{"uin":"ZUKHLIP25057V022425","name":"Health Maximiser","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425","insurer":{"slug":"zurich-kotak-general-insurance","name":"Zurich Kotak General Insurance Company (India) Limited","url":"https://indiainsurances.com/insurer/zurich-kotak-general-insurance"},"line":"health","category":"health-indemnity","category_name":"Health insurance (hospitalisation)","irdai_type":null,"kind":"product","status":"active","approved_on":null,"withdrawn_on":null,"summary":"Health Maximiser is a combi product whose health component is Health Premier, an indemnity health policy, and whose life component is Kotak Term Plan. The health policy has a 30-day initial waiting period, a 36/24-month pre-existing disease waiting period, a 24-month specified disease waiting period, and a 60-month moratorium.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:58:44.014665+00","note":"First pass: one AI reading; every stated fact carries a verbatim quote found in the cited clause, but it has not been reviewed. Check the clause before relying on it."},"facts":[{"key":"plan_variants","label":"Plans and variants","section":"Overview","meaning":"The named plans inside this product (not cover types or payout options). Facts can differ between them.","status":"not-stated","value":null,"display":null,"note":"The wording refers to the plan stated in the Policy Schedule, but does not name the product's plan variants.","quote":null,"sources":[],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"not-stated","value":null,"display":null,"note":"The wording defines Policy Period by the Policy Schedule and refers to 1 year and Multi Year policies, but does not state the selectable policy terms.","quote":null,"sources":[],"law":[]},{"key":"claim_intimation","label":"Claim intimation deadline","section":"Claims","meaning":"How soon you must tell the insurer about a claim or hospitalisation.","status":"quote-verified","value":"For cashless planned hospitalisation, contact the insurer or TPA at least 48 hours before admission. For emergency cashless hospitalisation, contact within 24 hours of commencement; reimbursement claims must be notified within 30 days of discharge, and critical illness claims within 30 days of first diagnosis.","display":"Planned cashless: at least 48 hours before hospitalisation; emergency cashless: within 24 hours; reimbursement: within 30 days of discharge; critical illness: within 30 days of first diagnosis","note":null,"quote":"At least 48 hours prior to a planned Hospitalization, We or Our TPA shall be contacted to request pre-authorization ... contacted to request pre-authorization for availing the Cashless Facility for that Emergency Care within 24 hours of commencement of Hospitalisation ... We shall be given written notice of the Claim for reimbursement along with the following details at least within 30 days of the Insured Person’s discharge from Hospital ... We shall be given written notice of the Claim within 30 days from the date of the first diagnosis of the Critical Illness","sources":[{"clause":null,"heading":"5. CLAIMS PROCEDURE","page":49,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-5-claims-procedure"},{"clause":"36(a)(vi)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-36-a-vi"},{"clause":null,"heading":"5.2 For Reimbursement Claims","page":51,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-5-2-for-reimbursement-claims"},{"clause":"2.23","heading":"Critical Illness Cover","page":40,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-23"}],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 20, 21","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_documents","label":"Claim documents","section":"Claims","meaning":"Documents the insurer asks for when you claim.","status":"quote-verified","value":["Duly completed Claim form signed by You and the Medical Practitioner","Hospital discharge summary","First consultation and follow up treatment papers","Original bills and receipts from the Hospital/Medical Practitioner","Original bills from chemists supported by proper prescription","Original investigation test reports (including CT/MR/USG/ECG, as applicable) and payment receipts","Indoor case papers, if available","Implant Invoice/ Sticker, if available","Ambulance Invoice, if applicable","FIR (if done) or MLC (if conducted) for Accident cases","Post mortem report (if conducted)","KYC documents viz. Photo ID and address proof along with duly completed form"],"display":"Claim form, discharge summary, treatment papers, original bills and receipts, pharmacy bills with prescriptions, investigation reports and receipts, indoor case papers, implant or ambulance invoice if applicable, FIR/MLC for accidents, post mortem report if conducted, and KYC documents","note":"The insurer or TPA may ask for any other document required to investigate the claim or payment obligation.","quote":"a) Duly completed Claim form signed by You and the Medical Practitioner (only for reimbursement claims);\nb) Hospital discharge summary;\nc) First consultation and follow up treatment papers;\nd) Original bills and receipts from the Hospital/Medical Practitioner;\ne) Original bills from chemists supported by proper prescription;\nf) Original investigation test reports (including CT/MR/USG/ECG, as applicable) and payment receipts;\ng) Indoor case papers, if available;\nh) Implant Invoice/ Sticker, if available;\ni) Ambulance Invoice, if applicable;\nj) FIR (if done) or MLC (if conducted) for Accident cases ;\nk) Post mortem report (if conducted);\nl) KYC documents viz. Photo ID and address proof along with duly completed form.","sources":[{"clause":null,"heading":"6. CLAIM DOCUMENTS","page":52,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-6-claim-documents"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 17","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 23","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"claim_settlement_time","label":"Claim settlement time promised","section":"Claims","meaning":"How quickly the policy says a claim is decided or paid, and from when that is counted (intimation or last document).","status":"quote-verified","value":"The Company shall settle or reject a claim within 15 days from receipt of the claim with claim form and necessary documents. For delay in payment, interest is payable from the date of receipt of the last necessary document to the payment date at 2% above the bank rate.","display":"Within 15 days from receipt of claim with claim form and necessary documents; delayed payment attracts interest at 2% above bank rate","note":null,"quote":"The Company shall settle or reject a claim, as the case may be, within 15 days from the date of receipt of claim along with claim form (and necessary documents). ... In the case of delay in the payment of a claim, the Company shall be liable to pay interest to the policyholder from the date of receipt of last necessary document to the date of\npayment of claim at a rate 2% above the bank rate.","sources":[{"clause":"17(i)","heading":null,"page":66,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-17-i"},{"clause":"17(ii)","heading":null,"page":66,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-17-ii"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64UM(4) to (6)","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 10","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 15","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 16","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 22","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(i), V.3(ii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, V.3(iii)","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, V.