What is a Health Insurance Policy?
Health insurance is like a financial security that you have for handling your medical expenses. Health insurance plans are like an investment that you make so that you can safeguard your hard-earned funds from being spent on expenses related to hospitalization, medicines, ambulance, doctor’s consultation and more. A health insurance policy can also be viewed as an agreement between you and your health insurance company that binds them to cover you financially in case of any medical emergency.
There are several types of health insurance plans in India. And, you should choose the best health insurance policy for yourself and your family so that you can relax when it comes to paying hefty medical bills. You not only get covered for the medical expenses with your health insurance plans, but also get facilities such as cashless treatment and quality health care at a reputed network hospital. Health insurance plans are like your friends that take away your financial burden in case of hospital related exigencies.
What is the Need For Health Insurance?
An effective medical insurance policy is essential because the prices of medicines and hospital treatments are rising day by day. If an accident or critical illness befalls you, it will cause a huge financial burden on you and your family. A hard-hitting truth is that whether your trip to hospital is planned or it comes as an unpleasant surprise, it is sure to cost you heavily. So, it’s better to have a protection of health insurance plans, that besides helping you manage your finances, also offer you a several other benefits at very affordable premium rates. You can also check out various health insurance quotes online to figure out which one is most suited to your budget.
Here are 5 reasons that will make you understand the importance of having the best health insurance plan:
✓ Financial Help : Your health insurance policy will ease your burden of paying heavy medical bills from out of your pocket. You can save your hard-earned money for living your life to the fullest, instead of spending a huge part of it on medical care. If you are worried about the premium rates, then please be assured that you can get an adequate health insurance policy at very affordable premium costs. You also get discounts like family discount, which will allow you to keep the medical insurance plan’s coverage intact while paying a relatively low health insurance premium.
✓ Quality Medical Care : You can avail the benefit of cashless claims and quality medical care if you decide to get your treatment at a network hospital. A network hospital is a hospital that has an agreement with your health insurance company, which enables you to get the best treatment without having to shell out from your pocket.
✓ 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 the maximum deductions of INR 1 lakh if you buy health insurance plans for yourself and your loved ones, and if you and your parents are senior citizens.
✓ Extensive Coverage : Health insurance plans in India not only cover you for hospitalization expenses, but also provide cover against critical illnesses, accident-related, maternity, consultations, check-ups and other such medical expenses with different types of health insurance plans.
✓ Peace of mind : If you are secured on the financial front, then even a trip to a hospital feels a little less stressed. Having a medical insurance gives you the peace of mind that can help you relax in a tense situation.
With so many health insurance plans in India offered by health insurance companies in India to choose from, you can certainly choose the best health insurance plan from among them.
Types of Health Insurance Plans
TIn India, buying a health insurance policy is not mandatory. But, having medical insurance has become very important and many people have now started investing in health insurance. However, most of them fail to understand the different types of health insurance policies available in the market and probably, they end up buying a plan that might not cover their specific needs.
Here, we explain to you different types of health insurance plans in India, so that you can decide which one fulfills your requirements the best:
Indemnity Based Health Insurance Plans in India:
The indemnity based health insurance plans give you the reimbursement for the expenses incurred by you for hospitalization or cashless claim settlement up to the Sum Insured opted by you. These plans are also known as traditional health insurance plans. These health insurance plans cover you for the expenses related to doctor’s fees, hospital room rent, OT (Operation Theatre) charges, medicines and more.
Fixed Benefit Health Insurance Plans in India:
The fixed benefit health insurance plans pay the full claim amount when you raise a claim with your health insurance policy. These health insurance plans are usually helpful in covering pre-determined illnesses, critical illnesses and hospitalization expenses in case of an accident.
Individual Health Insurance:
An affordable health insurance plan that protects individuals against medical bills. An individual health insurance policy covers you for Ayurvedic and Homeopathic treatment, day care procedures charges, bariatric surgery, pre & post hospitalization charges, organ donor expenses, road ambulance expenses and provides the benefit of daily cash
Family Health Insurance
Health insurance plans for family or a family floater health insurance gives you the option to cover yourself and your family members with individual Sum Insured (SI) or. Some of the key features of this plan are multiple Sum Insured options, immediate family cover, coverage for Ayurvedic and Homeopathic treatment, bariatric surgery cover, pre & post hospitalization expenses, maternity and newborn care cover.
Critical Illness Insurance
The Critical Illness insurance plan covers you from high-cost treatments for life-threatening diseases such as cancer, tumors, strokes etc. The benefit of a critical illness insurance cover is that it lets you avail the payable benefit once you are diagnosed with a critical illness.
Critical Illness Insurance for Women
This women’s health insurance plan is specifically designed to cater to their needs if they face any critical illness such as breast cancer, burns, vaginal cancer etc.
Health Insurance for Senior Citizens:
As you grow old, your body starts to show signs of weakness and you might suffer from age related problems. Also, your savings are limited in your later years. Health insurance for senior citizens takes care of these issues and protects you from the medical expenses in your golden years.
Health Infinity Plan:
Health Infinity plan, launched by Bajaj Allianz is a special plan that does not have any Sum Insured limit. One of the perfect health insurance plans for you and your family! The key features of this plan are unlimited Sum Insured, coverage for pre & post hospitalization expenses, day care procedures, road ambulance expenses and multiple policy term options.
Top Up Health Insurance:
Top up health insurance plans ensure that you are covered even if the Sum Insured of your base medical insurance plan has been exhausted. At Bajaj Allianz, we offer top up health insurance plans such as extra care plus & Extra Care that provide an add-on cover to your existing health insurance policy. The key features of this medical insurance plan are coverage for maternity expenses, pre & post hospitalization expenses, floater cover for entire family, coverage for pre-existing diseases and day care procedures.
Personal Accident Insurance:
A Personal Accident Insurance takes care of you and your family against unforeseen accidents. At Bajaj Allianz, we offer you a personal accident insurance policy with features like hospital confinement allowance, children education benefit and an extensive cover that covers you for death, permanent total disability, permanent partial disability, temporary total disability with plans such as Personal Guard. Also, our Global Personal Guard policy covers you for accidents and injuries irrespective of which corner of the world you are in. The key features of our international accident insurance are Sum Insured options up to INR 25 crore, cumulative bonus, and lifestyle modification benefit, coverage for entire family anywhere in the world and policy period up to 3 years.
M Care Health Insurance:
Bajaj Allianz’s M Care Health Insurance policy covers you against 7 vector borne diseases like Dengue Fever, Malaria, Chikungunya, Zika Virus etc. These diseases are very common and the medical treatment associated with these illnesses is very expensive. So, with our M Care Health Insurance policy, you can relax while getting cured for vector borne diseases. The key features of this policy are lifetime renewal facility, free look period of 15 days, multiple Sum Insured options and cashless claim facility.
It is a top-up cash benefit plan offered by Bajaj Allianz to protect you from unexpected hospitalization expenses. This health insurance policy provides a daily hospital cash benefit at very affordable premium rates. The key features of our Hospital Cash policy are multiple Sum Insured options, lifetime renewability, tax saving as per section 80D of the Income Tax Act and double cash benefit in case of ICU hospitalization.
