Edelweiss Health Insurance Health Insurance

About the Edelweiss Health Insurance

Edelweiss General Insurance is one of the most popular health insurance providers in India. Edelweiss Tokio Health Insurance has been delighting customers with its services since 2017 and they don’t plan on stopping any time soon.

Beyond purchasing Edelweiss Health Insurance, one can also get motor, travel, and ground insurance from the organization. Currently, the organization has claim support of 99.72% and a solvency ratio of 2.2. These impressive figures are some of the reasons why Edelweiss has been under the spotlight continuously over the years.

According to several Edelweiss Health Insurance Review, the insurer provides comprehensive coverage for different health treatments and malignant diseases, including cancer. Edelweiss is constantly working towards its goal of reducing the financial worries of its policyholders during their time of need or when they might be going through a medical emergency.

Edelweiss General Insurance has also received several awards and honors over the years. The organization was one of the top 25 financial innovations of India in 2021. It has also won the ‘Best Customer Experience Team of the Year’ in 2020. The Best BFSI Technology Award – Cloud also went to Edelweiss along with the ‘SAP – Process Innovation 2018 Game-Changing SAP Cloud for Insurance’ award.

Edelweiss got special recognition in 2018 and also reported a claim settlement ratio of 85.57%. It provides health policies dedicated to the treatment of COVID-19. Free health check-up facilities, in-house claim settlement facilities, and lifetime renewability benefit is also provided with some policies. Edelweiss has a network of over 2,578 hospitals and has sold millions of policies to date.

    Edelweiss Health Insurance policies are tailored to meet the medical care needs of its policyholders. Whether one is in need of regular medical assistance or treatment of COVID-19, the organization provides a policy that would suit every situation. If you want to know more about these policies, then go through the table mentioned below.

    Type of Plan

    Policy Category

    Description

    Edelweiss Health Insurance Company Plan

    Family Health Insurance

    The plan provides comprehensive coverage to the policyholder and his or her entire family

    Edelweiss Corona Rakshak Policy

    COVID-19

    The policy provides the policyholder with financial support if he or she is infected by COVID-19 and requires hospitalization

    Edelweiss Corona Kavach Policy

    COVID-19

    The plan covers all basic medical expenses of an individual if he or she is infected from COVID-19

    Edelweiss Arogya Sanjeevani Plan

    Family Health Insurance

    In this policy, the policyholder can get coverage for the entire plan and protect his or her savings account in their time of need

     

    Let us look at all of these policies in detail.

     

    1. Edelweiss Health Insurance Company Plan

    Edelweiss Health Insurance Policy is a standard insurance plan that provides comprehensive financial coverage to the policyholder if they are suffering from any long-term medical issues. There are three variants of this policy, including silver, gold, and platinum. You can find more information about these variants by going through the table mentioned below.

    Parameters

    Silver Plan

    Gold Plan

    Platinum Plan

    Minimum Entry Age

    3 months

    3 months

    3 months

    Maximum Entry Age

    65 years

    65 years

    No maximum limit

    Total Sum Assured

    Rs.1, 2, 3, 4, and 5 lakh

    Rs.5, 7.5, 10, 15, and 20 lakh

    Rs.15, 20, 50, 75, and 100 lakh

    Total Policy Term

    1 year, 2 years, or 3 years

    1 year, 2 years, or 3 years

    1 year, 2 years, or 3 years

    Premium Payment Options Available

    Single

    Single

    Single

    Renewal Age

    Lifetime renewability

    Lifetime renewability

    Lifetime renewability

     

    Beyond this, some key features of the silver plan are mentioned below.

    • The plan provides coverage to the policyholder if he or she is hospitalized due to an illness or injury. Expenses like room rent, nursing charges, operation theater charges, medical practitioner fees, ICU charges, and medication expenses are covered
    • All expenses of the policyholder incurred up to 30 days before the hospitalization took place and 60 days after the hospitalization ended are also covered
    • Day-care treatments are also covered under this plan. These treatments should not exceed 24 hours of hospitalization
    • If there is a medical emergency and the insured has to be transported to the hospital, then those ambulance charges will also be covered up to a value of RS. 1,500

    The key features of the gold plan are discussed below.