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 23","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"The Motor Vehicles Act, 1988: Chapter XI, insurance of motor vehicles against third party risks","section":"Section 149","url":"https://indiainsurances.com/law/motor-vehicles-act-1988"}]},{"key":"exclusions_main","label":"Main exclusions","section":"Exclusions","meaning":"What the policy does not pay for, in the policy's own words.","status":"quote-verified","value":["Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications","Expenses related to the treatment of any illness within 30 days from the first policy commencement date","Expenses related to the treatment of the listed Conditions, surgeries/treatments","Expenses related to any admission primarily for diagnostics and evaluation purposes only","Expenses related to any admission primarily for enforced bed rest and not for receiving treatment","Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions","Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex","Expenses for cosmetic or plastic surgery or any treatment to change appearance","Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports","Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof","Any treatment taken outside India","Any OPD treatment will not be covered"],"display":"PED and waiting-period exclusions, 30-day illness waiting period, 24-month specified disease/procedure waiting period, diagnostic-only admission, rest cure, obesity surgery not meeting conditions, gender-change treatment, cosmetic surgery, professional hazardous or adventure sports, alcohol/drug abuse, treatment outside India, and OPD treatment","note":null,"quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36/ 24 months ... Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident ... Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months ... Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. ... Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. ... Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions: ... Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. ... Expenses for cosmetic or plastic surgery or any treatment to change appearance ... Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof ... Any treatment taken outside India; ... Any OPD treatment will not be covered","sources":[{"clause":"3.1(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-1-a"},{"clause":"3.2","heading":"30 Day Waiting Period (Code – Excl03)","page":43,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-2-2"},{"clause":"3.3","heading":"Specified disease/ procedure waiting period (Code – Excl02)","page":44,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-3-2"},{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":45,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care (Code – Excl05)","page":45,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control (Code – Excl06)","page":45,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-excl06"},{"clause":"4","heading":"Change-of- Gender treatments (Code – Excl07)","page":45,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-4-4"},{"clause":"5","heading":"Cosmetic or plastic Surgery (Code – Excl08)","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-5-4"},{"clause":"6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-6-3"},{"clause":"9","heading":"Code- Excl12","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-9-2"},{"clause":"27","heading":null,"page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-27"},{"clause":"33","heading":"Any OPD treatment will not be covered","page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-33"}],"law":[{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 11","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grievance","label":"Grievance route","section":"Claims","meaning":"Who to complain to first, as stated in the policy, before going to the Insurance Ombudsman.","status":"quote-verified","value":"For health policy grievances, contact Zurich Kotak through its website, toll-free number 1800 2120, e-mail care@zurichkotak.com, courier address, or a branch. If not satisfied, contact grievanceofficer@zurichkotak.com before approaching the Insurance Ombudsman.","display":"Zurich Kotak website, 1800 2120, care@zurichkotak.com, courier/branch; then grievanceofficer@zurichkotak.com","note":null,"quote":"In case of any grievance the insured person may contact the company through Website: www.zurichkotak.com Toll free: 1800 2120 E-mail: care@zurichkotak.com\nCourier:\nZurich Kotak General Insurance Company (India) Limited, 401, 4th Floor, Silver Metropolis, Jai Coach Compound, Off Western Express Highway, Goregaon (East), Mumbai- 400063. Maharashtra, India.\nInsured person may also approach the grievance cell at any of the company's branches with the details of grievance If Insured person is not satisfied with the redressal of grievance through one of the above methods, insured person may contact the grievance officer at grievanceofficer@zurichkotak.com","sources":[{"clause":"16","heading":"Redressal of Grievance","page":65,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-16-3"}],"law":[{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 3","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 4","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"Consumer Protection (Jurisdiction of the District Commission, the State Commission and the National Commission) Rules, 2021","section":"Rule 5","url":"https://indiainsurances.com/law/consumer-jurisdiction-rules-2021"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(11)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 2(42)","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 34","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Consumer Protection Act, 2019","section":"Section 69","url":"https://indiainsurances.com/law/consumer-protection-act-2019"},{"title":"The Insurance Act, 1938","section":"Section 38","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 12","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 19","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 20","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 13","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 2","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(5), 5(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 5(9)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 25","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.1","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, VI.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 26","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 11","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 3","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 13","url":"https://indiainsurances.com/law/ombudsman-rules-2017"},{"title":"Insurance Ombudsman Rules, 2017","section":"Rule 14","url":"https://indiainsurances.com/law/ombudsman-rules-2017"}]},{"key":"sum_insured_options","label":"Sum insured options","section":"Cover","meaning":"The cover amounts you can choose from.","status":"not-stated","value":null,"display":null,"note":"The wording refers to the Base Sum Insured specified in the Policy Schedule, but does not state selectable sum insured amounts.","quote":null,"sources":[],"law":[]},{"key":"initial_waiting","label":"Initial waiting period","section":"Waiting periods","meaning":"Days from the start of the first policy during which illness claims are not paid (accidents usually are).","status":"quote-verified","value":{"unit":"days","amount":30},"display":"30 days","note":"Does not apply to covered accident claims; not applicable if the insured has Continuous Coverage for more than twelve months.","quote":"Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.","sources":[{"clause":"3.2","heading":"30 Day Waiting Period (Code – Excl03)","page":43,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-2-2"}],"law":[]},{"key":"ped_waiting","label":"Pre-existing disease waiting period","section":"Waiting periods","meaning":"How long you wait before conditions you already had when you bought the policy are covered. The law caps it at 36 months.","status":"quote-verified","value":{"unit":"months","amount":36},"display":"36/24 months, as mentioned in the Policy Schedule","note":"The wording gives 36/24 months depending on the Policy Schedule; it does not identify which plan has 24 months.","quote":"Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36/ 24 months (as mentioned in the Policy Schedule) of continuous coverage after the date of inception of the first policy with insurer.","sources":[{"clause":"3.1(a)","heading":null,"page":43,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-1-a"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.6","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting","label":"Specific illness waiting period","section":"Waiting periods","meaning":"Waiting period for a list of named illnesses and procedures (cataract, hernia, joint replacement...). With several tiers (24 and 36 months), the shortest in the answer, the others in the note.","status":"quote-verified","value":{"unit":"months","amount":24},"display":"24 months","note":"Does not apply to claims arising due to an accident; if a condition also falls under the PED waiting period, the longer waiting period