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Cashless treatment at 8,000 + network hospitals
In-house health administration team
Cover 09 plans/options with Health Prime Rider
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
Health insurance or medical insurance is an insurance product that provides coverage for medical expenses in the event of an illness or injury. Health insurance plans safeguard your hard-earned funds from being spent on expenses related to hospitalization, medicines, 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 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 plan, but also get facilities such as cashless treatment and quality health care at a reputed network hospital.
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 the protection of a health insurance policy, that besides helping you manage your finances, also offers you 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 a family discount, which will allow you to purchase medical insurance plans at a relatively low 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, 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.
✓ 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.
Health insurance in India is offered by various companies accompanied by several features and benefits. You can certainly evaluate these policies and choose the best health insurance plan from among them.
Buying a health insurance policy is important. Yet, there are times when people are reluctant to buy an appropriate cover. Often people get confused between different types of health insurance policies in India.
When buying medical insurance it is important to choose a health cover that fulfills their needs. Let us start by understanding the key differences between individual and family floater health insurance policies:
Point of Comparison |
Individual Health Insurance Policy |
Family Floater Health Insurance |
Definition |
Individual health insurance is the type of health insurance plan where the proposer and family members can be covered in the same plan. However, the sum insured is separate (not shared) for each insured member in an individual health insurance policy. |
Family floater health insurance is the type of health insurance where multiple family members can be covered under one plan. It means that the sum insured is shared amongst all family members in one plan. |
Sum Insured |
The sum insured will be separate for each insured member. |
The entire family gets covered under one sum insured |
Coverage |
The health insurance benefit is extended to the primary insured member and dependent family members that include self, spouse, children, parents, parents-in-law, sister, brother, grandchildren, aunt, uncle. However, each insured member will have a sum insured of their own. |
The health insurance benefit is extended to the primary insured member and dependent family members that include spouse and dependent children, dependent parents. |
Premium |
Since, in an individual health insurance policy, the sum insured is separate for each family member the premium is the determining basis of the sum insured, coverage opted and each member’s age. |
This type of health insurance plan is cost-effective as it is one premium paid for all the members of the family. Premium is decided according to the age of the eldest member covered under the plan. |
Under the individual health insurance policy, Proposer and dependent family members can be covered in the plan with a separate sum insured. So, in case you are looking forward to securing yourself along with your family members, where you need not share your sum insured, consider choosing an individual health insurance plan. You can avail of cashless treatment at over 7600+ network hospitals with our health insurance plan.
Some key features of Individual Health Insurance
Medical expenses do not come with any warning. It becomes important to have a robust health insurance policy. The family floater health insurance plan permits you to include multiple members of the family within the same health insurance plan with a single premium. Under this type of health insurance plan, the sum insured is shared by all the members covered in the plan. Secure the family at a feasible health insurance premium.
Some key features of Family Health Insurance
As a person ages, the body starts showing different signs that indicate ailments that may happen primarily because of age-related problems. Hence, it becomes important to be prepared for the golden days. Health insurance for senior citizens acts as a shield in case of any such medical condition during old age and doesn't leave them in financial distress.
