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Cashless treatment at 18,400 + network hospitals*

In-house health administration team

Cover 09 plans/options with Health Prime Rider

 

What is Health Insurance

WHAT IS HEALTH INSURANCE?

Health insurance is an insurance product that provides coverage for expenses in the event of an illness or injury. It can safeguard you from spending your hard-earned money on medical expenses. A health insurance policy can also be viewed as an agreement between you and your insurer. Here, the insurance company covers you financially in case of any medical emergency.

There are several types of health insurance policies in India. Choosing the right policy is necessary so that you can relax when it comes to paying hefty medical bills. Not only do you get covered for the treatment cost with your policy, but you may also get other health insurance benefits such as cashless treatment and quality healthcare at a reputed network hospital.

Up to 70% of Indians are paying for health expenditures out-of-pocket.

 

WHAT IS THE NEED FOR HEALTH INSURANCE IN INDIA?

A hard-hitting truth is that whether a hospitalisation is planned or not, it is unpleasant, and is sure to cost you heavily. So, it is better to have the protection of a health insurance policy, which may help manage your finances and offer you several other health insurance benefits at an affordable premium. You can also check out the various health insurance quotes online to know which one is most suited to your budget.

Here are 5 reasons that will make you understand the importance of having the right health insurance plan:

  • ✓ Financial Help :

    A health insurance policy can ease the burden of paying hefty medical bills from your pocket. If you are worried about the premium rates, then know that it is possible to get adequate insurance coverage at a pocket-friendly cost. Concessions, such as a family discount, allow you to purchase medical insurance plans at a relatively low premium.
  • ✓ Quality Medical Care :

    Health insurance benefits, such as cashless claims and quality medical care, are available at a network and a non-network hospital. A network hospital is a hospital that has an agreement with the health insurance company.
  • ✓ Tax saving :

    In India, the payments you make towards your health insurance policies are eligible for tax deductions under section 80D of the Income Tax Act. You can avail a maximum deduction of ₹1 lakh if you buy a policy for yourself and your family members, where both, you and your parents, are senior citizens.
  • ✓ Extensive Coverage :

    Health plans provide cover not only against hospitalisation expenses, but also critical illnesses, accidental injury, maternity-related expenses, consultations, check-ups, and more. This extensive coverage is offered through a wide array of different types of health insurance policies or add-ons.
  • ✓ Peace of mind :

    If you are secured on the financial front, then even a trip to a hospital can feel relatively less stressful. Having medical insurance gives you the peace of mind that can help you relax in a tense situation.

     

Approximately 514 million people across India were covered under health insurance schemes in 2021, which merely covers 37% of the people in the country.

 

KNOW WHAT A HEALTH INSURANCE PLAN OFFERS

You can choose a comprehensive health insurance policy to access quality healthcare anywhere across the nation without worrying about medical bills.

Here’s a quick rundown of what you can get after buying health insurance in India:

  • Multiple Sum Insured Options
  • In-patient Hospitalisation Expenses
  • Pre- and Post-hospitalisation Expenses
  • Preventive Health Check-up
  • Critical Illnesses Cover
  • Cashless Treatment at Network Hospitals
  • Tax benefits under Section 80D of the Income Tax Act, 1961
  • Peace of Mind

Disclaimer: The tax benefit is subject to change as per prevalent tax laws.

 

Secondary-level healthcare services via a public sector district hospital in north India cost up to ₹11.44 crore annually.

 

If You Think You Do Not Need A Health Insurance Plan, Think Again

The need for a health insurance plan is often underestimated until one faces a health scare. Some people may be in the prime of their health and assume that there is no need for a health policy. They may believe that since they are taking good care of their health, they may not require any such layer of financial protection.

On the other hand, some tend to assume that health insurance plans can prove to be quite expensive. Putting their money into something that may not directly add to their healthcare may not seem worthwhile.

Employees of organisations providing group health insurance may also believe that relying on their group health plans may suffice. However, the plan may not be enough in certain situations.

All these assumptions about not needing health insurance are usually rooted in misconceptions about health insurance.

A health emergency can come in any form. For example, someone meeting with an accident or developing an idiopathic (unexplained) health condition may not have anything to do with how well they are taking care of their health.

Furthermore, health plans need not be expensive. There are several health insurance options available. These can be compared online to get an idea of which one suits your budget while offering you the right coverage. One need not put oneself under financial stress to protect their health.

Lastly, even if you are covered by group insurance policies, know that they may tend to offer limited coverage. You often do not have control over the details of these policies, which may mean that any specific requirements that you might have, are not covered. If you were to leave the organisation, you would be left without any coverage.

Hence, if you want to ensure that you have access to the right healthcare when needed, without having to worry about the cost, it is crucial to consider a health insurance plan.

Types of Health Insurance

Buying a health insurance cover is important. Yet, there are times when people are reluctant to buy one. Often, people may get confused between the different types of health insurance policies that are available.

When buying a policy, it is important to choose the right health cover that fulfils your needs. There are different types of policies one can browse and then opt for.

  • Individual Health Insurance

    Individual Health Insurance

    A type of coverage is health insurance for individuals, which you can get for yourself or on behalf of one of your family members. So, in case you are looking forward to securing your health, consider choosing an individual insurance plan. You can avail of cashless treatments at over 18,400+ network hospitals* with our insurance plans..

    If you opt for Individual Health Insurance, you can enjoy the following features:

     

    • Multiple sum insured options available on an individual basis, which one can select based on their requirements
    • Customisable coverage to meet each individual’s specific needs
    • Cover for pre-hospitalisation and post-hospitalisation
    • Covers day-care procedures, extended family
    • Covers Ayurvedic and Homoeopathic treatment
    • Road ambulance cover
    • Daily cash benefit

    Individual health insurance plans can also be opted by families with an individual sum insured option for each family member. With this option, each family member can enjoy peace of mind, knowing that they have a sufficient sum insured amount for themselves.

  • Family Floater Health Insurance

    Family Floater Health Insurance

    The family floater policy permits you to include multiple family members within the same insurance plan for a single premium payment. Under this type of policy, the sum insured is shared by all the members covered in the plan, thereby securing the family at a reasonable insurance premium.

    If you opt for Family Floater Health Insurance, you can enjoy the following features:

    • Affordable coverage for dependent family members under a single plan
    • A single floater sum insured for all family members
    • Coverage of day-care procedures
    • Pre- and post-hospitalisation
    • Convalescence benefit
    • Bariatric surgery cover
    • Sum insured reinstatement, in case the total value runs out All eligible family members insured under the plan can benefit from its coverages, such as the ones mentioned above, as per the terms and conditions of the plan.
    How does a family floater policy differ from an individual plan?

    While there are different plans to choose from, let’s understand the key differences between an individual and family floater policy:

     

    Point of Comparison

    Individual Health Insurance Policy

    Family Floater Health Insurance

    Definition

    Health insurance for individuals is meant to cover a single person under a single policy. It can be customised to suit the individual’s needs.

    Under this type of policy, multiple family members can be covered under one plan. The sum insured is shared amongst all family members in one plan.

    Sum Insured

    The sum insured will be separate for each insured member.

    Families can also opt for individual health insurance, with each family member having a separate sum insured for themselves.

    The entire family gets covered under one sum insured.

    Hence, the plan is referred to as a floater plan.

    Coverage

    The coverage is designed to meet the needs of a single individual.

    The health insurance benefits are extended for the insured member alone.

    The coverage is designed to meet the varying needs of different family members.

    The policy benefit is extended to the primary member and dependent family members (spouse, dependent children & parents), as per their eligibility.

    Premium

    Premium is paid for the coverage extended to the individual covered under the policy.

    A single premium is paid for all members covered under the plan. Hence, it can be an affordable option compared to paying for separate plans for different members.

    Premium is usually decided according to the age of the eldest member covered under the plan

     

  • Health Insurance for Senior Citizens

    Health Insurance for Senior Citizens

    Health insurance for senior citizens acts as a shield in case of medical conditions during old age and doesn’t leave older adults in financial distress. If you may be looking for health insurance for your parents over 60 years of age, this type of policy may suit your needs as the entry age for such plans is 46 years.

    Some key features of Health Insurance for Senior Citizens:

    • Shorter waiting periods for Pre-existing Diseases
    • Waiver of co-payment
    • High entry age
    • Cumulative bonus
    • Free health check-up
  •  Critical Illness Insurance

    Critical Illness Insurance

    2 out of 5 cancer patients in India borrow money and sell assets to cover the cost of hospitalisation.

    Can such a situation in the country be avoided? While that is a difficult question to answer for a single individual, one could at least take the necessary steps to avoid such a situation.

    A critical illness insurance plan is extremely helpful as it offers coverage for high-cost treatments against some life-threatening diseases. The major advantage of a critical illness policy is that the lump-sum benefit becomes payable on being diagnosed with the listed critical illness, without a mandatory requirement of hospitalisation.

    Our critical illness plan, Criti Care, protects against 43 life-threatening diseases, including:

    • Major Surgery of Aorta
    • Cancer
    • Open Chest CABG
    • First heart attack of Specified Severity
    • Kidney failure
    • Major Organ transplant
    • Multiple sclerosis with persisting symptoms
    • Permanent paralysis of limbs
    • Stroke resulting in Permanent symptoms, etc. 

    Some key features of Critical Illness Insurance:

    • 100% pay-out on diagnosis of listed critical illnesses.
    • Multiple sum insured options

     

  • Critical Illness Insurance for Women

    Critical Illness Insurance for Women

    Critical illness insurance for women is specifically designed to protect against the risk of 8 life-threatening conditions that can adversely affect women. The benefit can be availed in the form of a guaranteed cash sum when diagnosed with a critical illness covered by the plan.