applies.","quote":"Expenses related to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.","sources":[{"clause":"3.3","heading":"Specified disease/ procedure waiting period (Code – Excl02)","page":44,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-3-2"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.7","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"specific_waiting_list","label":"Illnesses with a specific waiting period","section":"Waiting periods","meaning":"The named illnesses and procedures that carry the specific waiting period.","status":"quote-verified","value":["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 tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant","Dialysis required for chronic renal failure","Tonsillitis, adenoids and sinuses","Gastric and duodenal erosions and ulcers","Deviated nasal septum","Varicose Veins/ Varicose Ulcers"],"display":"Cataract; BPH; myomectomy/hysterectomy; hernia/hydrocele; fissures/fistula/piles; arthritis/gout/rheumatism/spinal disorders; joint replacement; sinusitis; urinary/biliary stones; D&C/endometriosis; tumors/cysts/nodules/polyps; chronic renal failure dialysis; tonsillitis/adenoids/sinuses; gastric/duodenal erosions and ulcers; deviated nasal septum; varicose veins/ulcers","note":null,"quote":"a) Cataract*;\nb) Benign Prostatic Hypertrophy;\nc) Myomectomy, Hysterectomy unless because of malignancy;\nd) All types of Hernia, Hydrocele;\ne) Fissures and/or Fistula in anus, haemorrhoids/piles;\nf) Arthritis, gout, rheumatism and spinal disorders;\ng) Joint replacements unless due to Accident;\nh) Sinusitis and related disorders;\ni) Stones in the urinary and biliary systems;\nj) Dilatation and curettage, Endometriosis;\nk) All types of skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant;\nl) Dialysis required for chronic renal failure;\nm) Tonsillitis, adenoids and sinuses;\nn) Gastric and duodenal erosions and ulcers;\no) Deviated nasal septum;\np) Varicose Veins/ Varicose Ulcers.","sources":[{"clause":"3.3","heading":"Specified disease/ procedure waiting period (Code – Excl02)","page":44,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-3-3-2"}],"law":[]},{"key":"moratorium","label":"Moratorium period","section":"Renewal and rights","meaning":"After this many months of continuous cover, the insurer cannot reject a claim for non-disclosure, except for proven fraud or permanent exclusions. The law sets 60 months.","status":"quote-verified","value":{"unit":"months","amount":60},"display":"sixty continuous months","note":"For enhanced sum insured, sixty continuous months applies from the date of enhancement only on the enhanced limits.","quote":"After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud.","sources":[{"clause":"14","heading":"Moratorium Period","page":65,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-14-4"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 13","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 8","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"portability","label":"Portability","section":"Renewal and rights","meaning":"Whether you can move this policy to another insurer and keep waiting-period credit.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 11","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 12","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.6","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, VII.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 24","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.4 and 1.5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 10","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"lifelong_renewal","label":"Lifelong renewal","section":"Renewal and rights","meaning":"Whether the policy can be renewed for life without a maximum age.","status":"not-stated","value":null,"display":null,"note":"The wording says the policy is ordinarily renewable but does not state lifelong renewal or no maximum renewal age.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II D.II","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"claim_loading","label":"Premium loading after claims","section":"Renewal and rights","meaning":"Whether the premium can go up at renewal because you made a claim.","status":"quote-verified","value":"Renewal cannot be denied because the insured person made a claim, and no loading applies on renewals based on individual claims experience.","display":"No loading on renewals based on individual claims experience","note":null,"quote":"Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding policy years. ... No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"10","heading":"Renewal of Policy","page":64,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-10-5"}],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 10","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.5","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 9","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 4","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"Review of revision in premium rates under health insurance policies for senior citizens, 2025","section":"Para 7","url":"https://indiainsurances.com/law/irdai-senior-premium-2025"}]},{"key":"permanent_exclusions","label":"Permanent exclusions","section":"Exclusions","meaning":"Conditions or treatments that are never covered: the standard IRDAI exclusion codes Excl04 to Excl18 and the product's own permanent exclusions. Excl01 to Excl03 are waiting periods, not permanent exclusions.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 16","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"cancellation_refund","label":"Cancellation by you","section":"Renewal and rights","meaning":"What you get back if you cancel during the year.","status":"quote-verified","value":"The policyholder may cancel at any time during the term with 7 days' written notice. For a 1-year policy, proportionate premium for the unexpired period is refunded if no claim was made; for a multi-year policy, future policy years are refunded in full and the started year pro-rata if no claim was made, subject to medical examination expense deductions where applicable.","display":"Cancel with 7 days' written notice; refund is proportionate for unexpired period if no claim, with multi-year future years refunded without deduction","note":"If the risk or part of the insurance coverage has commenced, expenses incurred by the Company on medical examination are also deducted before refunding premium.","quote":"The Policyholder may cancel his/her policy at any time during the term, by giving 7 days notice in writing. The Insurer shall -\n• For 1 year Policy- Refund proportionate premium for unexpired policy period subject to no claim(s) were made during the policy period.\n• For Multi Year Policy - o For any policy year where the risk date has not yet started, the premium will be refunded without any deduction. o For any policy year where the risk has started, the premium will be refunded on a prorata basis for that policy year, provided no claim has been made during the policy year and in full for future policy years.","sources":[{"clause":"7(i)","heading":null,"page":63,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-7-i"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 64VB","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on General Insurance Business, 2024","section":"Ch I, Para 8","url":"https://indiainsurances.com/law/irdai-general-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 6","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 17","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.4","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part C, IV.3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"territory","label":"Where it covers","section":"Overview","meaning":"Geographic area of cover: India only, worldwide, or listed countries. 