Kotak Health Shield

A Non-Linked, Non-Participating, Fixed Benefit Health Plan
Health is the greatest blessing for all human beings. Today, every individual is aware that the numbers of illnesses are increasing day by day, and so are the related costs for treatment. For most, treatment in the best facility could lead to a dent in the pockets while for some, it may lead to selling assets and mounting debts. Therefore, it is important to plan for your health emergencies before it is too late.
Presenting Kotak Health Shield, a fixed benefit health insurance plan which covers early or major stages illnesses/conditions related to Cancer, Cardiac, Liver, Neuro and also offers financial protection against Personal Accident - accidental death or disability.

What is Kotak Health Shield Plan?

Kotak Health Shield is a critical illness insurance plan that covers the most common life-threatening health conditions in India – cancer, cardiac problems, liver diseases, and neurological disorders. You can also include financial cover for an unfortunate event resulting from an accident in your plan.

Salient features of Kotak Health Shield plan

• Lump-sum payouts on the diagnosis of critical illnesses
  Today’s stressful lifestyle and changing food habits have caused a rapid rise in lifestyle diseases. Such disorders are principal causes of critical ailments, such as
  o Heart attack
  o Liver damage
  o Kidney failure
  o Stroke
  Hence, medical policies as financial safety nets against the treatment expenses have become a necessity these days.
  Regular health insurance plans compensate for hospitalisation costs and related expenses. But critical illnesses often need long-term medical care. Frequent doctor visits, diagnostic tests, and costs of medicines or rehabilitation therapies can become a financial burden.
  Kotak Health Shield medical insurance offers a lump-sum payout upfront on the diagnosis of the health conditions listed. The payment does not depend on actual medical costs incurred. It is based on the coverage you select when you buy the plan.
  Thus, you need not restrict your treatment to network hospitals affiliated with your insurance company to avail of the cashless benefit. You are free to undergo treatment from any healthcare
• Ease of claim disbursal
  Kotak Health Shield does not require you to submit medical and hospitalisation bills to get the coverage amount. Your claim is processed based on the medical test report confirming your diagnosis, ensuring fast access to funds.
  
• Income supplement in case of job loss
  Apart from funding your treatment costs, you can also use the payout amount to settle outstanding debts if any, or even supplement your household earnings. Add-on benefits can also provide a steady income stream in case of a career break due to ill health.
  
• Cover against death or disability due to accident
  The Personal Accident cover provides specific coverage against the loss of life, loss of limbs, disablement etc. It protects your family from financial instability in case of disability or dead of loved one due to accident.
  

Key Advantages:

• Flexibility to avail coverage against 4 Critical Illnesses under the same policy
• Cancer Shield
• Cardiac Shield
• Livo Shield
• Neuro Shield
• Flexibility to avail protection against Personal Accident and secure financial protection/future of your loved ones against accidental death or disability by opting for Personal Accident Shield
• Flexibility to extend the coverage to your spouse
• Option to enhance your coverage through
• Daily Hospitalization Cash Benefit
• Waiver of Premium on being diagnosed with Minor Conditions
• Income Benefit on being diagnosed with Major Conditions
• Inbuilt Wellness Benefit to ensure your safety
• Second Medical Opinion
• Emergency Medical Evacuation
• Medical Monitoring
• Medical Repatriation
• Compassionate Visit
• Provides Tax Benefits on premiums paid under Section 80(D) of Income Tax Act, 1961

Illustration

Mr Satish, a 35-year-old male, opts for Cancer Shield with Sum Assured of ₹30 lakhs & Cardiac Shield with Sum Assured of ₹20 lakhs for a period of 40 years. He also opts for all the Optional Benefits - Daily Hospital Cash Benefit (₹5,000/day), Waiver of Premium & Income Benefit. For this, he pays a regular premium of ₹15,435~ per annum.