    Listed below are the 8 life-threatening illnesses that are covered:

    • Breast cancer 
    • Fallopian tube cancer 
    • Cervical/ uterine cancer 
    • Ovarian cancer 
    • Vaginal cancer 
    • Permanent paralysis of limbs
    • Multi-trauma
    • Burns

    Some additional features of Critical Illness Insurance for Women:

    • 'Loss of job'  cover
    • Congenital disability benefit
    • Children education bonus
  •  Top Up Health Insurance

    Top-Up Health Insurance

    A top-up health policy ensures that even if the base policy’s sum insured gets exhausted, you are still covered. A top-up policy provides an extra or a “Top-Up” cover to the existing insurance policy.

    Some key features of Top Up Health Insurance:

    • Maternity cover
    • Pre- and post-hospitalisation expenses
    • Floater cover for the entire family
    • Shorter waiting period for pre-existing diseases
    • Day-care procedures

     

  • Personal Accident Insurance

    Personal Accident Insurance

    You can protect yourself from the expenses of any unforeseen accidents with a personal accident policy. Bodily injury, death, or disability that is caused because of a mishap is covered under this type of plan.

    Some key features of Personal Accident Insurance are:

    • Sum insured up to ₹ 25 Crore
    • Family cover
    • Children’s education bonus
    • Add on benefits like Adventure Sports Benefit, Accidental Hospitalisation, Coma Care, Fracture Care, etc.
  • Group Health Insurance

    Group Health Insurance

    This type of policy can take care of any medical treatment for members of a group. For example, an employer could use this to get health coverage for their employees.

    Some key features of Group Health Insurance are:

    • Hospitalisation expenses
    • Nursing charges
    • Cost of pacemaker and similar expenses

     

  • Health Insurance for Vector-borne Diseases

    Health Insurance for Vector-borne Diseases

    Health insurance for vector-borne diseases is a one-of-a-kind plan that takes care of the financial setback due to hospitalisation because of vector-borne illnesses. To put it simply, you can leave your worries to us as this policy for families exclusively covers vector-borne diseases such as Dengue, Malaria, Chikungunya, and Zika fever.

    Some key features of Health Insurance for Vector-borne Diseases:

    • Cover for spouse, dependent children, and parents
    • Cashless facility
    • Different sum insured options
    • Lifetime renewal option

    Most young people are presumed to be healthy but, as per the WHO, an estimated 2.6 million young people aged 10 to 24 years die each year and a much greater number of young people suffer from illnesses which hinder their ability to grow and develop to their full potential. Nearly two-thirds of premature deaths and one-third of the total disease burden in adults are associated with conditions or behaviours initiated in their youth (e.g., tobacco use, physical inactivity, high-risk sexual behaviours, injury from violence and others).

 

Benefits of Health Insurance Plans

One of the important benefits of getting an appropriate health cover is that you get to enjoy a certain sense of stability in terms of paying your hospital bills.

Some of the key benefits of getting a health policy include:

  • Cashless Treatment

    Cashless Treatment:

    You can avail the benefit of cashless health insurance plans at a network as well as a non-network hospital (subject to acceptance of policyholder and hospital). All you need to do for admission to a network hospital is to just show your health ID card along with the required documents. In case of a non-network hospital, mail us at Cashless.Forall@bajajallianz.co.in along with the required documents for claim processing. Your hospital bill settlement will be taken care of smoothly.

  • Additional Coverage via Health Insurance Riders

    Additional Coverage via Health Insurance Riders:

    Riders are the additional coverage that can be purchased to avail the benefits and make the plan more comprehensive. The cost of the rider depends on factors such as age, type of coverage, sum insured, and so on.

    For instance, you can opt for the non-medical expense rider if the insured is hospitalised because of an illness or accident during the policy term. The company will pay the insured for reasonable and customary non-medical expenses specified (belts/braces, cold/hot pack, spacer, steam inhaler, etc.). The non-medical expense rider can be availed with sum insured options of Rs 5 lakh and above, chosen under the health indemnity product. It is important to note that you can’t opt for this rider during the middle of the policy period. The rider needs to be continued for all renewals.

  • Tax Benefits

    Tax Benefits:

    Under Section 80D of the Income Tax Act, you can claim a tax deduction of up to ₹ 25,000 per year for the health insurance premium paid for yourself, if your age is less than 60 years, and up to ₹50,000 if you are a senior citizen.

  • Daily Hospital Cash

    Daily Hospital Cash*:

    If you have a health insurance policy, then you can get the benefit of daily hospital cash. This means that your insurance company will pay you a certain fixed sum of money daily (up to a limited number of days), which you can use to get reasonable accommodation for your family member/caretaker.

    *This feature is available in Individual Health Guard, Family Floater Health Guard and Health Care Supreme.

  • Cumulative Bonus

    Cumulative Bonus:

    If you renew your policy without any break and there has been no claim in the preceding year, then your Sum Insured (SI) increases by 5% for the first year and 10% for every successful claim-free policy renewal. This increment in the sum insured is capped at 50%.

    This feature is available for all health insurance products.

  • Free Health Check-Ups

    Free Health Check-Ups:

    With a health insurance policy by your side, you can avail the benefit of preventive care. You can regularly undertake health check-ups without having to worry about paying medical bills.

  • Life Long Renewability

    Life Long Renewability:

    Once you buy your annual policy, you just need to renew it every year before its expiry to get the benefits of health insurance for a long time. You may also enhance it with additional features, based on your needs.

 

What Are Defined Benefits In Health Insurance Plans?

Policies like critical illness health insurance may offer the following defined benefits that you can rely on if you were to make a claim*:

  • Lump sum pay-out :

     If the person insured by the policy were to be diagnosed with a condition covered by the policy, they may be able to claim a lump sum benefit from the policy. The amount will depend on the policy details and a few other factors. Claims are subject to terms and conditions set forth under health insurance policy.

  • Tax Benefits:

    Under Section 80D of the Income Tax Act, you may be able to claim an exemption for the premium paid towards your policy.**

* Standard T&C Apply

** Tax benefits are subject to change in prevalent tax laws.

Some Common Health Insurance Myths To Not Fall For

Some health insurance misconceptions floating around can keep you from buying a suitable plan, which may then lead to financial stress if you were to face a health emergency. Here are some common myths and the facts behind them that you should be aware of.

 

Myth: Health insurance can be expensive

Based on your specifications, a plan may seem expensive for you. However, not all plans are expensive. Whether a plan is expensive or not depends on your budget and your needs that a plan fulfils. You may find a plan to be expensive only if the cost involved exceeds your budgetary limits.

There is a variety of health insurance policy options available in the Indian insurance space. You can compare them online or consult an insurance advisor to find the right policy within your budget. It may then be possible that a plan that satisfies your insurance needs seems affordable to you.

 

Myth: Young people don’t need health insurance

Health insurance is seldom a necessity, but it is a way of prioritising health and not letting healthcare emergencies bog you down financially.* The need for medical attention could arise even if you are young and healthy. Thus, having health insurance, irrespective of age and medical history, can prove beneficial in the long run.

* Standard T&C Apply

 

Myth: You don’t need to buy coverage when you have group health insurance

Group health insurance plans are commonly offered to employees by their organisation. However, the coverage from these plans ceases when you leave the organisation. Healthcare needs may not always come with any preliminary signs or warnings. Therefore, at times, the coverage offered under group policies may not be enough for your needs. Hence, it may be ideal to consider individual or family health plans.

 

Myth: You should buy a cheap policy

Premium is one of the factors to consider when buying an insurance plan. However, it may not serve your needs to base your purchase decisions on premiums alone. Instead, look at the policy brochure or plan page to understand what a plan has to offer and choose based on what suits you best. It is important to respect your budget while also ensuring that your policy offers you the right features.

How To Choose Right Health Insurance Plan

With the types of health insurance plans available today, one can be more certain about finding a plan that suits them right. However, knowing which one is right for you and choosing a suitable plan from among the available options can be quite a task.

When looking to buy the right health insurance policy, here are a few factors you can consider that may help you choose.

  • ✓ Sum Insured/Coverage:

    One of the most important aspects of health insurance is the sum insurance amount. This is the factor that allows you to be more certain about your healthcare costs being met. Choosing a lower coverage may mean that you are paying a lesser premium. However, the sum insured may not suffice when you need it. On the other hand, choosing a premium higher than your requirements or means may put you in financial stress.

  • ✓ Premium:

    The price you pay for your health insurance plan, i.e., the premium, is based on several factors, including the age of the people covered, add-ons chosen, sum insured, and more. Ensure that your premium is buying you the right policy. However, it is also crucial to ensure that the cost of the policy is within your budget. You may use online health insurance premium calculators to get an idea of the premium of the policy you would like to get.

  • ✓ Network Hospitals:

    Network providers/hospitals refer to healthcare centres that have tied up with the insurer or the TPA (third-party administrator), for seamless claim settlements. While this facility was earlier limited to a network hospital only, now it can be availed even at a hospital outside the hospital’s network (subject to acceptance). Network hospitals can prove to be helpful when you or a family member covered by the policy requires hospitalisation. When buying a policy, ensure that hospitals accessible to you are on the network.

  • ✓ Waiting Period:

    It refers to the period between the purchase of the policy and the time when some of the policy benefits kick in. It is ideal to opt for plans with a lower waiting period.

 

WHY SHOULD YOU BUY HEALTH INSURANCE FROM BAJAJ ALLIANZ?

When it comes to health insurance, Bajaj Allianz General Insurance is indeed at the forefront of the country with its diverse range of cost-effective plans. We offer you the following features with our health insurance policies:

Cashless network hospitals

18,400+ across the country

Cashless Claim Settlement Time

Within 60 minutes for cashless claims

Claim Process

Cashless and reimbursement process

 

In-house Health Administration Team for faster claims processing

Cumulative Bonus

Under the Health Guard plan, if a policy is renewed without break and without any claims in the preceding year, then the sum insured is increased by 50% for the first 2 years.