'As stated in the schedule' is not an answer.","status":"quote-verified","value":"Base health claims are payable only where the cause of action arises in India, and treatment outside India is excluded. Critical Illness Cover and Personal Accident Cover are stated to apply worldwide.","display":"India only for health treatment; Critical Illness Cover and Personal Accident Cover are worldwide","note":"The worldwide statements are for Critical Illness Cover and Personal Accident Cover, which are optional covers on additional premium.","quote":"No Claims shall be payable under this Policy unless the cause of action arises in India, unless otherwise specifically provided in Policy. ... Any treatment taken outside India; ... Notwithstanding any provision to the contrary in the Policy, this Cover will be applicable on a worldwide basis; ... Notwithstanding any provision to the contrary in the Policy, this Cover will be applicable on a worldwide basis;","sources":[{"clause":"24","heading":"Cause of Action/ Currency for payments","page":69,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-24-2"},{"clause":"27","heading":null,"page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-27"},{"clause":"2.23","heading":"Critical Illness Cover","page":40,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-23"},{"clause":"2.24(c)","heading":null,"page":42,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-24-c"}],"law":[]},{"key":"free_look","label":"Free-look period","section":"Renewal and rights","meaning":"Days after you receive the policy in which you can return it for a refund if you do not agree with its terms.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 5","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 5","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(1), 20(2)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(3) to 20(5)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024","section":"Reg 20(6)","url":"https://indiainsurances.com/law/irdai-ppi-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, II.8","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, III.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"}]},{"key":"grace_period","label":"Grace period","section":"Renewal and rights","meaning":"Days you get after the due date to pay without losing cover or continuity.","status":"quote-verified","value":{"unit":"days","amount":30},"display":"atleast 30 days; 15 days for monthly instalments","note":"For instalment premium, monthly has 15 days; quarterly, half yearly and annual instalments have 30 days.","quote":"the policy shall terminate and can be renewed within the Grace Period of atleast 30 days to maintain continuity of benefits without break in policy. ... Grace Period of 15 days (where premium is paid on monthly instalments) and 30 days (where premium paid in quarterly / half yearly/ annual instalments) would be given to pay the instalment premium due for the policy.","sources":[{"clause":"10","heading":"Renewal of Policy","page":64,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-10-5"},{"clause":"12","heading":"Premium Payment in Instalments","page":64,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-12-4"}],"law":[{"title":"The Insurance Act, 1938","section":"Section 50","url":"https://indiainsurances.com/law/insurance-act-1938"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 8","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 9","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Life Insurance Products, 2024","section":"Chapter 1, Para 8","url":"https://indiainsurances.com/law/irdai-life-products-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part A, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Sec 1, Part B, IV.2","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"Master Circular on Protection of Policyholders' Interests, 2024","section":"Para 3","url":"https://indiainsurances.com/law/irdai-ppi-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule I, Para 1.2","url":"https://indiainsurances.com/law/irdai-products-regs-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 1.3","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"eligibility_entry_age","label":"Entry age","section":"Eligibility","meaning":"The youngest and oldest age at which you can buy this policy.","status":"not-stated","value":null,"display":null,"note":"The wording states eligible relationships but not minimum or maximum entry age.","quote":null,"sources":[],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"optional_covers","label":"Optional covers","section":"Cover","meaning":"Covers you can add for an extra premium. They change the answers above only if you buy them.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"grace_cover","label":"Cover during the grace period","section":"Renewal and rights","meaning":"Whether a claim during the grace period is paid.","status":"quote-verified","value":"For renewal grace period, coverage is not available during the grace period. If premium is paid in instalments during the policy period, coverage is available for the grace period also.","display":"Renewal grace period: no coverage; instalment premium grace period: coverage available","note":null,"quote":"Coverage is not available during the grace period. ... If the premium is paid in instalments during the policy period, coverage will be available for the grace period also","sources":[{"clause":"10","heading":"Renewal of Policy","page":64,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-10-5"},{"clause":"12","heading":"Premium Payment in Instalments","page":64,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-12-4"}],"law":[]},{"key":"room_rent","label":"Room rent limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for the hospital room, or the room category allowed. If you take a costlier room, other bills can be cut in proportion.","status":"quote-verified","value":"If Cap on Room Rent is opted and room rent incurred is higher than the eligible Room Rent specified in the Policy Schedule, the insurer pays only a rateable proportion of associated medical expenses. If this cover is not opted, eligible room rent and associated medical expenses are subject to the Base Sum Insured, Cumulative Bonus and Restoration Benefit if applicable.","display":"No stated rupee room-rent cap unless Cap on Room Rent is opted; eligible Room Rent is as specified in the Policy Schedule","note":"The wording does not state the eligible Room Rent amount; it is specified in the Policy Schedule.","quote":"If We have accepted a Claim for In-patient Hospitalization under the Policy and if the Insured Person incurs Room Rent that is higher than the eligible Room Rent as specified in the Policy Schedule then We will be liable to pay only a rateable proportion of the Associated Medical Expenses incurred ... In case this Cover is not opted for, Insured will get the eligible Room Rent and Associated Medical Expenses subject to Base Sum Insured including Cumulative Bonus and Restoration Benefit, if applicable.","sources":[{"clause":"2.25","heading":"Cap on Room Rent","page":42,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-25"}],"law":[]},{"key":"room_category","label":"Room category allowed","section":"Limits and co-pay","meaning":"Shared room, single private room or any room, by plan, when the limit is a room type rather than a rupee amount.","status":"not-stated","value":null,"display":null,"note":"The wording refers to eligible Room Rent specified in the Policy Schedule but does not state a room category such as shared or single private room.","quote":null,"sources":[],"law":[]},{"key":"icu_limit","label":"ICU limit","section":"Limits and co-pay","meaning":"The most the policy pays per day for intensive care.","status":"quote-verified","value":"ICU Charges are covered under in-patient treatment. The wording does not state a separate ICU per-day limit, and says proportionate deductions will not be applied to ICU Charges.","display":"No separate ICU limit stated; ICU Charges are covered and proportionate deductions do not apply to ICU Charges","note":null,"quote":"the Medical Expenses incurred are Reasonable and Customary and may be for one or more of the following:\ni) Room Rent and other boarding charges;\nii) ICU Charges; ... Further, proportionate deductions will not be applied in respect of ICU Charges.","sources":[{"clause":"2.1","heading":null,"page":26,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-1"},{"clause":"2.25","heading":"Cap on Room Rent","page":42,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-25"}],"law":[]},{"key":"proportionate_deduction","label":"Proportionate deduction","section":"Limits and co-pay","meaning":"If you choose a room above your limit, whether the insurer reduces associated charges (doctor fees, tests, procedures) by the same proportion.","status":"quote-verified","value":"If the insured incurs room rent higher than the eligible Room Rent in the Policy Schedule, the insurer pays only a rateable proportion of associated medical expenses. Proportionate deductions do not apply to hospitals without differential billing, expenses without differential billing by room