Acko Platinum Health
Overview
Acko Platinum Health is a premium and comprehensive health insurance plan offered by Acko General Insurance Limited. The plan offers all the benefits with no restrictions and has a zero waiting period. Acko offers health insurance plans via its online platforms only, eliminating intermediaries and commissions. Hence, it is a premium yet affordable health plan.
Acko General Insurance showcases a good claim settlement record. The company was founded in 2016 and started operations in 2018. Initially, Acko focused mainly on the motor insurance business. It started selling health insurance recently. Hence, it has a limited business track record.
Pros and Cons
- No room restrictions – Covers all room types with no sub-limits.
- No copayment – Does not impose any copayment clause.
- Zero waiting period – Zero initial and specified illness waiting period.
- Unlimited restorations – Restores the sum insured multiple times when exhausted.
- The plan is quite affordable.
- The insurer has a limited business track record.
Plan Benefits
Covers inpatient hospitalisation expenses with no sub-limits
Acko Standard Health plan covers hospitalisation and related expenses without any restrictions or sub-limits. The expenses are fully covered up to the sum insured.
No room rent capping
The plan does not restrict the room rent expenses. You can choose the room you like to get the treatment you deserve, and the insurer fully covers the cost.
Zero waiting period – offers day 1 coverage for all illnesses
The plan offers zero initial waiting period and zero specified illness waiting period. The coverage on illnesses starts from day 1. The insurer might impose a waiting period of zero to 3 years on disclosed pre-existing conditions, depending on the situation.
Covers pre and post hospitalisation expenses
You get coverage for hospitalisation-related expenses for up to 60 days before and 120 days after the hospitalisation. The insurer covers expenses such as consultation fees, diagnostic tests, and medication, among others, providing comprehensive coverage.
Full coverage for daycare treatments
Many treatments or surgeries done under anaesthesia now require less than 24-hour hospitalisation. They are called daycare treatments. The plan covers the cost of all such treatments fully.
Get unlimited restorations during a policy year
You do not have to worry about coverage for the next claim if you have already made a claim. Your insurer restores your sum insured multiple times during a policy year if your base cover is fully or partially exhausted. This feature comes in handy if you need to make multiple claims during any policy year.
Covers alternative treatment
Do you want to consider an alternative treatment for your ailment, such as Ayurveda or Homoeopathy? The plan covers the hospitalisation expenses of such alternative treatments.
Get cover for domiciliary hospitalisation
Are you forced to be hospitalised at home? Think of a situation when hospital beds are unavailable or the patient’s medical condition does not allow him to be moved to a nearby hospital. This is called domiciliary hospitalisation. The plan still covers the expenses related to hospitalisation if done under the supervision of a medical practitioner and exceeds 3 consecutive days.
Get coverage for road ambulance charges
You also get coverage for road ambulance charges if you need to be transported to the hospital by an ambulance.
Get cumulative bonus, irrespective of claims
You get a cumulative bonus equal to 10% of the base sum insured each year, irrespective of claims. The maximum bonus is capped at 100% of the base sum insured.
Organ donor expenses covered
Organ transplant surgeries are expensive. Moreover, the donor also requires surgery to harvest the organ. But you don’t have to worry anymore. The insurer covers the cost of harvesting an organ from a donor in case you are the organ recipient.
Get coverage for non-medical expenses
The plan also covers non-medical items, such as masks, syringes, gloves, etc. You don’t have to pay for them out-of-pocket.
Get annual preventive health check-up
All insured members are entitled to free preventive health check-up once in a policy year.
Doctor on call
You also get access to video or teleconsultations with medical practitioners at any time of the day. This facility is available only through the insurer’s empanelled service providers.
Policy Conditions
| Sum Insured Range | Rs. 1 Crore and Unlimited |
| Entry Age | 3 Months – 25 Years for dependent children, 18 Years and above for adults |
| Policy Tenure Options | : 1, 2 or 3 Years |
| Coverage Types | Individual and Family Floater |
| Family Coverage | Up to 10 members under the family floater option; self, spouse, 4 dependent children, parents, parents-in-law can be included. |
| Premium Payment | Monthly, Quarterly, Half-yearly, Annual |
Exclusions
Waiting Periods
- Initial Waiting Period: Zero (except accidents)
- Specific Illness Waiting Period: Zero
- Waiting Period on Pre-Existing Diseases: Zero to 3 years, based on health evaluation
Medical Exclusions
- Congenital external diseases
- Maternity / Sterility or Infertility treatments
- Obesity control
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven treatment
- Dental treatment
- Refractive error correction for less than 7.5 diopters
Non-Medical Exclusions
- Investigation and evaluation
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Expenses for treatment necessitated by committing breach of law with criminal intent
- Expenses for treatment taken by a medical practitioner outside his discipline.