Arogya Sanjeevani Policy:
It is a standard health insurance policy that takes care of the financial burden that might befall on you at the time of hospitalization. Key features of the Arogya Sanjeevani policy include option to pay the premium of this health insurance policy on installment basis (yearly, half-yearly, quarterly or monthly), coverage for AYUSH and cataract treatment, lifetime renewal option, Sum Insured up to INR 5 lakh and option to buy this policy for yourself (individual) or for your family as well (family floater).
Comprehensive Health Insurance
Bajaj Allianz’s Health Care Supreme is a comprehensive health insurance policy that covers you for a wide range of hospital expenses. This health insurance policy provides extensive healthcare benefits and gives you and your family a comprehensive protection, so that you leave nothing to chance. The key features of this health insurance policy are coverage for Ayurvedic and Homeopathic treatments, coverage for organ donor expenses, day care procedures expenses coverage, coverage for road ambulance expenses and coverage for pre & post hospitalization expenses.
Tax Gain is a unique family floater health policy, which in a smart move brings you the best both worlds. The key features of this plan are cashless facility, waiver of co-payment, no restriction on waiting period, ambulance cover, coverage for pre & post hospitalization expenses, health check-up benefit at the end of every 4 claim-free years.
Star Package Policy:
Star Package policy is a family floater, comprehensive insurance plan, which will cover you and your family from various health risks, education grant, household contents, and baggage during travel and public liability. It also has personal accident cover.
The Health Ensure plan is a comprehensive healthcare plan with no age limit. It covers daycare procedures, ambulance expenses, organ donor expenses and ayurvedic/homoeopathic accidental injuries. The sum insured range options range from INR 10 lakh to INR 25 lakh.
Global Personal Guard:
Global Personal Guard is an international accident insurance policy provides extensive worldwide coverage against partial permanent disability or total permanent disability, any other injuries caused due to an accident or death. It also covers accidents while traveling abroad as it provides a global coverage.
Benefits of Health Insurance Plans
The rising cost associated with medical care is one of the biggest reasons to buy a health insurance policy. And, the benefit of investing in adequate health insurance plans is that they gives you stability in terms of paying your hospital bills, even if it’s for simple day care procedures or preventive health care check-ups.
Following are the key benefits of Health Insurance Plans:
You can avail the benefit of cashless treatment, if you visit a network hospital for treatment. This means that you don’t have to arrange for funds from your pocket while getting quality health care. All you need to do it inform the insurance desk in the network hospital about your policy number. They will arrange for the pre-authorization letter from your insurance company, and the hospital bill settlement will be taken care of smoothly by the hospital and your health insurance company.
You can get a tax benefit by paying premium towards your health insurance plans in India. Whether you buy a health insurance for yourself or your family, you can get tax exemption as per section 80D of the Income Tax Act. You can claim tax deduction up to INR 25,000 per year for the health insurance premium paid for yourself, if your age is less than 60 years and up to INR 50,000 if you are a senior citizen.
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/care taker. Feature available in Individual Health Guard, Family Floater Health Guard and Health Care Supreme
If you renew your health insurance policy without any break and there has been no claim in the preceding year, then your Sum Insured (SI) is increased by 5% for the first year and 10 % for every successful claim free policy renewal. This increment in our SI is limited to 50% at max. Feature available for all health insurance products.
Free Health Check-Ups
It is said that prevention is better than cure. And, with your health insurance policy, you can avail the benefit of preventive care. You can regularly undertake heath check-ups without having to worry about paying medical bills.
Life Long Renewability
Once you buy your annual health insurance policy, you just need to renew it every year before its expiry to get the benefits of health insurance for a long time. You can add in some requirements as per your family size and the coverage needs at the time of renewal.
Our Health Insurance Plans Cover Coronavirus
Coronavirus is highly contagious, which has caused to it proliferate and spread to all corners of the world. This disease can cause severe problems that require extensive and continuous treatment and exhaust your financial backup. While it is extremely important to exercise caution, another form of assistance would be buying a health insurance policy. With a comprehensive coverage offered by our plans, you can rest assured knowing that medical expenses pertaining to COVID-19 are covered. Our health insurance plans cover hospitalization, day care procedures, AYUSH treatment, ambulance charges & offer quick claim settlements. Browse and select an adequate policy as per your requirements to cover yourself, your family members, children, senior citizens & expecting mothers to ensure that you are financially secure in these critical times. We also offer a dedicated cover termed as the Corona Kavach Policy. Apart from the common inclusions, this policy also extends coverage to pre-existing diseases, comorbid conditions, home care and other expenses, as per the terms & conditions of the policy, that fall under treatment for Coronavirus.
Here are the plans offered by Bajaj Allianz that cover Coronavirus:
- Bajaj Allianz Individual Health Insurance Plans
- Bajaj Allianz Family Health Insurance Plans
- Bajaj Allianz Silver Health Insurance Plans
- Arogya Sanjeevani Policy
- Corona Kavach Policy
Why Should You Buy Health Insurance From Bajaj Allianz?
When it comes to medical insurance, Bajaj Allianz General Insurance is at the forefront with a diverse range of affordable health insurance plans in India. They are customized to protect your savings from hospital bills. We respect your time and money and our offerings reflect our commitment to you. Unfortunate events can surprise you, so it is important to safeguard your hard-earned funds from being spent on heavy medical bills. We understand this and hence, we offer you the following benefits with our health insurance plans:
- Cashless claims facility at over 6,500+ hospitals across the country
- Cashless claim settlement within 60 minutes
- 24*7 call assistance for claims settlement and all your health insurance related queries
- In-house Health Administration Team (HAT) for faster claims processing
- Maximum coverage at affordable rates
- Easy to buy/renew online insurance policies
- Quick claim settlement up to INR 20,000 through our app via Health CDC (Claim by Direct Click)
- Access to better medical care with our wide range of Network Hospitals all over the country
We are an award-winning health insurance provider and our goodwill is steeped in safeguarding your precious time and hard-earned money. We care for you and ensure that our average claim settlement time is around 1 hour. This period of 60 minutes is one of the fastest claim settlement durations in the health insurance industry. Also, our premium rates are very competitive and all our health insurance policies are loaded with the latest features and best coverages. We are determined to make sure that you get your money’s worth at every stage and thus, we are there for you on every step of buying and renewing your health insurance policy as well as throughout your claim settlement process.
Things To Consider Before Buying a Health Insurance Policy
You’re spoiled for choice when it comes to buying insurance because of the numerous health plans and covers available today. But, you need all the information you can get before buying a medical insurance policy that suits your needs.
Keeping a note of some of the important things like waiting period, claim settlement process, list of network hospitals and more can help you choose the best health insurance plans for yourself and your family. To make your life simple, we’ve made a short list of factors that make a health insurance plan, the best health insurance plan for you:
Here they are:
- ✓ Always opt for adequate cover and ensure that it is sufficient for you and your entire family.
- ✓ Nowadays, most employees are covered by their company’s medical insurance. However, it is always an added benefit to select and purchase your own medical insurance plan after knowing all the terms and conditions.
- ✓ It’s ideal to combine hospital cash, critical illness and other benefits in your base cover to avail some form of compensation for non-payable losses.
- ✓ Always inform your insurer about any pre-existing diseases.
- ✓ Always keep a note of covers, maximum limits and waiting periods.