category, or ICU Charges.","display":"Yes, if room rent exceeds eligible Room Rent; not applied for no differential billing or ICU Charges","note":null,"quote":"if the Insured Person incurs Room Rent that is higher than the eligible Room Rent as specified in the Policy Schedule then We will be liable to pay only a rateable proportion of the Associated Medical Expenses incurred in the proportion of the difference between the eligible Room Rent and the Room Rent actually incurred ... Proportionate deductions will not be applied in respect of the hospitals which do not follow differential billing or for those expenses in respect of which differential billing is not adopted based on the room category. Further, proportionate deductions will not be applied in respect of ICU Charges.","sources":[{"clause":"2.25","heading":"Cap on Room Rent","page":42,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-25"}],"law":[]},{"key":"copay","label":"Co-payment","section":"Limits and co-pay","meaning":"The share of every admissible claim you pay yourself, and when it applies (age, zone, choice of hospital).","status":"quote-verified","value":"Zone-based co-payment applies when treatment is taken in a city in a higher zone than the eligible zone: Zone II to Zone I has 10%, Zone III to Zone I has 20%, and Zone III to Zone II has 10%. Zone I premium allows treatment all over India without co-payment; Zone II premium allows Zone II and III without co-payment; Zone III premium allows Zone III without co-payment.","display":"Zone co-pay: 10% for Zone II to Zone I, 20% for Zone III to Zone I, 10% for Zone III to Zone II","note":"The higher-zone co-payments do not apply to hospitalisation due to an accident.","quote":"Persons paying Zone I premium can avail treatment all over India without any Co-payment.\n• Persons paying Zone II premium can avail treatment in Zone II and Zone III without any co-payment\n• Persons paying Zone III premium can avail treatment in Zone III only without any co-payment ... Applicable Zone | Treatment Taken at | Co-payment applicable\nZone II | Zone I | 10%\nZone III | Zone I | 20%\nZone III | Zone II | 10%","sources":[{"clause":"22","heading":"Zone Classification","page":67,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-22-2"}],"law":[]},{"key":"deductible","label":"Deductible","section":"Limits and co-pay","meaning":"An amount of each claim or each year that you bear before the policy pays.","status":"not-stated","value":null,"display":null,"note":"The wording defines deductible but does not state any deductible amount or that a deductible applies to this product.","quote":null,"sources":[],"law":[]},{"key":"disease_sublimits","label":"Disease or procedure sub-limits","section":"Limits and co-pay","meaning":"Caps on what is paid for named treatments (cataract, knee replacement...), even if the sum insured is higher.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"pre_hospitalisation","label":"Pre-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days before admission that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":"The wording covers pre-hospitalisation expenses but says the number of days is as mentioned in the Policy Schedule; the number is not stated in the wording.","quote":null,"sources":[],"law":[]},{"key":"post_hospitalisation","label":"Post-hospitalisation cover","section":"Cover","meaning":"Medical costs in the days after discharge that are paid if related to the hospitalisation.","status":"not-stated","value":null,"display":null,"note":"The wording covers post-hospitalisation expenses but says the number of days is as mentioned in the Policy Schedule; the number is not stated in the wording.","quote":null,"sources":[],"law":[]},{"key":"day_care","label":"Day-care treatments","section":"Cover","meaning":"Treatments needing less than 24 hours in hospital (chemotherapy, dialysis, cataract) and whether all or only listed ones are covered.","status":"quote-verified","value":"Day Care Treatment is covered for medically necessary treatment following written advice of a medical practitioner, but only for the day care treatments listed in Annexure II. OPD treatment is not covered under this benefit.","display":"Listed day-care treatments only, as per Annexure II; OPD not covered","note":null,"quote":"We will indemnify the Medical Expenses incurred on the Insured Person’s Day Care Treatment during the Policy Period following an Illness or Injury that occurs during the Policy Period provided that: ... We will only cover the Medical Expenses for those Day Care Treatments which are listed in Annexure II of this Policy. ... We will not cover any OPD Treatment under this Benefit.","sources":[{"clause":null,"heading":"2.2 Day Care Treatment","page":27,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-2-day-care-treatment"}],"law":[]},{"key":"domiciliary","label":"Treatment at home","section":"Cover","meaning":"Whether treatment at home is covered when hospital admission is not possible or a doctor advises it.","status":"quote-verified","value":"Domiciliary hospitalisation is covered up to the Base Sum Insured when treatment at home would otherwise require hospitalisation, or the insured cannot be transferred to hospital, or a hospital bed is unavailable. The domiciliary hospitalisation must be medically necessary, follow written medical advice, and extend for at least 3 consecutive days.","display":"Covered up to Base Sum Insured, if home treatment would otherwise require hospitalisation or hospital transfer/bed is unavailable; minimum 3 consecutive days","note":"The cover excludes listed conditions such as asthma, bronchitis, chronic nephritis, diarrhoea/dysentery/gastro-enteritis, diabetes, epilepsy, hypertension, influenza/cough/cold, specified psychiatric or psychosomatic disorders, short pyrexia of unknown origin, tonsillitis/URTI, and arthritis/gout/rheumatism.","quote":"We will indemnify the Medical Expenses incurred on the Insured Person’s Domiciliary Hospitalization during the Policy Period following an Illness or Injury that occurs during the Policy Period up to the limits of the Base Sum Insured (subject to availability), provided that:\na) We will cover medical expenses of an Insured person for treatment of a disease, Illness or Injury taken at home which would otherwise have required hospitalisation or since the Insured person's condition did not allow a hospital transfer or a hospital bed was unavailable. ... The Insured Person's Domiciliary Hospitalisation extends for at least 3 consecutive days","sources":[{"clause":"2.7","heading":"Domiciliary Hospitalisation","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-7"}],"law":[]},{"key":"ayush","label":"AYUSH treatment","section":"Cover","meaning":"Ayurveda, Yoga, Unani, Siddha and Homeopathy treatment in a recognised hospital, and any limit.","status":"quote-verified","value":"Alternative Treatment under AYUSH is covered up to the Base Sum Insured, if administered by a licensed AYUSH medical practitioner and the insured is admitted to an AYUSH Hospital as an inpatient or for day care treatment.","display":"AYUSH covered up to Base Sum Insured for inpatient or day care treatment in an AYUSH Hospital","note":null,"quote":"We will indemnify the Medical Expenses incurred on the Insured Person’s Alternative Treatment during the Policy Period following an Illness or Injury that occurs during the Policy Period up to the limits of the Base Sum Insured (subject to availability), provided that:\na) The Alternative Treatment is administered by a Medical Practitioner who holds a valid practicing license in respect of such AYUSH Treatments;\nb) The Insured Person is admitted to AYUSH Hospital as an Inpatient or for Day Care treatment","sources":[{"clause":"2.6","heading":"Alternative Treatment","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-6-2"}],"law":[{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 1","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Guidelines on providing AYUSH coverage in Health Insurance policies, 2024","section":"Para 2","url":"https://indiainsurances.com/law/irdai-ayush-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 1","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch II A.I(1)","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"IRDAI (Insurance Products) Regulations, 2024","section":"Schedule III, Para 5","url":"https://indiainsurances.com/law/irdai-products-regs-2024"}]},{"key":"modern_treatments","label":"Modern treatments","section":"Cover","meaning":"Robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and the like, and any cap on them.","status":"not-stated","value":null,"display":null,"note":"The wording does not state a modern treatment methods benefit or caps for robotic surgery, immunotherapy, oral chemotherapy, stem cell therapy and similar treatments.