What does Zurich Kotak Health Insurance cover?

It covers hospitalisation expenses, day-care procedures, pre- and post-hospitalisation costs, organ donor expenses, and certain modern treatments depending on the plan variant.

Are pre-existing diseases covered?

Yes, pre-existing conditions are covered after the specified waiting period, which varies by plan type and policy term.

Is maternity treatment included?

Certain plans offer maternity and newborn cover, subject to waiting periods, annual limits, and plan terms.

Does it cover alternative treatments like Ayurveda or Homeopathy?

Yes, selected plans include in-patient treatment under AYUSH systems (Ayurveda, Yoga, Unani, Siddha, Homeopathy).

What is the cashless claim process?

Policyholders can avail cashless treatment at network hospitals by informing the insurer/TPA and presenting the health card and required documents for approval.

Are day-care procedures covered?

Yes, medical procedures requiring less than 24-hour hospitalisation, such as dialysis, chemotherapy, or cataract surgery, are included.

What is the waiting period for pre-existing diseases?

Waiting periods typically range from 24 to 48 months depending on the plan variant, during which claims for pre-existing conditions are not payable.

Are lifestyle diseases like diabetes and hypertension covered?

Yes, lifestyle-related conditions are covered after the applicable waiting period along with complications arising from them.

Does the plan cover critical illnesses?

Certain variants provide optional critical illness benefits or riders that pay a lump sum on diagnosis of covered critical conditions.

Are hospital room rent and ICU charges included?

Yes, inpatient hospitalisation including room rent, ICU, nursing, doctor fees, and treatment costs are part of the core coverage.

Is there coverage for organ transplants?

Medical and surgical costs for organ donors during transplantation are covered under specific plans.

What is not covered under Zurich Kotak Health Insurance?

Exclusions include cosmetic surgery, infertility treatments, substance abuse, experimental therapies, rest cure, and non-network hospital treatments.

Can I add riders or optional covers?

Yes, some plans allow add-ons such as maternity cover, critical illness benefit, personal accident cover, and higher sum insured limits.

How does the reimbursement claim work?

If treatment is availed at a non-network hospital, the insured pays upfront, submits bills and documents, and receives reimbursement as per policy terms.

Is there any wellness or preventive benefit?

Certain plans offer annual health check-ups, fitness rewards, and preventive care benefits to encourage healthy living and early disease detection.

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Zurich Kotak

Coverage & Benefits

Zurich Kotak Health Insurance Coverage & Benefits

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97%

Claim Settlement Ratio

10500+

Network Hospitals

Cover up

Cover up to 5 Crore

97%

Claim Settlement Ratio

10500+

Network Hospitals

Cover up

Cover up to 5 Crore

Zurich Kotak Health Insurance Coverage & Benefits

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

OneAssure helped me understand my needs and choose a product that was right for me. There was no pressure tactics or mis-selling. This experience was respectful, informed, and completely stress-free.

Shreya Goyal

Had a great experience with OneAssure during my insurance claim process. A special shoutout to Sunad Raj for his exceptional support, he was professional, responsive, and guided me every step of the way. Thanks to his consistent follow-ups and clear guidance, the entire claim settlement was smooth and hassle-free. Highly recommend OneAssure for their service and transparency!

Sanjay Dakalia

The team is very professional and prompt. I would have all my health and life insurance needs met through them.

Harish Jindal

Very professional service from Ruchir & Aman. They were recommended by a friend who had a positive experience with them. I have taken both health and life policies through them and they have advised me well throughout the process and found the best options available in the market. I had a medical condition due to which it was difficult to find a suitable health policy in the market, however this team was able to find one for me. I would recommend their services to anyone looking to buy health or life insurance.

Siddhartha Saha

Wonderful experience with Prost. Right from suggesting the insurance products to claim process the entire experience hai been seamless. They do not mis-sell and are very transparent. Sundar Raj from the team has been wonderful and ensured prompt guidance. All the best Ruchir and keep up the good work!

Adarsh Ravindranathan

verdict

Our Verdict: Zurich Kotak Health Insurance Coverage

Claim Settlement Ratio

Pros

Wellness support including annual health check-ups, teleconsultations, and rewards.

Fixed premium feature (Premium Secure) keeps premiums stable until a claim is made.

Unlimited restoration of sum insured for repeated claims of unrelated illnesses.

High sum-insured range from ₹5 lakh to ₹5 crore for major medical expenses.