- ✓ Make sure that you know the terms associated with health insurance such as deductible, cumulative bonus, waiting period, pre-existing illness, free look period and more.
- ✓ A higher sum insured is always better as there is a constant rise in the cost of medical expenses.
- ✓ It is advisable to check the insurance provider’s claim settlement record. You should always opt for a company with a good settlement record. This ensures that your claims are not wrongly withheld and prevents any unnecessary claim issues in the future.
- ✓ Renew your policy on a continual basis. If there is a break between the expiry and renewal, you may lose the benefits of the insurance.
- ✓ Choose an insurance provider that has an internal team to assist with claim and settlement process as they offer a better turnaround time and a seamless process.
- ✓ Opt for a health insurance company that allows insurance portability. This way you have the benefit to change your insurance company and opt for a medical insurance policy better than your current one.
- ✓ You should invest early in a health insurance policy, so that you start your health insurance cover with a lower premium amount and also get wider coverage as compared to when you buy health insurance plans when you are about to retire.
- ✓ You should choose to buy a health insurance policy from a company that has maximum tie-ups with hospitals, so that you get the benefit of cashless claims.
- ✓ Select a health insurance company that has a customer-friendly online setup to make the process of buying/renewing your health insurance policy as well as claim settlement easy, quick and convenient.
Hope these pointers helped you make an informed decision and help you choose the best health insurance plan for you and your family.
Health Insurance Coverage
In Patient Hospitalization
Our health insurance policies cover you for the expenses related to any medical treatment that you receive in a hospital for any illness, accident and injury with utmost care.
Pre & Post Hospitalization expenses
You are covered for pre and post hospitalization expenses up to 60 days and 90 days respectively, if these expenses are related to the treatment that you are receiving.
Organ donor expenses
Donating an organ to save someone’s life is a noble cause and we at Bajaj Allianz support you as much as we can for this noble deed. Most of our health insurance plans cover you financially for surgeries/medical procedures related to organ donation.
Day care procedures
with advancement in technology, you need not stay in hospital for more than 24 hours for minor medical procedures aka Day Care procedures. And, our health insurance policies cover you for these treatments as well.
At Bajaj Allianz, we cover you for ambulance charges that might be incurred when you going to the hospital or returning from the hospital.
With Bajaj Allianz’s health insurance policies, you will be eligible for a benefit payout of INR 5,000 annually, in case of continuous hospitalization for a period of 10 days or more.
Ayurvedic / Homeopathic expenses
We cover you for the expenses related to Ayurvedic and Homeopathic treatment that you might want to take as an alternate therapy treatment.
Maternity expenses and new born baby cover
LOur health insurance plans cover you for maternity expenses and medical expenses towards treatment of a newborn baby, subject to certain terms and conditions.
Daily Cash Benefit:
You can avail the daily cash benefit with our health insurance policies, which you can use to pay for the accommodation of a person accompanying you in the hospital.
While this may give you an idea of health insurance coverage, you should always check with health insurance companies, to know more about the types of health insurance coverage they offer. Also, to peruse the detailed list of inclusions & exclusions, refer to the health insurance policy wordings .
The general exclusions of health insurance policy are:
Our health insurance policies do not cover you for any claims raised for the treatment expenses resulting due to war.
Our health insurance policies do not cover you for dental treatment unless it is necessitated by an acute traumatic injury or cancer.
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.
Taking care of you is our top most priority and we do not want to see you hurt specially by self-inflicting injury. Our health insurance plans do not cover you for intentional self-injury.
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:
Our health insurance policies do not cover you for getting any sort of treatment that you receive outside India.
How to Choose the Right Health Insurance Cover?
|Your Requirement||Best Health Insurance||Useful Health Insurance Feature|
|Coverage for senior citizens||Bajaj Allianz Silver Health Insurance Plans||Pre-existing illness cover|
|Coverage for your family in one plan||Bajaj Allianz Health Infinity Plan, Individual Health Guard and Health Care Supreme||Unlimited Sum Insured|
|Coverage against critical illness||Bajaj Allianz Critical Illness Plans||100% payout|
|Coverage for Coronavirus Pandemic||Arogya Sanjeevani Policy and Health Indemnity clause mentioned in other Health products||Payment of premium in installment|
|Coverage for critical illnesses specific to women||Bajaj Allianz Critical Illness Plans for Women||Congenital disability benefit|
|Coverage against bodily injury or death caused by accident||Bajaj Allianz Personal Guard||Child Education Benefit|
|Coverage against bodily injury or death caused by accident||Bajaj Allianz Personal Guard||Child Education Benefit|
|Coverage against vector borne diseases||Bajaj Allianz M Care Health Insurance Plans||Cover for all with cashless facility|
Health Insurance Premium
Health insurance premium is the amount you pay to your health insurance provider so that you have a well-planned financial aid in case of a medical emergency. In other words, health insurance premium is the periodic (generally annual) payment you make to your health insurance company in order to avail their services for health related expenses. Different health insurance policies have different health insurance premiums depending upon the coverages offered by them. Health insurance premium is one of the major factors that you should consider before buying any health insurance plans. You can easily find out an estimate of your health insurance quotes or premium that you would be paying towards your health insurance policy by using Bajaj Allianz’s free health insurance calculator to get health insurance quotes.
Factors That Affect Your Health Insurance Premium
There are certain factors that determine the premium of your health insurance policy such as:
✓ Selected Sum Insured : Your health insurance premium also depends upon the coverages opted by you and the Sum Insured selected by you, as per your health insurance needs.
✓ Number of members covered : Your health insurance premium changes as you include more number of members to be insured like in the 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 purchase a health insurance policy when you are young.
✓ Body mass index (BMI) : Your BMI is the ratio of your height and weight. If your BMI is beyond the normal limit, then you might have to pay higher health insurance premium.
✓ Medical history : You might have to pay a higher premium if a certain illness runs in your family or if you have some complex medical history.
✓ Tobacco consumption : Your premium cost might be on the higher side if you smoke or chew tobacco and tobacco related products.
✓ Gender : Women might be required to pay higher premium than men as they tend to have more number of hospital visits.
The biggest impact on your medical insurance policy premium, however, is the health insurance coverage that comes with it. The wider the coverage, the steeper your health insurance quotes.
Steps To Calculate Your Health Insurance Premium Online
You can use Bajaj Allianz’s free health insurance calculator to find out an estimate amount of health insurance premium that you need to pay towards your health insurance policy. The quick and easy steps to calculate your health insurance premium online are:
Step 1 : Head to the online health insurance premium calculator .
Step 2 : Enter your personal details like your name, your date of birth, health insurance policy that you want to buy and details of other family members whom you want to cover under the selected health insurance policy, your pin code, contact number.
Step 3 : Click on Get My Quote button.
Step 4 : Your health insurance premium details will be displayed on the screen, where you can select co-payment as per your convenience and click on Confirm Plan button to buy a health insurance policy online.
Once you receive your health insurance quotes & make online payment of your premium, you will get your health insurance policy (softcopy) immediately.
Health Insurance Claim Procedure
You can settle your health insurance claim with your health insurance provider by either cashless claim settlement or reimbursement claim settlement process. Both the ways of settling your health insurance claim are easy, quick and convenient.