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 2","url":"https://indiainsurances.com/law/irdai-health-mc-2024"}]},{"key":"organ_donor","label":"Organ donor expenses","section":"Cover","meaning":"Whether the donor's hospital costs for an organ transplant are paid.","status":"quote-verified","value":"In-patient hospitalisation medical expenses for the organ donor for harvesting the organ are covered up to the Base Sum Insured, if the insured person's inpatient claim is accepted and the organ is for the insured person's transplant on medical advice.","display":"Donor inpatient harvesting expenses covered up to Base Sum Insured","note":"The cover excludes donor pre/post-hospitalisation expenses, organ acquisition costs, and other donor treatment or complications consequent to harvesting.","quote":"We will indemnify the In-patient Hospitalisation Medical Expenses towards the donor for harvesting the organ up to the limits of the Base Sum Insured (subject to availability), provided that:\na) We have accepted a Claim for In-patient Treatment under the Policy in respect of the Insured Person; ... The organ donated is for the use of the Insured Person who has been asked to undergo an organ transplant on Medical Advise;","sources":[{"clause":"2.5","heading":"Organ Donor Cover","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-5-2"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"Road ambulance expenses are covered up to the limit specified in the Policy Schedule if related to an accepted inpatient or day care claim and certified necessary by the treating medical practitioner. Air ambulance is also covered up to the Policy Schedule limit for emergency life-threatening conditions requiring airplane or helicopter ambulance transportation, but return transportation home by air ambulance is excluded.","display":"Road ambulance up to Policy Schedule limit; air ambulance up to Policy Schedule limit for emergency life-threatening conditions","note":null,"quote":"We will indemnify the amount incurred up to the limit specified in the Policy Schedule for the reasonable expenses incurred by You on availing ambulance services offered by a healthcare or Ambulance service provider ... We will indemnify the amount up to the limit specified in the Policy Schedule for the reasonable expenses incurred by You for ambulance transportation in an airplane or helicopter for emergency life threatening health conditions ... Return transportation to Your home by air ambulance is excluded","sources":[{"clause":"2.4","heading":"Ambulance Cover","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-4-2"},{"clause":"2.22","heading":"Air Ambulance Cover","page":40,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-22"}],"law":[]},{"key":"restoration","label":"Restoration of sum insured","section":"Cover","meaning":"Whether the sum insured is refilled after it is used up in a year, how much, how often, and whether it works for the same illness.","status":"quote-verified","value":"The policy provides 100% restoration of the Base Sum Insured once in a Policy Year if the Base Sum Insured and cumulative bonus are insufficient due to previous claims in that Policy Year. The restored sum insured is not available for the same illness and complications already accepted or paid for the same insured person in that policy year, and does not apply to the first claim unless it is an accident injury where the claim exceeds the Base Sum Insured.","display":"100% restoration of Base Sum Insured once per Policy Year; not for same illness already claimed","note":"Unused restored sum insured is not carried forward; no cumulative bonus applies on restored sum insured.","quote":"We will provide a 100% restoration of the Base Sum Insured amount once in a Policy Year if the Base Sum Insured and the Cumulative Bonus (if any) is insufficient as a result of previous Claims in that Policy Year, provided that:\na) The restored sum insured will not be available in respect of any Illness (including its complications) for which a Claim has already been accepted / paid in that Policy Year for the same Insured Person.\nb) The restoration of sum insured shall not apply to the first claim in that Policy Year unless related\nto an Injury due to Accident where the claim amount exceeds the Base Sum Insured.","sources":[{"clause":"2.9","heading":"Restoration Benefit","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-9"}],"law":[]},{"key":"no_claim_bonus","label":"No-claim or cumulative bonus","section":"Cover","meaning":"How much the cover grows each year, the maximum, whether it depends on not claiming, and what happens after a claim.","status":"quote-verified","value":"The Base Sum Insured increases by 10% at the end of the Policy Year if the policy is renewed with the insurer, subject to the maximum limit specified in the Policy Schedule. The wording does not make the 10% increase dependent on having no claim, and says earned cumulative bonus is carried forward if renewed before the grace period expires.","display":"Cumulative Bonus: 10% increase each renewed Policy Year, maximum as per Policy Schedule","note":"The maximum cumulative bonus limit is stated to be in the Policy Schedule and is not printed in the wording.","quote":"We will increase Your Base Sum Insured by 10% subject to the maximum limit specified in the Policy Schedule at the end of the Policy Year if the Policy is renewed with Us provided that: ... Cumulative Bonus will be carried forward to the next Policy Year, provided the Insured Person renews the Policy before the expiry of the Grace Period.","sources":[{"clause":"2.10","heading":"Cumulative Bonus","page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-10"},{"clause":"2.10(d)","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-10-d"}],"law":[]},{"key":"consumables","label":"Consumables and non-medical items","section":"Cover","meaning":"Gloves, PPE, syringes and other items hospitals bill that standard policies exclude; whether this policy pays them.","status":"quote-verified","value":"Inpatient treatment covers medicines, drugs and other allowable consumables prescribed by the treating medical practitioner. Non-medical expenses listed in Annexure III are excluded.","display":"Allowable consumables covered; Annexure III non-medical expenses excluded","note":"Annexure III lists some items as payable, not payable, or to be subsumed into room/procedure/treatment costs.","quote":"Medicines, drugs and other allowable consumables prescribed by the treating Medical Practitioner; ... All non-medical expenses listed in Annexure III (List I) of the Policy.","sources":[{"clause":"2.1","heading":null,"page":26,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-1"},{"clause":"31","heading":null,"page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-31"}],"law":[]},{"key":"maternity","label":"Maternity cover","section":"Cover","meaning":"Whether childbirth costs are covered, the limit and the waiting period.","status":"quote-verified","value":"Maternity expenses are covered up to the Maternity Benefit Sum Insured specified in the Policy Schedule for delivery, caesarean section, or medically necessary and lawful medical termination of pregnancy, after 36 months of continuous cover under this benefit. The insurer will not pay for more than 2 delivery events across all policy periods.","display":"Covered up to Maternity Benefit Sum Insured after 36 months; maximum 2 delivery events","note":"Pre-natal and post-natal expenses are covered up to the amount specified in the Policy Schedule if the delivery/termination claim is accepted. Ectopic pregnancy is considered under In-patient Treatment, not this benefit.","quote":"We will indemnify the Medical Expenses incurred up to the Maternity Benefit Sum Insured specified in the Policy Schedule for the delivery of the Insured Person’s child (including cesarean section) or the Medically Necessary and lawful medical termination of pregnancy during the Policy Period provided that: ... The cover shall be available to the Insured Person who has been continuously covered for at least 36 months under this Benefit ... We shall not be liable to pay for more than 2 events of deliveries across all Policy Periods with Us;","sources":[{"clause":"2.19","heading":"Maternity