{"uin":"ZUKHLIP27071V062627","name":"Health Premier (Advantage Plan)","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627","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 Premier Advantage is a health indemnity policy available for 1/2/3 years with individual or family floater cover and base sum insured options of 3 lac/ 4 lac/ 5 lac/ 7.5 lac/ 10 lac. For the Advantage plan, pre-hospitalisation is 60 days, post-hospitalisation is 90 days, PED waiting is 36 months and cumulative bonus is 10% per renewal up to 50%.","analysis":{"state":"machine","analysed_at":"2026-10-19 22:57:08.986549+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":"quote-verified","value":["Standard","Advantage","Edge","Elite","Absolute","360","Total"],"display":"Standard, Advantage, Edge, Elite, Absolute, 360, Total","note":null,"quote":"Plan Name | Standard | Advantage | Edge | Elite | Absolute | 360 | Total","sources":[{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details"}],"law":[]},{"key":"policy_term","label":"Policy term","section":"Eligibility","meaning":"How long one policy runs before it ends or must be renewed.","status":"quote-verified","value":"1/2/3 years","display":"1/2/3 years","note":null,"quote":"Policy Period | 1/2/3 years","sources":[{"clause":"1","heading":"SAILENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-1"}],"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 cashless emergency care, contact them within 24 hours of commencement of hospitalisation; reimbursement claims must be notified at least within 30 days of discharge.","display":"Planned cashless: at least 48 hours before hospitalisation; emergency cashless: within 24 hours of hospitalisation; reimbursement: within 30 days of discharge","note":"Critical Illness Cover, if opted, requires written notice within 30 days from first diagnosis.","quote":"At least 48 hours prior to a planned Hospitalization, We or Our TPA shall be contacted to request pre-authorization for availing the Cashless Facility for that planned Hospitalisation. ... If the Insured Person has been admitted into Hospital for Emergency Care, We or Our TPA shall be 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:","sources":[{"clause":null,"heading":"5.1 For Cashless Facility","page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-5-1-for-cashless-facility"},{"clause":"36(a)(vi)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-36-a-vi"},{"clause":null,"heading":"5.2 For Reimbursement Claims","page":34,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-5-2-for-reimbursement-claims"}],"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 and payment receipts","Indoor case papers, if available","Implant Invoice/ Sticker, if available","Ambulance Invoice, if applicable","FIR or MLC for Accident cases","Post mortem report, if conducted","KYC documents","Any other document as required by Us or Our TPA"],"display":"Claim form, discharge summary, consultation papers, bills and receipts, prescriptions, investigation reports, indoor case papers, implant/ambulance invoices where applicable, FIR/MLC for accidents, post-mortem report, KYC and other required documents","note":null,"quote":"a) Duly completed Claim form signed by You and the Medical Practitioner (only for reimbursement claims); b) Hospital discharge summary; c) First consultation and follow up treatment papers; d) Original bills and receipts from the Hospital/Medical Practitioner; e) Original bills from chemists supported by proper prescription; f) Original investigation test reports (including CT/MR/USG/ECG, as applicable) and payment receipts; g) Indoor case papers, if available; h) Implant Invoice/ Sticker, if available; i) Ambulance Invoice, if applicable; j) FIR (if done) or MLC (if conducted) for Accident cases ; k) Post mortem report (if conducted); l) KYC documents viz. Photo ID and address proof along with duly completed form. m) Any other document as required by Us or Our TPA to investigate the Claim or Our obligation to make payment for it.","sources":[{"clause":null,"heading":"6. CLAIM DOCUMENTS","page":35,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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.","display":"Within 15 days from receipt of claim with claim form and necessary documents","note":"For delayed payment, interest applies from receipt of the last necessary document to payment at 2% above the bank rate.","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).","sources":[{"clause":"17(i)","heading":null,"page":49,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-17-i"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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":"First contact Zurich Kotak through its website, toll-free number, email, courier address or branch grievance cell. If not satisfied, contact the grievance officer at grievanceofficer@zurichkotak.com before approaching the Insurance Ombudsman.","display":"Company website/toll-free/email/courier or branch grievance cell first; then grievanceofficer@zurichkotak.com; then Insurance Ombudsman","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 Courier: Zurich Kotak General Insurance Company (India) Limited, 401, 4th Floor, Silver Metropolis, Jai Coach Compound, Off Western Express Highway, Goregaon (East), Mumbai- 400063. Maharashtra, India. Insured 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":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-16-2"}],"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":"quote-verified","value":"For the Advantage plan, base sum insured options are 3 lac/ 4 lac/ 5 lac/ 7.5 lac/ 10 