 

And 10% per annum for the next 5 years.

Maximum up to 150% of the sum insured.  The cumulative bonus feature can vary for other health insurance products..

Health CDC

Health Claim on Direct Click is an app-based feature that allows policyholders to initiate & track claims easily. The policyholders can make claims for medical expenses up to Rs 20,000

Sum Insured

Multiple sum insured options

Why Buy Health Insurance With Us?

 

Why Buy Health Insurance With Us

 

DIFFERENT HEALTH INSURANCE PLANS OFFERED BY BAJAJ ALLIANZ GENERAL INSURANCE COMPANY

The table below shows all of Bajaj Allianz General Insurance Company’s online medical insurance plans, highlighting their key features and important aspects:

Plan Type & Suitability

Plan Name

Sum Insured

Key Features

Things to Note

Value-Added Benefit

Individual & Family Health Insurance (A comprehensive range of benefits and covers for larger expenses related to illness/injury)

Health Guard

(Individual as well as Floater Policy)

Silver Plan: ₹ 1.5/2 lakh

Gold Plan: ₹ 7.5/5/7.5/10/15/20/25/30/35/40/45/50 lakh

Platinum Plan: ₹ 5/7.5/10/15/20/25/30/35/40/45/50/75 lakh/1 crores

Inpatient hospitalisation treatment

Pre- &post-hospitalisation

Road ambulance

Day-care procedures

Organ donor expenses

Convalescence benefit

Daily cash benefit

Sum insured reinstatement benefit

Preventive health check-up

Bariatric surgery cover

Ayurvedic/homoeopathic

Hospitalisation expenses for gold & platinum plan only

Maternity expenses for gold & platinum plan only

Newborn baby cover for gold & platinum plan only

Super Cumulative bonus for the platinum plan only

Recharge benefit for the platinum plan only

Pre-existing diseases waiting period: 36 months

Specific waiting period:24 months

Initial waiting period: 30 days

Maternity waiting period: 72 months

Health prime rider

Non-medical expense rider

Wellness benefits

Comprehensive benefits, unlimited sum insured at competitive premiums to take care of medical costs

Health Infinity (Individual Policy)

No limit on the sum insured

In-patient hospitalisation  treatment

Pre- & post- hospitalisation 

Road ambulance

Day-care procedures

Preventive health check-up

Initial waiting period: 30 days

Pre-existing diseases: 36 months

Specific waiting period: 24 months

The payouts are indemnity payment basis

Co-payment opted by you will be triggered once the payable claim amount exceeds 100 times the room rent limit opted

The co-payment would apply on the claim amount exceeding 100 times the room rent limit and not on the complete claim

Arogya Sanjeevani Policy (A plan that protects you from the financial burden during hospitalisation)

Arogya Sanjeevani

(Individual & Floater Policy)

Hospitalisation: ₹ 1 lakh to ₹ 25 lakh

AYUSH treatment: ₹ 1 lakh to ₹ 25 lakh

Cataract treatment covered up to 25% of the sum insured or ₹ 40,000, whichever is lower, for each eye

Modern treatment method: 50% of hospitalisation sum insured

Hospitalisation expenses

Pre- & post-hospitalisation expenses

Day-care procedure

AYUSH coverage

Expenses on cataract treatment

Ambulance charges

Initial waiting period: 30 days

Pre-existing disease: 48 months

Specific waiting period:24/48 months

5% co-pay for all claims

Cumulative bonus

Critical Illness Insurance (A benefit policy that covers life-threatening illnesses. Lumpsum amount to be paid on diagnosis of listed critical illness)

Critical Illness

For the age group 06 years to 60 years: ₹ 1 lakh to ₹ 50 lakh

For the age group 61 years to 65 years: ₹ 1 lakh to ₹ 10 lakh

Covered for critical illnesses such as:

First heart attack (Myocardial infarction)

Cancer of specified severity

Open Chest CABG (Coronary Artery Disease Requiring Surgery)

Stroke Resulting in Permanent Symptoms

Multiple Sclerosis with Persisting Symptoms

Surgery of Aorta

Primary Pulmonary Arterial Hypertension

Permanent Paralysis of Limbs

Kidney failure requiring regular dialysis

Major organ transplantation

Waiting Period: Critical illnesses diagnosed within the first 90 days of the policy commencement

 

Criti Care

(Individual basis sum insured)

For entry age between 18 years to 65 years: ₹ 1 lakh

For entry age up to 60 years: ₹ 50 lakh/section

Up to ₹ 2Cr per member

For entry age between 61 years to 65 years: ₹ 10 lakh/section

43 critical illnesses covered

Lifetime renewal

Cancer Care

Cardiovascular Care

Kidney Care

Neuro Care

Transplants care

Sensory organs care

 

Dialysis Care

Cancer reconstructive surgery

Cardiac nursing

Physiotherapy care

Sensory care

Wellness Discount

Personal Accident Insurance (A plan that covers the insured against bodily injury/death/disability due to an accident and offers a high sum insured)

Global Personal Guard

₹ 50,000 to ₹ 25 crore

Children education benefit

Hospital confinement allowance

Accidental hospitalisation expenses

Hospital cash benefit

Air ambulance cover

Children education benefit

Coma cover

EMI payment cover

Fracture care

   

Top-Up Health Insurance (This policy can be taken as an add-on cover to the existing hospitalisation medical expenses policy)

 

Extra Care

(Floater Policy)

Sum Insured (Excluding Deductibles)

Deductible per hospitalisation

₹ 10 lakh

₹ 3 lakh

₹ 12 lakh

₹ 4 lakh

₹ 15 lakh

₹ 5 lakh

Hospitalisation expenses

Pre & post-hospitalisation expenses

Ambulance expenses

Modern treatment methods & advancements in technologies

Initial Waiting Period: 30 days

Specific waiting period: 48 months

Pre-existing diseases: 48 months

 

Extra Care Plus

(Floater Policy)

Sum Insured

Aggregate Deductible Options

₹ 3 lakh

₹ 2 lakh

     

₹ 5 lakh

₹ 2 lakh

₹ 3 lakh

   

₹ 10 lakh

₹ 2 lakh

₹ 3 lakh

₹ 5 lakh

 

₹ 15 lakh

 

₹ 3 lakh

₹ 5 lakh

 

₹ 20 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

₹ 25 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

₹ 50 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

In-patient hospitalisation expenses

Pre- & post-hospitalisation expenses

Day-care treatment

Modern treatment methods

Maternity expenses

Ambulance expenses

Organ donor expenses

Free medical check-up

Initial Waiting Period: 30 days

Specific waiting period: 12 months

Pre-existing diseases: 12 months

Maternity waiting period: 12 months

Optional air ambulance cover

A one-stop solution for the common vector-borne illnesses

M-Care

(Individual as well as Floater Policy)

₹ 25000

₹ 50000

₹ 75000

Lumpsum benefit for:

Dengue fever

Malaria

Filariasis

Kala Azar

Chikungunya

Japanese Encephalitis

Zika Virus

Any of the listed vector-borne diseases diagnosed within the first 15 days of the date of commencement of the Policy is excluded.

If the Policy is opted for after the occurrence of any of the listed vector-borne diseases, a 60-day waiting period shall be applicable for the specific ailment from the date of the previous admission

However, once a benefit is paid under the Policy Schedule during the Policy Period and the Named Insured renews the Policy, in such a scenario for the renewal Policy, a 60-day waiting period from the date of the previous admission would apply for the specific ailment of which a claim has been paid.

20%  discount applicable when bought online

 

BAJAJ ALLIANZ HEALTH INSURANCE PLANS COVER OMICRON & COVID-19 VARIANTS

We are living in times where having medical insurance is not a luxury but a necessity. The COVID-19 pandemic led to increased awareness of the same, highlighting the importance of preventive insurance coverage. With Bajaj Allianz’s health policy, you can ensure that you have the appropriate insurance coverage.

  • In-patient hospitalisation for COVID-19 is covered under all our insurance policies. You can claim health insurance for COVID-related treatment in all Bajaj Allianz health indemnity policies, at cost-effective premium rates.
  • You can also consider adding Health Prime Rider to your base health insurance policy to avail teleconsultation coverage where you can consult a doctor through video, audio, or chat channels.
  • The Corona Kavach Policy is a COVID-19-specific health insurance plan covering all major medical requirements associated with COVID-19, which a regular policy might not cover. This can include consumables such as PPE kits, oxygen, and gloves, when the claim is admissible under the COVID-19 hospitalisation expenses.
  • The insured member can also avail domiciliary hospitalisation.

 

The plan offers coverage for COVID-19 hospitalisation, home-care treatment expenses, AYUSH treatment, and pre-hospitalisation and post-hospitalisation. It also covers treatment expenses for any comorbidity along with COVID-19 treatment up to the sum insured.

Let us check the features offered under the Corona Kavach Policy:

Entry Age (Maximum)

65 years

Policy Term

3.5/6.5/9.5 months

Waiting Period

15 days

Premium Payment Term

Single

Pre-Policy Medicals

Not Applicable

 

 

Bajaj Allianz General Insurance Co. Ltd. Won the Best Customer Experience (Insurance) award at the 2nd Annual CX Excellence Awards 2023

 

Unveiling Protection: 7 Questions to Find Suitable Health Insurance for You


Before you buy a health insurance plan, ensure to ask the following questions:

 

1. Which type of health insurance policy best suits my requirements?

Before you zero down on a health policy, it is important to assess your needs. Select the right type of policy that fulfils all your medical requirements

 

2. Do I have adequate coverage to meet my medical needs?

When it comes to health insurance plans, it is vital to consider medical inflation. Also, ensure to compare health insurance and choose a plan that suits your pocket and checks all the prerequisites.

