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Health Insurance

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

 

What is Health Insurance

WHAT IS HEALTH INSURANCE?

Health insurance or medical insurance is an insurance product that provides coverage for expenses in the event of an illness or injury. Health insurance plans safeguard your hard-earned funds from being spent on expenses related to hospitalisation, medicines, consultation, and more. A health insurance policy can also be viewed as an agreement between you and your insurer that binds them to cover you financially in case of any medical emergency.

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

 

WHAT IS THE NEED FOR HEALTH INSURANCE IN 2023?

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 may cause a huge financial burden for you and your dependents. A hard-hitting truth is that whether the hospitalisation is planned or not, it comes as an unpleasant surprise, and it is sure to cost you heavily. So, it’s better to have the protection of a health insurance policy, which besides helping you to manage your finances, also offers you several other benefits at very affordable premium rates. You can also check out the 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 right health insurance plan:

  • ✓   Financial Help: A health insurance policy will ease the burden of paying hefty medical bills from 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 adequate insurance cover at a pocket-friendly cost. You also get discounts like such as 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 is available if the treatment is sought at a network hospital. A network hospital is a hospital that has an agreement with the health insurance company, which enables you to get the best treatment without having to shell out a large amount 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 ₹ 1 lakh if you buy a policy for yourself and your loved ones, and if you and your parents are senior citizens.

  • ✓   Extensive Coverage: Health insurance plans provide cover not only against hospitalisation 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 can feel a little less stressed. Having medical insurance gives you the peace of mind that can help you relax in a tense situation.

Health insurance offered by various companies in the country is accompanied by several features and benefits. You must evaluate these policies and select the best health insurance policy from them.

 

Types of Health Insurance in India

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

When buying a policy, it is important to choose a health cover that fulfils your needs. Let us start by understanding the key differences between individual and family floater policies:

Point of Comparison

Individual Health Insurance Policy

Family Floater Health Insurance

Definition

Individual health insurance is the type of policy where the proposer and family members can be covered in the same plan. However, the sum insured is separate (i.e., not shared) for each insured member in the policy.

A family floater policy is a type of health insurance policy where multiple family members can be covered under one plan. Here, 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 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, and uncle. However, each insured member will have a sum insured of their own.

The policy 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 policy, the sum insured is separate for each family member and thus, the premium is the determining basis of the sum insured, coverage opted and each member’s age.

This type of plan is cost-effective as it is one premium is paid for all the members of the family. Premium is decided according to the age of the eldest member covered under the plan.

 

  • Individual Health Insurance

    Individual Health Insurance

    Under the individual health policy, the 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 insurance plan. You can avail of cashless treatments at over 8000+ network hospitals with our insurance plans.

    Some key features of Individual Health Insurance

     

    • Multiple sum insured options
    • Cover for pre- and post-hospitalisation
    • Covers day-care procedures, extended family
    • Covers Ayurvedic and Homoeopathic treatment
    • Road ambulance cover
    • Daily cash benefit

     

  • Family Health Insurance

    Family Health Insurance

    Medical expenses do not come with any warning. Hence, it becomes important to have a robust health insurance policy as a part of your portfolio. The family floater policy permits you to include multiple family members within the same insurance plan for a single premium payment. Under this type of policy, the sum insured is shared by all the members covered in the plan, thereby secure the family at a feasible insurance premium.

    Some key features of Family Health Insurance

    • Cover for Dependent family members
    • Day-care procedures cover
    • Pre- and post-hospitalisation
    • Convalescence benefit
    • Bariatric surgery cover
    • Sum insured reinstatement
  • Health Insurance for Senior Citizens

    Health Insurance for Senior Citizens

    As a person ages, the body starts showing different signs that indicate ailments that may happen 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

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

    Critical Illness Insurance

    A regular health plan may not always cover expenses related to any critical illness. A 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 illness policy is that the lump-sum benefit becomes payable only on diagnosis with the listed critical illness, hospitalisation is not mandatory

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

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

    Some key features of Critical Illness Insurance

    • Covers you and your family members.
    • 100% pay-out on diagnosis of listed critical illnesses.
    • Multiple sum insured options