Some key features of Health Insurance for Senior Citizens
A regular health plan may not always cover expenses related to any critical illness. The critical illness insurance plan is extremely helpful as it offers a cover for high-cost treatments against life-threatening diseases. The major advantage of a critical insurance cover is that the lump sum benefit becomes payable only on diagnosis with the listed critical illness, hospitalization is not mandatory
Our critical illness insurance plan, Criti Care, protects against 43 life-threatening diseases including the following:
Some key features of Critical Illness Insurance
Critical illness insurance for women is specifically designed to protect against the risk of 8 life-threatening conditions that adversely affect a woman. The benefit can be availed in the form of a guaranteed cash sum when diagnosed with a life-threatening ailment
Listed below are the 08 life-threatening illnesses that are covered under critical illness insurance for women:
Some additional features of Critical Illness Insurance for Women
A top up health insurance plan ensures that even if the sum insured of the base medical insurance plan is exhausted you still are covered. A top up health insurance provides an extra or a “Top-Up” cover to the existing health insurance policy
Some key features of Top Up Health Insurance
The personal accident insurance policy takes care of you and the family members against any adversity. It provides comprehensive cover against accidents and supports in the crisis hour. Now, you can protect yourself from the expenses of any unforeseen accidents. It covers you and the family against any bodily injury/death/disability that is caused because of a mishap
Some key features of Personal Accident Insurance
In these tough times of rising medical expenses, group health insurance is the perfect protection for the employees and their families. It takes care of the medical treatment incurred during hospitalization from an accident or illness
Some key features of Group Health Insurance
Health insurance for vector-borne diseases is one of a kind plan, which takes care of the financial setback that may incur due to hospitalization on account of vector-borne illness. To put it simply, leave your worries to us as this health insurance policy for families covers exclusively vector-borne diseases such as Dengue, Malaria, Chikungunya, Zika Virus, etc.
Some key features of Health Insurance for Vector-borne Diseases:
The table below shows all the Bajaj Allianz General Insurance online health insurance plans highlighting their key features and important aspects:
Plan Type & Suitability |
Plan Name |
Sum Insured |
Key Features |
Things to Note |
Value-Added Benefit |
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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: Rs 1.5/2 lakh Gold Plan: Rs 3/4/5/7.5/10/15/20/25/30/35/40/45/50 lakh Platinum Plan: Rs 5/7.5/10/15/20/25/30/35/40/45/50/75 lakh/1 crore |
Inpatient hospitalization treatment Pre &post hospitalization Road ambulance Daycare procedures Organ donor expenses Convalescence benefit Daily cash benefit Sum insured reinstatement benefit Preventive health checkup Bariatric surgery cover Ayurvedic/ homeopathic hospitalization 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 |
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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 hospitalization treatment Pre & post-hospitalization Road ambulance Daycare procedures Preventive health checkup |
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 |
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Arogya Sanjeevani Policy (A plan that protects you from the financial burden during hospitalization) |
Arogya Sanjeevani (Individual & Floater Policy) |
Hospitalization: Rs 1 lakh to Rs 25 lakh AYUSH treatment : Rs 1 lakh to Rs 25 lakh Cataract treatment covered up to 25% of the sum insured or Rs 40,000, whichever is lower, for each eye Modern treatment method: 50% of hospitalization sum insured |
Hospitalization expenses Pre & post-hospitalization expenses Daycare 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% copay for all claims |
Cumulative bonus |
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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: Rs 1 lakh to Rs 50 lakh For the age group 61 years to 65 years: Rs 1 lakh to Rs 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 illness diagnosed within the first 90 days of the policy commencement |
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Criti Care (Individual basis sum insured) |
For entry age between 18 years to 65 years: Rs 1 lakh For entry age up to 60 years: Rs 50 lakh/section Up to 2Cr per member For entry age between 61 years to 65 years: Rs 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 |
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Personal Accident Insurance (A plan that covers insured against bodily injury/death/disability due to an accident and offers a high sum insured) |
Global Personal Guard |
Rs 50,000 to Rs 25 crore |
Children education benefit Hospital confinement allowance Accidental hospitalization expenses Hospital cash benefit Air ambulance cover Children education benefit Coma cover EMI payment cover Fracture care |
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Top Up Health Insurance (This policy can be taken as an add on cover to the existing hospitalization medical expenses policy) P |
Extra Care (Floater Policy) |
|
Hospitalization expenses Pre & post-hospitalization expenses Ambulance expenses Modern treatment methods & advancements in technologies |
Initial Waiting Period: 30 days Specific waiting period: 48 months Pre-existing diseases: 48 months |
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Extra Care Plus (Floater Policy) |
|
In-patient hospitalization expenses Pre& post-hospitalization expenses Daycare 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 |
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A one-stop solution for the common vector-borne illnesses |
M-Care (Individual as well as Floater Policy) |
Rs 25000 Rs 50000 Rs 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 after the occurrence of any of the listed vector-borne diseases, a 60 days 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 |
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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:
Cashless Treatment:
You can avail the benefit of cashless health insurance plans 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 is 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.