 

3. Will this health insurance plan be easy on my pocket?

The key benefit of having a health policy can never be overstated. Having an insurance cover will help you receive the needed medical care during emergencies without blowing your hard-earned savings. A health insurance policy offers coverage for much more than hospitalisation costs. Some plans also cover domiciliary hospitalisation in case of home-based medical treatment.

 

4. Does the insurer offer a wide range of network hospitals & swift claim processes?

Network hospitals are a crucial aspect to consider while zeroing in on a health insurance policy. They offer cashless facilities and help avail of quality treatment. Since you do not have to pay a significant amount for cashless treatment, barring the health insurance deductible, it becomes handy to have a network hospital in your vicinity.

We at Bajaj Allianz GIC have a range of 18,400+ network hospitals* across India. We believe in protecting you and your hard-earned money. Our average claim settlement time is around 1 hour. It is one of the fastest claim settlement durations in the insurance industry.

 

5. Does the plan also cover treatment with alternative therapies?

At Bajaj Allianz General Insurance, we provide coverage for Ayurvedic and Homeopathic hospitalisation. However, other treatments such as naturopathy, acupuncture, magnetic therapy, etc. are not covered. This may vary between insurers and their plans. Hence, compare health insurance plans carefully, assess the needs, and only then, make the buying decision.

 

6. Will this medical insurance policy continue to be right if my needs change?

You can make changes to your existing health insurance coverage as per the terms and conditions mentioned in the policy schedule. 

 

7. Are any value-added services offered with the policy?

The value-added services differ from plan to plan. Before you zero down on any health policy, it’s better to understand the policy wordings, its inclusions, and exclusions to avail of the maximum benefit.

HEALTH INSURANCE COVERAGE

If you have opted for a health policy from Bajaj Allianz, you can enjoy the following coverages:

 

  • In Patient Hospitalization

    In Patient Hospitalisation

    Our health insurance policies provide coverage for the expenses related to any medical treatment that you receive at a hospital for any illness, accident, or injury.

  • Pre & Post Hospitalization expenses

    Pre- & Post-Hospitalisation expenses

    You are covered for pre- and post-hospitalisation expenses up to 60 and 90 days respectively, if these expenses are related to the treatment that you are receiving.

  • Organ donor expenses

    Organ donor expenses

    Most of our plans cover you financially for surgeries/medical procedures related to organ donation.

  • Day care procedures

    Day-care procedures

    Our health insurance policies cover treatments even when you are not admitted to a hospital for more than 24 hours for minor medical procedures, aka Day-Care procedures

  • Ambulance Charges

    Ambulance Charges

    We cover you for ambulance charges that might be incurred when you are going to or returning from the hospital.

  • Convalescence Benefit

    Convalescence Benefit

    With Bajaj Allianz’s health insurance policies, you will be eligible for a benefit pay-out of ₹ 5,000 annually, in case of continuous hospitalisation for a period of 10 days or more.

  • Ayurvedic / Homeopathic expenses

    Ayurvedic and Homeopathic expenses

    We cover you for alternate treatment expenses related to Ayurveda and Homeopathy.

  • Maternity expenses and new born baby cover

    Maternity expenses and newborn baby cover

    The maternity cover in our health insurance plans takes care of maternity expenses. It also covers medical expenses towards the treatment of a newborn baby, subject to certain terms and conditions.

  • Daily Cash Benefit

    Daily Cash Benefit

    You can avail the daily cash benefit with our health insurance policies, which can be used to pay for the accommodation of a person accompanying you in the hospital.

For more details, you should check with the health insurance companies to know more about the other benefits they offer. To access the detailed list of inclusions & exclusions, refer to the wordings of the health insurance policy

 

Unveiling Health Insurance Exclusions: What's Not Covered?

The general exclusions of a health insurance policy are:

  • War:

    Our health policies do not cover you for any claims raised for the treatment expenses resulting due to war.

  • Dental treatment:

    Our insurance policies do not cover you for dental treatment unless it is necessitated by an acute traumatic injury or cancer.

  • External appliances/devices:

    The cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth etc., are also excluded from the coverage provided by health insurance plans.

  • Intentional self-injury:

    Our policies do not offer coverage for intentional self-injury.

  • Plastic surgery:

    Any kind of cosmetic surgery, unless necessary for the treatment of cancer, burns, or accidental Bodily Injury, is excluded from the coverage of our health insurance policies.

  • Treatment outside India:

    Some insurance policies do not cover any treatment that you receive outside India.
    However, some policies do. Therefore, it is advisable to go through the exclusions of your policy before proceeding.

HEALTH INSURANCE ADD-ONS

Health insurance add-ons, also known as health insurance riders, are an additional way to enhance your policy’s coverage. At Bajaj Allianz General Insurance Company, there are two popular riders to consider that help to enhance your plan. 

 

1. HEALTH PRIME RIDER

 

What is Health Prime Rider?

Health Prime is a rider for select retail and group Health/PA products. It can take care of multiple accompanying medical service expenses that otherwise remain uncovered.

 

Who Can Opt for Health Prime Rider?

Anyone who has an eligible Bajaj Allianz retail insurance policy, or a personal accident policy, can buy the Health Prime rider for themselves or their family members.

 

Eligibility Criteria to Opt for Health Prime Rider

 

Entry Age As per the opted base policy
Policy Period

1 year, 2 years, or 3 years as per the term of the base plan

Up to 5 years maximum for group products, as per the base policy tenure.

Premium

To be paid via the same instalment premium option as the base health policy, with any effective changes applicable to both.

Waiting Period

A 30-day waiting period is applicable on all covers. Waiting period/s for pre-existing diseases will be applicable as per the base policy.

 

Disclaimer: Please refer to the policy wordings for complete terms and conditions carefully

 

Benefits of the Health Prime Rider

Read on to know more about the health insurance benefits of our Health Prime rider.

 

24x7 Unlimited Tele-Consultation Cover

If the insured member suffers from any illness or injury, they can easily consult the Medical Practitioner/ Physician/Doctor listed on the digital platform through video, audio, or chat channels.

 

Doctor Consultation Cover

The insured person suffering from any illness or injury can consult a Medical Practitioner/ Physician/Doctor in person from prescribed network centres. One can also consult outside prescribed network centres up to the limit as specified in the terms and conditions..

 

Doctor-Prescribed Investigations Cover – Pathology & Radiology Expenses

The insured person suffering from any illness or injury can avail of this service for doctor-prescribed investigations for pathology or radiology from prescribed network centres or outside, up to the limit as specified in the terms & conditions. 

 

Annual Preventive Health Checkup Cover

The insured person can avail of the free preventive health checkup once in each policy year, as per the list given below:

 

Silver Gold Platinum
Hemogram Hemogram Hemogram
Liver function test Liver function test Liver function test
Urine routine Urine routine Urine routine
Diabetic profile Diabetic profile Diabetic profile
Lipid profile Lipid profile Lipid profile
Kidney function tests Complete kidney function profile Complete kidney function profile
Thyroid Thyroid Thyroid
Bone health Bone health Bone health
  Vitamins Vitamins
    ron deficiency profile
    Cardiac risk markers

 

  • ✓ The health check-up can be availed via network hospitals or diagnostic centres within the rider period only.
  • ✓ Dental Wellness

    Under this cover, one can opt for the following benefits to ensure dental wellness:
    1.Consultation with dentists
    2.Dental Fillings
    3.Dental X-ray investigation (IOPA)
    4.Procedures like Root Canal Treatment, Extractions, and Crown restorations

  • ✓ Diet and Nutrition Consultations

    With this cover, the insured members can get expert advice on maintaining a balance between good nutrition and diet as well as the benefit from video/audio/chat consultations with renowned dieticians and nutritionists listed on the digital platform.

    Note: This is a cashless service.

  • ✓ Emotional Wellness Cover

    The insured member can consult an emotional health coach/ psychologist listed on the digital platform under this cover. Note: This is a cashless service.

  • ✓ Physical Fitness Coverage

    The insured member can avail fitness facilities in network Gymnasiums – with a total of 365 sessions, and per day one session, allowed under the cover.

Options Available in Health Prime Rider

The insured member is eligible for health insurance benefits via the coverage as per the plan selected from the table given below. Note that each member would have to be separately insured for the rider. This applies whether it is health insurance for individual coverage or a floater plan.

 

Individual Policy :(Amount in ₹)

 

Benefits Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8
Tele-Consultation Cover (Insta Consultation) Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
(GPs) (All specialties) (All specialties) (All specialties) (All specialties) (All specialties) (All specialties) (All specialties)
Doctor Consultation Cover(In-clinic)     1000 2000 3000 15000 7,500 30,000
Doctor-Prescribed Investigations Cover – Pathology & Radiology Expenses NA 1,500 3,000 5,000 7,000 7,500 30,000
Annual Preventive Health Check-up Cover 1 voucher 1 voucher 1 voucher 1 voucher 1 voucher 1 voucher 1 voucher 1 voucher
(silver) (Silver) (Silver) (Silver) (Silver) (Silver) (Gold) (Platinum)
Dental Wellness Cover - - - - - - 5,000 30,000
Diet and Nutrition Coverage - - - - - - 10 sessions 30 sessions
Emotional Wellness - - - - - - 6 sessions 20 sessions
Physical Fitness Coverage - - - - - - - 365 sessions
Premium (in ₹) (without co-pay) 117 298 589 932 1,268 1,839 2,583 24,932
Premium (in ₹) (with 20% co-pay) 117 262 518 820 1,116 1,618 2,273 21,940

 

Family Floater :(Amount in ₹)

 

Benefits Option 1 Option 2 Option 3 Option 4
Tele-Consultation Cover(Insta Consultation) Unlimited Unlimited Unlimited Unlimited
(All specialties) (All specialties) (All specialties) (All specialties)
Doctor Consultation Cover   10,000 20,000 25,000 10,000
Doctor-Prescribed Investigations Cover – Pathology & Radiology Expenses       10,000
Annual Preventive Health Check-up Cover 2 vouchers 2 vouchers 2 vouchers 2 vouchers
(Silver) (Silver) (Silver) (Gold)
Dental Wellness - - - 10,000
Diet and Nutrition Consultation - - - 15 sessions
Emotional Wellness - - 8 sessions 15 sessions
Physical Fitness Coverag - - - -
Premium (in ₹) (without co-pay) 2,120 3,495 4,344 5,370
Premium (in ₹) (with 20% co-pay) 1,866 3,075 3,823 4,725

Premium listed here is exclusive of GST.

