Kotak Mahindra Group Health Insurance

Kotak Mahindra Group Health Insurance

Claim settlement ratio (2019-20)

75.45%

Network hospitals

3976+

Total GHI lives insured (2020-21)

9.7 Lakhs

Total GHI claims incurred (2020-21)

Rs 30.15 Crores

TPA

External TPA

About Kotak Mahindra group health insurance

Kotak General Insurance provides comprehensive group insurance policies that are designed to protect employer-employee groups along with non-employer-employee groups like banks, credit societies, educational institutions, travel companies, etc. Considering the potential risks people are prone to in their daily lives, the Kotak Mahindra group health insurance policies offer superior coverage to the workforce/group members and their families against unexpected medical expenditures as well as accidental risks. 

With Pazcare, your Kotak Mahindra group health insurance experience becomes even better. We get you the best group health insurance quotes for your employees at pocket-friendly prices. Moreover, the HR/Admin can administer the Kotak Mahindra group health insurance in one place using our tech-enabled Pazcare dashboard. The employer dashboard can also be integrated with the HRMS tools. 

How to buy Kotak Mahindra group health insurance at Pazcare?

These simple steps allow you to purchase Kotak Mahindra group health insurance online at Pazcare.

  1. Visit https://www.pazcare.com/ and click on the products drop down and choose group health insurance
  2. Fill in the following information including your name, work email, phone number, company name and the number of employees you wish to insure. 
  3. After submitting this form, our health insurance consultant will contact you within 24 hours. Tell us your requirements for the tailor-made group health insurance policy. These include the type of policy, sum insured, and many more.
  4. After this we will get back to you with competitive quotes from Kotak Mahindra health insurance and a few other insurers.
  5. After you decide on the insurer and accept the terms and conditions of the policy, you process the payment.
  6. The onboarding process is carried out within 24 hours of making the payment. 

For more information, you can write to us at support@getpaz.com, You can also call our customer care at +91 78291 11300. We also provide an option to connect on Whatsapp using the number +91 81973 79596.

Types of Kotak Mahindra group health insurance plans

The Kotak Mahindra group health insurance has 8 plan types. They are

  1. Kotak Group Health Care

In the Kotak Group Health Care policy, you can get customised health insurance coverage for employees/group members and their dependents according to the company’s requirements. The policy is available at flexible and affordable. Companies can cushion the financial strain faced by their employees/group members due to unexpected medical expenses.

  1. Kotak Group Secure Shield 

In Kotak Group Secure Shield, a lumpsum benefit is provided on the occurrence of the specified list of critical illnesses. A lump sum benefit is also provided in case of death or disability due to an accident. This policy is usually beneficial for banks/financial institutions to protect the loan liability of the customers. When customers are diagnosed with critical illness or there is death/disability, the policy will take care of the loan liability of the customer.

  1. Kotak Group Accident Protect

Kotak Group Accident Protect is a comprehensive plan that financially protects every member of the company against the unexpected risks due to sudden death or disability. 

  1. Kotak Group Smart Cash

Kotak Group Smart Cash provides a fixed amount for hospitalisation every day, irrespective of the medical costs. This policy helps cover medical and non-medical expenses that are not covered under the basic health insurance policy.

  1. Corona Kavach Group Policy.

Corona Kavach Group Policy is a standard group policy that provides coverage against expenses incurred due to hospitalization for the treatment of Covid. The diagnosis must be proved to be Covid positive in a government-authorized diagnostic centre. 

  1. Kotak Covid-19 Secure

Kotak Covid-19 Secure is a group policy providing lumpsum benefits along with covering hospitalisation expenses in case of a positive diagnosis of Covid in a government-authorized diagnostic centre. 

  1. Kotak Group Smart Health

Kotak Group Smart Health is a comprehensive group insurance policy. It can be customised according to the requirements of the group. The policy also consists of various sections which can be taken as per the group requirements.

  1. Kotak Group Health Assure

Kotak Group Health Assure policy provides tailor-made health insurance coverage to the group members based on the group’s preferences. The policy helps to protect the financial liability faced by group members due to unforeseen medical emergencies.