Cashless health insurance claim settlement:
You can get the treatment for your health related issue without paying anything from your pocket. You can avail the benefit of cashless claims with your health insurance policy if you are admitted to a network hospital. Your medical bill will be settled by your network hospital and your health 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 a network hospital.
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 health insurance claim. To register a health insurance claim, you need to submit your hospital bills and medical records related to the treatment received to your health insurance company. Once these documents are verified, the claim amount will be settled in your registered bank account.
If you have to undergo a planned medical procedure like cataract surgery, which is covered in your health insurance policy, then you can use cashless claim facility to get the surgery done without having to pay anything. All you need to do is fill out a pre-authorization form at the network hospital and they will send this form to your health insurance provider, who will verify the required details and give approval for cashless treatment.
In case of an emergency like accident, you can use your health card provided by your health insurance company and submit it along with the pre-authorization letter. If the approval comes through, you can avail cashless claims benefit. If not, then you can go for reimbursement health insurance claim settlement process.
Health CDC (Claim by Direct Settlement) is a feature provided by Bajaj Allianz to you for settling your health insurance claims up to INR 20,000 instantly using our mobile app - Caringly Yours.
What are Network Hospitals?
Network hospital is a hospital that has an agreement signed with your health insurance company. This tie-up between the hospital and your health 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 your search criteria, you need to click on 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 treatment or the treatment of your family members are:
- You get the benefit of cashless health insurance, so that you don’t have to pay for the treatment upfront.
- You get quality assurance for treatment with well-trained doctors, latest medical equipments and best in class hospitality.
- You can relax when the payment of your medical bill is taken care by your health insurance provider.
- You get the required care during hospitalization as well as for pre & post hospitalization treatments.
Tax Benefits of Health Insurance
In India, you can get a tax benefit of under section 80D of the Income Tax Act, if you pay a health insurance premium for yourself and/or your family members. Along with providing you peace of mind, financial support during a medical emergency, access to quality health care services, easy, quick and hassle-free claim settlement process, your health insurance policy also takes care of you by helping you save tax. Thus, you can save a lot by investing in a suitable health insurance policy.
A health insurance policy can help you save tax up to INR 1 lakh under Section 80D of the Income tax Act, 1961 against the premium paid. Here is how you can earn tax benefit as per sec 80D deduction:
- On opting for Health Insurance policy for yourself, your spouse, children and parents, you can avail INR 25,000 per annum as a deduction against your taxes (provided you are not over 60 years).
- 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.
- As a taxpayer, you may, therefore, maximize 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.
- 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, then, INR 1 lakh.
Common Health Insurance Terms You Should Be Aware Of
Sum Insured (SI): Sum Insured is the maximum amount that your health insurance company is liable to pay if you are hospitalized. If the expenses of your medical treatment exceed the Sum Insured opted by you, then you will have to pay the amount over the Sum Insured on your own. Thus, you should opt for health insurance plans with a higher Sum Insured.
Pre-existing diseases: If you are suffering from an ailment before buying a health insurance policy, then that ailment come under pre-exiting diseases category.
Waiting period: It is the time span that you need to wait before some or all of the coverage for your health insurance policy begins. For e.g. many health insurance policies have a fixed waiting period before they provide coverage for pre-existing diseases.
Sub-limits: Sub-limits are caps that your health insurance providers place in order to restrict the expenses that they need to pay for a particular condition. This is mainly done to reduce the fraud claim cases. Most of the health insurance companies have sub-limits on room rents, common ailments, pre-planned procedures, ambulance expenses and doctor’s fees. Sub-limit can be a fixed percentage of the Sum Insured opted by you or a fixed amount as agreed between you and your health insurance company.
Co-payment: Co-payment or Co-pay is the fixed percentage of the claim amount that you need to pay for your health related expenses before your insurance company pays for the same. Co-pay is decided by you when you buy or renew your health insurance policy. A higher co-pay can help you reduce your premium amount.
Deductible: Deductible is the concept of cost sharing between you and your insurance company for paying for your health care expenses. It is a fixed amount that you need to pay every time you make a health insurance claim. High deductible health insurance plans can be beneficial for you, if your visits to a doctor/hospital are less frequent. Also, having high deductible health insurance plans can help you lower your premium amount.
Room rent limit: Room rent limit is the maximum coverage your health insurance policy provides you for per day room charges, in case you are admitted to a hospital.
Coinsurance: If you have multiple health insurance policies, then you can file a health insurance claim with all of them and you will be reimbursed the claim amount by all the health insurance companies, as per fixed percentage decided by you. This concept is called coinsurance. So, if you decide the coinsurance between two health insurance companies (A and B) as 40% and 60% respectively, then on a claim of INR 1 lakh, company A will reimburse INR 40,000 to you and company B will reimburse INR 60,000 to you, as per the terms and conditions of your health insurance policies.
Free look period: Health insurance companies offer a free look period of 15 days to you. In this period you can check out your health insurance policy and decide whether it is best suited for you. If you think that it not an adequate medical insurance plan for you, then you can cancel this medical insurance policy within 15 days. No cancellation charges will be applicable if you cancel the policy within 15 days. However, you will be charged a premium for the number of days you took to take the decision.
Grace period: After the expiry of your health insurance policy, you have a time span of 30 days for renewing your health insurance policy. This 30 day period is the grace period. If you renew your policy in these 30 days, then you will get the benefits of your health insurance policy like waiting period, coverage for pre-existing diseases etc. reinstated. But, you will not be covered for any claims you make during the grace period.
Difference Between Health Insurance & Mediclaim Insurance
If you’re wondering what the difference between a health insurance plan and a mediclaim policy is, you just need to read on.
While mediclaim insurance is a category of insurance, a mediclaim policy only covers hospitalization-related expenses for the duration of the mediclaim policy. Unlike medical insurance plans, a mediclaim plan will not offer comprehensive coverage. There are a few other distinctions between mediclaim insurance and a health policy in India.
In the below table we’ve highlighted these differences between medical insurance plans and a mediclaim policy for you to better understand and make a more informed choice to buy medical insurance online or otherwise.
|Point of Difference||Health Insurance||Mediclaim Policy|
|Coverage||Provides extensive coverage such as coverage for hospitalization expenses, coverage for annual health check-ups, OPD expenses, pre & post hospitalization expenses, daily cash benefit and more.||Mediclaim policy covers only hospitalization expenses in case of accident, sudden illness and surgery.|
|Add-on Covers||You can opt for Bajaj Allianz’s Extra Care Plus add-on cover, Hospital Cash Daily Allowance Policy.||No add-on covers can be purchased along with mediclaim policy.|
|Sum Insured||Multiple Sum Insured options with wide range from INR 1.5 lakh to 25 crore.||Maximum Sum Insured can be INR 5 lakh for a mediclaim policy|
|Claims||You can get your claims settled via cashless or reimbursement process. You can also get a lump sum amount as claim settlement in case of health covers like critical illness cover.||With a mediclaim policy can get your claims settled in a policy year until you exhaust your SI.|
|Flexibility||More flexible, as you have multiple Sum Insured options, choice of add-on covers, facility to enhance Sum Insured and comprehensive coverage.||A mediclaim policy may not be very flexible when compared to health insurance plans.|
|Critical Illness Cover||Provides critical illness cover.||A mediclaim policy may not provide critical illness cover.|
We hope that this information on mediclaim and mediclaim policies helps you understand the distinction between a health insurance and a mediclaim policy.
