Health Insurance

Health Insurance plans

Kotak Health Premier - Advantage

Name: Kotak Health Premier - Advantage
Brand: Kotak General Insurance Company Limited

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Introduction Verdict Pro’s & Cons Specific Exclusions About Insurer Detailed Ratings

Introduction to Kotak Health Premier - Advantage

Kotak Health Premier (Advantage) is a health insurance policy offered by Kotak General Insurance Company Limited. A health insurance plan promises to pay for hospitalization-related expenses. It acts as a protective shield for savings and healthcare, so you and your family can live a happy, fulfilling life. With Kotak’s Health Premier (Advantage) Plan, you can ensure that you and your loved ones have access to the medical care needed without worrying about the financial burden of unexpected medical expenses.

Verdict: Kotak Health Premier - Advantage

This plan is a cost-effective option when compared to other products available in the market, making it a budget-friendly choice. Although it covers essential expenses like hospitalization, maternity costs, and more, it falls short of providing comprehensive coverage. It excludes coverage for non-medical expenses or the costs of consumables such as gloves, oxygen masks, nebulization kits, and similar items. Additionally, it places sub-limits on common treatments like cataract procedures, potentially resulting in substantial out-of-pocket expenses. Further, while it does offer various options for obtaining premium discounts, it does not provide the flexibility of paying premiums on a monthly basis. And, our research suggests that the insurer has received a higher number of complaints regarding claim settlements and policy purchases. This indicates a poor track record in terms of both purchasing and claiming services.

Pros & Cons: Kotak Health Premier - Advantage

Cheaper than other products in the market
No restrictions on the type of hospital room you choose
Covers expenses associated with pregnancy
Multiple options available for getting premium discounts
Cashless facility available for Health Check-Up

Monthly premium payment mode not available
Sub-limits on common treatments like cataract, etc.
Received higher number of complaints during policy purchase compared to other insurers
Received higher number of complaints on claim settlement compared to other insurers
Our study observed their responses on Twitter to be relatively slower than other insurers

Specific Exclusions: Kotak Health Premier - Advantage

01 Prosthesis or external equipments of any kind used for diagnosis or treatment except due to accident

02 Elastic stockings, diabetic test strips, and other similar medical supplies

03 Dental treatment except for treatment required due to an accident

04 Expenses related to acupressure, acupuncture, magnetic and other similar therapies

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About Kotak General Insurance Company Limited

Kotak General Insurance Company Limited is a 100% subsidiary of India’s fastest growing bank, Kotak Mahindra Bank Limited. It offers a wide range of general insurance products including health, car and bike Insurance. It was founded in 2015 and is headquartered in Mumbai, Maharashtra. Mr. Suresh Agarwal is the company's CEO and MD.

Founded in

2015

JV Partners

Turnover (GWP)

106.77 Crores

Number of Policies

2,57,451

Number of Claims

47,768

Detailed Product Specs: Kotak Health Premier - Advantage

Claims Experience advisor

Customer Service advisor

Product Benefits (10L Sum Insured) advisor

Limits and Exclusions advisor

% of claims settled in less than 30 days

Reflects on the speed of settling valid claims

87.29%

% of Complaints received on overall claims

% customers unhappy with claims experience

0.18%

Claims Incurred Ratio

57.14%

Claim Settlement Ratio (No. of claims)

What % of the claims received were paid?

71.04%

No. of Cashless Hospitals

7700+

Notes

1- The health insurance data was last updated in September 2023. All data has been sourced from product brochures, policy wordings, prospectus, public disclosures (Q1, FY 2023-2024), insurer websites, and the IRDAI website.

2- The Claims Settlement Ratio data is taken from NL-37, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the number of claims settled by the sum of claims outstanding at the beginning of the year and claims reported during the year.

3- The data related to claim complaints and policy purchase complaints is taken from NL-45, insurer public disclosures (Q1, FY 2023-2024).

4- The Solvency Ratio data is taken from NL-26, insurer public disclosures (Q1, FY 2023-2024).

5- The data related to claims settled within 30 days is taken from NL-39, insurer public disclosures (Q1, FY 2023-2024).

6- The Claims Incurred Ratio data is taken from NL-4 and NL-5, insurer public disclosures (Q1, FY 2023-2024). It is calculated by dividing the Net Claims Incurred by the Net Earned Premium.

7- For now, we have considered the most comprehensive plans from leading insurance companies. We will keep updating the product pages with new plans in the coming days.

8- We have rated only those plans that can be serviced by individual advisors. This is because of our strong belief that health insurance customers need professional assistance from individual advisors before and after purchase. We do not recommend and hence do not rate direct-to-customer health insurance plans or plans where there aren't enough advisors available to service.

9- Affordability assessment of plans:

・The affordability of comprehensive plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1 opting for a cover of ₹10 Lakhs. And, the premiums are as of 30th September 2023.

・The affordability of Care Freedom Plan is assessed using premiums for a 30-year-old male residing in Zone 1 opting for a cover of ₹5 Lakhs. And, the premiums are as of 30th September 2023.

10- The product benefits section is based on a sum insured of ₹10 Lakhs and only highlights the top benefits and features of health insurance plans.

11- Only those hidden and special conditions that apply to the benefits and features we have considered are included on the product pages.

12- The product pages only include the most significant specific exclusions under each plan.

13- The product pages do not include any generic terms, conditions, or exclusions (those that are the same and apply to all health insurance plans).

14- If the policy wording, brochure, or prospectus states that a benefit/feature is available with a specific plan but it is not available online when generating the premium quote, we have not considered that benefit/feature to be available with the plan.

15- The response time on Twitter (Beta) was calculated using a sample set of tweets from February 2023 to August 2023 (analyzed in September 2023).

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