    • Pre- and post-hospitalization benefits are provided to policyholders. The plan cover charges incurred up to 60 days before hospitalization and 90 days after getting discharged from the hospital
    • Ambulance expenses are covered up to a total of Rs.3,000 in case of an emergency
    • The plan also comes with organ donor expense cover. This is applicable against an organ donor’s inpatient treatment for harvesting the organ. The maximum sum assured is Rs.1 lakh
    • Maternity benefit of up to Rs.50,000 is provided in case of two deliveries or lawful termination of the pregnancy of the insured individual

    Some important features of the platinum plan are mentioned below.

    • The insured can get hospital cash benefits of up to a total of Rs.15,000 if the hospitalization exceeds three consecutive days. This amount can be received for up to 7 days of hospitalization
    • Pre- and post-hospitalization charges of 90 days before hospitalization and 180 days after hospitalization are also covered
    • An ambulance cover of up to Rs.10,000 is provided with this plan
    • In case of inpatient treatment of an organ donor, one can receive an organ donor treatment benefit of up to Rs.2 lakh
    • The platinum plan also covers any charges incurred for treatments under Ayur, Unani, Ayurveda, Siddha, and Homeopathy in any government or government-recognized hospital or institution

     

    1. Edelweiss Corona Kavach Policy

    If an individual falls ill with COVID-19, then the Edelweiss Corona Kavach Policy is designed to provide him or her with the necessary financial protection. This policy is available on both an individual basis and a family floater basis. Some details of this policy are discussed below.

    Parameter

    Plan Details

    Minimum Entry Age

    18 years

    Maximum Entry Age

    65 years

    Total Sum Assured

    Value can range from Rs.50,000 to Rs.5 lakh

    Total Policy Period

    3.5 months, 6.5 months, and 9.5 months

    Pre-Hospitalization Charges

    The plan provides cover for any expenses incurred up to 15 days before hospitalization

    Post-Hospitalization Charges

    The plan provides cover for any expenses incurred up to 30 days after hospitalization

    Home Care Treatment

    The plan covers the expenses of an individual who goes under treatment for COVID-19 at home after the approval of a government-certified doctor. This is provided up to 14 days

    Pre-Policy Medical Check-Up

    No medical check-up is required for people up to 60 years of age

    Daily Hospital Cash Benefit

    0.5% of the total sum assured value is provided every single day to the insured in case of a continuous period of hospitalization. The benefit can be provided for a total of 15 days

     

    1. Edelweiss Corona Rakshak Policy

    Under the Edelweiss Corona Rakshak Policy, an individual can get 100% insurance cover if he or she requires uninterrupted hospitalization for at least 72 hours. The only requirement in this policy is that the test for COVID-19 should be done at a diagnostic center that has been authorized by the government. You can find more details related to this policy below.

    Parameters

    Policy Details

    Minimum Entry Age

    18 years

    Maximum Entry Age

    65 years

    Total Sum Assured

    The value can range from Rs.50,000 to Rs.2.5 lakh

    Total Policy Period

    3.5 months, 6.5 months, and 9.5 months

    Total Waiting Period

    15 days

     

    1. Edelweiss Arogya Sanjeevani Policy

    The Edelweiss Arogya Sanjeevani Policy is designed for every individual who feels as if hospital costs and medical treatment charges are constantly soaring up. This policy provides several benefits from day-care charges to pre-hospitalization charges. Other details of this comprehensive plan are mentioned in the table below.

    Parameters

    Policy Details

    Minimum Entry Age

    18 years

    Maximum Entry Age

    65 years

    Total Sum Assured

    Rs.1 lakh to Rs.5 lakh

    Total Members Covered

    Eight Family Members

    Premium Payment Options

    Annually, Half-Yearly, Quarterly, and Monthly

    Hospitalization Benefit

    The coverage will be provided up to the total sum assured value if the insured is hospitalized for at least 24 hours

    Day-care Benefit

    Day-care treatments charges are also covered under this policy

    Pre-Hospitalization Charges

    All charges incurred up to 30 days before the hospitalization are covered

    Post-Hospitalization Charges

    All charges incurred up to 60 days after being discharged from the hospital are also covered

    Cataract Treatment Benefit

    If the policyholder needs cataract treatment, then the policy provides coverage of up to Rs.40,000 or 25% of the SI per eye

    Cumulative Bonus Advantage

    The total sum assured will increase by 5% every year up to a maximum of 50% if the policyholder does not place a claim in a policy year

    There are also key inclusions and exclusions that fall under the different types of Edelweiss health insurance policies. We’ll first look at the key inclusions.

