Overview of Health Insurance Platinum
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 of Health Insurance Platinum
Written by Nikhil Nair
Senior Writer
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.
You always have full cover irrespective of the disease, a highly valued feature.
Day Care treatments covered, which adds significant value to the policy.
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 10 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
90% CSR, calculated as a 3-year average
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
10,000+
Zuno (erstwhile Edelweiss) maintains a moderate network of 10,000 hospitals, offering reasonable coverage across key locations.
Complaints
21 complaints per 10,000 claims registered
Zuno (erstwhile Edelweiss) experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
The aforementioned ratios have been averaged over three years (FY24-FY26)
Features of Health Insurance Platinum
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 just 2 years. It's probably the best deal you can get to be honest.
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 - 90 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons of Health Insurance Platinum
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 100% of sum insured for listed Critical illnesses.
Exclusions in Health Insurance Platinum
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.
Custodial care at home or in a facility for help with daily activities is 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 Health Insurance Platinum
Doctor consultations are not covered.
Reviews for Health Insurance Platinum
S
Sneha Pillai
For a 34-year-old family in Kochi, Platinum finally has a cover range I can work with Maternity is up to ₹2 lakh, and pre/post-hospitalisation is 90/180 days. Stronger than Gold, though the four-year maternity wait is still long.
A
Arjun Mehta
I like the refill structure for a high-cover plan. The in-built restoration gives 100% once after exhaustion for an unrelated illness, and the optional Recharge can work for the same illness or same hospitalisation.
S
Shabana Ali
At 39 in Mumbai, the ₹1 crore ceiling is attractive, but some sub-limits still look modest beside it: ₹10,000 ambulance cover and ₹2 lakh organ-donor cover. Room eligibility is a standard single private room, not any room category. It's high SI, not truly limit-free cover.
P
Pranav Bhatnagar
The 24-month PED wait is a real improvement over Silver and Gold's 36 months. I also like the 50% NCB each claim-free year up to 100% and the claim-free health check-up. For my 52-year-old self in Noida, those are meaningful, but the age-linked co-pay later is hard to ignore.
N
Nandini Rao
We're a young couple in Mysuru and the ₹2 lakh maternity cap is far more practical than Gold's ₹50,000. Still, waiting four full years and having no routine OPD consultation cover makes the 'premium' tier feel incomplete. I'd need the price gap versus other ₹25–50 lakh plans to be small.
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?
TALK TO OUR ADVISORS
Get real help from advisors who listen, guide and go the extra mile for you.