lac.","display":"Advantage: 3 lac/ 4 lac/ 5 lac/ 7.5 lac/ 10 lac","note":"Other plans have different base sum insured options.","quote":"Plan Name | Standard | Advantage | Edge | Elite | Absolute | 360 | Total Base Sum Insured | 2 lac | 3 lac/ 4 lac/ 5 lac/ 7.5 lac/ 10 lac","sources":[{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details"}],"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 accident claims or if the insured person 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":26,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-2"}],"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 months","note":"The cited plan chart states 36 months for the Advantage plan. The policy wording also allows 36/ 24 months as mentioned in the Policy Schedule.","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. ... Waiting period for PED | 36 months for all age groups","sources":[{"clause":"3.1","heading":"Pre-Existing Diseases (Code – Excl01)","page":26,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-1"},{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details-2"}],"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":"Not applicable for claims arising due to an accident; if the disease/procedure is also a pre-existing disease, 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":27,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-3"}],"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 replacements; sinusitis; urinary/biliary stones; D&C/endometriosis; skin/internal tumours/cysts/nodules/polyps; chronic renal failure dialysis; tonsillitis/adenoids/sinuses; gastric/duodenal ulcers; deviated nasal septum; varicose veins/ulcers","note":null,"quote":"a) Cataract*; b) Benign Prostatic Hypertrophy; c) Myomectomy, Hysterectomy unless because of malignancy; d) All types of Hernia, Hydrocele; e) Fissures and/or Fistula in anus, haemorrhoids/piles; f) Arthritis, gout, rheumatism and spinal disorders; g) Joint replacements unless due to Accident; h) Sinusitis and related disorders; i) Stones in the urinary and biliary systems; j) Dilatation and curettage, Endometriosis; k) All types of skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant; l) Dialysis required for chronic renal failure; m) Tonsillitis, adenoids and sinuses; n) Gastric and duodenal erosions and ulcers; o) Deviated nasal septum; p) Varicose Veins/ Varicose Ulcers.","sources":[{"clause":"3.3","heading":"Specified disease/ procedure waiting period (Code – Excl02)","page":27,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-3"}],"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":"Applies to sums insured of the first policy; enhanced sums insured get a separate sixty continuous months from enhancement.","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. This period of sixty continuous months is called as moratorium period.","sources":[{"clause":"14","heading":"Moratorium Period","page":48,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-14-2"}],"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":"quote-verified","value":"The insured person may port the policy to another insurer by applying at least 30 days before, but not earlier than 60 days from, the renewal date. Continuity benefits in waiting periods are given if continuously covered without lapses under a health insurance policy with an Indian general/health insurer.","display":"Can port to another insurer with waiting-period continuity; apply 30 to 60 days before renewal","note":null,"quote":"The insured person will have the option to port the policy to other insurers by applying to such insurer to port the entire policy along with all the members of the family, if any, at least 30 days before, but not earlier than 60 days from the policy renewal date as per IRDAI guidelines related to portability. If such person is presently covered and has been continuously covered without any lapses under any health insurance policy with an Indian General/Health insurer, the proposed insured person will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on portability.","sources":[{"clause":"8","heading":"Portability","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-8-2"}],"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":"quote-verified","value":true,"display":"Yes, life-long renewal","note":null,"quote":"Exit Age / Renewal | The Policy provides for life-long renewal","sources":[{"clause":"1","heading":"SAILENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-1"}],"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":"No loading applies on renewal based on individual claims experience.","display":"No loading based on individual claims experience","note":"Underwriting loading up to 200% may apply based on declarations and health status, but not based on individual claim experience.","quote":"No loading shall apply on renewals based on individual claims experience.","sources":[{"clause":"10","heading":"Renewal of Policy","page":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-10-2"}],"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":"quote-verified","value":["Investigation & Evaluation(Code- Excl04)","Rest Cure, rehabilitation and respite care (Code – Excl05)","Obesity/ Weight Control (Code – Excl06)","Change-of- Gender treatments (Code – Excl07)","Cosmetic or plastic Surgery (Code – Excl08)","Hazardous or Adventure sports: (Code- Excl09)","Breach of law (Code – Excl10)","Excluded Providers: (Code- Excl11)","Alcoholism, drug or substance abuse or any addictive condition","health hydros, nature cure clinics, spas or similar establishments","Dietary supplements and substances