Also, note that the HPR premium cannot exceed 33 % of the base policy premium

Exclusions Under the Health Prime Rider

Let us understand a few points regarding exclusions under the Health Prime rider:

  • ✓   The 30-day waiting period is applicable only in the first year. In subsequent renewals, when there is no break in coverage, no waiting period is applicable.
  • ✓   If no coverage is availed during the rider period, the benefit cannot be carried forward to the subsequent policy year.

Moving ahead, let us understand the specific exclusions under health prime rider.

 

For Tele-Consultation Cover

Teleconsultation outside the digital platform is not covered by the rider. The teleconsultation benefit will not be transferred to any other member unless the member is covered under the base health policy and has opted for this rider. Reimbursement of expenses for teleconsultations benefit is not covered.

 

For Doctor Consultation Cover

Any other expenses of investigations, medicines, procedures, or any medical or non-medical items are not covered. Claims related to ante-natal consultations, and dietician/nutritionist consultations shall not be covered.

 

For Doctor-Prescribed Investigation Cover- Pathology & Radiology Expenses

The investigation cover can be availed in the respective policy year only. Claims related to ante-natal investigations, preventive health tests, and invasive tests shall not be covered.

 

For Annual Preventive Health Check-up Cover

Preventive health check-ups cannot be availed outside the prescribed list of hospitals or diagnostic centres. For the locations where home sample collection is unavailable, the customer will have to physically go for the tests. The required tests need to be completed in a single appointment. Reimbursement of expenses incurred for preventive health check-ups is not covered.

 

For Dental Wellness Cover

Any expenses of investigations, medicines, surgical or non-surgical procedures or any medical, or non-medical items not mentioned under this coverage are excluded. Cosmetic level scaling/polishing, bleaching, cap of teeth, braces, aligner, and tooth replacement, any other cosmetic and aesthetic treatment, are not covered under the plan. Dental wellness coverage cannot be availed outside the prescribed list of dentists and hospitals.

 

For Diet and Nutrition Consultation Cover

Coverage is only limited to in-app/website/audio/ chat consultations. This benefit is not transferable and reimbursement for availing dietician and nutritionist expenses is not covered.

 

For Emotional Wellness Cover

Coverage is limited to virtual sessions only; in-clinic/physical sessions are not permitted or covered under this benefit. The coverage is not transferable, and neither is any reimbursement incurred for emotional wellness consultation expenses covered under this benefit.

 

For Physical Fitness Cover

The benefit can only be availed at the prescribed network of gyms and fitness centres. Children below 18 years of age are not eligible for this benefit.

For a complete list of general exclusions as well as coverage-specific exclusions, please refer to the policy wordings.

 

2. SENIOR PRIME RIDER

 

Missed Call Number for Respect- Senior Care Rider : 9152007550

 

Whether you live with your parents or reside separately, you can be the constant care companion for the precious senior citizens amidst your busy schedules. At Bajaj Allianz General Insurance, care is at the core of everything we do, and we have introduced Respect- Senior Care Rider. It is a senior citizen health insurance rider for parents that has made caretaking smarter and easier.

 

What is Respect- Senior Care Rider?

The Respect- Senior Care Rider is a one-stop solution for all senior-care needs. It is a health insurance rider for senior citizens providing timely care and assistance. 

We understand that taking care of parents is not as easy as it may sound. The guilt of not being by their side to help on a regular basis can be demotivating as well. With the Respect- Senior Care Rider, you can easily recreate the experience of constant safety round-the-clock with its extensive health insurance benefits.

 

Eligibility Criteria to Opt for Respect- Senior Care Rider

The table below shows the eligibility criteria for the Respect- Senior Care Rider:

 

Parameters

Details

Entry Age

50 years and above

Policy Term

As per the tenure of the base health insurance policy. Also, the rider cannot be chosen during the mid-term of the base policy

Premium

As per the plan chosen

 

Note: For more information, please read the policy wording carefully.

 

What are the Plans Available Under Respect- Senior Care Rider

The Respect- Senior Care Rider offers three plans with varying features. Opt for a plan with senior citizen health insurance coverage that fulfils the needs of the elderly loved ones in your life. The below grid shows the Respect- Senior Care Rider benefits of every plan: 

 

Coverages

Plan 1

Plan 2

Plan 3

Emergency Road Ambulance Service

✓  

Planned Road Ambulance Service

Fall Detection Technology through Smart Watch

No

No

✓  

Physiotherapy Service at Home

No

Nursing Care at Home

No

Tele-Consultation Service for Psychological Services

No

Concierge Assistance Services

✓  

✓  

Premium (excl. GST)

Rs. 710

Rs. 2088

Rs. 7497

Additional Premium for Optional Cover (excl. GST) Unlimited Medical Tele-consultation Services

Rs. 197

Rs. 197

Rs. 217

 

 

Note: For more information, please read the policy wording carefully.

 

Benefits of Respect- Senior Care Rider

Let us now briefly understand the benefits offered under the Respect- Senior Care Rider:

·         Ambulance Service

✓    Emergency Road Ambulance Service (up to 2 ambulance services in a year per insured person)

✓    Planned Road Ambulance Service (up to 2 ambulance services in a year per insured person)

·         Fall Detection Technology through Smart Watch

·         Physiotherapy Service at Home (up to 5 days a year with up to 1-hour session per day)

·         Nursing Care at Home (5 days a year, 12 hours per day)

·         Unlimited Medical Tele-consultation services

·         Tele-consultation services for  Psychological conditions  (up to 2 consultations in a year)

·         Concierge Assistance Services

✓    Daily Care / Home Assistance 

-  Assistance for arranging Physiotherapy at home

-  Assistance for arranging Nursing at home

-  Appointment Booking assistance at Hospital/Laboratory

-  Assistance for booking Air Conditioning/water purifier/washing machine repair and maintenance services

-  Assistance for booking Electrician, Plumber, and Carpenter services

-  Assistance for booking Pest control services

-  Assistance for booking Car wash/sanitization services

✓    Cyber Assistance

-  Assistance on how to block debit/credit card

-  Assistance in understanding mobile phones and their usage

-  Assistance in downloading OTT (Over The Top) media, making payments, etc.

-  Assistance on gadget/app  use as per demand e.g. Lab and Medicine Orders, Senior care related  products, etc. from the e-commerce platform 

✓    Travel Assistance

-  Assistance is required in terms of travel booking

✓    Legal Assistance

-  Assistance for seeking a legal consultation on will, property contract vetting, etc.

 

*This is not an exhaustive list.

Note: *Standard T&C apply. For more information, please read the policy wording carefully.

 

Give your parents the same care, compassion, and love that they have given you. Together, let’s move towards building an ecosystem for senior citizens with the right rider for health insurance for parents above 60

Avoid These Mistakes While Buying a Medical Insurance Policy

Here is a rundown of the common mistakes that you should avoid when buying a health policy:

  • Skipping a Comprehensive Health Cover Due to Your Corporate Policy

    A corporate insurance policy will cover you only till the time you are in employment. So, whenever you leave the job or switch companies, you lose the health insurance benefits. Such policies usually offer a low sum insured and do not provide comprehensive coverage. Plus, you may not get coverage during probation. Hence, it is recommended to compare health insurance and choose a comprehensive health policy.

  • Opting for a Low Sum Insured

    In case you live in a metro city, it is advisable to select a policy with a high sum insured considering the cost of medical treatment in such cities is high. Select a sum insured that covers the medical expenses as per the requirements. In case you have immediate dependents, then opt for a health insurance plan assessing their needs, medical inflation, and an appropriate sum insured.

  • Choosing a Low-cost Plan Without Assessing Coverage

    Before you buy a policy available at a low premium, look at the coverage and benefits it offers.

    In case you buy a health insurance plan with a low premium, there are chances that you are missing out on critical coverage. Compare health insurance plans and choose a value-for-money plan. Ensure it can take care of the rising medical needs considering your lifestyle. You can also increase the health insurance deductible if you want a low-cost plan.

  • Buying Health Insurance Solely for Tax

    Remember, having a comprehensive health insurance policy is more than just saving taxes. A health insurance plan surely lets you avail of the tax benefit under Section 80D of the Income Tax Act. However, you should have medical insurance in place so that you are worry-free in critical times, at least financially. In case your family is to be taken care of, choose a family floater health insurance policy.

  • Hiding Your Medical History

    Sometimes, individuals hide their past medical records and history from the insurance company in an attempt to reduce their premiums. This can backfire in many ways. If the insurance company comes to know that you have hidden or repressed any medical history, they may reject your claim. Thus, you may be bereft of financial support when you need it the most. Hence, ensure to provide full, accurate medical information to the insurer when buying/ renewing the plan.

  • Not Reading the Fine Print

    Your health policy is an important financial document. It lays down the terms and conditions regarding the extent of the coverage under the insurance plan. The document lists the general exclusions of the plan as well as the specific limits that each coverage aspect may have. Hence, reading through it to understand different features and limitations is important. Otherwise, you may have problems during claim raising and settlement.