Tax Benefits:
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
Cumulative Bonus
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.
What is Health Prime Rider?
Health Prime is a rider for select retail and group Health/PA products. The Health Prime is the rider that will take care of all the accompanying medical service expenses that otherwise remain uncovered.
Who Can Opt Health Prime Rider?
Anyone who has a Bajaj Allianz retail health insurance or PA policy can buy the Health Prime rider for themselves or their family members. The Health Prime rider has a total of 09 plans/options.
Eligibility Criteria to Opt 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 For the group products, the policy term can be up to 05 years maximum as per the base policy tenure |
| Premium | The installment premium option of the base policy shall mutatis mutandis apply to the installment premium |
Disclaimer: Please refer to the policy wordings for complete terms and conditions carefully
Benefits of Health Prime Rider
Our Health Prime rider offers holistic health services solutions. Read on to know about the benefits of our health prime rider.
Tele Consultation Cover
If the insured member suffers from any illness or injury can easily consult the Medical Practitioner/ Physician/Doctor listed on the digital platform through video, audio, or chat channel.
Doctor Consultation Cover
The insured person suffering from any illness or injury can easily consult a Medical Practitioner/ Physician/Doctor in person from prescribed network centers. If required, one can also consult outside prescribed network centers up to the limit as specified in terms & conditions.
Investigations Cover – Pathology & Radiology Expenses
The insured person suffering from any illness or injury can avail of the service for investigations for pathology or radiology from prescribed network centers or outside. This will be up to the limit as specified in terms & conditions.
Annual Preventive Health Checkup Cover
The insured person can avail of the free preventive health checkup once in each policy year for the following:
The health checkup can be easily availed on a cashless basis in any of the prescribed lists of hospitals or diagnostic centers. It should be availed within the rider period only. This cover cannot be extended after the rider period expiry.
Options Available in Health Prime Rider
Within each policy year under the rider period, the insured member is entitled to coverages as per the plan selected from the table below. The plan should be opted separately for each insured member covered under the rider. It is regardless of the fact whether the base policy is an individual sum insured plan or a floater plan. The cover will be applied every year for the rider with more than one year rider period.
Individual Policy :
| Benefits | Option 1 (In INR) | Option 2 (In INR) | Option 3 (In INR) | Option 4 (In INR) | Option 5 (In INR) | Option 6 (In INR) |
|---|---|---|---|---|---|---|
| Tele Consultation Cover | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited |
| (GPs) | (All specialties) | (All specialties) | (All specialties) | (All specialties) | (All specialties) | |
| Doctor Consultation Cover | NA | 1500 | 3000 | 5000 | 7000 | 15000 |
| Investigations Cover – Pathology & Radiology Expenses | NA | NA | 1000 | 2000 | 3000 | |
| Annual Preventive Health Checkup Cover | Yes | Yes | Yes | Yes | Yes | Yes |
| (1 voucher) | (1 voucher) | (1 voucher) | (1 voucher) | (1 voucher) | (1 voucher) |
Family Floater :
| Benefits | Option 1 (In INR) | Option 2 (In INR) | Option 3 (In INR) |
|---|---|---|---|
| Tele Consultation Cover | Unlimited | Unlimited | Unlimited |
| (All specialties) | (All specialties) | (All specialties) | |
| Doctor Consultation Cover | 10,000 | 20,000 | 25,000 |
| Investigations Cover – Pathology & Radiology Expenses | |||
| Annual Preventive Health Checkup Cover | Yes | Yes | Yes |
| (2 vouchers) | (2 vouchers) | (2 vouchers) | |
Exclusions Under Health Prime Rider
Let us first understand the general exclusions under the health prime rider
Moving ahead let us understand the specific exclusions under health prime rider.