that can be purchased without prescription","Refractive Error (Code- Excl15)","Unproven Treatments (Code – Excl16)","Sterility and Infertility (Code- Excl17)","Maternity (Code- Excl18)","routine medical, eye or ear examinations preventive health check-ups, spectacles, laser surgery for correction of refractory errors, contact lenses, hearing aids, dentures or artificial teeth","prosthesis, corrective devices, external durable medical equipment","personal comfort, cosmetics, convenience and hygiene related items and services","dental treatment unless necessitated due to an Accident","Acupressure, acupuncture, magnetic and such other therapies","Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident","Vaccination or inoculation of any kind, unless it is post animal bite and there is hospitalisation as an in-patient","Intentional self-injury","Treatment relating to Congenital external Anomalies","sleep disorder or sleep apnoea syndrome, general debility, convalescence, run-down condition","health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel","Any treatment taken outside India","All non-medical expenses listed in Annexure III (List I) of the Policy","Any OPD treatment will not be covered","Treatment and supplies for analysis and adjustments of spinal subluxation","External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), and Hyperbaric Oxygen Therapy","Any physical, medical condition or treatment that is specifically excluded in the Policy Schedule under Important Conditions"],"display":"Permanent exclusions include Excl04 to Excl18 and product exclusions such as routine exams, external durable medical equipment, comfort/convenience items, dental treatment except accident inpatient/day-care, alternative therapies, vaccination except post animal bite with hospitalisation, self-injury, congenital external anomalies, treatment outside India, non-medical expenses, OPD treatment and schedule-specific exclusions","note":null,"quote":"We will not be liable under any circumstances, for any Claim in connection with or with regard to any of the following permanent exclusions as specified below: ... Excl04 Investigation & Evaluation(Code- Excl04) ... Excl05 Rest Cure, rehabilitation and respite care (Code – Excl05) ... Excl06 Obesity/ Weight Control (Code – Excl06) ... Change-of- Gender treatments (Code – Excl07) ... Cosmetic or plastic Surgery (Code – Excl08) ... Hazardous or Adventure sports: (Code- Excl09) ... Breach of law (Code – Excl10) ... Excluded Providers: (Code- Excl11) ... Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof ... Treatments received in health hydros, nature cure clinics, spas or similar establishments ... Dietary supplements and substances that can be purchased without prescription ... Refractive Error (Code- Excl15) ... Unproven Treatments (Code – Excl16) ... Sterility and Infertility (Code- Excl17) ... Maternity (Code- Excl18) ... Costs of routine medical, eye or ear examinations preventive health check-ups, spectacles, laser surgery for correction of refractory errors, contact lenses, hearing aids, dentures or artificial teeth; ... Any expenses incurred on prosthesis, corrective devices, external durable medical equipment ... Any expenses incurred on personal comfort, cosmetics, convenience and hygiene related items and services ... Expenses incurred on all dental treatment unless necessitated due to an Accident and treatment is taken in in-patient department of hospital or day care centre; ... Acupressure, acupuncture, magnetic and such other therapies; ... Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident; ... Vaccination or inoculation of any kind, unless it is post animal bite and there is hospitalisation as an in-patient; ... Intentional self-injury (whether arising from an attempt to commit suicide or otherwise) ... Treatment relating to Congenital external Anomalies; ... Any treatment related to sleep disorder or sleep apnoea syndrome, general debility, convalescence, run-down condition; ... Costs incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose; ... Any treatment taken outside India; ... All non-medical expenses listed in Annexure III (List I) of the Policy. ... Any OPD treatment will not be covered ... Treatment and supplies for analysis and adjustments of spinal subluxation ... Treatment such as External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), and Hyperbaric Oxygen Therapy will not be covered unless it forms a part of In-Patient Treatment in case of hospitalisation or part of discharge advice upto the Post hospitalisation period as specified in the Policy Schedule. ... Any physical, medical condition or treatment that is specifically excluded in the Policy Schedule under Important Conditions","sources":[{"clause":"3.5","heading":"Permanent Exclusions","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-5"},{"clause":"Excl04","heading":"Investigation & Evaluation(Code- Excl04)","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-excl04"},{"clause":"Excl05","heading":"Rest Cure, rehabilitation and respite care (Code – Excl05)","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-excl05"},{"clause":"Excl06","heading":"Obesity/ Weight Control (Code – Excl06)","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-excl06"},{"clause":"4","heading":"Change-of- Gender treatments (Code – Excl07)","page":28,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-4"},{"clause":"5","heading":"Cosmetic or plastic Surgery (Code – Excl08)","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-5"},{"clause":"6","heading":"Hazardous or Adventure sports: (Code- Excl09)","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-6"},{"clause":"7","heading":"Breach of law (Code – Excl10)","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-7"},{"clause":"8","heading":"Excluded Providers: (Code- Excl11)","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-8"},{"clause":"9","heading":"Code- Excl12","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-9"},{"clause":"10","heading":"Code- Excl13","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-10"},{"clause":"11","heading":"Code- Excl14","page":29,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-11"},{"clause":"12","heading":"Refractive Error (Code- Excl15)","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-12"},{"clause":"13","heading":"Unproven Treatments (Code – Excl16)","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-13"},{"clause":"14","heading":"Sterility and Infertility (Code- Excl17)","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-14"},{"clause":"15","heading":"Maternity (Code- Excl18)","page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-15"},{"clause":"16","heading":null,"page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-16"},{"clause":"17","heading":null,"page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-17"},{"clause":"18","heading":null,"page":30,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-18"},{"clause":"19","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-19"},{"clause":"20","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-20"},{"clause":"21","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-21"},{"clause":"22","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-22"},{"clause":"23","heading":"Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)","page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-23"},{"clause":"24","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-24"},{"clause":"25","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-25"},{"clause":"26","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-26"},{"clause":"27","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-27"},{"clause":"32","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-32"},{"clause":"33","heading":"Any OPD treatment will not be covered","page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-33"},{"clause":"34","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-34"},{"clause":"35","heading":"Treatment such as External Counter Pulsation (ECP), Enhanced External Counter Pulsation","page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-35"},{"clause":"36","heading":null,"page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-36"}],"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 by giving 7 days written notice. For a 1 year policy, the insurer refunds proportionate premium for the unexpired policy period if no claims were made; for a multi-year policy, future policy years are refunded in full and the started policy year is refunded pro rata if no claim was made, with medical examination expenses deducted where applicable.","display":"7 days notice; proportionate refund for unexpired period if no claim, with multi-year and medical-exam deductions as stated","note":null,"quote":"The Policyholder may cancel his/her policy at any time during the term, by giving 7 days notice in writing. The Insurer shall - • For 1 year Policy- Refund proportionate premium for unexpired policy period subject to no claim(s) were made during the policy period. • 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. Additional Deductions - Notwithstanding the above, if (i) the risk under the Policy has already commenced, or (ii) only a part of the insurance coverage has commenced, and the option of Policy cancellation is exercised by the Policyholder, then expenses incurred by the Company on medical examination of the Policyholder will also be deducted before refunding of premium.","sources":[{"clause":"7(i)","heading":null,"page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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 claims are payable only when the cause of action arises in India and treatment outside India is excluded, unless the policy specifically provides otherwise.","display":"India only, unless otherwise specifically provided","note":"Critical Illness Cover and Personal Accident Cover state worldwide basis if opted.","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;","sources":[{"clause":"24","heading":"Cause of Action/ Currency for payments","page":52,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-24-2"},{"clause":"27","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-27"}],"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":"quote-verified","value":{"unit":"days","amount":30},"display":"thirty days from date of receipt of the policy document","note":"Applicable on new individual health insurance policies and not on renewals or at the time of porting/migrating.","quote":"The insured person shall be allowed free look period of thirty days from date of receipt of the policy document to review the terms and conditions of the policy, and to return the same if not acceptable.","sources":[{"clause":"6","heading":"Free Look Period","page":45,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-6-2"}],"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","note":"Monthly instalment premiums have a 15-day grace period; quarterly, half-yearly and annual instalments have 30 days.","quote":"At the end of the policy period, 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":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-10-2"},{"clause":"12","heading":"Premium