  • Buying Health Insurance Only During Old Age

    One of the biggest misconceptions that people hold about health insurance is that it is only for senior citizens. Hence, they delay unnecessarily in buying it. The truth is that health insurance should be bought at the earliest. This not only leads to lower premiums but also means that you get coverage for a longer period.

Are You Eligible for Medical Insurance?

The table below shows the common eligibility criteria that are considered while selecting a suitable health insurance cover: 

 

Age criteria

A health insurance plan can be bought for children, adults, and senior citizens. There are dedicated plans as per the age of the individual. Usually, a standard plan covers individuals aged between 18 to 65 years of age

Next, you have senior citizen health insurance plans catering to the needs of people who are 46 years and older, since that is the entry age for these plans.

Pre-existing Diseases

A pre-existing disease is covered only after the completion of the waiting period. When buying the policy, the insurer may inquire in regard to current medical conditions. This can determine your coverage. 

Smoking Habits

The lifestyle of a person also has an important role in the buying process. For instance, the premiums for a non-smoker, compared to a smoker, are relatively low.

Medical Check-up

Medical check-up is a part of the policy, specifically, if you are aged 45 years or more. So, before the medical insurance policy is issued, these individuals may have to undergo a medical screening.

 

 

How Many Dependent Members Can I Add To My Family Health Plan?

An ideal family health insurance plan is the one that protects all your family members. However, it is possible that the needs of some members of the family may be slightly different from the rest. They may need special coverage. For such members, you may choose to buy other plans.

The rest of the family members can be added as dependents on your family floater health insurance plan.

As a policyholder, you can choose to add your children as well as your grandchildren to your policy. The age limit for this is between 3 years to 30 years. On the other hand, family members between 18 years to 65 years of age, who are not children or grandchildren, can also be included in the policy. These could be spouses, parents, parents-in-law, siblings, aunts, and uncles.*

A policy may differ in the way it functions when compared to another one. You may consult your insurance provider to understand how many members could be added to your policy and whether it may affect your premium or any other aspect of your policy.

* Standard T&C Apply

FACTORS THAT AFFECT YOUR HEALTH INSURANCE PREMIUM

Certain factors that determine the premium of your medical insurance policy are:

  • ✓ Selected Sum Insured:

    The coverage and the sum insured selected by you decide your insurance premium.

  • ✓ Number of members covered:

    More family members in a policy means a higher premium, like in family floater health insurance plans.

  • ✓ Age:

    Young people are healthier than older people and the risk associated with them is less. So, the premium is lower if you buy a health insurance policy when you are young.

  • ✓ Body mass index (BMI):

    BMI is the ratio of your height and weight. If your BMI is beyond the normal limit, then you might have to pay a higher insurance premium.

  • ✓ Medical history:

    Having a genetic disease or any pre-existing disease means the policy premium might be higher.

  • ✓ Tobacco consumption:

    The premium might be on the higher side if you smoke or chew tobacco and tobacco-containing products.

  • ✓ Gender:

    Women might be required to pay a higher premium than men, as they tend to have more hospital visits.

How To Reduce Health Insurance Premiums?

The cost of a policy should not have to be a concern when you are prioritising your health, as well as that of your family members. It is ideal to look for a plan that fits your budget while also providing adequate coverage. However, as a policy buyer, you should also be aware of some of the factors that can influence your policy premiums:

  • ✓ Age:

    Age can play a key role in influencing the premium costs of health insurance plans. The younger a person, the lesser their premiums may cost, depending on other factors. Thus, it is advisable to buy a policy when you are younger.

  • ✓ Occupation:

    A higher mortality risk may drive your premium costs up as well. If your work puts you at a high risk of accidents, health issues, or fatality, you may be quoted a relatively higher premium as compared to your counterparts who are not engaged in a high-risk occupation.

  • ✓ Smoking Habits:

    Smoking is known to lead to several health issues. If you are a regular smoker, it may affect your premiums. To get lower premiums subsequently, as well as to take better care of your health, it may help to quit smoking and focus on a healthier lifestyle.

  • ✓ Type of Policy:

    Some policies can offer more features than others, and hence, tend to be more expensive. When buying a policy, ensure that you respect your budget. Consider your needs before you opt for the costlier option. It is possible to get enough coverage even if you opt for a policy within your budget.

 

Why Buy Health Insurance Online?

There are a number of benefits to buying a health insurance plan online.

In a time where most policy details are available on the website of the insurer, the journey of policy purchase for a potential policyholder often begins online. It can be quite convenient if this journey can be completed online as well. This is one of the common reasons why several policyholders may opt for an online purchase. The convenience offered by the option of online purchases can mean quicker and more hassle-free policy purchases from wherever you are.

Furthermore, when you buy a policy online, you seldom have to wait for the policy copy to be delivered to you. Once the online policy buying process goes through smoothly, you may receive a copy of your policy via email. You may also be able to download it directly. This also reduces the hassle of having to take care of a physical copy of your policy.

Buying a policy online also allows you to compare the plans to figure out which one suits you best. Once you have decided to buy a policy, it can be purchased right away.

Steps To Calculate Your Health Insurance Premium Online

With the help of Bajaj Allianz’s free health insurance calculator, you can get an estimated quote for the policy that you wish to purchase. The quick and easy steps to know your health insurance premium online are:

  • Step 1:

    Head to the online Health insurance premium calculator .

  • Step 2:

    Enter information like your personal details, the details of those whom you wish to insure, and contact details.

  • Step 3:

    Select the plan you wish to purchase, and provide further information such as medical history, pre-existing ailments, and lifestyle habits if any.

  • Step 4:

    Click on the ‘Get My Quote’ button.

  • Step 5:

    Your premium details will be displayed. Click on the ‘Confirm Plan’ button to buy a suitable policy online.

Once you receive the insurance quotes & make the online payment of your premium, you will get your health insurance policy (softcopy) immediately.

 

WHY YOU SHOULD COMPARE HEALTH INSURANCE PLANS ONLINE?

Selecting a health insurance policy is often regarded as a task, due to the plethora of options available. It can get confusing to choose the most suitable policy for your medical needs among all the options. However, one way you can select a health insurance cover fitting all your needs is by comparing policies online.

 So, let us understand some of the key advantages of comparing policies online:

 

  • Accessible & Time-saving:

    Every important piece of information related to your policy is available in just a few clicks.

 
  • Free Quotes/No-Cost:

    You can compare health insurance quotes with online calculators, which are available for free, and select the best suitable policy.

 
  • Compare Multiple Plans With Ease:

    With the calculator, the ability to compare health insurance plans online is convenient and hassle-free. You can view the plans, and compare their features, benefits, and premiums side-by-side

 
  • Check Customer Reviews:

    Online reviews help to choose the insurer and look for the claim settlement ratio of that company. Selecting an insurer that has a good reputation in the market ensures a swift claim settlement.

 

How To Get A Physical Copy Of Your Health Insurance Policy?

Buying a policy online is a simple process that anyone could opt for. When you buy a policy online, you are immediately issued a soft copy of the policy.

However, if you require a physical copy for any reason, you may take a printout of the soft copy you have received. When making claims, it is important to have the policy details with you, a purpose that is served by a soft copy as well as a physical copy.

Furthermore, a physical policy document may be issued to you if you buy the policy offline. You may be able to opt for this with the help of an insurance agent or by getting in touch with a representative of the insurance provider.

If you are relying entirely on a physical copy of your health insurance, store it carefully and safely. You as well as your family members should be able to access the copy whenever needed.

 

Health Insurance Claim Procedure

Health insurance claims can be settled by either a cashless or a reimbursement claim. Both ways of settling your health insurance claim are easy, quick, and convenient.

  • Cashless health insurance claim settlement

    The treatment for your ailment under a cashless claim is possible without paying anything from your pocket. The medical bill will be directly settled by the network as well as the non-network hospital with your insurer as per the terms and conditions mentioned in your policy. Most of the health insurance companies in India provide a health card that can be used to avail cashless treatment at one of the network and non-network hospitals.

  • Reimbursement health insurance claim settlement

    If you choose to get the treatment for your ailment at a non-network hospital, or if your preferred hospital is not a network hospital, then you can file a reimbursement insurance claim. To register the claim, you need to submit the relevant hospital bills and medical records to your insurance company. Once these documents are verified, the claim amount will be settled in your registered bank account.

  • Planned hospitalisation

    In case of planned treatments or hospitalisation, you can use the cashless claim facility. You need to inform your insurer 48 hours before the planned treatment date. Next, the network or non-network hospital needs to fill out a pre-authorisation form and send this form to your insurance provider. Your insurance provider will verify the required details and provide approval for the cashless treatment. For non-network hospitals, the approval for such cashless treatment is subject to acceptance by such hospitals outside the insurer’s hospital network.

  • Emergency hospitalisation

    In case of an emergency, like an accident, you can use the health card provided by your insurance company and submit it at the hospital’s medical desk. If the approval comes through, you can avail cashless claims benefit. For the ‘cashless everywhere’ feature, you will need to inform your insurer within 24 hours of the treatment’s commencement by mailing us at Cashless.Forall@bajajallianz.co.in along with the required documents for claim processing.

  • Health CDC

    Health CDC (Claim by Direct Settlement) is a feature provided by Bajaj Allianz for settling your health insurance claims up to ₹ 20,000 instantly using our mobile app - Caringly Yours.

 

Is There A Time Limit To Claim Health Insurance?

Claims on your health insurance cannot be made during the waiting period, if any. This may differ from policy to policy. Hence, it is essential to consult your insurance provider or read your policy document to understand your waiting period.

Furthermore, it is ideal to initiate a claim as soon as you or a dependant covered by the policy are in need of any of the treatments covered by the policy. When you buy the policy, it is best to get yourself acquainted with the claim process beforehand.

What are Network Hospitals in Health Insurance?