For Tele Consultation Cover
Teleconsultation outside the digital platform is not covered under the Rider. The teleconsultation benefit will not be transferred to any other member unless the member is covered under the base policy & has opted for this rider.
For Doctor Consultation Cover
Any other expenses of investigations, medicines, procedures or any medical, non-medical items are not covered.
For Investigation Cover- Pathology & Radiology Expenses
In case the investigation cover is not availed in the respective policy year the benefit cannot be carried forward to the subsequent policy year after renewal. Also, the first 30 days waiting period is applicable for investigation cover- pathology & radiology expenses related to illness only in the first rider year. This waiting period is not applicable for renewals without a break.
For Annual Preventive Health Checkup Cover
Preventive health check-ups cannot be availed outside the prescribed list of hospitals or diagnostic centers. At select locations, the home collection facility can be availed. For the locations where home sample collection remains unavailable, the customer will have to physically go for the tests. All the tests mentioned above need to be completed in a single appointment.
Health Insurance Riders
Health insurance riders are the additional coverage that can be purchased to avail of the benefits and make the plan more comprehensive. The health insurance rider premium cost depends on factors such as age, type of coverage, sum insured, and so forth.
Let's have a look at some of the important riders that should be considered while buying a health insurance policy in India:
Non-Medical Expenses Rider
Non-medical expenses rider is helpful if the insured is hospitalized because of an illness or accidental injury during the policy term. The company will pay the insured for reasonable and customary non-medical expenses specified. The non-medical expenses 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 this rider can’t opt during the mid of the policy period. The rider needs to be continued for all renewals.
Listed below are some of the non-medical items payable when opting for this rider are:
· Belts/braces
· Cold/hot pack
· Nebulizer kit
· Steam inhaler
· Spacer
· Thermometer, etc.
When it comes to health insurance in India, Bajaj Allianz General Insurance is indeed at the forefront with its diverse range of cost-effective health insurance plans. Now, customize the health insurance plan as per the needs.
We understand the importance of time and your hard-earned money. Hence, it becomes important to protect it. Adversity can happen at any point in time. We offer you the following features with our health insurance plans:
Cashless hospitals |
|
Claim Settlement Time |
Within 60 mins for cashless claims |
Cashless and reimbursement process
In-house Health Administration Team for faster claims processing |
|
Cumulative Bonus |
If a health insurance plan is renewed without break with no claim in the preceding year, then the sum insured is increased by 50% for the first 2 years
And 10% per annum for next 5 years maximum up to 150% of sum insured
Feature available for all health insurance products. |
Health Claim on Direct Click is an app-based feature that allows the 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 |
We are living in times where having medical insurance is not a luxury but a necessity. The pandemic led to increased consciousness highlighting the importance of preventive health insurance in India. COVID-19 is a classic example to understand that emergencies do not come with prior notice. Moreover, how important it is to be financially secured. A medical emergency like this can easily result in financial strain if not wholly prepared. Ensure that you have the right health insurance coverage.
At Bajaj Allianz GIC we take utmost care of your needs and do not wish to see you undergoing any stress. Our health insurance plans cover the treatment and expenses that may incur due to coronavirus. Our health insurance plans offer to compete for protection to you and your family against COVID-19 treatment expenses at cost-effective premium rates.
Listed are the Bajaj Allianz health insurance plans that cover coronavirus:
*Please note that this is not an exhaustive list. The COVID-related treatment is covered in all Bajaj Allianz health indemnity policies
You can also consider adding Health Prime Rider to the base plan. Avail of the benefit of teleconsultation cover. Here the insured member when unwell can easily consult a doctor listed through video, audio, or chat channel
The Corona Kavach Policy is a COVID-19-specific health insurance plan for you. It is beneficial for everyone who wishes to be fully prepared to fight against the novel coronavirus. The plan covers all major medical requirements that are associated with COVID-19, which in general a regular health insurance plan might not cover.