     

  • Critical Illness Insurance for Women

    Critical Illness Insurance for Women

    Critical illness insurance for women is specifically designed to protect against the risk of 8 life-threatening conditions that 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:

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

    Some additional features of Critical Illness Insurance for Women

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

    Top-Up Health Insurance

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

    Some key features of Top Up Health Insurance

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

     

  • Personal Accident Insurance

    Personal Accident Insurance

    The personal accident policy takes care of you and the family members against any adversity. It provides comprehensive cover against accidents and supports in the hour of a crisis. 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

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

    Group Health Insurance

    In these tough times of rising medical expenses, group insurance policy is the perfect protection for the employees and their families. It takes care of the medical treatment incurred during hospitalisation from an accident or illness.

    Some key features of Group Health Insurance are:

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

     

  • Health Insurance for Vector-borne Diseases

    Health Insurance for Vector-borne Diseases

    Health insurance for vector-borne diseases is a one-of-a-kind plan that takes care of the financial setback due to hospitalisation because of vector-borne illnesses. To put it simply, leave your worries to us as this 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:

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

 

Online Health Insurance Plans

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

Plan Type & Suitability

Plan Name

Sum Insured

Key Features

Things to Note

Value-Added Benefit

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

Health Guard

(Individual as well as Floater Policy)

Silver Plan: ₹ 1.5/2 lakh

Gold Plan: ₹ 3/4/5/7.5/10/15/20/25/30/35/40/45/50 lakh

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

Inpatient hospitalisation treatment

Pre- &post-hospitalisation

Road ambulance

Day-care procedures

Organ donor expenses

Convalescence benefit

Daily cash benefit

Sum insured reinstatement benefit

Preventive health check-up

Bariatric surgery cover

Ayurvedic/homoeopathic

Hospitalisation expenses for gold & platinum plan only

Maternity expenses for gold & platinum plan only

Newborn baby cover for gold & platinum plan only

Super Cumulative bonus for the platinum plan only

Recharge benefit for the platinum plan only

Pre-existing diseases waiting period: 36 months

Specific waiting period:24 months

Initial waiting period: 30 days

Maternity waiting period: 72 months

Health prime rider

Non-medical expense rider

Wellness benefits

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

Health Infinity (Individual Policy)

No limit on the sum insured

In-patient hospitalisation  treatment

Pre- & post- hospitalisation 

Road ambulance

Day-care procedures

Preventive health check-up

Initial waiting period: 30 days

Pre-existing diseases: 36 months

Specific waiting period: 24 months

The payouts are indemnity payment basis

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

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

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

Arogya Sanjeevani

(Individual & Floater Policy)

Hospitalisation: ₹ 1 lakh to ₹ 25 lakh

AYUSH treatment: ₹ 1 lakh to ₹ 25 lakh

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

Modern treatment method: 50% of hospitalisation sum insured

Hospitalisation expenses

Pre- & post-hospitalisation expenses

Day-care procedure

AYUSH coverage

Expenses on cataract treatment

Ambulance charges

Initial waiting period: 30 days

Pre-existing disease: 48 months

Specific waiting period:24/48 months

5% co-pay for all claims

Cumulative bonus

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

Critical Illness

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

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

Covered for critical illnesses such as:

First heart attack (Myocardial infarction)

Cancer of specified severity

Open Chest CABG (Coronary Artery Disease Requiring Surgery)

Stroke Resulting in Permanent Symptoms

Multiple Sclerosis with Persisting Symptoms

Surgery of Aorta

Primary Pulmonary Arterial Hypertension

Permanent Paralysis of Limbs

Kidney failure requiring regular dialysis

Major organ transplantation

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

 

Criti Care

(Individual basis sum insured)

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

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

Up to ₹ 2Cr per member

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

43 critical illnesses covered

Lifetime renewal

Cancer Care

Cardiovascular Care

Kidney Care

Neuro Care

Transplants care

Sensory organs care

 