One of the most useful health insurance benefits, a network hospital, is a medical facility that has an agreement signed with the health insurance company. This tie-up between the hospital and the insurance provider allows you to avail the benefit of cashless health insurance claims. You can check out the list of Bajaj Allianz’s network hospitals online.

You can search for a network hospital on our website by entering the name of the hospital or the city where you want to get the medical treatment. Once you enter the search criteria, you need to click on the ‘Find Hospital’ button. You will be displayed a list of network hospitals defined by your search criteria.

The benefits of choosing a network hospital for your or your family members’ treatment are:

  • Cashless claim benefit means you do not need to pay for treatments from your pocket.

  • You get quality assurance for treatment with well-trained doctors, the latest medical equipment, and best-in-class hospitality.

  • You get the required care during hospitalisation as well as for pre- & post-hospitalisation treatments.

TAX BENEFITS OF A HEALTH INSURANCE POLICY

Section 80D of the Income Tax Act, 1961, permits the taxpayers to avail of the deduction on the premium paid towards the health insurance policy. This can be availed on the regular insurance premiums, along with the premiums paid for the top-up on health insurance, as well as for critical illness plans.

You can avail of the deduction under Section 80D on the premiums paid towards purchasing a policy for yourself, dependent children, spouse, and parents.

The premium paid qualifies for a deduction of up to Rs 25,000 under Section 80D in each financial year. If either your parents or any one of them is a senior citizen, then the deduction goes up to Rs 50,000 in one financial year.

The following are the tax deductions available to an individual under Section 80D (as of 2023-24):

Individuals Covered

Premium Paid

Tax Exemption

 

Self, Children & Family

Parents

 

Individual & parents who are less than 60 years of age

₹ 25,000

₹ 25,000

₹ 50,000

Individual & family less than 60 years but parents are more than 60 years

₹ 25,000

₹ 50,000

₹ 75,000

Individuals, parents & family more than 60 years of age

₹ 50,000

₹ 50,000

₹ 1,00,000

Members of HUF & Non-resident Individual

₹ 25,000

₹ 25,000

₹ 25,000

Disclaimer:The tax benefits are subject to change as per the prevailing laws.

What is a Mediclaim Policy?

Medical emergencies tend to come unannounced. If you do not have a health insurance policy in place, then you could end up paying hefty medical bills. Despite the rising healthcare expenses, people often overlook the importance of securing themselves or their families with a suitable mediclaim policy.

A mediclaim policy is insurance coverage wherein your insurer covers the cost of treatment. Having a mediclaim policy is especially beneficial if treatment is sought at a network hospital, where you can enjoy the benefit of a cashless claim.

Common Health Insurance Terms You Should Be Aware Of

✓ Sum Insured (SI) in Health Insurance:

The Sum Insured is the maximum amount that your health insurance company is liable to pay. If the expenses of your medical treatment exceed the Sum Insured opted by you, then you will have to bear the amount exceeding such Sum Insured.

 

✓ Pre-existing diseases in Health Insurance:

If you are suffering from an ailment before buying an insurance policy, then that ailment is classified as a pre-existing disease.

 

✓ Waiting period in Health Insurance:

It is the time span you need to wait before the coverage for your health insurance policy begins. For instance, many policies have a fixed waiting period before they provide coverage for pre-existing diseases.

 

✓ Sub-limits in Health Insurance:

Sub-limits are limitations your health insurance providers place to restrict the expenses they need to pay for a particular ailment. It can help reduce the cases of fraudulent claims. Most insurance companies have sub-limits on room rents, common ailments, pre-planned procedures, ambulance expenses, and doctor’s fees. Sub-limits can be a fixed percentage of the Sum Insured opted by you, or a fixed amount as agreed with the insurer.

 

✓ Co-pay in Health Insurance:

Co-payment or co-pay in health insurance is a fixed percentage of the claim amount you need to pay before the insurance company pays for the same. You can opt for the co-payment clause when you buy or renew your health insurance policy. Since it is the amount you need to pay from your own pocket, it helps to reduce the premium amount.

 

✓ Deductible in Health Insurance:

Deductible rests on the concept of cost-sharing between you and the insurance company providing you with health insurance. It is a fixed amount that you (the policyholder) need to pay every time you raise an insurance claim. There are two types of deductible: voluntary and compulsory, depending on the type of policy you purchase.

 

✓ Room rent limit in Health Insurance:

Room rent limit is the maximum coverage your health insurance policy provides for each day of room charges, in case you are admitted to a hospital.

 

✓ Coinsurance in Health Insurance:

If you have multiple health insurance policies, then you can file a claim with all of them. The claim amount will be reimbursed by all such insurance companies as per a fixed percentage decided by you. This concept is called coinsurance.

So, if you apply the concept of coinsurance between two insurance companies, A and B, as 40% and 60% respectively, then, on a claim of ₹ 1 lakh, company A will reimburse ₹40,000 to you and company B will reimburse ₹60,000 to you, as per the terms and conditions of the health insurance policies.

 

✓ Free-look period in Health Insurance:

Health insurance companies offer a free-look period. This period is usually 15 days for the policies purchased offline and 30 days for those purchased online. In this period, you can check your policy and decide whether it is best suited for you or not.

If you think it isn’t adequate, you can cancel this policy within the said period. No cancellation charges will be applicable during the free-look period. However, a premium will be charged on a pro-rata basis for the days the coverage was active.

 

✓ Grace period in Health Insurance:

After the expiry of your health insurance policy, you have a time span of 30 days to renew it. This 30-day period is the grace period.

If you renew your policy within these 30 days, you will get the benefits of your medical insurance policy, such as the waiting period and coverage for pre-existing diseases reinstated. Any claims made during the grace period will not be covered by the insurer.

HEALTH INSURANCE V/S MEDICLAIM INSURANCE: WHAT DISTINGUISHES THEM?

One of the common mistakes that people often tend to commit is implying that mediclaim is the same as health insurance. However, that is not the case. Let us understand the differences between health insurance and mediclaim insurance.

Parameters Health Insurance Mediclaim Policy
Coverage

A health insurance plan offers coverage for hospitalisation, pre- & post-treatment expenses, ambulance charges, etc., where the policyholder is reimbursed for the expenses

A mediclaim policy, on the other hand, offers to cover the expenses related to hospitalisation without the policyholder having to pay for it.

Flexibility

It offers the flexibility to enhance the plan by paying a nominal premium.

In terms of coverage, a mediclaim policy does not have flexibility.

Add-on Cover

Offers multiple add-ons.

No add-on covers are available.

Critical Illness Cover

It offers coverage for more than 10 life-threatening diseases.

Cover for critical illness isn’t available. 

Nearly 10-30 per cent of young people suffer from health-impacting behaviours and conditions that need the urgent attention of policy makers and public health professionals. Nutritional disorders (both malnutrition and over-nutrition), tobacco use, harmful alcohol use, other substance use, high-risk sexual behaviours, stress, common mental disorders, and injuries (road traffic injuries, suicides, violence of different types) specifically affect this population and have a long-lasting impact.

WHY SHOULD YOU CONSIDER BUYING MEDICAL INSURANCE AT A YOUNG AGE?

When you start earning early, it’s important to save for the future. Buying medical insurance at an early age may help you be less worried about paying any medical bills.

 

Here is a rundown of the benefits of buying medical insurance at an early age:

  • Comprehensive coverage for any health emergency that may occur, that would otherwise leave you in financial distress.

  • In case of any pre-existing disease, your waiting period might be short.

  • At a young age, you are less likely to fall ill or be prone to diseases. Thus, during these years, insurance premiums tend to be rather cost-effective.

  • The tax benefits under Section 80D enable savings on income and directs your money towards secured future planning.

  • Health insurance plans provide a cumulative bonus which helps to increase the sum insured for each claim-free year. Since you would be buying the medical insurance policy early in life, the chances of filing a claim may be lower. This could help you avail a higher sum insured in the long run.

  • You can enhance the insurance coverage using add-on riders, which can make the health insurance plan more comprehensive.

When you are young, you tend to be less vulnerable to any chronic illness or diseases. Nonetheless, it is wise to make a financial investment when you are young and healthy. It lets you enjoy significant benefits throughout life. Securing your health with the help of an insurance policy, especially with changing lifestyles, rising pollution, and newer infectious agents in our environment, enables you to get proper financial assistance during medical emergencies.

What is the Cashless Everywhere Feature?

The General Insurance Council (GIC) has introduced the ‘Cashless Everywhere’, for the benefit of health insurance policyholders.

With ‘Cashless Everywhere’, in the event of hospitalisation, policyholders of health insurance can:

  • Avoid on-the-spot cash payments:

    Policyholders can apply for an admissible claim and avoid paying out of their own pocket. The bill will then be settled by the insurer.

  • Instant assistance at any hospital:

    As long as all the terms and conditions pertaining to the claims are met, the cashless facility can be availed at any hospital. Thus, a policyholder need not worry about arranging funds for the treatment.
    For hospitals not part of the network hospital list, it would be best to inform the insurer about the claim 48 hours before the admission for any planned procedures and within 24 hours after admission in case of an emergency treatment.

  • Initiate a claim without documentation:

    To avail the benefit of cashless facility for medical insurance when applying for a claim at a network hospital, you need to simply inform your insurer about it via the official contact channels.

Please read all the terms and conditions related to the feature before choosing a policy or submitting a claim.

DOCUMENTS REQUIRED TO BUY A HEALTH INSURANCE POLICY

1. Passport-sized photographs

2. Policy proposal form

3. Residential proof:

 You can submit any of the following documents as your residential proof:

✓    Voter’s ID

✓    Aadhaar card

✓    Passport

✓    Electricity bill

✓    Driving license

✓    Ration card

 

4. Age proof:

 Any of the following documents suffice as your age proof:

✓    Passport

✓    Aadhaar card

✓    Birth certificate

✓    PAN card

✓    10th and 12th class mark sheet

✓    Voter’s ID

✓    Driving license

 

5. Identity Proof:

 Any of the documents mentioned below can be used as your identity proof:

✓    Aadhaar card

✓    Driving license

✓    Passport

✓    PAN card

✓    Voter’s ID

Based on the coverage opted by you, your age, medical history, current lifestyle choices, and your residential address, you might be asked to submit a few more documents.