Why choose Kotak Mahindra group health insurance as your insurance partner?

With more than 20 health insurance players in the market, here is why you have to choose the Kotak Mahindra group health insurance from Pazcare.

Easy claim settlement

With Kotak Mahindra group health insurance, you do not have to depend on the external TPA. The claim settlement is easy and quick with their in-house claim settlement team. The claims can be raised by calling their toll-free number or by just dropping an email. 

Larger health network

With a presence in around 2300+ cities and 10,000+ cashless network hospitals, Adiya Birla health insurance has a large healthcare network. A large network of cashless hospitals means the probability of one undergoing cashless treatment is higher.

High claim settlement ratio

The claim settlement ratio of the insurer has always been consistent. The claim settlement ratio of Kotak Mahindra health insurance is 70.81% for the year 2019-2020. A higher claim settlement ratio indicates that the insurer is more reliable and more credible. It also means high customer satisfaction.

No medical check-up is needed

Unlike your retail health insurance policy, the Kotak Mahindra group health insurance policy does not require a medical check-up before the policy is purchased. 

Kotak Mahindra group health insurance claim settlement ratio

A health insurance claim settlement ratio (CSR) is the ratio between the number of claims settled to the number of claims made or requested in a financial year by the health insurance company. 

Hence, a CSR ratio can be calculated as

Claim settlement ratio = Number of claims settled/Number of claims made*100

Financial Year Claim settlement ratio
2019-20 75.45%
2018-19 47%

Network hospitals of Kotak Mahindra group health insurance

All health insurance companies have a list of network hospitals or cashless hospitals, where one can claim cashless treatment. Larger the list of network hospitals, the higher the chances of finding a cashless network hospital near your location. Kotak Mahindra group health insurance has around 10,000+ network hospitals located in pan India. This makes sure that you can get high-quality treatment near your location and you will be able to file for a cashless claim.

Claim Kotak Mahindra group health insurance

Kotak Mahindra group health insurance cashless claim

With Kotak Mahindra group health insurance you can make a cashless claim using the following steps.

Step 1: Fill out the pre-authorization letter

In case of planned hospitalisation, a pre-authorization letter is to be filled out by the insurer. This can be easily done by informing the employer. HR takes it forward by informing the insurance company. It is to be noted that the insurance company has to be intimated 48 hours prior to hospitalisation. 

In case of emergency hospitalisation, the insurance company has to be intimated within 24 hours of hospitalisation. This can be done by filling out the pre-authorization letter and submitting it to the insurance help desk in the hospital. 

Step 2: Seek treatment

Once the insurer approves the request, you can seek treatment free of cost. 

Step 3: Claim is settled

Along with the incurred expenses, the claim is settled directly to the hospital authority. 

Kotak Mahindra group health insurance reimbursement claim

In case you get hospitalised at a non-network hospital, the reimbursement claim from Kotak Mahindra group health insurance can be carried out by the following steps.

Step 1: Intimate the insurer

The insurer can be intimated through the toll-free number 1800 266 4545. The intimation can be done immediately on hospitalisation or the employer can be informed as well. 

Step 2: Register a claim

Once you pay the hospital bills initially, you can register a claim for the reimbursement process. However, the original bills have to be attached along with the claim form. 

Step 3: Claim under the reimbursement clause

Within a particular time frame specified in the policy, the reimbursement has to be claimed. Once the documents are verified by the insurer, the insurance company will transfer the money to the registered bank account of the insured. 

You can email us at support@pazcare.com, to guide you through the whole process. A 24X7 claim assistance is provided for your employees. 

Kotak Mahindra group health insurance renewal process

The Kotak Mahindra group health insurance can be renewed easily with Pazcare at end of your policy term. Here are the steps to renew your Kotak Mahindra group health insurance plan.

Step 1: Contact Pazcare and submit a form containing details like your name, name of the company, number of employees you wish to insure, work email address and phone number.

Step 2: Once the form is submitted, our consultants will get in touch with you. Since this is not a fresh policy, you will have to submit the following documents.