Long Term Vs Short Term Health Insurance
|Point of Difference||Short Term Health Insurance||Long Term Health Insurance|
|Tenure||A short term health insurance policy is valid for 12 months.||A long term health insurance policy is valid for 2 to 3 years.|
|Renewal||You need to renew your short term health insurance plans after every 12 months.||You can skip the worry to renew your long term health insurance plans for 2 to 3 years.|
|Premium||The premium for short term health insurance policy is lower as compared to long term health insurance plans.||The premium for long term health insurance policy is higher.|
|Premium Rate Revisions||The premium rate revisions are applicable every year (depending on product modification or age slab changes).||The premium rate revisions are not applicable up to the expiry of your policy.|
|Discount on Premium||Short term health insurance policies do not offer a considerable discount on the premium amount.||Health insurance companies tend to offer great discount to you, if you buy a long term health insurance policy.|
|Suitable for||These health insurance plans are suitable for you, if you are young and healthy.||These health insurance plans are suitable for senior people, as they will help them manage their finances, since the premium rate remains fixed for a couple of years.|
Documents Required to Buy Health Insurance in India
Passport sized photographs
Policy proposal form
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
Age proof: You can use the following documents as your age proof:
- ✓ Passport
- ✓ Aadhaar card
- ✓ Birth certificate
- ✓ PAN card
- ✓ 10th and 12th class mark sheet
- ✓ Voter’s ID
- ✓ Driving license
Identity Proof: You can submit any of the following documents as your identity proof:
- ✓ Aadhaar card
- ✓ Driving license
- ✓ Passport
- ✓ PAN card
- ✓ Voter’s ID
Based on the coverages opted by you, your age, medical history, current life style choices and your residential address you might be asked to submit a few more documents.
Steps to Buy Health Insurance Online
If you’re looking to buy medical insurance online, look no further. You can buy Bajaj Allianz’s health insurance policy online quickly and conveniently with the help of the following steps:
- Step 1
Select the medical insurance plan that you want to buy.
Enter your personal details like your name, your date of birth, health insurance policy that you want to buy and details of other family members whom you want to cover under the selected health insurance policy, your pin code, contact number.
Click on Get My Quote button.
Your health insurance quotes and premium details will be displayed on the screen, where you can select co-payment as per your convenience and click on Confirm Plan button to buy a health insurance policy online.
Once you make online payment of your health insurance premium, you will get your health insurance policy (softcopy) immediately.
Most health insurance companies in India have a website which feature their health insurance policies. Some companies, including Bajaj Allianz General Insurance, even have an app for fulfilling your online health insurance needs.
You can also buy our health insurance policy online 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 on: +91 80809 45060.
Health Insurance renewal is very important to maintain continuity of the coverage provided by your health insurance policy. You should renew your health insurance policy before its expiry. If you don’t renew your health insurance policy even after it expires, then your insurer will provide you a grace period of 30 days for health insurance renewal . However, you will not be covered for any health insurance claim in these 30 days. And, if you do not renew your policy in the grace period as well, then you will lose the benefits of any medical insurance plans like NCB (No Claim Bonus), waiting period etc.
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 requirement.
Health Insurance Portability
Health insurance portability allows you to switch your health insurance provider without losing the benefits of your existing health insurance policy. So, if you are not satisfied with your current medical insurance plan or you are looking for something more in your medical insurance plans, then you can choose to change your health insurer or your health insurance policy from the same company with all the credits that you gained in your current medical insurance plan.
You have the following options when you decide to switch your health insurance:
- You can switch from one health insurance provider to another.
- You can switch between medical insurance plans with the same health insurance provider.
- You can switch from Individual to Floater policy and vice versa.
- You can apply for revised Sum Insured (SI) with the new insurer.
- You can enhance the coverages provided with your existing health insurance policy. However, you might need to undergo some medical tests and also, there may be new waiting periods for these coverages.
Health insurance portability criteria:
- You can switch your health insurance policy only at the time of renewal.
- You should approach your new health insurance provides at least 45 days prior to the expiry of your existing health insurance policy.
- You should make sure that there are no breaks in the health insurance renewal process.
- You should submit the following documents for health insurance portability:
✓ Previous policies
✓ Claim experience in detail
✓ Proposal form
✓ Age proof
✓ If any positive declarations – discharge card, investigation reports, latest prescriptions & the clinical condition
✓ *Any other document as requested by the insurer
My happiness and satisfaction regarding my claim settlement which was approved within 2 days...
Speed with which insurance copy was delivered in times of lockdown. Hats off to the Bajaj Allianz team
I would like to thank the team of Bajajallianz Vadodara, Specifically Mr. Hardik Makwana and Mr. Ashish Gupta...
Hassle Free through web with all option we can review while taking policy.
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 a financial security like that of a health insurance policy to handle any kind of medical emergencies.
2. What do I get with a Bajaj Allianz Health Insurance policy?
With our Health Insurance policy, you enjoy coverage for pre and post hospitalization expenses for up to 60 and 90 days, respectively. The policy also covers in-hospital expenses, ambulance charges, room rent and boarding expenses (coverages will differ based on the selected product). You can avail cashless treatment at over 6,500+ hospitals across India. We also cover medical examinations, physician fees/doctor’s consultation fees and ambulance charges, leaving you totally stress-free!
3. Should I be buying Health Insurance online?
If you want a quick and hassle-free purchase, buying online is the way to go. We are here to help you to buy Health Insurance easily and efficiently. Our multiple payment options will further ease your payment woes. Your medical insurance policy is issued online, which saves you the effort of ever carrying a hard copy. All these factors, along with proactive customer support, makes buying Health Insurance policy online a better alternative.
4. How can I save taxes with Health Insurance?
Bajaj Allianz General Insurance 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 you pay for yourself, your spouse, children and parents, you can avail INR 25,000 per annum as a deduction against your taxes (provided you are not over 60 years). 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. As a taxpayer, you may, therefore, maximize 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. 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, then, INR 1 lakh.
5. Who is eligible to purchase health insurance?
You can purchase a health insurance policy in India, if you are an Indian citizen and above 18 years of age. If you are a minor (below 18 years of age), then your parents can cover you under their any medical insurance plans.
6. What is covered by health insurance?
Health insurance covers you for hospitalization expenses including pre & post hospitalization expenses, doctor’s consultation fees and in-patient expenses.
7. I’ve already invested in life insurance. Do I still need Health Insurance?
Life insurance is a great investment and death cover option but it won’t come in handy to pay rising medical bills. A Health Insurance cover is a solution to deal with hospitalization and pay heavy medical expenses, should they arise. So, Health Insurance plans are your cover against unexpected health-related costs that may threaten to deplete your savings.
8. do you mean by entry age and exit age?
Entry age specifies that you should be at least that much old, so that you can get coverage under a health insurance policy. Exit age means that you will not be covered under your health insurance policy after crossing a certain age limit. The entry age and exit age are different for different health insurance plans.
9. What is a ‘Free look Period’?
Health insurance companies in India grant you a free look period of 15 days, during which you can analyze the health insurance policy that you have purchased. You can cancel your health insurance policy in these 15 days if you think that this medical insurance plan is not suitable for you without paying any cancellation fee.