Dialysis Care

Cancer reconstructive surgery

Cardiac nursing

Physiotherapy care

Sensory care

Wellness Discount

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

Global Personal Guard

₹ 50,000 to ₹ 25 crore

Children education benefit

Hospital confinement allowance

Accidental hospitalisation expenses

Hospital cash benefit

Air ambulance cover

Children education benefit

Coma cover

EMI payment cover

Fracture care

   

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

 

Extra Care

(Floater Policy)

Sum Insured (Excluding Deductibles)

Deductible per hospitalisation

₹ 10 lakh

₹ 3 lakh

₹ 12 lakh

₹ 4 lakh

₹ 15 lakh

₹ 5 lakh

Hospitalisation expenses

Pre & post-hospitalisation expenses

Ambulance expenses

Modern treatment methods & advancements in technologies

Initial Waiting Period: 30 days

Specific waiting period: 48 months

Pre-existing diseases: 48 months

 

Extra Care Plus

(Floater Policy)

Sum Insured

Aggregate Deductible Options

₹ 3 lakh

₹ 2 lakh

     

₹ 5 lakh

₹ 2 lakh

₹ 3 lakh

   

₹ 10 lakh

₹ 2 lakh

₹ 3 lakh

₹ 5 lakh

 

₹ 15 lakh

 

₹ 3 lakh

₹ 5 lakh

 

₹ 20 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

₹ 25 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

₹ 50 lakh

 

₹ 3 lakh

₹ 5 lakh

₹ 10 lakh

In-patient hospitalisation expenses

Pre- & post-hospitalisation expenses

Day-care treatment

Modern treatment methods

Maternity expenses

Ambulance expenses

Organ donor expenses

Free medical check-up

Initial Waiting Period: 30 days

Specific waiting period: 12 months

Pre-existing diseases: 12 months

Maternity waiting period: 12 months

Optional air ambulance cover

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

M-Care

(Individual as well as Floater Policy)

₹ 25000

₹ 50000

₹ 75000

Lumpsum benefit for:

Dengue fever

Malaria

Filariasis

Kala Azar

Chikungunya

Japanese Encephalitis

Zika Virus

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

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

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

20%  discount applicable when bought online

 

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 an adequate health cover 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 check-ups.

Following are some of the key benefits:

  • Cashless Treatment

    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 healthcare. All you need to do is inform the insurance desk in the network hospital about your policy number. They will arrange for the pre-authorisation letter from your insurance company, and the hospital bill settlement will be taken care of smoothly by the hospital and your insurer.

     

  • Tax Benefits

    Tax Benefits:

    You can get a tax benefit by paying a premium towards your insurance policy. Whether you buy a policy for yourself or your family, you can get tax exemption as per Section 80D of the Income Tax Act. You can claim a tax deduction of up to ₹ 25,000 per year for the health insurance premium paid for yourself, if your age is less than 60 years and up to ₹ 50,000 if you are a senior citizen.

  • Daily Hospital Cash

    Daily Hospital Cash*:

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

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

  • Cumulative Bonus

    Cumulative Bonus

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

    This feature is available for all health insurance products.

  • Free Health Check-Ups

    Free Health Check-Ups

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

  • Life Long Renewability

    Life Long Renewability

    Once you buy your annual policy, you just need to renew it every year before its expiry to get the benefits of health insurance for a long time. You can add in some requirements as per your family size and the coverage needs at the time of renewal.

 

Health Prime Rider

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 for Health Prime Rider?

Anyone who has a Bajaj Allianz retail insurance policy, or PA policy, can buy the Health Prime rider for themselves or their family members. This rider has a total of 9 plans/options.

 

Eligibility Criteria to Opt for Health Prime Rider

 

Entry Age As per the opted base policy
Policy Period

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

For group products, the policy term can be up to 5 years maximum, as per the base policy tenure

Premium

The instalment premium option of the base policy shall mutatis mutandis apply to the instalment premium

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

 

 

Benefits of the 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, they 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 centres. If required, one can also consult outside prescribed network centres up to the limit as specified in terms and conditions.

