Edelweiss Health Insurance
Part of Edelweiss Group, Edelweiss General Insurance Company Limited provides health insurance policies throughout the nation. Edelweiss General Insurance Company offers three types of health insurance plans to its customers. These plans are catered to different types of clients and also covers life-threatening diseases.
Edelweiss Health Insurance Plans
The various Edelweiss Health Insurance plans are mentioned in detail below -
Plan | Minimum Coverage | Maximum Coverage | Age Limit |
Edelweiss Top Up Insurance Plan | Rs.1 lakh | Rs.5 crore | No age limit |
Edelweiss Health Insurance Plan | Rs.1 lakh | Rs.1 crore | No age limit |
Edelweiss Health Plus Policy | Rs.1 lakh | Rs.1 crore | No age limit |
Benefits of Edelweiss Health Insurance
The various benefits of Edelweiss Health Insurance are mentioned below -
- Up to Rs.2 crores of coverage are available under the platinum plan of Edelweiss health insurance.
- You can get health insurance for up to 8 people, including yourself, your spouse, your three children, and other family members (as permissible in the plan)
- No matter the plan, you are eligible for the following benefits: medical monitoring insurance, medical repatriation insurance, medical referral insurance, compassionate visitation, emergency medical evacuation, return of mortal remains, and second medical opinion.
Edelweiss Health Insurance Plans
The most comprehensive health insurance plans offered by Edelweiss Health Insurance comes in 3 varieties -
- Gold plan – Up to Rs.20 lakh sum assured
- Silver plan – Up to Rs.5 lakh assured
- Platinum plan – Up to Rs.1 crore
Benefits | Gold Plan | Silver Plan | Platinum Plan |
Medical expenses for pre- and post- hospitalization | 60 to 90 days | 30 to 60 days | 90 to 180 days |
Rent limit of room per day (standard single private room) | No capping | Rs.3 lakh and above | No capping |
No limit of ICU charges | Covered | Covered | Covered |
Expenses of hospitalization | Covered | Covered | Covered |
Organ donor cover | Up to Rs.1 lakh | Not Covered | Up to Rs.2 lakh |
Day care treatment | Covered | Covered | Covered |
Ambulance cover | Up to Rs.3,000 | Up to Rs.1,500 | Up to Rs.10,000 |
Domicillary hospitalization | Covered | Covered | Covered |
No-claim Bonus | Assured Sum increases by 50% for each year without a claim, with a maximum increase of 100% | Assured Sum increases by 10% for each year without a claim, with a cap of 50%. | Assured Sum increases by 50% for each year without a claim, with a maximum increase of 100% |
Maternity benefit | Up to Rs.50,000 (with a waiting period of 4 years) | Not Covered | Up to Rs.2 lakh (with a waiting period of 4 years) |
Health Checkup for each year without a claim | Covered | Covered | Covered |
Shared accommodation | Rs.1,000 per day (Maximum Rs.5,000) | Rs.800 per day (Maximum Rs.4,000) | Rs.1,200 per day (Maximum Rs.6,000) |
Coverage of critical illness (begins the moment you receive a critical disease diagnosis.) | There is a 50% increase in the sum assured amount | Not covered | There is a 100% increase in the sum assured amount |
Recovery benefits (from the day of hospitalization) | Rs.1,000 per day from 11th to 20th day | Not covered | Rs.1,000 per day from 11th to 20th day |
Edelweiss Health Insurance Inclusion
The common inclusion similar for all Edelweiss Health Insurance plans are mentioned below -
- The sum insured amount covers hospitalization costs up to that amount.
- The cost of ambulances is covered.
- The cost of a normal single private hospital room is covered.
- The costs of organ donors are paid.
- Costs for in-home medical care up to the maximum amount guaranteed
- Icu room charges are covered
- Coverage of critical illness is provided
- Benefits of recharge is provided
- Benefit of restoration
Edelweiss Health Insurance Exclusion
The following benefits are excluded from Edelweiss Health Insurance -
- First day waiting period of 30 days
- Fistula/fissure in anus, Piles/hemorrhoids, pilonidal sinus, gastric, and duodenal ulcers
- Oral chemotherapy
- Sexually transmitted diseases like syphilis, chlamydia, pubic lice, etc.
- Myomectomy of fibroids
- Any fees for the purchase of hearing aids. eye and ear exams, glasses, contact lens, artificial teeth, laser surgery, and other similar external equipment, as well as any related costs.
- Cosmetic/plastic surgeries
- Mental conditions like stress-related psychological disorders, mental illness, Alzheimer's disease, or Parkinson's disease.
How to Claim Edelweiss Health Insurance
It's important to alert the insurer at least 72 hours in advance of a planned hospitalization in order to take advantage of your Edelweiss health insurance policy's advantages. It is necessary to notify the insurer of an emergency hospitalization within 48 hours after admission, or before the date of discharge, whichever comes first. In exceptional circumstances, the insurance may, however, take into account delays together with a proof.
Below mentioned are few ways in which you can alert Edelweiss Health Insurance about your medical emergency -
Notify Edelweiss Health Insurance by contacting them on their helpline number 1800 12000 or by emailing them on support@edelweissinsurance.com
Note - Your claim process will begin, and in the case of cashless claims, your claim amount will be reimbursed or settled directly at the hospital.
Documents Required to Claim Edelweiss Health Insurance
The following documents are needed to file a claim with Edelweiss Health insurance -
- Filled and signed Edelweiss health insurance claim form
- Original pre-authorisation request
- Reports of medical investigation
- A copy of pre-authorisation approval letter
- Doctor’s reference slip4
- Hospital discharge summary
- Reports/notes of operation theater
- Bills from chemist
- Final bill from the hospital
- Break-up bill from the hospital
Edelweiss Health Insurance Renewal
Online renewal of an Edelweiss health insurance policy is simple and straightforward. Online renewal reduces work and saves time. If there is a specific process that must be followed in order to renew the policy online, you can inquire with the insurer.
FAQs on Edelweiss Health Insurance
- Can I upgrade the coverage offered by the health insurance policies from Edelweiss?
Yes, you can upgrade the benefits of your plan when you renew. Your silver health plan can be upgraded to a gold or platinum plan. You can further upgrade it by choosing optional features.
- How many members of my family are covered by my Edelweiss health insurance plan?
Your spouse, up to three children who are between the ages of three months and twenty-one., and you are all covered under the family floater policy.
- Can I transfer my No-Claim Bonus from my former insurance company to the Edelweiss Health Insurance plan?
Yes, you may continue to benefit from your No-claims discount even after switching insurance providers. To receive the NCB, however, be sure to renew your insurance on time or before the expiration date.
- How long will my Edelweiss health insurance policy be in effect?
You can purchase coverage for 1, 2, or 3 years with a single premium. And with timely plan renewals, coverage is offered for a lifetime.
- Does my Edelweiss health insurance policy cover critical illness?
Yes, however it depends on the kind of plan you have bought. The basic coverage covers critical illness if you purchase a gold or platinum plan. With your silver plan, you can, however, add this as an additional advantage.
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