- War, terrorism, nuclear events
- Injuries from hazardous sports
About the Insurer
Acko General Insurance Limited is a newer general insurance company. The company was founded in 2016 and started operations in 2018. It is India’s first fully digital insurance company catering directly to retail clients online, thus, eliminating intermediaries and commissions.
Initially, its major focus was on the motor insurance business. In 2023, it started offering retail health insurance plans. Currently, it offers plans covering motor, travel, and health insurance. The company’s high claim settlement ratio and moderate volume of claim complaints speak about its claim settlement efficiency. However, the company has a very limited overall business record.
Performance Highlights (FY24)
Turnover – Rs. 2,016 Crore
Claim Settlement Ratio – 98.13%
Incurred Claim Ratio – 69.57%
Volume of Claim Complaints – 27.33 per 10,000 claims
Network Hospitals – 11,500+
Get In Touch
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Related Variants
Frequently Asked Questions
What is the Acko Platinum Health Insurance Plan?
Acko Platinum Health Insurance is a comprehensive health plan with zero waiting period that provides 100% hospital bill coverage with no deductions.
Which sum insured options are available under Acko Platinum Health Insurance?
You can choose from a fixed sum insured option of Rs. 1 Crore or go unlimited under the Platinum plan.
Does Acko Platinum Health Insurance have a waiting period?
No, this plan offers zero waiting period from Day 1, including for disclosed pre‑existing conditions.
Are pre‑existing diseases covered under Acko Platinum Health Insurance?
Yes, once disclosed, pre‑existing conditions are covered immediately with no waiting period. The insurer might impose a waiting period of up to 3 years, depending on the illness.
Is there any copayment or deductible?
No, Acko Health Platinum plan ensures zero copay and no deductible on claims.
Is there a room-rent limit for hospitalisation?
No, you can choose any room, including a suite or deluxe, with full coverage.
Are non‑medical expenses covered under Acko Platinum Health Insurance?
Yes, consumables like syringes, masks, gloves and similar non‑medical items are fully covered.
Are pre‑hospitalisation and post‑hospitalisation expenses covered?
Yes, Acko Platinum Health covers up to 60 days pre and 120 days post‑hospitalisation, subject to the sum insured.
Does the plan cover daycare and domiciliary treatment?
Yes, all daycare procedures and domiciliary treatments are included up to the sum insured.
Are modern treatments and critical illnesses covered under Acko Platinum Health Insurance?
Yes, treatments such as stem cell therapy, radio surgery, and critical illness hospitalisation are covered under the plan up to the sum insured.
Does Acko Platinum Health cover organ donor expenses?
Yes, inpatient costs for harvesting the organ from the donor are included up to the sum insured.
Are AYUSH treatments covered?
Yes, alternative treatments are covered up to the sum insured on a hospitalisation basis.
Are teleconsultations and second opinion services included under Acko Platinum Health Insurance?
Yes, the built-in cover includes the doctor on call facility and second opinion consultations.
Is there a restoration benefit available?
Yes, the plan provides unlimited restorations of the sum insured after cover exhaustion due to a claim.
Does it offer No Claim Bonus (NCB)?
Yes, NCB or guaranteed cumulative bonus of 10% of the sum insured is available each year, accumulating up to 100%, irrespective of claims.
How do I buy the policy online?
You can get a quote via Acko’s website or app by providing your details. Medical tests may be required for higher ages.
How are claims processed at Acko General Insurance Limited?
Claims are fully digital. Upload documents via the insurer’s app for cashless settlement at 10,500+ network hospitals.
What are the key exclusions under Acko Platinum Health Insurance Plan?
Standard IRDAI exclusions apply: undisclosed pre‑existing conditions, maternity (unless added), cosmetic or bariatric surgery (unless injury), infertility, OPD, worldwide hospitalisation, and suicide attempts.
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