GOQii Insure+ India’s first ‘outcome based health and life insurance program’ that enables you to get a Health Insurance cover for up to ₹5 lakhs* by getting healthier on the GOQii App.

We have partnered with some of India’s leading health insurance providers for the GOQii Insure+ program.

You can get healthier on the GOQii App by logging in your daily habits such as steps, food intake, water logs, sleep, exercises and others (set by your personal coach) and achieving your daily health targets. This in turn helps you improve your S.A.F.E. score on the GOQii app and enables you to get healthier in the process.

On activating GOQii personal care subscription, you automatically activate the GOQii Insure+ plan of Health Insurance cover. Every GOQii player (user) that activates their Insure+ plan starts their health journey on the lowest tier of the SAFE score i.e. Sedentary. At this level, you are eligible for a Health Insurance cover of ₹1 Lakh. By leading a healthy lifestyle and engaging on the GOQii App, players can improve their SAFE score and progress to Active, Fit and Elite to increase the value of their health insurance cover. On reaching Elite, players are eligible for up to ₹5 lakh* Health Insurance Cover.

Refer to the below table to understand the tiers in the SAFE Score.

GOQii SAFE SCORE	ELIGIBLE INSURANCE COVER
Sedentary	Up to ₹1 lakh Health Insurance Cover
Active	Up to ₹2 lakh Health Insurance Cover
Fit	Up to ₹3 lakh Health Insurance Cover
Elite	Up to ₹5 lakh Health Insurance Cover

If you are unable to maintain your SAFE Score, you will drop down 1 level from your existing tier and will be eligible for the insurance cover under the tier you fall in. (For e.g. If you belong to the Elite Tier and are unable to maintain the minimum SAFE score, you will drop down to the Fit level and will be eligible for health insurance cover of ₹3 lakh Health Insurance Cover at the time of claim).

At present, GOQii Insure+ cover are provided on select GOQii devices only. GOQii Insure+ cover is provided only with 12 months GOQii Personal Care Subscription Plan.

You can buy any GOQii Device from the GOQii Website & Mobile App

• For new GOQii Players who have purchased the new GOQii Insure+ devices, they get a 12-month personal care subscription
• Existing GOQii Players can avail the GOQii Insure+ program on renewing or purchasing a 12 month Insure+ subscription

A 12 month GOQii Insure+ plan includes a personal health coach, certified health experts, tele-consultations with doctors, interactive video coaching, GOQii Cash Rewards, Challenges, GOQii Health Store, and much more.

For new GOQii players

• Download the GOQii App from the Google Play Store or Apple App Store
• Login to the GOQii App using your mobile number and the activation code received along with the GOQii Smart Device
• Insurance plan will be activated automatically post successful activation

For existing GOQii players

• Go to the ‘my subscriptions’ tab on the GOQii app
• Tap on the ‘Change Plan’ option
• Scroll to the ‘Annual’ section and subscribe to the GOQii Personal Care Plan

• Health Insurance age group between 5 years to 60.
• Life Insurance age group between 18 years to 60 years.
• Currently, it is available only for Indian citizens.

No. This is an individual plan only available to GOQii players who activate the personal coaching subscription on the GOQii App.

Yes, you can view your insurance details in the GOQii App and also track your GOQii SAFE Score based on your healthy habits and engagement with the GOQii app.

Yes, you can view & download your Insurance Health Card in the GOQii App.

The Insurance plan will be valid for a period of 12 months from the date of activation of your personal care subscription.

You can renew the insurance plan by purchasing the 12-month GOQii Personal Care Subscription Plan from the GOQii Mobile App.

There is a 30-day waiting period from the policy start date.

Yes, under the insurance section in the GOQii App, click on Hospital List and search the network hospital basis city & pincode

In case of reimbursement, you must notify about your hospitalization directly to your Insurance Company. However, in case of cashless, you can directly get in touch with the onsite TPA stationed at the network hospital.

PRE-HOSPITALISATION: Medical Expenses covered up to a period of 30 days
Pre-hospitalisation expenses are medical expenses that are incurred in 30 days before hospitalisation of the patient.

POST-HOSPITALISATION: Medical Expenses covered up to a period of 60 days
Post-hospitalisation expenses are medical expenses that are incurred in 60 days after the patient is discharged from the hospital.