10. Who are considered to be ‘dependents’?
Your children, spouse, parents and parents-in-law can be added as dependents in your health insurance policy.
11. What is ‘Co-payment’? What are ‘deductibles’?
Co-payment is the fixed percentage of the claim amount that you need to pay for every health insurance claim. While, deductible is the fixed amount that you need to pay when you make a health insurance claim.
12. What is meant by ‘restoration’ or ‘reinstatement’ of sum assured?
Restoration or reinstatement of sum assured means that if you exhaust your existing SI, then it will automatically replenished to cover you for the next hospitalization expenses in the same policy year. However, you cannot carry forward the restoration benefit and it cannot be used for the same illness/injury for which you have once made a claim in your policy year.
13. What is the benefit of day care health insurance?
With technological advancement, you are not required to get hospitalized for procedures like Septoplasty or lithotripsy. But, the medical expenses related to these procedures are very expensive. It is beneficial to have day care medical insurance plans, so that you are covered for these kinds of surgeries or medical procedures where you are not required to stay in the hospital for more than 24 hours.
14. What is 'any one illness’?
Any one illness refers to continuous period of illness, including any relapse that happens within a certain number of days as per the terms and conditions of your health insurance policy.
15. How insurance helps in health check-up facility?
You are eligible for free health check-up if you renew your health insurance policy continuously for 4 years without filing any health insurance claim. The expenses related to this health check-up are borne by your health insurance company.
16. What are the minimum and maximum policy durations?
You can buy a health insurance policy for a period of 1, 2 or 3 years. If you purchase a long term health insurance policy (more than 1 year), then you can get great discounts.
17. What are some of the top myths about health insurance?
Some of the myths associated with health insurance are:
- You need to check the empanelled hospitals only when you buy any health insurance plans.
- Health insurance provided by employer is enough to cover you.
- If you have health insurance, then all your medical expenses are covered.
- You need to be hospitalized for at least 3 hours to get the benefit of your health insurance plans.
- You do not need health insurance if you are fit.
- Smokers cannot purchase health insurance
18. Tell me about pre-existing diseases and waiting period.
Pre-existing diseases are those you may already know the existence of in your life before you buy a medical insurance policy. Hence, you must declare any pre-existing disease/condition at the time of buying medical insurance plans.
One of the key factors to keep in mind is that the pre-existing diseases have a waiting period (which differs from company to company). Hence, by taking a policy at a young age you can only 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, you can ensure that you are eligible to avail full benefits of your medical insurance policy.
19. Which are the expenses that are included in sub-limit amount?
Sub-limit is the maximum amount that your health insurance policy will pay towards your medical expenses. The sub-limits usually include room rent sub-limit, post hospitalization sub-limit, ambulance charges, oxygen supply, doctor’s fees, diagnostic tests etc.
20. What are the differences between Health Insurance and Personal Accident Insurance?
Health insurance is where you can file a claim and your insurer will reimburse you the claim amount up to the Sum Insured. On the other hand, Personal Accident insurance plan pays you the entire Sum Insured once you file a claim.
21. What is the difference between Family Floater & Individual Health Policy?
Individual health insurance policy has different Sum Insured for all the members covered under the policy, whereas all the insured members share a common Sum Insured under a family floater health insurance.
22. Which health insurance plans are available for women?
At Bajaj Allianz, we have special health insurance plans that takes care of expenses related to the health issues faced by women. Our critical illness plan for women is a special policy for all the ladies out there, that covers you against the risk of 8 critical illnesses like burns, breast cancer, vaginal cancer etc.
23. What is the waiting period and Sum Assured for maternity insurance plan in India?
A waiting period of 72 months is applicable for the coverage of maternity expenses. If you opt for Sum Insured between INR 3 lakhs and INR 7.5 lakhs, then the coverage is restricted to INR 15000 for normal delivery and INR 25000 for caesarean section and if you opt for Sum insured between INR 10 lakhs and INR 50 lakhs, then it is restricted to INR 25000 for normal delivery and INR 35000 for caesarean section. The waiting period for Maternity for every product will differ based on the terms and conditions of every product.
24. How can I get a new member added to my existing family floater health insurance?
You can fill a health declaration and endorsement form along with the additional premium amount to cover a new member to any existing family floater medical insurance plans.
25. How do I make changes in my health insurance policy details after receiving the policy documents?
You can change your details online by visiting our website or contact our customer care executive, who will help you make the required changes.
26. How can I check the status of my policy?
You can check the status of your policy online. Log onto our website with your user ID and password and enter the details of your policy – policy number, etc. to check the status. Alternately, you can download our ‘customer portal’ app and check your policy status.
27. Can I buy more than one Health policy?
Yes, you can buy more than one health insurance policies. However, it usually becomes cumbersome to handle multiple policies. We recommend you to buy a single health insurance policy with high SI instead of buying multiple health insurance policies with low SI.
28. What if I want to renew my health insurance policy after one year?
You can renew your health insurance policy after one year. But, if there has been a break in your health insurance renewal, then you might need to contact our customer support team, who can guide you to take further necessary steps.
29. Will I need to undergo a medical checkup every time I renew my policy?
No. You do not have to undergo a medical check-up every time you renew your health insurance policy. However, if there has been a break in health insurance renewal or if you have upgraded the coverages of your medical insurance plan while renewing the policy, then you might be required to undergo some medical check-ups.
30. I am already having health insurance and want to increase sum insured, what should I do?
You can contact our customer support team and get complete details of the steps that you need to take to increase the Sum Insured.
31. If my policy is not renewed in time before expiry date, will I be denied for renewal?
You can renew your health insurance policy even after its expiry during the grace period of 30 days with all the benefits reinstated. However, if you do not renew your policy after the grace period is over, then you might have to start from scratch to get yourself covered.
32. Is it possible to transfer my policy from one insurance company to another without losing the renewal benefits?
Yes, with health insurance portability, you can switch your health insurance company.
33. Is Medical Test mandatory for everyone?
No. usually medical tests are not mandatory for people below the age of 45 years. However, your insurance company can ask you to undergo certain medical tests depending upon the medical history submitted by you and the health insurance policy opted by you.
34. Who pays for the medical examination?
You have to bear the cost of the medical examination that you undergo before buying a health insurance policy. It can also be reimburse depending upon policy terms and conditions.
35. Is my health insurance policy valid for Pan-India?
Yes, you are covered for all your health related emergencies with your health insurance provider all over India, subject to terms and conditions of your policy.
36. What are the fine prints which I should know before buying health policy?
Before you buy a health insurance policy, you should take care of the following things:
- You should look for the exact coverages provided by your health insurance policy.
- You should take a note of waiting periods and exclusions.
- You should not hide anything from your health insurance provider like pre-existing illnesses.
- You should check the online processes of the insurance company.
- You should thoroughly enquire about topics like policy cancellation, policy lapse and policy renewal with your insurer.
- You should also take a good look at the break-up of your health insurance premium and clear all your doubts before making the payment.
37. What do you mean by health card?
Health insurance companies in India provide you a health card with your health insurance policy, which you can use at network hospitals to avail the cashless treatment benefit.
38. Will duplicate policies be issued if the original is lost?
Yes, you can get a duplicate health insurance policy if you lose the original one. However, you might have to pay some fixed amount to get the duplicate copy of your health insurance policy.
