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Bajaj Allianz Life Insurance

Health Insurance

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020-66495000
 

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Family Floater Health Guard
   

Personal Accident

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Life is uncertain. Your future doesn't have to be. Accidental death or injury of a breadwinner can create serious financial problems for the family. Our Personal Accident health insurance plan ensures total security and peace of mind.

Personal Accident is a policy that covers the insured against bodily injury or death caused due to accidents.
 
Sl / Age Basic Wider Comprehensive
Death      
Permanent Total Disability      
Permanent Partial Disability      
Temporary Total Disability      
Children's Education Bonus      
Medical Expenses + Hospital Confinement (Add on covers)      
 
1. What are the benefits of this policy?
 
  • Highest compensation of 125% of the sum insured incase of permanent total disability.
  • Medical Expenses arising out of accident.
  • Children's education bonus / in case of death or permanent total disability.
  • Cumulative bonus @10% per claim free year to a maximum of 50% (reduced by 10% if claim is lodged).
  • Family discount of 10%.
Benefit Compensation
Medical Expenses Reimbursement upto 40% of valid claim amount
or actual medical bills, whichever is less
Hospital Confinement Rs.1000/- per day for a maximum of 30 days hospitalization
Children's Education Bonus Rs.5000/- for a child or Rs. 10,000/- maximum
for 2 children below the age of 19 or 10% of
capital sum insured, whichever is less
In case of permanent partial disablement, we will pay the percentage, of sum assured as applicable given in the table below:-
Scale of benefits description Compensation as% of sum insured
An arm at the shoulder joint 70
An arm above the elbow joint 65
An arm beneath the elbow joint 60
A hand at the wrist 55
A thumb 20
An index finger 10
Any other finger 5
A leg above the mid-thigh 70
A leg upto mid-thigh 60
A leg upto beneath the knee 50
A leg upto mid-calf 45
A foot at the ankle 40
A large toe 5
Any other toe 2
An eye 50
Hearing loss in one ear 30
Hearing loss on both ears 75
Sense of smell 10
Sense of taste 5
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2. Premium Rate
  The premium differs in case of different risk levels determined by your occupation.
  Risk Level I: Administrative / managing functions, accountants, doctors, lawyers, architects, teachers and similar occupations.
 
  Risk Level II :
  Manual labour, garage mechanic, machine operator paid driver (car / truck / heavy vehicles) cash carrying employee, builder, contractor, veterinary doctor and similar occupations.
 
  Risk Level III:
  Workers in underground mines, electric installations with high tension supply, jockey, circus performers, big game hunters, mountaineers, professional river rafters and similar occupations.
(For occupations not specified above, please enquire with us).
   
  Annual Premium Rate
 
Premium rates given below (%) -Rs per 1000/-
Cover Risk Class
  I II III
Basic 0.45 0.6 0.9
Wider 1.0 1.25 1.75
Comprehensive 1.5 2.0 Not available
Medical Expenses 25% of above premium 25% of above premium 25% of above premium
Hospital Confinement Rs. 300 per person Rs. 300 per person Rs. 300 per person
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3. Who is eligible for this policy?
  1. How do I submit my claim?
 
  • If you meet with an accident and injure any part of your body that may result in a claim, you or someone claiming on your behalf must inform us in writing immediately, and in any event within 14 days.
  • Incase of death due to accident, the same must be informed to us in writing immediately and a copy of the post mortem report should be sent to us within 14 days.
   
  2. What are the steps to be taken?
 
  • You must immediately consult a Doctor and follow the advice and treatment that he recommends.
  • You must get yourself examined by our medical advisors if we ask for this, and as often as we consider this to be necessary.
  • You or someone claiming on your behalf must promptly provide us the documentation and other information we ask for in order to investigate the claim or to carry out our obligation to make payment for it.
   
  3. How soon can I get my compensation? What is the mode of payment?
 
  • Bajaj Allianz believes in quick processing. Claims are processed within seven working days from the date of fulfilling all the requirements.
  • You must get yourself examined by our medical advisors if we ask for this, and as often as we consider this to be necessary.
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4. Claim Procedure
1. The illness / claim should be reported to BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD. with an immediate notice by telephone or in Writing (email / letter).

2. On receipt of claim intimation, BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD will forward a claim form and check list for the documents to be submitted by the claimant.

3. After receiving the claim form the claimant should submit the completed claim form mentioning the following mandatory details:-
  • Insured details (Name / Address / Age / Sex / Contact No.)
  • Accident details (Date and circumstances of accident / injury).
  • Details of the other Personal Accident policies in force.
  • Signature of the claimant.
4. The other relevant documents to be submitted along with the claim form are as follows:-
A. Death
  • Claim form
  • Police Panchanama, FIR, Post mortem Report, Death Certificate
  • If admitted - the Admission history.
B. PTD (Permanent Total Disability) & PPD (Permanent Partial Disability)
  • Claim form
  • Disability Certificate from Civil Surgeon of Government Hospital
  • All the investigation reports / X-Rays with films
C. Temporary Total Disablement (Weekly Benefit)
  • Claim form
  • Medical Certificate from the Civil Surgeon of Government Hospital
  • Leave certificate from the employer.
  • All the investigation reports / X-Rays with films
5. If there is a discrepancy / disagreement on the percentage of disability, the insured may be referred to an independent orthopedic surgeon for an unbiased opinion.

6. The claims team would assess the claim for completeness of documentation and admissibility. A written communication would be sent to the insured regarding requirement of documents if any or if the claim is deemed to be inadmissible as per policy terms and conditions.

7. In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document.
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Disclaimer: Notwithstanding my telephone/mobile is registration with NDNC and or notwithstanding the Telecom Regulatory Authority of India [TRAI] restrictions/guidelines on unsolicited telecalls, by my accessing this web site and leaving the site half way enquiring/verify Bajaj Allianz General Insurance Co. Ltd's [BAGIC] products/services and or my making a request to call me back, it is deemed that I have expressly authorized BAGIC and or I am hereby authorizing BAGIC to call me back or send me text messages for solicitation and procurement of various insurance products and services of BAGIC. In this regard I shall not have any complaint nor complain to TRAI as to any alleged unsolicited calls by BAGIC to me.

Disclaimer

Notwithstanding my telephone/mobile is registration with NDNC and or notwithstanding the Telecom Regulatory Authority of India [TRAI] restrictions/guidelines on unsolicited telecalls, by my accessing this web site and leaving the site half way enquiring/verify Bajaj Allianz General Insurance Co. Ltd's [BAGIC] products/services and or my making a request to call me back, it is deemed that I have expressly authorized BAGIC and or I am hereby authorizing BAGIC to call me back or send me text messages for solicitation and procurement of various insurance products and services of BAGIC. In this regard I shall not have any complaint nor complain to TRAI as to any alleged unsolicited calls by BAGIC to me.

 
   
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