Payment in Instalments","page":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-12-2"}],"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":"quote-verified","value":"Entry age is 91 Days for Child and 18 years for Adult, with No Upper Limit for maximum entry age. Children have maximum entry age of 25 years, after which the child is considered an adult.","display":"Child: 91 Days; Adult: 18 years; maximum entry age: No Upper Limit; children: 25 years","note":null,"quote":"Entry Age: | 91 Days for Child and 18 years for Adult Maximum Entry Age: | No Upper Limit Maximum Entry age for children | 25 years, after which the Child will be considered as an Adult","sources":[{"clause":"1","heading":"SAILENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-1"}],"law":[]},{"key":"premium_modes","label":"Premium payment options","section":"Premium","meaning":"How often you can pay: yearly, half-yearly, quarterly, monthly.","status":"quote-verified","value":["Annual","Half Yearly","Quarterly","Monthly"],"display":"Annual, Half Yearly, Quarterly, Monthly","note":null,"quote":"If the insured person has opted for Payment of Premium on an instalment basis i.e. Half Yearly, Quarterly or Monthly ... Grace Period of 15 days (where premium is paid on monthly instalments) and 30 days (where premium paid in quarterly / half yearly/ annual instalments)","sources":[{"clause":"12","heading":"Premium Payment in Instalments","page":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-12-2"}],"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":"Coverage is not available during the renewal grace period. If premium is paid in instalments during the policy period, coverage is available for the grace period also.","display":"Renewal grace: coverage not available; instalment grace: 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":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-10-2"},{"clause":"12","heading":"Premium Payment in Instalments","page":47,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-12-2"}],"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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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-applicable","value":null,"display":null,"note":"The Advantage plan documents state room-rent limits by sum insured percentage only for an optional cap, not by room category.","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":"not-stated","value":null,"display":null,"note":null,"quote":null,"sources":[],"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 optional Cap on Room Rent is chosen and actual room rent is higher than eligible room rent, the insurer pays only a rateable proportion of Associated Medical Expenses. Medicines/pharmacy, medical consumables, medical implants and diagnostic costs are reimbursed on actuals, and proportionate deductions do not apply to ICU charges or to hospitals/expenses without differential billing.","display":"Yes, for optional Cap on Room Rent; rateable proportion on associated expenses, not ICU and not listed actual-cost items","note":"Applies to the optional Cap on Room Rent cover.","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, provided that Reasonable and Customary costs incurred on medicines/pharmacy, medical consumables, medical implants and diagnostic costs will be reimbursed based on the actual amounts 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":25,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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 if treatment is taken in a city in a higher zone than the insured person's eligible zone: Zone II treated in Zone I is 10%, Zone III treated in Zone I is 20%, and Zone III treated in Zone II is 10%. Zone I premium allows treatment all over India without co-payment, and higher-zone co-payments do not apply to accident hospitalisation.","display":"Higher-zone treatment co-pay: Zone II to Zone I 10%; Zone III to Zone I 20%; Zone III to Zone II 10%","note":null,"quote":"Persons paying Zone I premium can avail treatment all over India without any Co-payment. ... Aforesaid Co-payments for claims occurring outside of the Zone will not apply in case of Hospitalisation due to an Accident. ... In case of treatment taken in a city, in a Zone higher than the eligible Zone for the Insured Person, the Co-payment percentages as below shall apply: Applicable Zone | Treatment Taken at | Co-payment applicable Zone II | Zone I | 10% Zone III | Zone I | 20% Zone III | Zone II | 10%","sources":[{"clause":"22","heading":"Zone Classification","page":50,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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 clauses provide only a generic definition of deductible and do not state a deductible amount or basis for the Advantage plan.","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":"quote-verified","value":["Cataract: 10% of the Base Sum Insured up to a maximum of INR 100,000 per eye for each Policy Year"],"display":"Cataract: 10% of Base Sum Insured up to INR 100,000 per eye per Policy Year","note":null,"quote":"Our maximum liability for any Claim for an Insured Person’s cataract treatment shall be 10% of the Base Sum Insured up to a maximum of INR 100,000 per eye for each Policy Year of the Policy Period.","sources":[{"clause":"3.3","heading":"Specified disease/ procedure waiting period (Code – Excl02)","page":27,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-3-3"}],"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":"quote-verified","value":{"unit":"days","amount":60},"display":"60 days","note":"This is the Advantage plan