 

Investigations Cover – Pathology & Radiology Expenses

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

 

Annual Preventive Health Checkup Cover

The insured person can avail of the free preventive health checkup once in each policy year for the following: 

  • ✓    Blood sugar - Fasting
  • ✓    Blood urea
  • ✓    ECG
  • ✓    HbA1C
  • ✓    Hemogram & ESR
  • ✓    Lipid profile
  • ✓    Liver function test
  • ✓    Serum creatinine
  • ✓    T3/T4/TSH
  • ✓    Urine routine

The health check-up can be easily availed on a cashless basis in any of the prescribed lists of hospitals or diagnostic centres. It should be availed within the rider period only. This cover cannot be extended after the rider period expires. 

 

Options Available in Health Prime Rider

Within each policy year under the rider period, the insured member is entitled to a coverage as per the plan selected from the table below. The plan should be opted for 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 a one-year rider period. 

 

Individual Policy :

Benefits Option 1 (In ₹) Option 2 (In ₹) Option 3 (In ₹) Option 4 (In ₹) Option 5 (In ₹) Option 6 (In ₹)
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 Check-up 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 ₹) Option 2 (In ₹) Option 3 (In ₹)
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 Check-up Cover Yes Yes Yes
(2 vouchers) (2 vouchers) (2 vouchers)

 

Exclusions Under the Health Prime Rider

Let us first understand the general exclusions under the health prime rider

  • ✓   The 30-day waiting period is applicable only in the first year of the rider period. Yet, the exclusion is not applicable for renewals without break.
  • ✓   If any of the coverage is not availed in the policy year during the rider period, the benefit cannot be carried forward to the subsequent policy year during the rider period.

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

 

For Tele-Consultation Cover

Teleconsultation outside the digital platform is not covered by the rider. The teleconsultation benefit will not be transferred to any other member unless the member is covered under the base 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-day 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 Check-up Cover

Preventive health check-ups cannot be availed outside the prescribed list of hospitals or diagnostic centres. 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

Riders are the additional coverage that can be purchased to avail of the benefits and make the plan more comprehensive. The 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 policy:

 

Non-Medical Expenses Rider

Non-medical expense rider is helpful if the insured is hospitalised 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 expense rider can be availed with sum insured options of ₹ 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.

Respect- Senior Care Rider

Missed Call Number for Respect- Senior Care Rider : 9152007550

 

As we get closer to fulfilling our personal and professional goals, we become so engrossed in the orbit of success that we barely have time for anything else. There is a chance that you will be unable to take care of the various healthcare needs of your parents timely during this process.

Whether you live with them or reside in a different state/country, you can be the constant care companion for senior citizens amidst your busy schedules. At Bajaj Allianz General Insurance, care is the core of everything we do, and we have introduced Respect- Senior Care Rider. A health insurance rider for parents that have made caretaking smarter and easier.

What is Respect- Senior Care Rider?

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

We understand that taking care of parents is not easy as it may sound. The guilt of not being by their side at times to help them with mundane activities is not so good. With the Respect- Senior Care Rider now you can easily recreate the experience of constant safety round-the-clock

 

Eligibility Criteria to Opt for Respect- Senior Care Rider

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

 

Parameters

Details

Entry Age

50 years and above

Policy Term

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

Premium

As per the plan chosen

 

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

 

What are the Plans Available Under Respect- Senior Care Rider

If you are planning to buy a Bajaj Allianz Health Insurance policy, you should look at adding the Respect- Senior Care Rider for optimum protection of your parents. If you are an existing customer, you may include this rider at the time of renewal.

The Respect- Senior Care Rider offers three plans with varying features. Opt for a plan that fulfills the needs of senior citizens. The below grid shows the Respect- Senior Care Rider benefits of every plan: 

 

Coverages

Plan 1

Plan 2

Plan 3

Emergency Road Ambulance Service

✓  

Planned Road Ambulance Service

Fall Detection Technology through Smart Watch

No

No

✓  

Physiotherapy Service at Home

No

Nursing Care at Home

No

Tele-Consultation Service for Psychological Services

No

Concierge Assistance Services

✓  

✓  

Premium (excl. GST)

Rs. 710

Rs. 2088

Rs. 7497

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

Rs. 197

Rs. 197

Rs. 217

 