Benefit","page":38,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-19"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"Hospitalisation medical expenses of the insured person's newborn baby are covered during the Policy Period within the Maternity Sum Insured if the maternity claim is accepted. The newborn can be covered beyond 90 days on payment of requisite premium by endorsement or at next renewal, whichever is earlier.","display":"Newborn hospitalisation covered within Maternity Sum Insured; beyond 90 days with requisite premium","note":"Pre and post hospitalisation expenses for the newborn are not covered under this benefit.","quote":"We will indemnify the Medical Expenses incurred on the Hospitalization of the Insured Person’s New Born Baby during the Policy Period within the limits of the Maternity Sum Insured subject to the following:\na) We have accepted a Claim for Maternity Benefit under the Policy. ... You can cover the New Born Baby beyond 90 days on payment of requisite premium for the New Born Baby by way of an endorsement or at the next Renewal, whichever is earlier.","sources":[{"clause":"2.20","heading":"New Born Baby Cover","page":39,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-20"}],"law":[]},{"key":"mental_illness","label":"Mental illness","section":"Cover","meaning":"Cover for in-patient treatment of mental illness.","status":"not-stated","value":null,"display":null,"note":"The wording does not expressly state cover for in-patient treatment of mental illness; it only lists psychiatric or psychosomatic disorders among exclusions under domiciliary hospitalisation.","quote":null,"sources":[],"law":[{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch I Para 3","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"Master Circular on Health Insurance Business, 2024","section":"Ch III I","url":"https://indiainsurances.com/law/irdai-health-mc-2024"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(4)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 2(1)(s)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"},{"title":"The Mental Healthcare Act, 2017","section":"Section 21(1)","url":"https://indiainsurances.com/law/mental-healthcare-act-2017"}]},{"key":"health_checkup","label":"Health check-up","section":"Cover","meaning":"Free preventive check-ups and how often.","status":"quote-verified","value":"The insurer will arrange one free health check-up at a network provider for each insured person above 18 years of age, for each policy year, regardless of any claim admitted or registered. The listed tests include CBC, MER, serum cholesterol, serum creatinine, SGPT/SGOT, ECG, and random blood sugar.","display":"One free health check-up each Policy Year for each insured person above 18 years","note":null,"quote":"We will arrange for one free health check-up at Our Network Provider for each Insured Person that is above 18 years of Age, for each Policy Year for the specified tests. This will be offered regardless of any claim admitted/ registered under the Policy.\nThe health check-up will consist of the following tests for all eligible Insured Persons ... a) CBC;\nb) MER;\nc) Serum Cholesterol;\nd) Serum Creatinine;\ne) SGPT /SGOT\nf) ECG;\ng) Random Blood Sugar.","sources":[{"clause":"2.8","heading":"Annual Health Check-up","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-8"}],"law":[]},{"key":"opd","label":"Out-patient (OPD) cover","section":"Cover","meaning":"Doctor consultations, tests and medicines without admission, and the limit.","status":"quote-verified","value":"OPD treatment is not covered. Reward points under Health and Rewards can be redeemed for outpatient medical expenses like consultation charges, medicines and drugs, dental expenses, wellness and preventive care, and other miscellaneous charges.","display":"OPD treatment not covered; reward points may be redeemed for outpatient medical expenses","note":"The reward-point redemption is under Health and Rewards, not a standalone OPD indemnity limit.","quote":"Any OPD treatment will not be covered ... Outpatient medical expenses like consultation charges, medicine & drugs, dental expenses, wellness & preventive care and other miscellaneous charges","sources":[{"clause":"33","heading":"Any OPD treatment will not be covered","page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-33"},{"clause":"2.12(a)","heading":null,"page":34,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-2-12-a-2"}],"law":[]},{"key":"zone_pricing","label":"Zone or city-based premium","section":"Premium","meaning":"Whether premium or co-pay depends on the city you are treated in.","status":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"law":[]},{"key":"cashless","label":"Cashless treatment","section":"Claims","meaning":"Whether and where the insurer pays the hospital directly instead of you paying and claiming back.","status":"quote-verified","value":"Cashless facility is available at network providers of the company. The updated provider list is available on the insurer's website or from the call centre, and pre-authorisation is required.","display":"Available at Network Providers with pre-authorisation","note":null,"quote":"Cashless Facility will be available at a Network Provider of the Company. The complete list of Providers is available on Our website (The list is updated as and when there is any change in the Network Provider) or can be obtained from Our call centre. In order to avail of Cashless Facility, the following procedure shall be followed:","sources":[{"clause":null,"heading":"5. CLAIMS PROCEDURE","page":49,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-5-claims-procedure"}],"law":[]},{"key":"claims_handled_by","label":"Claims handled by","section":"Claims","meaning":"The insurer itself or a third-party administrator (TPA).","status":"quote-verified","value":"Claims may be handled by Zurich Kotak General Insurance or its TPA. The wording names Family Health Plan (TPA) Ltd for sending relevant claim documents.","display":"Zurich Kotak General Insurance or its TPA; Family Health Plan (TPA) Ltd named","note":null,"quote":"We or Our TPA shall be contacted to request pre-authorization ... In the event of claims, please send the relevant documents to:\nFamily Health Plan (TPA) Ltd, Srinilaya – Cyber Spazio Suite # 101,102,109 & 110, Ground Floor, Road No. 2, Banjara Hills, Hyderabad, 500 034.","sources":[{"clause":null,"heading":"5. CLAIMS PROCEDURE","page":49,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-5-claims-procedure"},{"clause":"36(a)(vi)","heading":null,"page":50,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-36-a-vi"}],"law":[]},{"key":"family_floater","label":"Family floater available","section":"Cover","meaning":"Whether one sum insured can be shared by the whole family.","status":"quote-verified","value":true,"display":"Yes, Family Floater available","note":null,"quote":"For Family Floater sum insured basis (Floater Policy), the amount specified in the Policy Schedule which is Our maximum, total and cumulative liability for any and all claims arising during a Policy Year in respect of any one and/or all Insured Persons. ... Family Floater | means a Policy described as such in the Policy Schedule where You and Your family members as mentioned in Eligibility (Part III) and named in the Schedule are insured under this Policy as at the Policy Period Start Date.","sources":[{"clause":"1(b)","heading":null,"page":20,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431#c-1-b"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Protect Rider","pages":3,"fetched_at":"2026-10-17 20:13:54+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Protect_Rider_Policy_Wording_ZK_v1_24_25_30092024_7afc84ff4d.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18293"},{"kind":"wording","label":"Health Maximiser","pages":92,"fetched_at":"2026-10-17 20:21:56+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Maximiser_Policy_Wording_ca3efecf34.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18431"},{"kind":"prospectus","label":"Health Maximiser - Prospecus","pages":60,"fetched_at":"2026-10-17 20:07:14+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Maximiser_Prospectus_a531d6dd00.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425/document/18180"}],"versions":[{"uin":"ZUKHLIA25055V022425","version":null,"approved_on":null},{"uin":"ZUKHLIP25057V022425","version":null,"approved_on":null}],"where_to_buy":[{"purpose":"buy","kind":"insurer","name":"Zurich Kotak General Insurance ( ) official website","url":"https://www.zurichkotak.com/","note":"Buy directly from the insurer."