Cons

Routine outpatient (OPD) treatment is not covered.

Optional add-ons like maternity or critical illness increase premiums.

Top-tier plans can be costly.

Waiting periods for pre-existing conditions.

Pros

Wellness support including annual health check-ups, teleconsultations, and rewards.

Fixed premium feature (Premium Secure) keeps premiums stable until a claim is made.

Unlimited restoration of sum insured for repeated claims of unrelated illnesses.

High sum-insured range from ₹5 lakh to ₹5 crore for major medical expenses.

Cons

Routine outpatient (OPD) treatment is not covered.

Optional add-ons like maternity or critical illness increase premiums.

Top-tier plans can be costly.

Waiting periods for pre-existing conditions.

Final Verdict

Zurich Kotak Health 360 stands out as a highly flexible and comprehensive health insurance plan that caters to individuals and families seeking robust medical protection. With a wide sum-insured range from ₹5 lakh to ₹5 crore, it ensures financial security even in major medical emergencies. The unlimited restoration feature allows...

Zurich Kotak Health 360 stands out as a highly flexible and comprehensive health insurance plan that caters to individuals and families seeking robust medical protection. With a wide sum-insured range from ₹5 lakh to ₹5...

Key Coverages & Benefits Offered Under Zurich Kotak Health Insurance

Learn what’s covered and what’s not under Zurich Kotak Health Insurance so you can make an informed decision

Inclusions

Wellness benefits: Annual health check-ups and no-claim bonus, as per plan terms.

Modern treatments: Includes robotic surgeries and other advanced medical procedures.

Organ donor expenses: Medical costs related to in-patient treatment during organ transplants.

AYUSH treatment: In-patient care under Ayurveda, Homeopathy, Unani, and Siddha systems.

Domiciliary treatment: For medically necessary home treatment when hospitalisation isn’t possible.

Day-care procedures: Covers treatments that don’t require a 24-hour hospital stay.

Pre- & post-hospitalisation expenses: Includes tests, consultations, and treatments for a specified number of days.

In-patient hospitalisation: Covers room rent, ICU, nursing, doctors’ fees, medicines, and procedures.

Exclusions

Other exclusions: Treatments for STDs, substance abuse, or complications arising from them; unregistered or non-approved hospitals/practitioners; rest cure, rehabilitation, or observation-only admissions without active treatment.

Cosmetic surgeries: Not covered unless medically required after an accident.

Permanent exclusions: Infertility treatments, IVF, and reproductive procedures.

Pre-existing diseases: Covered only after the applicable waiting period.

Specified disease waiting period: Conditions like cataract, hernia, and similar illnesses have defined waiting periods.

Initial waiting period: 30 days for most illnesses (accidents covered from day one).

Inclusions

Wellness benefits: Annual health check-ups and no-claim bonus, as per plan terms.

Modern treatments: Includes robotic surgeries and other advanced medical procedures.

Organ donor expenses: Medical costs related to in-patient treatment during organ transplants.

AYUSH treatment: In-patient care under Ayurveda, Homeopathy, Unani, and Siddha systems.

Domiciliary treatment: For medically necessary home treatment when hospitalisation isn’t possible.

Day-care procedures: Covers treatments that don’t require a 24-hour hospital stay.

Pre- & post-hospitalisation expenses: Includes tests, consultations, and treatments for a specified number of days.

Exclusions

Other exclusions: Treatments for STDs, substance abuse, or complications arising from them; unregistered or non-approved hospitals/practitioners; rest cure, rehabilitation, or observation-only admissions without active treatment.

Cosmetic surgeries: Not covered unless medically required after an accident.

Permanent exclusions: Infertility treatments, IVF, and reproductive procedures.

Pre-existing diseases: Covered only after the applicable waiting period.

Specified disease waiting period: Conditions like cataract, hernia, and similar illnesses have defined waiting periods.

Initial waiting period: 30 days for most illnesses (accidents covered from day one).

Claims Process

How to file Zurich Kotak claims?

Zurich Kotak Health Insurance Coverage & Benefits

How Coverage and Benefits Vary in Zurich Kotak Health Insurance

Different Plan Variants Offer Varying Sum Insured & Limits

Zurich Kotak Health Insurance offers multiple plan variants, including Support, Secure, Shield, and Premium. Higher variants provide larger sum insured amounts, no room rent caps, and stronger financial protection against major medical expenses.