5 Quick Steps To Buy Health Insurance Online

 

If you’re looking to buy medical insurance online, look no further. You can purchase Bajaj Allianz’s health insurance policy online quickly and conveniently with the help of the following steps:

  • Step 1

    Click on ‘I Want to Buy’ present in the top-right corner of the page.

  • Step 2

    Select the health insurance policy that you want to buy.

  • Step 3

    Enter your details like your name, your date of birth, the medical insurance policy that you want to buy and the details of other family members whom you want to cover under the selected health insurance policy, your pin code, and contact number.

  • Step 4

    Click on the ‘Get My Quote’ button.

  • Step 5

    Your health insurance quotes and premium details will be displayed on the screen. Here you can also select the co-payment option as per your convenience. Then, click on ‘Confirm Plan’ button to buy a health insurance policy online.

Once you make an online payment of the premium, you will get your softcopy of the health insurance policy immediately.

Most health insurance companies in India have a website which features their policies. Some companies, including Bajaj Allianz General Insurance, even have an app for fulfilling your online insurance needs.

You can also buy our health insurance policy by downloading our mobile app – Caringly Yours, by us a simple ‘Hi’ on our WhatsApp number: +91 75072 45858 or by giving a missed call at: +91 80809 45060.

Why Should You Never Delay Health Insurance Renewal?

Insurance renewal is essential to maintain the continuity of the coverage provided by your health insurance policy. Thus, renewal must be made before your insurance plan expires. If you fail to renew your policy even after it expires, then the insurer will provide you a grace period of 30 days for health insurance renewal .

During this period of 30 days, you will not be covered for any health insurance claims. To renew your Bajaj Allianz’s health insurance policy, you can visit our website or download our mobile app – Caringly Yours. You can also send us a ‘Hi’ on our WhatsApp number (+91 75072 45858) and our customer support team can assist you with your requirements.

Health Insurance Portability

Health insurance portability allows you to switch your insurance provider without losing the benefits of your existing insurance policy. So, if you are not satisfied with your current medical insurance plan, or you are looking for something more in your policy,You always have the option of porting your health insurance policy to another insurer.You have the following options when you decide to switch your health insurance policy:

  • You can switch from one insurance provider to another.
  • You can switch between plans with the same health insurance company.
  • You can migrate from an Individual to a Floater policy, and vice versa.
  • You can apply for a revised Sum Insured (SI) with the new insurer.
  • You can enhance the coverage provided with your existing health insurance policy. However, you might need to undergo some medical tests and there may be new waiting periods for these coverages.

 

The Criteria for Health Insurance Portability

  • You can switch your health insurance policy only at the time of renewal.
  • Approach your new health insurance provider at least 45 days prior to the expiry of your existing policy.
  • Make sure that there are no breaks in the insurance renewal process.
  • Submit the following documents for medical insurance portability:

      ✓    Previous health insurance policies

      ✓    Claim experience in detail

      ✓    Proposal form

      ✓    Age proof

      ✓    Any positive declarations – discharge card, investigation reports, latest prescriptions & the clinical condition

      ✓    Any other document as requested by the insurer

 

CUSTOMER STORIES

 

Average Rating:

 4.75

(Based on 3,912 reviews & ratings)

 

ASHISH JHUNJHUNWALA

My happiness and satisfaction regarding my claim settlement which was approved within 2 days ...

SUNITA M AHOOJA

Speed with which insurance copy was delivered in times of lockdown. Hats off to the Bajaj Allianz team.

Reni George

I would like to thank the team of Bajajallianz Vadodara, Specifically Mr. Hardik Makwana and Mr. Ashish Gupta...

Satish Chand Katoch

Hassle Free through web with all option we can review while taking policy.

Ashish Mukherjee

Easiest for anyone, no hassle, no confusion. Great work. Good luck.

Jaykumar Rao

Very user friendly. I got my policy in less than 10 minutes.

 

HEALTH INSURANCE FAQS

 

 

 

   1. Is it necessary to buy health insurance in India?

It is not mandatory to buy a health insurance policy in India. But it is very important to have the financial security of one to handle any kind of medical emergency.

   2. How can I save taxes with health insurance?

Bajaj Allianz’s Health Insurance policy helps you save tax up to INR 1 lakh under Section 80D against the premiums you pay. Here’s how you can save tax:

On the premiums paid for self, spouse, children, and your parents, you can avail a deduction of INR 25,000 per annum against your taxable income (provided you are not over 60 years of age).

If you pay a premium for your parents who are senior citizens (age 60 or above), the maximum health insurance benefit for tax purposes is capped at INR 50,000.

Therefore, as a taxpayer, you may maximise the tax benefit under Section 80D up to a total of INR 75,000, if you are below 60 years of age and your parents are senior citizens.

However, if you are above the age of 60 years and are paying a medical insurance premium for your parents, the maximum tax benefit under Section 80D is INR 1 lakh.

   3. Why should I purchase a health insurance policy if I already have insurance from my employer, or if me and my family are already covered by my corporate policy?

A health insurance policy from your employer might have a few benefits, but there are also some limitations associated with corporate medical insurance plans:

  • You will not be able to customize the corporate plan as per your personal insurance requirements and health conditions.
  • The coverage ends as soon as you resign from the company.
  • Corporate plans from your employer will no longer offer coverage after retirement.
  • Corporate plans have very little scope for planning your future.
  • You are covered for a smaller sum insured as compared to private health insurance policies.

   4. What factors determine my Health Insurance premium amount?

The premium amount mainly depends on the sum insured and the number of members covered under the policy. Here are a few other factors that determine your premium:

  • Your age
  • Pre-existing diseases
  • Add-on covers (optional)

 

 

   1. What should I know about pre-existing diseases and the waiting period?

Pre-existing diseases are those ailments that you may be suffering from before buying a medical insurance policy. Hence, you must declare any pre-existing disease/condition at the time of purchase.

One of the key factors to keep in mind is that pre-existing diseases have a waiting period, and it differs between insurance companies. Hence, by purchasing a policy at a young age, you can hope that by the time, and if you are diagnosed with a disease that falls under the pre-existing category, your waiting period will be complete. Also, an early policy purchase ensures you are eligible to avail full benefits of your medical insurance policy.

   2. Is my health insurance policy valid pan-India?

Yes, you are covered for all your health-related emergencies with your insurance provider all over the country, subject to the terms and conditions of your policy.

   3. Do health insurance plans cover maternity?

Yes, health insurance plans provide maternity and newborn coverage. However, there will be a waiting period before the coverage for the same begins. Check the coverage and the waiting period with your insurer if you are buying a policy specifically for covering maternity expenses.

   4. Will my existing health insurance policy cover hospitalisation expenses for COVID-19?x

Yes, the hospitalisation expenses on account of COVID-19 will be covered under your existing health insurance policy, under In-Patient Hospitalisation, as per the terms and conditions mentioned.

 

 

   1. What is the claim settlement ratio? Why is it important?

The claim settlement ratio correlates the number of claims settled by a health insurance company with the total number of claims raised in a given time frame. The higher the claim settlement ratio, the better the insurance company’s pay-out.

   2. What is the procedure to raise a claim for health insurance?

You can either file a cashless health insurance claim or a reimbursement claim. At Bajaj Allianz, we have our in-house Health and Administration Team (HAT), for quick and easy claim-processing.

For cashless claims, you need to get a pre-authorisation letter from the network hospital. Bajaj Allianz will then approve the claim after successful verification of the pre-authorisation form and the health insurance policy. You can avail the benefit of cashless claims once the approval is given to the network hospital.

For reimbursement claims, you will need to send Bajaj Allianz the medical bills, along with the policy details and the discharge summary provided by the non-network hospital. After verification of these documents, the claim amount will then be settled and directly deposited in your bank account.

   3. How long does it take to process a health insurance claim?

At Bajaj Allianz, we settle your cashless claims within 60 minutes with the help of our fast claim-processing in-house Health Administration Team (HAT).

With the Health CDC (Claim by Direct Click) feature of our mobile app, “Caringly Yours”, we settle your claims up to INR 20,000 within 20 minutes.

We settle your reimbursement claims within 10 days after receiving and assessing all the documents submitted by you.

   4. What are the reasons for denial of claims under health insurance?

Your health insurance company might deny your claim settlement in case of the following scenarios:

  • Claim filed for intentional self-injury.
  • Misrepresentation, fraud, non-disclosure of material facts, or non-cooperation from the insured’s end.
  • Claim filed for coverage of the pre-existing diseases before the waiting period gets over.
  • Claim filed for any of the exclusions mentioned in the policy document.

   5. How can I intimate my claim after hospitalisation?

With Bajaj Allianz’s smooth claim settlement process, here is how you can register and settle your health insurance claim during the lockdown:

  • With our “Caringly Yours” app, you can register health insurance claims up to INR 20,000 via a paper-less procedure – Health CDC (Claim by Direct Click) available on our “Caringly Yours” App.
  • You can give us a missed call at +91 80809 45060, and we’ll call you back to take you through the process.
  • You can also SMS ‘WORRY’ to 575758.
  • You can choose to send us an e-mail at bagichelp@bajajallianz.co.in to register your claim as well.
  • Another way to register and track your claim is by visiting our online claim portal, where you can enter some of your basic details, such as your policy number, and quickly make a claim.

 

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 Written By : Bajaj Allianz - Updated : 15th Mar 2024

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