    • Inpatient hospitalization charges for room, doctor’s fee, and medicine up to the total sum assured value
    • Pre-hospitalization for 30 days in silver policy, 60 days in gold policy, and 90 days in platinum policy
    • Day-care treatment expenses are either reimbursed or one can get cashless treatment
    • Emergency ambulance charges for necessary transportation of the patient
    • Charges related to an organ donor
    • Post-hospitalization charges for 60 days in silver plan, 90 days in gold plan, and 180 days in a platinum plan

    The exclusions factors of the Edelweiss health insurance policy are:

    • Any treatment, condition, or item that falls under the list of non-medical items
    • Expenses for corrective devices, external prosthesis, and focused ultrasound
    • Any therapies or treatments related to magnetic, acupressure, or acupuncture
    • Any condition directly or indirectly related to STDs or AIDS/HIV
    • Medical expenses incurred on newborn children below the age of 91 days
    • Cosmetic surgery, plastic surgery, or any other related treatment

    Edelweiss provides the most trusted health insurance plans in the market for general medical treatment and COVID-19 patients. The organization has a wide network of hospitals which ensures that one can get cashless treatments done at one of those facilities.

    Further, according to the IRDAI Annual Report 2019 - 2020, the Annual Gross Premium value of Edelweiss Health Insurance is 45.06 crore. There was also a significant growth in this value from the financial year 2018 - 2019. Customers have also rated the policy and services of Edelweiss health insurance very highly. You can go through some of those reviews below.

    • Excellent Policies by Lajvanti Raman (5 stars / 5 stars): I would like to sincerely thank Edelweiss General Insurance for providing Indians with such good policies. I have been looking for a good health insurance policy for weeks but couldn’t find one that suited me. Thankfully, I stumbled across Edelweiss before I ended my search.
    • Expert Customer Support by Falguni Verma (5 stars / 5 stars): I have been renewing my Edelweiss family health insurance for years now and I don’t have a single complaint. I have availed of both cashless treatments and applied for claims. Their customer service department is also very supportive and offers me the help that I need during difficult times. I would 100% recommend them to other buyers.
    • Efficient Services by Devarsh Kumar (5 stars / 5 stars): I was trying to renew my Edelweiss health insurance recently but there were some problems. So, I contacted their customer support and they were responsive. My issue was resolved quickly and I’m now a very happy Edelweiss customer.

    Edelweiss Health Insurance FAQs

    I want to submit a reimbursement claim for my Edelweiss Health Insurance. What documents do I need to do it?

    To place a reimbursement claim request for an Edelweiss health insurance policy, one would need the following documents:
    A claim form that is duly filled and signed
    All hospital bills
    Receipts from the chemist
    Receipts from the medical practitioner
    Prescriptions
    Discharge card from the hospital
    NEFT and KYC details of the policyholder
    Original medical investigation reports
    Any other document asked by the organization

    What is the process for filing a claim for my Edelweiss Health Insurance plan?

    Edelweiss General Insurance has a claim process comprising three steps. These three steps are:
    Claim Intimation: It is important for all policyholders to intimate the company about any claim in case of a planned or emergency hospitalization. One can call at 1800 12000 for the same
    Submit the Documents: It is vital to submit all documents for processing of the claim, including medical records, claim form, discharge summary, and other receipts to the company within a deadline
    Claim Decision: In case of cashless hospitalization, Edelweiss will directly inform and pay the hospital for the same if the claim is approved. In case of reimbursement, the organization will transfer the specific amount to the bank account of the policyholder
    If there are any other queries, then one can shoot a mail at support@edelweissinsurance.com.

    How can I purchase an Edelweiss health insurance policy?

    One can purchase an Edelweiss health insurance policy both online and offline. To purchase the policy online, simply visit the official website and tap on the ‘Health Insurance’ section. Click on the ‘Get Quote’ option and select the plan of your choice.
    Customize the details if you want and pay the premium. You will receive the policy documents on your registered email ID. For offline purchases, you can visit the nearest branch of Edelweiss General Insurance.