limit.","quote":"3 | Pre- Hospitalization Medical Expenses | 60 days | 60 days","sources":[{"clause":"Row 3","heading":"Pre- Hospitalization Medical Expenses","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-row-3"}],"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":"quote-verified","value":{"unit":"days","amount":90},"display":"90 days","note":"This is the Advantage plan limit.","quote":"Post- Hospitalization Medical Expenses | 90 days | 90 days","sources":[{"clause":"Row 3","heading":"Pre- Hospitalization Medical Expenses","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-row-3"}],"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":"The policy covers only the listed day-care treatments in Annexure II; the plan chart states 405 Named Day-care Surgeries & Procedures. OPD treatment is not covered under this benefit.","display":"405 Named Day-care Surgeries & Procedures; OPD not covered","note":"The list is in Annexure II.","quote":"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. ... 2 | Day Care Treatment | 405 Named Day-care Surgeries & Procedures | 405 Named Day-care Surgeries & Procedures","sources":[{"clause":null,"heading":"2.2 Day Care Treatment","page":10,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-2-day-care-treatment"},{"clause":"Row 2","heading":"Day Care Treatment","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-row-2"}],"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 have required hospitalisation, the patient cannot be moved or a hospital bed is unavailable, and the domiciliary hospitalisation extends for at least 3 consecutive days.","display":"Covered up to Base Sum Insured; at-home treatment must otherwise require hospitalisation, or transfer/bed not possible, and last at least 3 consecutive days","note":"The domiciliary cover excludes specified illnesses such as asthma, bronchitis, diabetes, hypertension, influenza/cough/cold and listed psychiatric or psychosomatic disorders.","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: a) 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. ... d) The Insured Person's Domiciliary Hospitalisation extends for at least 3 consecutive days","sources":[{"clause":"2.7","heading":"Domiciliary Hospitalisation","page":12,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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 Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy is covered up to the base sum insured when administered by a licensed practitioner and taken as inpatient or day-care treatment in an AYUSH Hospital.","display":"AYUSH covered up to Base Sum Insured as inpatient or day-care treatment in AYUSH Hospital","note":null,"quote":"Alternative Treatment (AYUSH) | refers to the medical and/ or hospitalization treatments given under Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems ... 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: a) The Alternative Treatment is administered by a Medical Practitioner who holds a valid practicing license in respect of such AYUSH Treatments; b) The Insured Person is admitted to AYUSH Hospital as an Inpatient or for Day Care treatment","sources":[{"clause":"1","heading":"DEFINITIONS","page":1,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-1"},{"clause":"2.6","heading":"Alternative Treatment","page":11,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-6"}],"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":"quote-verified","value":"External Counter Pulsation, Enhanced External Counter Pulsation and Hyperbaric Oxygen Therapy are not covered unless they form part of inpatient treatment or part of discharge advice up to the post-hospitalisation period. No separate cap for other modern treatments is stated.","display":"ECP, EECP and Hyperbaric Oxygen Therapy covered only if part of in-patient treatment or discharge advice up to post-hospitalisation period","note":null,"quote":"Treatment such as External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), and Hyperbaric Oxygen Therapy will not be covered unless it forms a part of In-Patient Treatment in case of hospitalisation or part of discharge advice upto the Post hospitalisation period as specified in the Policy Schedule.","sources":[{"clause":"35","heading":"Treatment such as External Counter Pulsation (ECP), Enhanced External Counter Pulsation","page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-35"}],"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":"The policy covers the donor's inpatient hospitalisation medical expenses for harvesting the organ up to the base sum insured, when the insured person's inpatient treatment claim is accepted and the donor and transplant comply with applicable law. Pre- and post-hospitalisation expenses for the donor, organ acquisition costs and donor complications are not covered.","display":"Donor inpatient harvesting expenses covered up to Base Sum Insured; donor pre/post hospitalisation, organ acquisition and donor complications excluded","note":null,"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: a) We have accepted a Claim for In-patient Treatment under the Policy in respect of the Insured Person; b) The organ donor is any person in accordance with the Transplantation of Human Organs Act 1994 (amended) and other applicable laws and rules; c) The organ donated is for the use of the Insured Person ... We will not cover expenses towards the donor in respect of: i) Any Pre-Hospitalization Medical Expenses or Post-Hospitalization Medical Expenses; ii) Costs directly or indirectly associated to the acquisition of the organ; iii) Any other medical treatment or complication in respect of the donor, consequent to harvesting.","sources":[{"clause":"2.5","heading":"Organ Donor Cover","page":11,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-5"}],"law":[]},{"key":"ambulance","label":"Ambulance cover","section":"Cover","meaning":"Road (and air) ambulance cover and its limit.","status":"quote-verified","value":"For the Advantage plan, road ambulance cover is up to INR 20000 per year. Air Ambulance Cover is not available for the Advantage plan.","display":"Road ambulance: up to INR 20000 per year; air ambulance: Not Available","note":"The road ambulance cover is payable when the inpatient or day-care claim is accepted and ambulance use relates to the same illness/medical condition.","quote":"4 | Ambulance Cover | Upto INR 20000 per year | Upto INR 20000 per year ... 