As far as the treatment of COVID-19 is concerned an infected individual can be treated either at home or in a hospital. You are covered for both courses of treatment. The plan offers a cover for COVID hospitalization, home care treatment expenses, AYUSH treatment, and pre and post-hospitalization. It also covers expenses incurred on treatment of any comorbidity along with the treatment for Covid up to the Sum Insured.
The Corona Kavach Policy covers the cost of PPE kits, oxygen, and gloves when the claim is admissible under the covid hospitalization expenses. Let us check the features offered under 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 |
1. Which type of health insurance policy best suits my requirements?
Before you zero down the health insurance plan, it is important to assess the needs. Select the right type of health insurance that fulfills all your medical needs.
2. Do I have adequate coverage to meet my medical needs??
When it comes to health insurance plans, take into account the medical inflation. Choose a sum insured that suits your pocket and fulfills all the prerequisites
3. Will this health insurance plan be easy on my pocket??
The key benefit of having a health insurance policy can never be overstated. Having medical insurance will help you receive the best medical care in times of need without blowing your hard-earned money/savings. A health insurance policy offers much more than hospitalization costs.
4. Does the insurer offer a wide range of network hospitals & swift claim processes? ?
Network hospitals are a crucial aspect that should be evaluated while zeroing in on health insurance in India. The key reasons are that network hospitals offer cashless facilities and also help avail quality treatment. Since you do not have to pay a significant amount for cashless treatment, barring the deductible, it becomes handy to have a network hospital in your vicinity.
We at Bajaj Allianz GIC have a range of 7600+ network hospitals across India. We believe in protecting you and your hard-earned money. Our average claim settlement time is around 01 hour. It is one of the fastest claim settlement duration in the health insurance industry
5. Does the plan cover treatment with alternative therapies as well?
At Bajaj Allianz General Insurance, we provide coverage for Ayurvedic and Homeopathic hospitalization. But, other treatments such as naturopathy, acupuncture, magnetic therapy, etc. are not covered in health insurance plans. However, this may vary from insurer to insurer and plan to plan. Hence, it is recommended to go through the plan carefully, assess the needs and only then make the buying decision
6. Will this health insurance policy still be right if my needs change?
You can make changes to the existing health insurance 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 a health insurance plan, it’s better to understand the policy, its inclusions, and exclusions to avail of the maximum benefit.
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.
Ambulance Charges
At Bajaj Allianz, we cover you for ambulance charges that might be incurred when you going to the hospital or returning from the hospital.
Convalescence Benefit
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 various additional benefits 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.
Our health insurance policies do not cover you for getting any sort of treatment that you receive outside India.
There are chances you might think that buying a health insurance policy is not much important. Here is a rundown of the common things that we often think about:
If you think that only a corporate health insurance policy is enough to secure the medical expenses then you are mistaken. A corporate health insurance policy will cover you only for the job term. So whenever you leave the job or switch companies, you lose the health insurance benefits. Some companies do not offer health insurance coverage during probation. Corporate health insurance usually offers low sum insured and does not provide comprehensive coverage. Hence, it is recommended to choose a comprehensive health insurance policy
In case you live in a metro city, it is advised to choose a high sum insured considering the medical treatment in such cities is higher. Only buying health insurance with insufficient coverage is of no use in the long run. 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 likewise choose the sum insured.
Do not buy a health insurance plan just because it is offering a low premium. It is important to look at the coverage and benefits that medical insurance is offering. This aspect should not be neglected at any cost. In case you buy a health insurance plan with a low premium, there are chances that you are missing out on critical coverage. Choose a health insurance plan that is value for money and takes care of the rising medical needs considering the lifestyle we lead.
Remember, having a comprehensive health insurance policy is more than 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 financial. In case your family is to be taken care of, choose a family floater health insurance policy.
When it comes to buying a health insurance policy in India, several factors are to be taken care of. The table below shows the common eligibility criteria that are taken into consideration while selecting a health insurance plan in India:
| Age criteria | Age is an important aspect that should be considered while buying a medical insurance plan. A health plan can be bought for children, adults, and senior citizens.