},{"purpose":"buy","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."}],"claims_and_complaints":[{"purpose":"claim","kind":"insurer","name":"Claims","url":"https://www.zurichkotak.com/services/claims","note":null},{"purpose":"claim","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"grievance","kind":"insurer","name":"Grievance redressal process","url":"https://www.zurichkotak.com/customer-support/grievance-redressal-process","note":null},{"purpose":"grievance","kind":"official","name":"Bima Bharosa (IRDAI grievance portal)","url":"https://bimabharosa.irdai.gov.in/","note":"Register and track a complaint against any insurer with IRDAI. Complain to the insurer first; escalate here if the reply is late or unsatisfactory."},{"purpose":"grievance","kind":"official","name":"e-Daakhil (consumer commission e-filing)","url":"https://edaakhil.nic.in/","note":"Not reachable from our crawler on 2026-10-19; use e-Jagriti if this link does not open."},{"purpose":"grievance","kind":"official","name":"e-Jagriti (consumer commission filing)","url":"https://e-jagriti.gov.in/","note":"Ministry of Consumer Affairs platform for consumer commission cases, a route for insurance disputes that the Ombudsman does not settle."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Ahmedabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Gujarat, Dadra & Nagar Haveli, Daman and Diu. Email: oio.ahmedabad@cioins.co.in. Phone: 079 - 25501201/02. Address: Office of the Insurance Ombudsman, Jeevan Prakash Building, 6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bengaluru","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Karnataka. Email: oio.bengaluru@cioins.co.in. Phone: 080 - 26652048 / 26652049. Address: Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru – 560 078."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhopal","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Madhya Pradesh, Chhattisgarh. Email: oio.bhopal@cioins.co.in. Phone: 0755 - 2769201 / 2769202 / 2769203. Address: Office of the Insurance Ombudsman, 1st floor,\"Jeevan Shikha\", 60-B,Hoshangabad Road, Opp. Gayatri Mandir,Arera Hills Bhopal – 462 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Bhubaneswar","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Odisha. Email: oio.bhubaneswar@cioins.co.in. Phone: 0674 - 2596461 /2596455/2596429/2596003. Address: Office of the Insurance Ombudsman, 62, Forest park, Bhubaneswar – 751 009."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chandigarh","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Punjab, Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal Pradesh, Union Territories of Jammu & Kashmir,Ladakh & Chandigarh. Email: oio.chandigarh@cioins.co.in. Phone: 0172-2706468. Address: Office Of The Insurance Ombudsman, Jeevan Deep Building SCO 20-27, Ground Floor Sector- 17 A, Chandigarh – 160 017."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Chennai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Tamil Nadu, PuducherryTown and Karaikal (which are part of Puducherry). Email: oio.chennai@cioins.co.in. Phone: 044 - 24333668 / 24333678. Address: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI – 600 018."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Delhi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Delhi & following Districts of Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh. Email: oio.delhi@cioins.co.in. Phone: 011 - 46013992/23213504/23232481. Address: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Guwahati","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura. Email: oio.guwahati@cioins.co.in. Phone: 0361 - 2632204 / 2602205 / 2631307. Address: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Near Pan Bazar , S.S. Road, Guwahati – 781001(ASSAM)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Hyderabad","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Andhra Pradesh, Telangana, Yanam and part of Union Territory of Puducherry. Email: oio.hyderabad@cioins.co.in. Phone: 040 - 23312122 / 23376991 / 23376599 / 23328709 / 23325325. Address: Office of the Insurance Ombudsman, 6-2-46, 1st floor, \"Moin Court\", Lane Opp.Hyundai Showroom , A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Jaipur","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Rajasthan. Email: oio.jaipur@cioins.co.in. Phone: 0141- 2740363. Address: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kochi","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Kerala, Lakshadweep, Mahe-a part of Union Territory of Puducherry. Email: oio.ernakulam@cioins.co.in. Phone: 0484 - 2358759. Address: Office of the Insurance Ombudsman, 10th Floor, Jeevan Prakash,LIC Building, Opp to Maharaja's College Ground,M.G.Road, Kochi - 682 011."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Kolkata","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: West Bengal, Sikkim, Andaman & Nicobar Islands. Email: oio.kolkata@cioins.co.in. Phone: 033 - 22124339 / 22124341. Address: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th Floor, 4, C.R. Avenue, KOLKATA - 700 072."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Lucknow","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar. Email: oio.lucknow@cioins.co.in. Phone: 0522 - 4002082 / 3500613. Address: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Mumbai","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: List of wards under Mumbai Metropolitan Region excluding wards in Mumbai – i.e M/E, M/W, N , S and T covered under Office of Insurance Ombudsman Thane and excluding areas of Navi Mumbai. Email: oio.mumbai@cioins.co.in. Phone: 022 - 69038800/27/29/31/32/33. Address: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Noida","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Uttarakhand and the following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur. Email: oio.noida@cioins.co.in. Phone: 0120-4027589. Address: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: offices and jurisdiction","url":"https://www.cioins.co.in/Ombudsman","note":"Addresses, phone numbers, e-mail and the states or districts each Ombudsman office covers."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Patna","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Bihar, Jharkhand. Email: oio.patna@cioins.co.in. Phone: 0612-2547068. Address: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey Road, Patna 800 001."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Pune","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: State of Goa and State of Maharashtra excluding areas of Navi Mumbai, Thane district,Palghar District, Raigad district & Mumbai Metropolitan Region. Email: oio.pune@cioins.co.in. Phone: 020-24471175. Address: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman: register a complaint online","url":"https://cioins.co.in/Complaint/Online","note":"Council for Insurance Ombudsmen. Free. For disputes with an insurer after its own grievance process; the office is chosen by where you live (see the offices list)."},{"purpose":"grievance","kind":"official","name":"Insurance Ombudsman, Thane","url":"https://www.cioins.co.in/Ombudsman","note":"Covers: Area of Navi Mumbai, Thane District, Raigad District, Palghar District and wards of Mumbai , M/East, M/West, N, S and T. Email: oio.thane@cioins.co.in. Phone: 022-20812868/69. Address: Office of the Insurance Ombudsman, Jeevan Chintamani Building, 2nd Floor,Near New RTO Office, Louis Wadi,Vasantrao Naik Mahamarg, Thane (West)- 400604."},{"purpose":"grievance","kind":"official","name":"National Consumer Helpline","url":"https://consumerhelpline.gov.in/public/","note":"Government consumer helpline; can take up a complaint before you go to a consumer commission."},{"purpose":"port","kind":"ours","name":"Get free help from IndiaInsurances","url":"/help","note":"Free. We do not sell insurance and earn no commission; your request is not passed to anyone."},{"purpose":"renew","kind":"insurer","name":"Renewals","url":"https://www.zurichkotak.com/renewal","note":null}],"notice":"Information, not advice. IndiaInsurances is not an insurer or an insurance intermediary, does not sell insurance and earns no commission. Policy terms change and your own policy schedule can differ: always confirm with the policy document and the insurer before you buy or claim.","cite_as":"Health Maximiser (UIN ZUKHLIP25057V022425), IndiaInsurances, https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-maximiser-zukhlip25057v022425"}