22 | Air Ambulance Cover | Not Available | Not Available","sources":[{"clause":"Row 4","heading":"Ambulance Cover","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-row-4"},{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details-2"}],"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. It is not available for the same illness for which a claim was already accepted/paid for the same insured person in that policy year, and it does not apply to the first claim unless the first claim is an accident injury claim exceeding the base sum insured.","display":"100% of Base Sum Insured, once in a Policy Year; not for same illness; not for first claim except accident injury exceeding Base Sum Insured","note":null,"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: a) 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. b) The restoration of sum insured shall not apply to the first claim in that Policy Year unless related to an Injury due to Accident where the claim amount exceeds the Base Sum Insured.","sources":[{"clause":"2.9","heading":"Restoration Benefit","page":13,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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":"For the Advantage plan, cumulative bonus is 10% of the base sum insured for each renewal up to a maximum of 50%. The wording states the increase is at the end of the policy year if the policy is renewed with the insurer, and it does not say the bonus reduces after a claim.","display":"10% of Base Sum Insured for each renewal, maximum 50%","note":"The 50% maximum is for the Advantage plan.","quote":"10 | Cumulative Bonus | 10% of the Base Sum Insured, for each renewal upto a maximum of 50% | 10% of the Base Sum Insured, for each renewal upto a maximum of 50% ... 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","sources":[{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details-2"},{"clause":"2.10","heading":"Cumulative Bonus","page":14,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-10"}],"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 includes medicines, drugs and other allowable consumables prescribed by the treating medical practitioner. Non-medical expenses in Annexure III List I are excluded under the base policy, while the Claim Protect rider can cover listed non-medical expenses if bought.","display":"Allowable consumables covered; non-medical expenses excluded unless Claim Protect rider is opted","note":"Claim Protect is a rider/add-on for additional premium, not part of the base Advantage cover.","quote":"vi) 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. ... Claim Protect- By opting for this Benefit, listed non-medical expenses (as per Annexure I - Optional items listed in the Policy wordings) not covered under the base policy will get covered.","sources":[{"clause":"2.1","heading":"In-patient Treatment","page":9,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-1"},{"clause":"32","heading":null,"page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-32"},{"clause":null,"heading":"Health Protect Rider (UIN: ZUKHLIP25054V052425)","page":44,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-health-protect-rider-uin-zukhlip25054v052425"}],"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 Benefit is not available under the Advantage plan.","display":"Not Available","note":"The row lists Standard then Advantage; the second Not Available is the Advantage plan. Other plans may offer maternity as optional or inbuilt with a 3-year waiting period.","quote":"19 | Maternity Benefit* (with 3 year waiting period) | Not Available | Not Available","sources":[{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details-2"}],"law":[]},{"key":"newborn","label":"Newborn baby cover","section":"Cover","meaning":"Whether a newborn is covered from birth and for what.","status":"quote-verified","value":"New Born Baby Cover is not available under the Advantage plan.","display":"Not Available","note":"The row lists Standard then Advantage; the second Not Available is the Advantage plan.","quote":"20 | New Born Baby Cover* ( with 3 year waiting period) | Not Available | Not Available","sources":[{"clause":null,"heading":"PLAN-WISE COVER DETAILS","page":46,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-plan-wise-cover-details-2"}],"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":null,"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 policy arranges one free health check-up at a network provider for each insured person above 18 years of age, for each policy year, for specified tests, regardless of any admitted or registered claim.","display":"One free health check-up each Policy Year for each insured person above 18 years","note":"The specified tests listed are CBC, MER, Serum Cholesterol, Serum Creatinine, SGPT/SGOT, ECG and Random Blood