There are dedicated plans as per the age of the individual. Usually, a normal health insurance plan covers an individual aged between 18-65 years of age. Next, you have senior citizens' health insurance plans catering to the needs of people who are 60 years of age and above. |
| Pre-existing Diseases | A pre-existing disease is covered only after the completion of the waiting period. While buying the health insurance policy, the insurer asks the applicant about the current medical condition such as kidney problem, blood pressure, etc. |
| Smoking Habit | Lifestyle habit also has an important role in the process of buying. If you are a non-smoker then compared to a smoker the health insurance premium is relatively low |
| Medical Check-ups | The medical check-ups are a part specifically if you are aged between 45 years of age and above. So before the medical insurance policy is issued, individuals have to undergo a medical screening |
Certain factors 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.
You can use Bajaj Allianz’s free health insurance calculator to find out the estimated amount of 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.
Comparing health insurance policies online helps to choose the best that takes care of the healthcare needs. More often than not, choosing a health insurance policy becomes a task. We understand that with a plethora of options available you might get confused.
So let us understand some of the key advantages of comparing health insurance plans online::
✓ Accessible & Time-saver : You can get every important information related to the health insurance plan in just some clicks. It also helps to save your time wherein you need to speak to the insurance age. You will have all the information under one umbrella that is correct and reliable.
✓ Free Quotes/No-Cost : You can compare health insurance quotes with online calculators and choose the one that best fits your pocket and requirements. There are no brokerage or agent fees involved, and the policyholder ends up saving a significant amount. Moreover, if you pay health insurance premiums online you mostly end up getting a good deal.
✓ Compare Multiple Plans With Ease : The ability to compare health insurance plans online is convenient and hassle-free. You can see the plans, and compare the features, benefits, and health insurance quotes. Moreover, when it comes to buying or renewing the health insurance plan it can be done digitally without getting into hassles of paperwork, etc.
✓ Check Customer Reviews :With a plethora of health insurance plans available in the market you can check for the reviews online. When you choose the insurer ensure to look for the claim settlement ratio of the company. Select an insurer that has a reputation in the market as the claim process becomes swift.
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.
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.
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.
A 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:
Section 80D of the Income Tax Act, 1961 permits the taxpayers to avail of tax deductions on the complete premium paid towards the health insurance. This can be availed on the regular health insurance premiums with the premiums paid for the top-up as well as critical illness plans.
You can avail of Section 80D deductions on the premiums that are paid towards purchasing health insurance for yourself, dependent children, spouse, and parents.
The health insurance premium paid for senior citizens qualifies for a Section 80D deduction of Rs 25000 each financial year. If either your parents or any one of them is a senior citizen then the tax rebate limit goes up to Rs 50,000 in one financial year.
Take a look at the table below to understand the tax deductions available to an individual under Section 80D of the Income Tax Act as of 2021-22:
Individuals Covered |
Premium Paid |
Tax Exemption |
|
|
Self, Children & Family |
Parents |
|
Individual & parents who are less than 60 years of age |
Rs 25,000 |
Rs 25,000 |
Rs 50,000 |
Individual & family less than 60 years but parents are more than 60 years |
Rs 25,000 |
Rs 50,000 |
Rs 75,000 |
Individuals, parents & family more than 60 years of age |
Rs 50,000 |
Rs 50,000 |
Rs 1,00,000 |
Members of HUF & Non-resident Individual |
Rs 25,000 |
Rs 25,000 |
Rs 25,000 |
Disclaimer: The tax benefits are subject to change as per the prevailing laws.
We are aware that medical emergencies mostly come unannounced and in case you do not have health insurance in place then you would end up paying hefty medical bills. Despite the rising healthcare expenses people do not cover themselves or their families with a suitable mediclaim policy.
Mediclaim policy is the insurance cover that shields against the increasing medical expenses that might incur due to hospitalization. A mediclaim insurance financially protects in case of hospitalization due to an illness/accident. Mediclaim policy benefits can be easily exercised by paying the premiums timely.