Treatment Coverage Differs by Plan

While all plans cover hospitalisation, day-care procedures, and pre- & post-hospitalisation costs, sub-limits may vary. Advanced treatments, AYUSH therapies, and maternity benefits generally receive higher coverage in premium variants.

Value-Added Benefits Vary Across Plans

Premium variants include extra perks such as sum insured restoration, cumulative bonuses for claim-free years, annual health check-ups, and wellness rewards. Lower-tier plans offer fewer of these benefits, making premium plans more comprehensive.

Different Plan Variants Offer Varying Sum Insured & Limits

Zurich Kotak Health Insurance offers multiple plan variants, including Support, Secure, Shield, and Premium. Higher variants provide larger sum insured amounts, no room rent caps, and stronger financial protection against major medical expenses.

Treatment Coverage Differs by Plan

While all plans cover hospitalisation, day-care procedures, and pre- & post-hospitalisation costs, sub-limits may vary. Advanced treatments, AYUSH therapies, and maternity benefits generally receive higher coverage in premium variants.

Value-Added Benefits Vary Across Plans

Premium variants include extra perks such as sum insured restoration, cumulative bonuses for claim-free years, annual health check-ups, and wellness rewards. Lower-tier plans offer fewer of these benefits, making premium plans more comprehensive.

How to Choose

How to Choose the Right Health Insurance Coverage

What is the Waiting Period in Zurich Kotak Health Insurance?

A waiting period is the minimum duration you must complete after purchasing your Zurich Kotak Health Insurance policy before certain illnesses, treatments, or pre-existing conditions become eligible for claims. Any medical expense related to a condition still under the waiting period will not be reimbursed.
Below is the updated breakdown of waiting periods under Zurich Kotak Health 360:

Maternity Waiting Period – 4 Years

For plans that include maternity and newborn benefits (such as Gold or Premium variants), the waiting period is 4 years. Only after completing this period can you claim for normal delivery, C-section, or newborn coverage, where applicable.

Other Applicable Waiting Periods

Depending on your plan, additional waiting periods may apply, including:

90 days for critical illness coverage
3 years for LASIK, bariatric surgery, or mental health treatments (if included in your plan)

These waiting periods apply only if your chosen plan includes the respective benefits.

Initial Waiting Period – 30 Days

For all illnesses, there is a standard 30-day waiting period from the policy start date. Accidental hospitalisation is excluded from this, meaning accidents are covered immediately from day one.

Pre-Existing Disease (PED) Waiting Period

The PED waiting period depends on the plan variant you select:

Support Variant: 48 months
Secure / Support Plus / Shield: 36 months
Premium Variant: 24 months

This applies only if the pre-existing condition was disclosed at the time of purchasing the policy.

Specified Diseases / Procedures Waiting Period – 24 Months

Certain listed illnesses and treatments carry a 24-month waiting period. These typically include cataract, hernia, joint replacement, ENT surgeries, internal congenital conditions, arthritis, and other specified procedures. Exact coverage may vary slightly depending on the plan variant.

Maternity Waiting Period – 4 Years

For plans that include maternity and newborn benefits (such as Gold or Premium variants), the waiting period is 4 years. Only after completing this period can you claim for normal delivery, C-section, or newborn coverage, where applicable.

Other Applicable Waiting Periods

Depending on your plan, additional waiting periods may apply, including:

90 days for critical illness coverage
3 years for LASIK, bariatric surgery, or mental health treatments (if included in your plan)

These waiting periods apply only if your chosen plan includes the respective benefits.

Initial Waiting Period – 30 Days

For all illnesses, there is a standard 30-day waiting period from the policy start date. Accidental hospitalisation is excluded from this, meaning accidents are covered immediately from day one.

Pre-Existing Disease (PED) Waiting Period

The PED waiting period depends on the plan variant you select:

Support Variant: 48 months
Secure / Support Plus / Shield: 36 months
Premium Variant: 24 months

This applies only if the pre-existing condition was disclosed at the time of purchasing the policy.

Specified Diseases / Procedures Waiting Period – 24 Months

Certain listed illnesses and treatments carry a 24-month waiting period. These typically include cataract, hernia, joint replacement, ENT surgeries, internal congenital conditions, arthritis, and other specified procedures. Exact coverage may vary slightly depending on the plan variant.