Sugar.","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.","sources":[{"clause":"2.8","heading":"Annual Health Check-up","page":13,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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 under the base policy. Reward points, if earned, may be redeemed against outpatient medical expenses, but redemption does not create a cash benefit.","display":"OPD treatment not covered; reward points may be redeemed for outpatient medical expenses","note":"Health and Rewards is available for the Advantage plan, but reward redemption is not a base OPD cover.","quote":"Any OPD treatment will not be covered ... i) Outpatient medical expenses like consultation charges, medicine & drugs, dental expenses, wellness & preventive care and other miscellaneous charges ... Redemption of rewards points does not entail any cash benefit to be provided to You.","sources":[{"clause":"33","heading":"Any OPD treatment will not be covered","page":31,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-33"},{"clause":"2.12(a)","heading":null,"page":17,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-12-a-2"},{"clause":"2.12(e)","heading":null,"page":18,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-2-12-e"}],"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":"quote-verified","value":"The proposer’s city determines the zone, and co-payment applies for treatment in a higher zone. Zone I is Mumbai including Thane and Navi Mumbai, and Delhi including NCR areas; Zone II is Kolkata, Hyderabad, Chennai, Pune, Bangalore and Gujarat; Zone III is the rest of India excluding Zone I and Zone II.","display":"Yes, zone based; treatment in a higher zone can attract 10% or 20% co-payment","note":"A higher zone than the actual zone can be selected on payment of relevant premium.","quote":"Zone I: Mumbai (including Thane and Navi Mumbai) and Delhi (including NCR areas) Zone II: Kolkata, Hyderabad, Chennai, Pune, Bangalore and Gujarat Zone III: Rest of India excluding the locations mentioned under Zone I & Zone II • Identification of Zone will be based on the city of the Proposer. ... In case of treatment taken in a city, in a Zone higher than the eligible Zone for the Insured Person, the Co-payment percentages as below shall apply: Applicable Zone | Treatment Taken at | Co-payment applicable Zone II | Zone I | 10% Zone III | Zone I | 20% Zone III | Zone II | 10%","sources":[{"clause":"22","heading":"Zone Classification","page":50,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-22-2"}],"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 a network provider of the company, with the complete list available on the website or from the call centre. Pre-authorisation is required for planned and emergency hospitalisation.","display":"Available at Network Providers","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":"5.1 For Cashless Facility","page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-5-1-for-cashless-facility"}],"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 the insurer or its TPA. The wording names Family Health Plan (TPA) Ltd for sending claim documents.","display":"Insurer or TPA; Family Health Plan (TPA) Ltd named for claim documents","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: Family 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":"5.1 For Cashless Facility","page":32,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#c-5-1-for-cashless-facility"},{"clause":"36(a)(vi)","heading":null,"page":33,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298#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":"For the Advantage plan, Individual/ Floater is shown as Both.","quote":"Policy Type | Individual/ Family Floater ... For Family Floater (*) | In case of a Family Floater policy, one family will share a single Sum Insured. A Family Floater policy can cover a maximum of 2 adults and 3 dependent children under a single policy.","sources":[{"clause":"1","heading":"SAILENT FEATURES OF THE POLICY","page":1,"url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124#c-1"}],"law":[]}],"documents":[{"kind":"wording","label":"Health Premier","pages":74,"fetched_at":"2026-10-17 20:13:44+00","source_url":"https://cms.zurichkotak.com/uploads/KHP_Policy_Wordings_1d81dbc2d9.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18298"},{"kind":"prospectus","label":"Health Premier","pages":51,"fetched_at":"2026-10-17 20:04:46+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Premier_Prospectus_0ebbf64f69.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18124"},{"kind":"cis","label":"Health Premier","pages":10,"fetched_at":"2026-10-17 20:09:06+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Premier_CIS_950651fe9c.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18207"},{"kind":"brochure","label":"Health Premier","pages":16,"fetched_at":"2026-10-17 20:04:18+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Premier_Brochure_521cec66b4.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18114"},{"kind":"benefit-illustration","label":"Health Premier (Advantage Plan) – Benefit Illustration","pages":1,"fetched_at":"2026-10-17 20:03:52+00","source_url":"https://cms.zurichkotak.com/uploads/Health_Premier_Advantage_Benefit_Illustration_d133a0e93e.pdf","url":"https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627/document/18102"}],"versions":[],"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 Premier (Advantage Plan) (UIN ZUKHLIP27071V062627), IndiaInsurances, https://indiainsurances.com/policy/zurich-kotak-general-insurance/health-premier-advantage-plan-zukhlip27071v062627"}