum; Varicose Veins/Varicose Ulcers.
  • 4-Year Exclusions: This exclusion applies to any pre-existing disease at the time of buying the policy. Any such pre-existing disease will not be covered for a period of 48 months of continuous coverage.
  • Costs of routine medical, eye or ear examinations preventive health check-ups, spectacles, laser surgery for correction of refractory errors, contact lenses, hearing aids, dentures or artificial teeth,
  • Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, crutches, instruments used in treatment of sleep apnoea syndrome or continuous ambulatory peritoneal dialysis, (C. A. P. D.) and oxygen concentrator for bronchial asthmatic condition, cost of cochlear implant(s) unless necessitated by an
  • Expenses incurred on all dental treatment unless necessitated due to an Accident
  • Any naturopathy treatment, acupressure, acupuncture, magnetic and such other therapies
  • Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident
  • Sterility, venereal disease or any sexually transmitted disease;
  • Intentional self-injury (whether arising from an attempt to commit suicide or otherwise) and Injury or Illness due to use, misuse or abuse of intoxicating drugs or alcohol
  • Any expenses incurred on treatment of mental Illness, stress, psychiatric or psychological disorders;
  • Any aesthetic treatment, cosmetic surgery or plastic surgery including any complications arising out of or attributable to these, unless necessitated due to Accident or as a part of any Illness;
  • Any expenses incurred on treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy, childbirth, miscarriage, abortion or complications of any of these, including caesarean section) and any fertility, infertility, sub fertility or assisted conception treatment or sterilization or procedure, birth control procedures and hormone replacement therapy. However, this exclusion does not apply to ectopic pregnancy proved by diagnostic means and which is certified to be life threatening by the Medical Practitioner
  • Treatment relating to Congenital External Anomalies
  • All expenses arising out of any condition directly or indirectly caused to or associated with Acquired Immuno Deficiency Syndrome (AIDS) whether or not arising out of HIV, Human T-Cell Lymphotropic Virus Type III (HTLV–III or IITLB-III) or Lymphadinopathy Associated Virus (LAV) or the Mutants
  • Expenses on supplements, vitamins and tonics unless forming part of treatment for Injury or Illness as certified by the attending Medical Practitioner
  • Costs incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose
  • Any Claim directly or indirectly related to criminal acts
  • Any treatment taken outside India
  • Any treatment taken from anyone not falling within the scope of definition of Medical Practitioner. Any treatment charges or fees charged by any Medical Practitioner acting outside the scope of licence or registration granted to him by any medical council
  • Non- allopathic treatment; unless covered under extension ‘Alternative treatment’
  • Any Injury or Illness directly or indirectly caused by or arising from or attributable to war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority

Disclaimer:“For the detailed list of exclusions under the policy, kindly refer to the same provided in your policy kit”)

Kotak General Health Insurance FAQ’s

The pre-hospitalisation claim documents duly completed should be submitted at the following address within 15 days from the date of discharge. All post-hospitalisation claim documents should be submitted within 30 days from the date of completion of treatment, or expiry of the post-hospitalisation period as per the Policy, whichever is earlier.

The following documents are required for the processing of reimbursement claims:

  • Claim form duly filled and signed by the insured and attending doctor
  • All treatment papers of current ailment mentioning first symptoms and date of occurrence of the ailment, previous treatment papers (if any)
  • Discharge card from the hospital
  • All original medical investigation reports (viz. X-ray, ECG, blood test, etc.)
  • Original hospital bills and receipts
  • Original bills of chemist, medical practitioner, medical investigation, etc. supported by prescriptions
  • NEFT details: Cancelled cheque of policy holder, copy of blank passbook/statement of policy holder if cancelled cheque does not contain name of the policy holder, and copy of the PAN card of the policy holder
  • Know Your Customer (KYC) details viz. address proof, photo ID, and 2 recent passport size photographs (applicable for claim amounts overRs.1 lakh)

You need to submit the original documents to one of the insurance companies. After settlement of the claim, you need to obtain certified true copies of the documents along with a settlement letter and submit the same to the other insurer for the claim.

  • Reimbursement Claim: These claims shall be processed within 15 working days from the receipt of complete documents. Complete documents means submission of all medical documents as mentioned in the claim procedure along with all previous treatment papers (if any).
  • Cashless Claims: We shall convey our decision on the cashless mode within 6 business hours from the receipt of complete details. Complete details means submission of pre-authorisation form with information viz. provisional / final diagnosis, estimated treatment expense, length of stay & past medical history (if any) and duly signed by the treating doctor.

Brochure

Review Kotak General Super Top Up Insurance brochure to understand coverage details.


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Proposal form

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Policy wordings

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Network hospitals

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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