• He gets diagnosed with Early Stage Cancer during the policy term – Payout of 25% of Cancer Shield Sum Assured, i.e. ₹7.5 lakhs is given to him.
• Premium is waived for 3 years.
• After 3 years, he continues paying the premium of ₹15,435 per annum.
• During the term, he gets diagnosed with Major Stage Cardiac - Payout of 100% of Cardiac Sum Assured, i.e. ₹20 lakhs is paid and cover under Cardiac Shield, and the Plan Option terminates.
• He receives Income Benefit of ₹20,000 per month for 12 months.
• He pays reduced Premium of ₹5,909 per annum for Cancer Shield & all optional benefits to continue.

(~The above premium figure is exclusive of Goods and Services Tax and Cess, as applicable. Goods and Services Tax and Cess are subject to change from time to time as per the prevailing tax laws.)

What are the Different Plan Options?

Five different Plan Options are available under Kotak Health Shield health insurance plan. You can select any one option, or more, as per your health care needs. The options include:

Plan Option A: Personal Accident Shield

Your job may need you to travel a lot, or you may love to visit new places. Or you may have to work in unsafe conditions.

In case of any eventualities due to an accident, your dependents may have to face financial challenges. If you have pending debts, they will have to shoulder the EMIs.

The Personal Accident Shield safeguards your loved ones against such economic distress. The lump-sum payout in case of an accident-related death or disability can cover their immediate expenses and unpaid loans.

However, the Personal Accident Shield option is not available as a standalone option. You can opt for it only when you select at least one other option available under the plan.

Plan Option B: Cardiac Shield

Heart diseases have emerged as one of the leading medical conditions in India. It is no longer an age-related health issue. A shocking study reveals that 35% of the patients hospitalised due to their first heart attack were below the age of 35 years.

The treatment for cardiac conditions often requires lifelong medication. Complications can lead to surgeries. The Cardiac Shield Option can shield your resources against the financial strain of such long-term medical care.

Plan Option C: Cancer Shield

The National Cancer Registry Programme Report 2020 by the Indian Council of Medical Research (ICMR) predicts India’s cancer load to reach 13.9 lakh cases in 2020. Fortunately, recent advancements in medicine enable complete recovery from this deadly disease. However, treatment can be expensive.

Moreover, even after successful surgery to remove a malignant tumour, annual diagnostic scans are vital to ensure remission. The lump-sum payout from the Cancer Shield health insurance can cover such expenses.

Plan Option D: Neuro Shield

The estimated frequency of severe neurological disorders, like brain stroke in India, is from 14 to 17 per 1000 individuals. Yet, in terms of health insurance, India lags significantly in coverage for neurological diseases.

The Neuro Shield Option offers payouts on the diagnosis of various nerve-related ailments and can make your recovery process free from financial anxieties.

Plan Option E: Livo Shield

Incidences of liver diseases are mostly linked to erratic lifestyles nowadays. The seriousness of the issue becomes clear from the staggering figure of 10 lakh liver cirrhosis cases reported in India every year. With liver transplant prices going up to about ₹37 lakhs (USD 50,000), costs for adequate medical care in liver diseases can be prohibitive.

The Livo Shield Plan can provide the financial fallback to help you get the best possible treatments.

What are the Different Payouts under the Plan Options?

Personal Accident Shield

• Payout for an unforeseen demise due to an accident during the policy tenure - 100% of the Sum Assured less any claims have already been paid due to disability.
• Payout for a permanent disability occurring within 120 days of an accident as a result of physical injuries sustained – A defined percentage based on the extent of disability, partial or total, as mentioned in your policy document.