  • Data of the active employees - name, age, gender
  • Claim analysis report
  • Claim dump report from the insurer/TPA
  • Policy copy

Step 3: You can choose additional add-ons to your existing policy like dental insurance riders, maternity insurance riders to your existing policy. Furthermore, with Pazcare one can choose additional health and wellness add-ons to your Kotak Mahindra group health insurance. These add-ons include wellness and therapy sessions, unlimited doctor consultations, comprehensive check-ups, and many more.

Step 4: Our consultants will get back to you with the competitive quotes for your Kotak Mahindra group health insurance.  Based on your claims report and the add-ons you choose, your health insurance premium may vary from the previous financial year.

Step 5: The next step is to agree to the terms and conditions of the policy and pay the premium for your Kotak Mahindra group health insurance policy. After the renewal, the policy will be usually valid for a year.

Step 6: In case, you are purchasing your Kotak Mahindra group health insurance for the first time with Pazcare, the onboarding process will be carried out in 24 hours. During this period, our associate will get in touch with you and provide you with all the essential information to get started with your group health insurance. 

We make sure that your Kotak Mahindra group health insurance experience will be seamless using our Pazcare dashboard. Your employees can access their policy using Pazcare’s employee app which is available on both the app store and the play store. 

How is the Kotak Mahindra group health insurance premium calculated?

The Kotak Mahindra group health insurance premium is directly proportional to the risks involved. There are also certain factors which influence the premium for your group health insurance policy is calculated. They are -

Average age 

The premium is calculated based on the average age of the people insured. The younger the age, the lower the premium. This is because the older generation poses higher health risks. 

Type of plan opted

Different types of group health insurance policies opted are (E) employee only, (ESC) employee+spouse+children and (ESCP) employee+spouse+children+parents plans. The number of people covered under the ESCP plan is higher than the ones covered in the E plan. Hence, the premium will be higher when the scope of coverage is higher.

Nature of the job

The nature of the job one performs is also a factor considered to decide the annual premium. Jobs associated with more risks will have a higher premium compared to the lower-risk jobs. For instance, employees working in a factory will have higher group health insurance premiums than the ones working in the IT industry.

Sum insured

Sum insured is the maximum amount that an insurance company will pay you in case of any hospitalisation in a particular year. If the hospital expenses cross the sum insured, it will be paid by the policyholder itself. So the higher the sum insured, the higher the premiums paid towards the group health insurance policy.

Add-ons opted

The add-ons opted for say, maternity insurance riders, dental insurance riders along with the existing group health insurance policy will increase your group health insurance premium. The premium increases depending on the type of add-ons opted for.

Claims history

In the case of a group health insurance policy renewal, the claim history is considered to calculate the premium for that particular financial year. If the number of claims raised in a previous financial year is higher, then the premium towards the policy will increase during the policy renewal.

For instance, let a company named XYZ wants to renew their Kotak Mahindra group health insurance policy for 2022. The premiums paid by them for 2021 were ₹50,000. If the number of claims raised during 2021 is higher than that of 2020, then the premiums for 2022 will be greater than ₹50,000.

What is covered under your Kotak Mahindra group health insurance?

Your group health policy is tailor-made according to your preferences. Here is what your Kotak Mahindra group health insurance covers.

Accidental hospitalisation

Pre and post hospitalisation expenses are included for accidental hospitalisation. 

Emergency ambulance

Up to a certain fixed amount, ambulance services are covered which can be availed in times of emergency. 

Daily cash benefit for ICU

A certain amount is dedicated to daily hospital cash, which can be availed when you are admitted to the ICU. 

Personal accident cover

A personal accident cover is provided in the case of disability, injury or accidental death which can lead to sudden loss of income. 

Domiciliary expenses

The insured is covered for domiciliary expenses under the Kotak Mahindra group health insurance. Home nursing expenses are included under this policy as well. 

Convalescence benefit cover

Convalescence is the time period within which the insured goes through recovery from an illness or injury. Kotak Mahindra group health insurance provides a convalescence benefit for a smoother recovery. 