39. How do I cancel my health insurance policy?
If you have just purchased your health insurance policy, you can cancel it in the free look period without paying any cancellation fee. But, you will have to pay the premium amount for the number of days the policy covered you.
You can also cancel your health insurance policy before its expiry instead of renewing it.
You might also be eligible for certain benefits, if you surrender your policy after renewing it without break for a certain fixed number of years. You can contact your health insurance provider and know the complete details to cancel your medical insurance plan.
1. How much cover do I need?
Your coverage amount depends on your lifestyle, medical background, pre-existing diseases, members of your family, annual income, residential address and age.
2. Tell me about the pre and post hospitalization medical expenses that you cover.
Pre hospitalization expense is as a result of tests, medication that would have to be undertaken prior to the hospitalization for the treatment. Similarly, post hospitalization expenses can be for recovery and medicines that need to be taken post the hospitalization treatment. Pre and post hospitalization are 60 and 90 days respectively, depending on the policy terms and conditions When you fall sick, you usually consult your family physician and get relevant investigations done. On the advice of your physician, you get hospitalized for further treatment of the disease if required. These medical expenses incurred before hospitalization are called pre hospitalization expenses. Post hospitalization expenses include all expenses or charges incurred by you after you are discharged or after hospitalization treatment is done. For example, the consulting physician may prescribe certain tests to ascertain your progress or recovery after surgery.
3. What do you mean by Domiciliary Hospitalization? What does it cover?
Domiciliary Hospitalization refers to a situation where you are undergoing a treatment or are under medical care at home instead of hospital and still you are considered as hospitalized. You might be taking the treatment as home because of non-availability of hospital beds/room in the hospital or you are not in a condition to be shifted to a hospital for the treatment.
The domiciliary hospitalization covers you for the expenses related to the treatment you receive for an Illness/disease/injury at home instead of a hospital.
4. What are the non-payable items under your health insurance plans?
Non-medical items such as hair removal cream, hand wash, cozy towel, baby bottles, brush, paste, moisturizer, caps, eye pad, comb, cradle buds etc. are all non-payable under your health insurance policy. For a detailed list of non-payable items, please read your policy wordings carefully.
5. Does health insurance policy offer coverage to diabetes patients?
Yes, health insurance companies offer coverage to diabetes patients. However, you might have to undergo some medical tests before you get the coverage. Also, there might be some waiting period applicable as per your medical test reports. *Also subject to UW acceptance
6. Does health insurance in India cover any kind of diagnostic charges like MRI, X-Ray or any other body scans?
Yes, health insurance in India covers some medical tests and scans as per the terms and conditions mentioned in your policy for in-patient hospitalization.
7. Do health insurance plans cover maternity?
Yes, health insurance plans cover you for maternity and new born care. However, there will be a waiting period before the coverage for the same starts. You should check the coverage and the waiting period with your insurer if you are buying a health insurance in India specifically for maternity expenses coverage.
8. Do insurance policies cover outpatient expenses also?
Yes, outpatient expenses are covered under medical insurance plans either with mandatory hospitalization of 24 hours or as a top-up in the form of OPD cover.
9. What treatments does day care health insurance in India cover?
Some of the day care procedures covered under health insurance in India are:
- Incision of bone, septic and aseptic
- Dilatation of digestive tract strictures
- Surgical treatment of hemorrhoids
- Surgery for ligament tear
- Cataract surgery
- Glaucoma Surgery
- Foreign body removal from nose
- Removal of metal wire
- Removal of fracture pins/nails
- Foreign body removal from lens of the eye
You can refer your policy document for a detailed list of day care procedures.
10. Is dental treatment covered under health insurance in India?
Dental treatment means a treatment related to teeth or structures supporting teeth including examinations, fillings (where appropriate), crowns, extractions and surgery.
Any dental treatment that comprises of cosmetic surgery, dentures, dental prosthesis, dental implants, orthodontics, surgery of any kind is excluded unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization.
11. Does health insurance in India cover homeopathy treatments?
Health insurance policies that cover AYUSH treatments also cover homeopathic treatments. You can check the same with your health insurance provider or refer your policy wording to know whether the coverage is included in your health cover or not.
12. What are the illnesses covered under critical illness insurance?
With Bajaj Allianz’s critical illness policy, you are covered for 10 major critical illnesses:
- Aorta graft surgery
- Coronary artery bypass surgery
- First heart attack (myocardial infarction)
- Kidney failure
- Major organ transplant
- Multiple sclerosis with persisting symptoms
- Permanent paralysis of limbs
- Primary pulmonary arterial hypertension
13. Why should I take a health policy if I already have health insurance from my employer, or if my family and I are already covered by my corporate?
A health insurance policy from your employer might have a few benefits, but, there are also some drawbacks associated with the corporate health insurance plans like:
- You will not be able to customize the corporate plan as per your health insurance requirements and health conditions.
- Your coverage will be over as soon as you resign from the company.
- Health insurance plans from your employer will not cover you after you retire.
- Corporate health insurance plans have very little scope for planning your future.
- You are covered for a lesser SI as compared to private health insurance plans.
Thus, you should also buy an individual medical insurance plan that suits your budget as well as your health insurance requirements.
14. Can I Increase Health Insurance Cover During Renewal?
Yes, you can increase your medical insurance plan’s cover during renewal. You might be required to submit a few documents for the same and also pay the additional premium for enhancing the coverage of your medical insurance plans.
15. Can I Add My Elderly Parents on My Medical Insurance Policy?
No, but you can buy our Silver Health plan, which is a Special health insurance designed for senior citizens.
1. What factors determine my Health Insurance premium amount?
The Health Insurance premium amount mainly depends on the sum insured and the number of members covered under the Health Insurance policy. Here are a few other factors that determine your Health Insurance premium:
- Your age
- Pre-existing diseases
- Add-on covers (optional)
2. How do I estimate the cost of health insurance in India?
You can use our health insurance calculator to get an estimate of the premium that you need to pay towards your health insurance policy. You can use our health insurance calculator for free and use the generated quote for future references.
3. What are the modes available for the payment of premiums?
You can make the premium payment using the following modes:
- Cheque or cash payment at our branch
- Online payment – Debit/credit card and net banking
4. Under what conditions is my policy premium likely to increase at renewal?
Your health insurance premium might increase during renewal under the following circumstances:
- Change in the age band
- Premium revision by the regulator (of which you will be informed well in advance of your health insurance renewal
- Change in taxes, duties and cess as per government laws
5. How does smoking affect health insurance premiums?
You might have to pay a higher premium towards your health insurance policy if you are a smoker. Also, you might need to undergo a few medical tests before a health insurance policy provides coverage to you.
6. What if I forgot to pay my health insurance premiums?
You should pay your health insurance premium before your policy expires, so that there is a continuity of the coverages provided by your health insurance policy. However, if you are unable to pay your health insurance premium before policy expiry, then you can use the grace period given by your insurer to renew your medical insurance policy. But, if you do not renew your policy in the grace period as well, then your health insurance policy will lapse and you will not be covered for any medical emergency.
7. What is GST and how does it impact health insurance?
GST is Goods and Service Tax. It was first launched in 2017 and it covers all the indirect taxes such as service tax, VAT etc. There are four tax slabs under GST – 0%, 5%, 12% and 28%. And, there are two types of GST – State GST and Central GST.