Cardiac Shield, Neuro Shield & Livo Shield

• Payout on the first diagnosis of Minor Conditions mentioned under the plan – 25% of the Sum Assured
• Payout on the detection of a Major Condition as listed in your policy – 100% of the Sum Assured

Cancer Shield

The benefits payable are as follows:

• Early Stage Cancer or Carcinoma in situ (CIS) - 25% of Sum Assured
• Cancer of Specified Severity (Major Stage Cancer) - 100% of Sum Assured

Stipulations for the payouts for Minor Conditions:

• After the payout, the coverage will continue with the Balance Sum Assured, if any.
• You can place multiple claims for different Minor Conditions until your Sum Assured becomes exhausted. For Neuro Shield Option, recurring claims are subject to a maximum payout of 50% of Sum Assured.
• You cannot receive the benefit twice for the same condition.
• If you suffer from or undergo surgery for more than one condition at once, the claim for the Condition with the highest payout will be payable.

What are the Optional Benefit Payouts under the Kotak Health Shield Plan?

The Kotak Health Shield medical insurance plan offers the flexibility to increase your coverage at an additional premium. The options include:

1. Daily Hospitalization Cash Benefit

This benefit offers a specified lump-sum payout for each day of hospitalisation for an illness covered under the plan.

For hospitalisation in a non-ICU room, the daily payout choices include:

• ₹2,000
• ₹3,000
• ₹5,000

For hospitalisation in an ICU room, the payable amount doubles. You can select one of the options when you buy the plan, and it remains fixed regardless of the expenses you incur.

The payouts can cover any shortfall or incidental expenses arising during the hospital stay. You can raise the claim only for hospitalisation longer than 24 hours.

Yearly allowance for the number of days of hospitalisation –

• For non-ICU room - 30 days
• For ICU room - 15 days

Maximum number of hospitalisation days for which claims are payable during the entire policy tenure –

• For non-ICU room – 90 days/li>
• For ICU room - 45 days in

2. Waiver of Premium Benefit

With this benefit, you can keep your coverage active without paying any premiums for three policy years after receiving a claim for a minor condition listed in your policy.

You can claim this benefit as many times as you need during the policy period. This benefit can provide relief if you need to take a break from your work life while recovering from your illness.

3. Income Benefit

With this add-on cover, you can receive 1% of the Sum Assured every month for 12 months, under the following conditions:

• When 100% of the Sum Assured is payable due to a permanent disability under the Personal Accident Shield Plan Option
• On the diagnosis of or undergoing surgery for any Major Condition under the Cardiac, Livo, and Neuro Shield Plan Options
• When diagnosed with advanced-stage cancer

This benefit can cover your family’s living costs in case of a job loss due to poor health.

Other Benefits available under the Kotak Health Shield Plan

Kotak Health Shield provides several value-added services irrespective of benefits availed under the base plan. These wellness benefits, built into your coverage, include:

• Emergency Medical Evacuation
  If a medical emergency arises at a location without provisions for adequate medical care, Kotak Life wellness partners arrange for your transfer to a suitable medical facility. Along with transportation, necessary personnel and equipment are also provided. Your health policy covers the full cost of such evacuation.
• Medical Monitoring
  The wellness partners supervise if appropriate care is provided during your hospital stay and convey the necessary details to your family members.
• Medical Repatriation
  Once your health condition stabilises during hospital treatment away from your home, your return transportation will be organised. The transfer will take place under medical supervision if needed.
• Compassionate visit
  In the case of ill health away from home, the presence of a near one provides relief. It may even help in the healing process. Kotak Health Shield arranges for economy, round-trip transportation charges for one close relative or friend to the location where you undergo treatment. This benefit is applicable for hospitalisation longer than seven days.
• Second medical opinion
  On the detection of a grave illness, it is crucial to be sure of the right line of treatment. This benefit allows you to receive a documented second opinion from a medical specialist. This extra consultation can help remove any ambiguity about the diagnosis or the prescribed treatment.

Tax Benefit of Kotak Health Shield Plan

Regarding the penetration of health insurance, India is sadly behind, and so the government incentivises buying health covers with tax reliefs on health insurance. The premiums you pay for Kotak Health Shield are eligible for deductions from your taxable income. This tax relief is available under Section 80D of the Income Tax Act, 1961. The payouts are also tax-free.

The applicable tax benefits are subject to the prevailing tax laws.