Overview
The Zuno Health Insurance Silver plan offers comprehensive health coverage for individuals and families, with a maximum sum insured of ₹5 lakhs. It includes benefits like a daily hospital cash allowance [500 / day from the 4th day till the 10th day of hospitalization] and a no-claim bonus of 10% for each claim-free year, up to a maximum of 50% of the sum insured. The plan also covers pre-existing diseases after a three-year waiting period and includes no disease-wise sub-limits.
Experts Review
Written by Ishita Jain
Editor
The Zuno Health Insurance Silver plan is a cost-effective option for those seeking basic health coverage. Its key advantages include no disease-wise sub-limits and coverage for daycare, AYUSH, pre-post hospitalization [30-60 days respectively], and domiciliary treatments. However, the plan has a room rent restriction limited to a single private room.
[For Sum Insured up to ₹2,00,000, 1% of the Sum Insured; ICU Charges- 2% of the Sum Insured; For Sum Insured above 2,00,000: Standard Single Private Room. No Capping on ICU charges and a maximum sum insured of ₹5 lakhs, which may not be sufficient for extensive medical needs.
The plan's premium is generally 10-15% lower than comparable plans due to its basic coverage structure. While it is economical, buyers should consider its limitations, such as compulsory co-payment of 20% shall be applicable to each and every Claim made, for each Insured Person aged above 60 Years, room rent restrictions, lack of in-built restoration benefit.. Zuno's operational efficiency and claim settlement ratio should also be evaluated before purchasing this policy.
Pros
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some.
Zuno (erstwhile Edelweiss)
Key Insights
Founded
2016
Zuno (erstwhile Edelweiss) was established 9 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
90% claims settled in 30 Days
Zuno (erstwhile Edelweiss) settles 90% of all claims it receives. This is reasonable performance, though there is room for improvement compared to top insurers.
Network Hospitals
6,200+
Zuno (erstwhile Edelweiss) has a limited network of 6,200 hospitals, which may restrict access to cashless services for policyholders.
Complaints
15 complaints per 10,000 claims registered
Zuno (erstwhile Edelweiss) experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Bad
Co-payment
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Customisable
Room Rent
Anything below twin sharing room
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Restoration
Recommended
Restores the cover once a year up to 100% of the sum insured for any illness.
Critical Illness
Voluntary Co-Payment
Critical Illness
With this add-on you get a lumpsum payment in the event you are diagnosed with critical illnesses outlined in the policy document.
Restoration
With the add-on, one-time restoration up to 100% of Sum Insured is available on a partial basis for the treatment of different illnesses only.
Co-payment
This benefit helps to opt for co-payment between 10% to 20%. This add-on is available only for people aged up to 60 years at the time of taking the plan.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Any Injury or Illness sustained or contracted due to flying other than as a passenger on a
scheduled regular carrier.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Arthritis-related conditions (if non-infective), including:
Osteoarthritis
Osteoporosis
Gout
Rheumatism
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered.
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Frequently Asked Questions
Does Health Insurance Silver have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Health Insurance Silver have room rent restrictions?
Does Health Insurance Silver offer a restoration benefit?
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