Before GST, the tax rate applicable on health insurance policy was 15% and now the tax rate applicable is 18% on all health insurance policies.
8. Can I pay health insurance premium monthly?
All the health insurance policies do not accept the payment of your health insurance premium on installment basis. However, with policies like Arogya Sanjeevani, you can pay health insurance premium on installment basis – yearly, half-yearly, quarterly and monthly as per your convenience.
1. What is claim settlement ratio?
Claim settlement ratio of a health insurance company is the ratio of the number of claims settled by a health insurance company to the total number of claims raised in a given time frame. The higher the number of claim settlement ratio, the better the health insurance company.
2. How to check the status of my Health Insurance claim status?
You can track the status of your health insurance claim using our mobile app - Caringly Yours, by using our online claim settlement portal and by calling our customer care.
3. What are the procedures involved while claiming for health insurance in India?
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), so the claim processing is quick and easy.
For cashless claims, you need to get a pre-authorization letter from the network hospital and we will approve the claim after successful verification of your pre-authorization form and your health insurance policy. You can avail the benefit of cashless claims once we provide the approval to the network hospital.
In case of reimbursement claim settlement, you will need to send us documents like your medical bills along with your policy details and discharge summary provided by the non-network hospital. We will verify these documents and settle your claim by depositing the final claim amount directly in your bank account.
4. 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.
5. When should I make a claim?
You should make a health insurance claim only if you think that the medical expenses are huge and you cannot pay for them from out of your pocket. This will help you earn the benefit of NCB (No Claim Bonus) when you renew your health insurance policy.
6. What is the maximum number of claims I can make over a year?
You can make any number of valid health insurance claims in a policy year. However, the number of times you file a claim depends upon the exhaustion of your Sum Insured.
7. What is cashless mediclaim?
When you get the treatment for your illness/injury in a network hospital, you are eligible for cashless mediclaim. With cashless mediclaim, your medical bill will be automatically by your health insurance provider to the network hospital where you are undergoing a treatment. However, you will have to bear the cost of non-medical items and other non-payable items as per your health insurance policy.
8. If I want to claim for cashless treatment, how will I approach?
To avail the benefit of cashless claims, all you need to do is approach a network hospital and show your health card, which has your policy number, name of the insurance company and type of health insurance policy. You will also have to fill up a pre-authorization form that will be sent by the network hospital to your insurance company. On verification of these documents, your claim will be directly settled by your insurer to the hospital.
9. What happens to the coverage amount when a claim is filed?
After your claim is filed and settled, your insurance cover will be reduced by the amount that has already been paid to you.
10. If I avail cashless facility, will you pay the entire amount or will I be required to bear part of the bill at the hospital?
Yes, the best health insurance policy will cover you for all the medical expenses. However, you will have to pay for non-medical items and the non-payable items as mentioned in your he insurance policy.
11. What happens to my policy after a claim is filed and settled?
After your claim is filed and settled, your insurance cover will be reduced by the amount that has already been paid to you. For example, if your policy was issued in January with INR 5 lakh coverage and if you claimed an amount of INR 3 lakh in July, then a balance of INR 2 lakh is available to you between August-December.
12. If I do not make a claim within a policy period, can I get a refund of my money?
You will not get a refund of your health insurance premium even if you do not file a health insurance claim in the policy year. But, you will be eligible for NCB (No Claim Bonus), which will reduce the premium amount when you renew your health insurance policy. Also, you will be eligible for cumulative bonus, which lets you enjoy the benefit of increased SI by paying the same premium as the previous policy year.
13. What is TPA?
TPA stands for Third Party Administrator. It is an organization that processes claims on behalf of your health insurance provider. It acts as an intermediary between you and your health insurance company for processing and settling your health insurance claims.
14. Can I change the hospital during the course of treatment?
Yes, you can change your hospital during the course of treatment. But, you will have to inform the same to your health insurance provider and also submit the related documents to them.
15. How many times can I claim Convalescence Benefits?
You can claim Convalescence Benefits once in a year.
16. Will my policy cover medical treatment at any hospital I choose?
Yes, your medical policy will cover the medical treatment at any hospital you choose (network or non-network hospital). However, there might be some hospitals that may have been delisted by your insurance provider and you will not be covered in case you choose one of those hospitals for getting the required medical attention.
17. Can I get Reimbursements in case of treatment in non- network hospitals?
Yes, you can submit your medical bills along with other documents to file a reimbursement claim if you get treatment in a non-network hospital.
18. Do I have to pay the difference if the actual expenses are more than the cover?
Yes, if the actual expenses exceed the cover opted by you, you will have to pay the difference amount.
19. What is the Health Administration Team?
The Health Administration Team (HAT) comprises of doctors and paramedics who are responsible for health underwriting and claims settlement. It is a single window assistance for healthcare related services. This in-house team resolves issues related to health insurance customers. The team ensures faster claim settlement as a single point of contact. It is effective for quick resolution of customer queries by health insurance experts. It also controls claim settlements and customer service, given its in-house capabilities.
20. What are the reasons for denial of claims under health insurance?
Your health insurance company might deny your claim settlement in case of following scenarios:
- Claim filed for intentional self-injury
- In case of misrepresentation, fraud, nondisclosure of material facts or non-cooperation from insured’s end
- Claim filed for coverage of the pre-existing diseases before the waiting period gets over
- In case of claim filed for any of the exclusions mentioned in the policy document
1. Will my existing health insurance policy cover hospitalization expenses on account of COVID-19?
Yes, the hospitalization expenses on account of COVID-19 will be covered under your existing health insurance policy under In Patient Hospitalizarion as per the terms and conditions mentioned in your policy.
2. Will my family members be covered for expenses on account of COVID-19?
If your family members are covered in your existing health insurance policy, then they will be covered for the hospitalization expenses (Under In Patient Hospitalization) as per policy terms & Condition related to COVID-19.
3. What are the expenses incurred for COVID-19 that will not be covered under my policy?
All the non-payable items mentioned in your policy document along with the list of non-payables issued by IRDAI will be excluded from COVID-19 coverage.
4. Are the consultations with a Medical Practitioner and diagnostic tests in relation to COVID-19 covered under my Health Insurance policy?
These expenses are covered if your health insurance policy provides coverage for out-patient hospitalization. Please contact your insurer and get clarification on these coverages under your health insurance policy.
5. Will my travel history abroad affect the admissibility of claim under the policy?
No, your travel history abroad will not affect the admissibility of claim under your health insurance policy, if you are hospitalized in India.
6. How can I intimate my claim after hospitalization?
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 paper-less procedure – Health CDC (Claim by Direct Click) available on our Caringly Yours App.
- You can give us a missed call on +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 a mail on firstname.lastname@example.org to register your claim as well.
- Another way to register and track your claim is visiting our online claim portal, where you can enter some of your basic details such as your policy number and quickly make a claim.
7. Are any waiting periods applicable to claims under COVID-19?
Yes, a standard waiting period of 30 days is applicable to COVID-19 health insurance.
8. Will I be allowed to enhance my sum insured?
You will be able to enhance your Sum Insured during the renewal of your policy as per underwriting terms and conditions.