What is not covered under your Kotak Mahindra group health insurance?

Following are some of the exclusions of your Kotak Mahindra group health insurance - 

Employment duration 

As your Kotak Mahindra policy is a group health insurance, it is only valid till you are within the organisation. Once you terminate your employment with the organisation, the claims cannot be further made.  

No Ayush treatments coverage

Any Ayush treatments like Ayurveda, Homeopathy, Naturopathy, Immunisations, etc. are not covered. The Kotak Mahindra group health insurance also does not cover plastic surgery or cosmetic surgery.  

Intentional injury or suicide attempts

Any intentional injuries, suicides or suicide attempts are not covered within the Kotak Mahindra group health insurance.

Natural death or disability

Natural death or any disability are exempted from the policy.

Injuries due to criminal activity

Any injuries pertaining to involvement in criminal activities are excluded from the Kotak Mahindra group health insurance plan.

Kotak Mahindra group health insurance benefits

Free Health Check-up

A free-health check-up is provided each year from any of the network hospitals as an added advantage. However, the insured must be above 18 years of age. Availing of the free health-check up does not affect the base annual sum insured or the cumulative bonus.

Tailor-made policy

Kotak Mahindra group health insurance is tailor-made according to your company's needs. You can choose the type of policy, sum insured, or any other add-ons as per the needs of your employees.

Tax Benefits

The premiums paid towards Kotak General health insurance plans qualify for deduction under Section 80D of the Income Tax Act, 1961. This aids in preventing from creating a hole in your pockets! 

Kotak Mahindra group health insurance claim process

1

Intimate your insurer

Intimate your claim to the insurer within 48 hours, in case of an emergency and at least 3 days prior in case of a planned hospitalisation.

2

Verify your identity

Provide the proof of identity - policy number/health insurance ID card, company ID and a valid unique govt. ID card.

3

Submit the pre-authorization form

Fill out the pre-authorization form and hand it over to the hospital

4

Claim settlement

The claim will be settled directly at the network hospital once the details are verified.

5

Contact us for assistance

For any questions or assistance contact Pazcare at support@getpaz.com. You can also all us at +91 78291 11300.

1

Intimate your insurer

Intimate your claim to the insurer within 48 hours. in case of an emergency, you should intimate the insurer at least 3 days prior in case of a planned hospitalisation.

2

Settle your bills

Settle all your bills and collect the original copies of hospital bills, doctor consultation reports and other essential documents.

3

Submit the documents

Submit these original documents along with the claim form to the insurer.

4

Claim settlement

Once verified, the claim will be settled in your bank account directly.

5

Contact us for assistance

For any questions or assistance contact Pazcare at support@getpaz.com or call us at +91 78291 11300.

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Why buy a group health insurance
policy online from Pazcare?

  • Choose the suitable policy with our consulting approach
  • Custom-made plan with health and mental wellness add-ons
  • The tech-enabled Pazcare dashboard to manage endorsements
  • Integrate the dashboard with your HRMS tool

Kotak Mahindra group health insurance customer care number

For any queries or assistance, reach out to us at any time. We provide 24X7 customer assistance.

Kotak Mahindra group health insurance

Frequently asked questions around Kotak Mahindra group health insurance

How do I cancel my Kotak health insurance policy?

The Kotak Mahindra group health insurance customer care number is 1800-270-7000. Alternatively, you can email them at care@kotak.com.

To cancel, you can call on the 24x7 toll-free number - 1800 266 4545 from any landline or mobile. You can also contact the nearest Kotak Mahindra General Insurance Branch.

How many critical illnesses are covered by Kotak Health Insurance?

Kotak Health Insurance covers a total of 18 listed critical illnesses for the customers.

What is Kotak Mahindra group health insurance claim settlement ratio?

The Kotak Mahindra group health insurance claim settlement ratio FY 2019-20 is 75.45%.

Is there any tax benefit on buying a health insurance policy from Kotak General Insurance?

Yes! You get tax benefits under Section 80D of the Income Tax Act, 1961, when you buy a health insurance policy from Kotak General Insurance.