Overview
The Zuno Health Insurance Platinum plan offers comprehensive coverage with a sum insured up to ₹1 crore. It includes benefits like maternity cover [Up to 2,00,000, maximum up to 2 deliveries] after a four-year waiting period, critical illness cover providing 100%of the sum insured, and annual health check-ups [for every claim-free year]. The plan features a restoration benefit [once for unrelated illness], ensuring the sum insured is replenished once a year, and covers daycare treatments and domiciliary hospitalization [both up to Base SI].
Experts Review
Written by Ishita Jain
Editor
The Zuno Health Insurance Platinum plan is a robust health insurance solution that covers most medical needs without imposing disease-wise sub-limits. Its critical illness cover is a standout feature, offering 100% of the sum insured upon diagnosis of severe conditions like cancer.
Basic cover includes 90-180 days pre- and post-hospitalization, daycare, AYUSH, and domiciliary treatments up to the Sum Insured, a No Claim Bonus of 50% per claim-free year (up to 100%), and room rent capped at a single private room.
However, if purchased after age 61, a 20% co-payment clause applies to all claims, which may increase out-of-pocket expenses. Compared to the Gold plan, the Platinum plan offers higher sum insured options and more comprehensive benefits, but its premium is generally 15-20% higher due to these enhanced features.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
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
Maternity
STANDOUT
The insurer will also cover expenses related to maternity— Think hospitalization expenses incurred while giving birth. But they’ll only pay upto ₹2,00,000 and make you wait 4 years before covering this expense.
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
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 just 2 years. It’s probably the best deal you can get to be honest.
Add-ons
Recharge Benefit
Recommended
Restores the cover once a year up to 100% of the sum insured for any illness.
Voluntary Co-Payment
Recharge Benefit
With the add-on, one-time restoration up to 100% of Sum Insured will be available on a partial basis for the treatment of any illness (whether same or different).
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
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
Doctor consultations are not covered.
Customer Reviews
H
Harish M.
Sum insured up to ₹1 crore offers very high coverage.
H
Heena I (new)
no disease-wise limit is a good long-term benefit for families.
I
Inder M.
Critical illness cover providing 100% of the sum insured is a massive payout.
L
Lata C (new)
Zuno's track record is still developing, especially for high-value claims.
K
Kiran D (new)
Four-year waiting period for maternity is quite long.
J
Jyoti J (new)
Good for those needing very high sum insured and extensive critical illness protection.
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Frequently Asked Questions
Does Health Insurance Platinum 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 2-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 Platinum have room rent restrictions?
Does Health Insurance Platinum offer a restoration benefit?
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