Kotak General Super Top Up Insurance

Kotak General Super Top Up Insurance benefits

• 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”