Diseases Covered/not Covered

Diseases Covered/Not Covered Under Zurich Kotak Health Insurance

Diseases Covered

Organ Donor Treatment

Bariatric Surgery (Medically Necessary)

Mental Health & Psychiatric Care

Hernia, Hydrocele & Similar Surgeries

Cataract & Eye Disorders

Kidney & Gallbladder Conditions

Cardiac & Heart-Related Diseases

Diabetes & Hypertension

Diseases / Conditions Not Covered

Sleep-Related Disorders (Variant Dependent)

Rehabilitation & Rest Cure

Unproven or Experimental Treatments

Congenital External Anomalies

Self-Inflicted Injuries & Substance Abuse

Infertility & Reproductive Treatments

Cosmetic & Elective Surgeries

Diseases Covered

Organ Donor Treatment

Bariatric Surgery (Medically Necessary)

Mental Health & Psychiatric Care

Hernia, Hydrocele & Similar Surgeries

Cataract & Eye Disorders

Kidney & Gallbladder Conditions

Cardiac & Heart-Related Diseases

Diseases / Conditions Not Covered

Sleep-Related Disorders (Variant Dependent)

Rehabilitation & Rest Cure

Unproven or Experimental Treatments

Congenital External Anomalies

Self-Inflicted Injuries & Substance Abuse

Infertility & Reproductive Treatments

Cosmetic & Elective Surgeries

Pre-existing Diseases

Pre-Existing Diseases Covered Under Zurich Kotak Health Insurance

Chronic Lifestyle Conditions

Pre-existing conditions like diabetes, hypertension, and related complications are covered once the mandatory waiting period is completed, ensuring protection for long-term lifestyle-related illnesses.

Heart & Cardiac Disorders

Conditions such as coronary artery disease, previous cardiac surgeries, and other heart-related complications become eligible for coverage after serving the pre-existing disease waiting period.

Respiratory Diseases

Asthma, chronic bronchitis, COPD, and other persistent respiratory conditions are included once the waiting duration ends, helping manage long-term breathing disorders.

Thyroid & Hormonal Disorders

Endocrine-related illnesses such as hypothyroidism and hyperthyroidism are covered after completing the waiting period, ensuring proper management of hormonal imbalances.

Joint & Musculoskeletal Issues

Chronic joint conditions like arthritis, osteoarthritis, and spondylosis are included post-waiting period, providing coverage for degenerative bone and joint problems.

Digestive & Gastrointestinal Conditions

Persistent digestive issues such as GERD, chronic acidity, ulcers, and IBS are covered after the waiting period, supporting treatment for ongoing gastrointestinal concerns.

Kidney & Liver Disorders

Chronic kidney disease, kidney stones, hepatitis, and liver dysfunction are included once the PED waiting period is over, offering protection for vital organ-related ailments.

Mental Health Conditions

In-patient psychiatric illnesses that existed before policy purchase are covered after completing the waiting duration, ensuring support for mental health care when needed.

Chronic Lifestyle Conditions

Pre-existing conditions like diabetes, hypertension, and related complications are covered once the mandatory waiting period is completed, ensuring protection for long-term lifestyle-related illnesses.

Heart & Cardiac Disorders

Conditions such as coronary artery disease, previous cardiac surgeries, and other heart-related complications become eligible for coverage after serving the pre-existing disease waiting period.

Respiratory Diseases

Asthma, chronic bronchitis, COPD, and other persistent respiratory conditions are included once the waiting duration ends, helping manage long-term breathing disorders.

Thyroid & Hormonal Disorders

Endocrine-related illnesses such as hypothyroidism and hyperthyroidism are covered after completing the waiting period, ensuring proper management of hormonal imbalances.

Joint & Musculoskeletal Issues

Chronic joint conditions like arthritis, osteoarthritis, and spondylosis are included post-waiting period, providing coverage for degenerative bone and joint problems.

Digestive & Gastrointestinal Conditions

Persistent digestive issues such as GERD, chronic acidity, ulcers, and IBS are covered after the waiting period, supporting treatment for ongoing gastrointestinal concerns.

Kidney & Liver Disorders

Chronic kidney disease, kidney stones, hepatitis, and liver dysfunction are included once the PED waiting period is over, offering protection for vital organ-related ailments.

Mental Health Conditions

In-patient psychiatric illnesses that existed before policy purchase are covered after completing the waiting duration, ensuring support for mental health care when needed.

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