Overview
The Zuno Health Insurance Gold plan offers comprehensive health coverage with a sum insured up to ₹20 lakhs. Alongside the standard benefits, the plan provides maternity benefits [Up to 50,000, maximum up to 2 deliveries] after a four-year waiting period. The plan also features a critical illness cover, which increases the sum insured by 50% upon first diagnosis of a listed critical illness, providing enhanced financial support during severe health crises.
Experts Review
Written by Nikhil Nair
Senior Writer
The Gold plan by Zuno Health Insurance is a robust policy that covers a wide range of medical expenses without imposing disease-wise sub-limits. Its critical illness cover is a standout feature, offering an additional 50% of the sum insured upon diagnosis, which can be particularly beneficial for severe conditions like cancer. The plan also includes maternity benefits and a restoration benefit [once for unrelated illness], making it appealing for families seeking comprehensive protection.
Other basic covers include daycare, domiciliary, and AYUSH treatments up to the base Sum Insured, 60-90 days pre- and post-hospitalization, and a No Claim Bonus of 50% per claim-free year, up to a maximum of 100%. Though the plan has no disease-wise sub-limits, it comes with a room rent restriction of a single private room and a mandatory 20% co-pay for individuals aged 61 and above.
Compared to the Silver plan, the Gold plan offers higher sum insured options and additional benefits like maternity and critical illness coverage, making it more suitable for those seeking extensive health protection. However, the premium for this plan is generally 20-25% higher than the Silver plan due to its enhanced features. Buyers should weigh these factors before opting for this policy.
Pros
Feature set is satisfactory.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Cons
Doctor consultations are not covered, which is a notable gap.
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
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
Choose a co-payment between 10% and 20% to reduce premiums for ages 60 years and above.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
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 - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Add-ons
Recharge Benefit
Recommended
Restores the cover once a year up to 100% of the sum insured for any illness.
Co Payment
Choose a co-payment between 10% and 20% to reduce premiums for ages 60 years and above.
Critical Illness
Paid out as a lump sum of 50% of sum insured for listed Critical illnesses.
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
Doctor consultations are not covered.
Customer Reviews
A
Ashok S.
Critical illness cover included is a significant benefit.
B
Bharati V.
Annual health check-ups help in proactive health management.
B
Bhavesh G.
Offers comprehensive health coverage with good sum insured options.
G
Gita J (new)
Being a newer insurer, their claim settlement efficiency is yet to be proven over long term.
D
Divya K (new)
Premium costs need to be evaluated against benefits, especially with critical illness.
D
Deepa P.
Covers inpatient, pre/post hospitalization, and daycare procedures.
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Frequently Asked Questions
Does Health Insurance Gold 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.
- Maternity and Newborn Waiting Period: There’s a 4-year waiting period before you can make claims related to pregnancy and childbirth.
Does Health Insurance Gold have room rent restrictions?
Does Health Insurance Gold offer a restoration benefit?
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