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.
One of the common mistakes that often tend to commit is that mediclaim and health insurance are synonymous. Let us understand the differences between health insurance and mediclaim insurance:
| Parameters | Health Insurance | Mediclaim Policy |
|---|---|---|
| Coverage | A health insurance plan offers cover for hospitalization, pre & post expenses, ambulances charges, etc. | Offers cover for hospitalization, accident-related treatment & up to a pre-determined limit the pre-existing diseases |
| Flexibility | It offers the flexibility to enhance the plan by paying a nominal premium | As such in terms of coverage, it offers no flexibility |
| Add-on Cover | Offers multiple add-on covers | No add-on covers are offered |
| Critical Illness Cover | It offers cover for more than 10 life-threatening diseases |
No cover for critical illness |
Buying medical insurance at an early age will be much more beneficial and you would need not take stress about paying medical bills. When you start earning early, it's important to save for the future. You would not want to get your finances drained
Here is a rundown of the benefits of buying medical insurance at an early age:
When you are young you are less vulnerable to any chronic illness or diseases. Having said it, it is wise to make a financial investment when you are young and healthy. It lets you enjoy significant benefits throughout life.
Health is indeed the biggest wealth. With the sedentary lifestyle, rising pollution, etc. health is a major concern. Having a comprehensive health insurance policy will help to take care of the medical treatment expenses during an emergency.
Passport sized photographs
Policy proposal form
Residential proof: You can submit any of the following documents as your residential proof:
Age proof: You can use the following documents as your age proof:
Identity Proof: You can submit any of the following documents as your identity proof:
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.
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:
Click on “I Want to Buy” present in the top-right corner of the page.
Select the medical insurance plan that you want to buy.
Enter your details like your name, your date of birth, the 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, and 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 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:
Health insurance portability criteria:
✓ 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
(Based on 3,912 reviews & ratings)
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.
Easiest for anyone, no hassle, no confusion. Great work. Good luck.
Very user friendly. I got my policy in less than 10 minutes.
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.
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 8,000+ hospitals across India. We also cover medical examinations, physician fees/doctor’s consultation fees and ambulance charges, leaving you totally stress-free!
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.
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.
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.
Health insurance covers you for hospitalization expenses including pre & post hospitalization expenses, doctor’s consultation fees and in-patient expenses.
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.
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.
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.
Your children, spouse, parents and parents-in-law can be added as dependents in your health insurance policy.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
You can change your details online by visiting our website or contact our customer care executive, who will help you make the required changes.
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.
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.
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.
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.
You can contact our customer support team and get complete details of the steps that you need to take to increase the Sum Insured.
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.
Yes, with health insurance portability, you can switch your health insurance company.
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.
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.
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.
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.
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.
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.
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.
Your coverage amount depends on your lifestyle, medical background, pre-existing diseases, members of your family, annual income, residential address and age.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
With Bajaj Allianz’s critical illness policy, you are covered for 10 major critical illnesses:
✓ Aorta graft surgery
✓ Cancer
✓ 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
✓ Stroke
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.
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.
No, but you can buy our Silver Health plan, which is a Special health insurance designed for senior citizens.
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)
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.
You can make the premium payment using the following modes:
✓ Cheque or cash payment at our branch
✓ ECS
✓ Online payment – Debit/credit card and net banking
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
After your claim is filed and settled, your insurance cover will be reduced by the amount that has already been paid to you.
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.
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.
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.
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.
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.
You can claim Convalescence Benefits once in a year.
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.
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.
Yes, if the actual expenses exceed the cover opted by you, you will have to pay the difference amount.
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.
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
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.
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.
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.
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.
No, your travel history abroad will not affect the admissibility of claim under your health insurance policy, if you are hospitalized in India.
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 bagichelp@bajajallianz.co.in 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.
Yes, a standard waiting period of 30 days is applicable to COVID-19 health insurance.
You will be able to enhance your Sum Insured during the renewal of your policy as per underwriting terms and conditions.
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