Day Care Treatment Covered
Day-care involves medical treatment, operation and surgeries for patients that require hospitalisation for less than 24-hours. Day Care Treatment is covered upto your eligible Sum Insured Amount

Emergency Ambulance Covered up to ₹2000/claim
Emergency Ambulance covers the ambulance expenses for transportation to the hospital in case of an emergency. Emergency Domestic Road Ambulance Covered up to ₹2000/hospitalization

Room Rent Capping:
For Sedentary & Active Customers: (Eligible Sum Insured - 1 & 2 Lakhs)
Normal Rooms – Up to 2% of Eligible Sum Insured
ICU Rooms - Up to 4% of Eligible Sum Insured

For Fit & Elite Customers: (Eligible Sum Insured - 3 & 5 Lakhs)
Single Private Room - Up to 2% of Eligible Sum Insured
ICU Rooms – No Room Rent Limit

If the room rent exceeds the limit prescribed, the medical expenses payable will be on a pro-rata basis.

Donor expenses covered
Any expenses that refer to the organ transplant which is recommended and approved as part of the medical expenses for the policyholder. Donor Expenses Covered up to eligible Sum Insured

Inpatient treatment covered

• In Patient Treatment covered up to eligible Sum Insured

Sub-Limits: Cataract – Up to ₹20,000/- Per Eye

Pre-Existing diseases are covered only after 24 months
There is a 24 month waiting period for pre existing diseases to be covered. This means, any claim of a pre-existing illness won’t be covered before 24 months since the start of the policy issued.

Expenses and direct complications related to the treatment of a pre-existing Disease (PED) shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with the insurer.

30 Day Waiting Period
There is a 30 Day Waiting Period from the policy start date.

Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. This exclusion shall not, however, apply if the Insured Person has Continuous Coverage for more than twelve months.

Only 12 months of waiting for specific diseases / procedure
Expenses related to the treatment of the listed conditions/ surgeries/treatments shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first policy.

This exclusion shall not be applicable for claims arising due to an accident. If any of the specified disease/procedure falls under the waiting period specified for pre-Existing diseases, then the longer of the two waiting periods shall apply.

List of excluded diseases/procedures

• Cataract
• Benign Prostatic Hypertrophy
• Myomectomy, Hysterectomy unless because of malignancy
• All types of Hernia, Hydrocele
• Fissures and/or Fistula in anus, hemorrhoids/piles
• Arthritis, gout, rheumatism and spinal disorders
• Joint replacements unless due to Accident
• Sinusitis and related disorders
• Stones in the urinary and biliary systems
• Dilatation and curettage, Endometriosis
• All types of skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant
• Dialysis required for chronic renal failure
• Tonsillitis, adenoids and sinuses
• Gastric and duodenal erosions and ulcers
• Deviated nasal septum
• Varicose Veins/ Varicose Ulcers

Tap to find out the list of permanent exclusions from the policy.

Following things are not excluded in this policy:

• Investigation & Evaluation
• Rest Cure, rehabilitation and respite care
• Obesity/ Weight Control
• Change-of- Gender treatments
• Cosmetic or plastic Surgery
• Hazardous or Adventure sports
• Breach of law
• Excluded Providers: Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible.
• Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
• Treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons
• Dietary supplements and substances that can be purchased without prescription
• Refractive Error: Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters
• Unproven Treatments
• Sterility and Infertility
• Maternity
• Costs of routine medical, eye or ear examinations preventive health check-ups, spectacles, laser surgery for correction of refractive errors, contact lenses, hearing aids, dentures or artificial teeth;
• Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs, crutches, instruments used in treatment of sleep apnoea syndrome or continuous ambulatory peritoneal dialysis (C.A.P.D.) and oxygen concentrator for bronchial asthmatic condition, cost of cochlear implant(s) unless necessitated by an Accident or required intra-operatively
• Expenses incurred on all dental treatment unless necessitated due to an Accident
• Any expenses incurred on personal comfort, cosmetics, convenience and hygiene related items and services
• Any acupressure, acupuncture, magnetic and such other therapies
• Circumcision unless necessary for treatment of an Illness or necessitated due to an Accident
• Vaccination or inoculation of any kind, unless it is post animal bite
• Intentional self-injury (whether arising from an attempt to commit suicide or otherwise)
• Treatment relating to Congenital external Anomalies
• Any treatment related to sleep disorder or sleep apnoea syndrome, general debility, convalescence, run-down condition
• Costs incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose
• Any treatment taken outside India
• Any treatment taken from anyone not falling within the scope of definition of Medical Practitioner. Any treatment charges or fees charged by any Medical Practitioner acting outside the scope of license or registration granted to him by any medical council
• Non-allopathic treatment; unless covered under ‘Alternative treatment’
• Any consequential or indirect loss arising out of or related to Hospitalization
• Any Injury or Illness directly or indirectly caused by or arising from or attributable to war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority
• Any Illness or Injury directly or indirectly caused by or contributed to by nuclear weapons/materials or contributed to by or arising from ionising radiation or contamination by radioactivity by any nuclear fuel or from any nuclear waste or from the combustion of nuclear fuel
• All non-medical expenses listed in Annexure III (List I) of the Policy
• Any OPD treatment will not be covered
• Medical supplies including elastic stockings, diabetic test strips, and similar products.
• Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding hairline fractures) and dislocations of the mandible and extremities
• Treatment such as External CounterPulsation (ECP), Enhanced External CounterPulsation (EECP), Hyperbaric Oxygen Therapy will not be covered unless it forms a part of in-patient treatment in case of hospitalization or part of discharge advice up to the Post hospitalization period as specified in the policy Schedule/ Certificate of Insurance
• Any physical, medical condition or treatment that is specifically excluded in the Policy Schedule under Important Condition

Claims can be of 2 types

• 1. Cashless
  

  Hasslefree and quick

  Cashless claims in health insurance is a mode of claim settlement where the policy holder does not have to pay cash for treatment and the settlement of the bills is taken care of directly between the hospital and the insurance company. To avail cashless facility of up to ₹5 Lakhs (depending on your S.A.F.E. Score), the policyholder must be hospitalised in any of GOQii’s network hospitals.

• 2. Reimbursement
  

  Pay yourself first and get it reimbursed later

  Reimbursement claim in health insurance is a mode of claim settlement where the policyholder pays first to the hospital for medical/hospitalisation bills for the availed medical treatment. Then the policy holder can reach out to the insurer and claim reimbursement for the amount paid.

FOR CASHLESS CLAIMS:

In case of cashless, policy holder will have to connect with the onsite TPA stationed in the network hospital at the time of admission

• Select a network hospital
  Select a networked hospital from the designated network hospital list

• Connect with onsite TPA
  Connect with the onsite TPA and get yourself admitted to selected hospital

• Hassle free experience
  Get your treatment done without any hassles

FOR REIMBURSEMENT CLAIMS:

In case of reimbursement, policyholder will have to connect with the Kotak General Insurance Customer Care

• 1. Fill claim form: In case of a reimbursement claim, policyholders have to fill Claim Forms A & B

• 2. Submit the documents: Policy holder will have to mandatorily courier original documents of hospitalization & medical expenses to the Kotak General/TPA address for authentication & processing the claims (Address: Family Health Plan (TPA) Limited, Gr. Floor, Srinilaya Cyber Spazio, Road No. 2, Banjara Hills, Hyderabad, Telangana – 500034; Toll Free – 1800 2664545; Email: care@kotak.com)

  Customer to provide below mentioned Mandatory Claims Documents for smooth claim process:

  • Duly filled and signed Claim form A & B
  • Original Hospital discharge summary
  • All original Hospital bills and Hospital bill paid receipts.
  • Original Chemist bills and receipts
  • All original medical test reports
  • First consultation and follow up treatment papers
  • Canceled cheque with printed name on it of policy holder or pass book in support for claim pay-out is submitted
  • CKYC form, PAN Card and address proof is submitted for claims more than ₹1 lakh
  • Mention email address (registered & alternate) and mobile number in claim form for any claim update communication (email/SMS) from Kotak GI

Policyholders will have to directly contact Kotak General Insurance Toll Free Helpline on 18002664545 or email: care@kotak.com to resolve their queries.