 

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

 

Benefits of Respect- Senior Care Rider

With us, you get smarter care for senior citizens. Let us now briefly understand the benefits offered under the Respect- Senior Care Rider:

·         Ambulance Service

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

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

·         Fall Detection Technology through Smart Watch

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

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

·         Unlimited Medical Tele-consultation services

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

·         Concierge Assistance Services

✓    Daily Care / Home Assistance 

-  Assistance for arranging Physiotherapy at home

-  Assistance for arranging Nursing at home

-  Appointment Booking assistance at Hospital/Laboratory

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

-  Assistance for booking Electrician, Plumber, and Carpenter services

-  Assistance for booking Pest control services

-  Assistance for booking Car wash/sanitization services

✓    Cyber Assistance

-  Assistance on how to block debit/credit card

-  Assistance in understanding mobile phones and their usage

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

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

✓    Travel Assistance

-  Assistance is required in terms of travel booking

✓    Legal Assistance

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

*This is not an exhaustive list.

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

 

Give your parents the same care, compassion, and love that they have given you. Together towards building an ecosystem for senior citizens with a dash of our care. 

 

WHY SHOULD YOU BUY HEALTH INSURANCE FROM BAJAJ ALLIANZ?

When it comes to health insurance, Bajaj Allianz General Insurance is indeed at the forefront in the country with its diverse range of cost-effective health insurance plans. Now, you can customise these plans as per your 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 policies:

Cashless hospitals

8,000+ across the country

Claim Settlement Time

Within 60 mins for cashless claims

Claim Process

Cashless and reimbursement process

 

In-house Health Administration Team for faster claims processing

Cumulative Bonus

If a policy 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 CDC

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 ₹ 20,000

Sum Insured

Multiple sum insured options

Why Buy Health Insurance With Us?

 

Why Buy Health Insurance With Us

 

 

OUR HEALTH INSURANCE PLANS COVER OMICRON & COVID-19 VARIANTS

We are living in times where having medical insurance is not a luxury but a necessity. The pandemic led to increased awareness of the same, highlighting the importance of preventive insurance coverage. 

COVID-19 is a classic example to understand that emergencies do not come with prior notice. Moreover, however important it is to be financially secured, a medical emergency like this can easily result in financial strain if not prepared for. With Bajaj Allianz’s policy, you can ensure that you have the appropriate insurance coverage. 

At Bajaj Allianz GIC we take utmost care of your needs and do not wish to see you undergoing any stress. Our insurance plans cover the treatment and expenses that you may incur due to coronavirus at cost-effective premium rates.

Listed are the Bajaj Allianz health insurance plans that cover coronavirus:

  • Bajaj Allianz Individual Health Guard
  • Bajaj Allianz Family Floater Health Guard
  • Bajaj Allianz Silver Health Insurance Plan
  • Bajaj Allianz Arogya Sanjeevani Plan
  • Bajaj Allianz Corona Kavach Policy

*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 policy 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 coverage for COVID-19 hospitalisation, 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 hospitalisation 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

7 QUESTIONS TO HELP YOU CHOOSE THE BEST HEALTH INSURANCE POLICY IN 2023

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

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

 

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

When it comes to health insurance plans, 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 an insurance cover will help you receive the best medical care in times of need without blowing your hard-earned savings. A health insurance policy offers coverage for much more than hospitalisation 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 a health insurance policy. The key reason is that network hospitals offer cashless facilities and help avail of 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 8000+ network hospitals across India. We believe in protecting you and your hard-earned money. Our average claim settlement time is around 1 hour. It is one of the fastest claim settlement durations in the insurance industry.

 

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

At Bajaj Allianz General Insurance, we provide coverage for Ayurvedic and Homeopathic hospitalisation. However, other treatments such as naturopathy, acupuncture, magnetic therapy, etc. are not covered in health insurance plans. This, however, may vary between insurer to insurer and plan to plans. Hence, it is recommended to go through the plan carefully, assess the needs, and only then, make the buying decision.

 

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

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

 

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

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

HEALTH INSURANCE COVERAGE

  • In Patient Hospitalization

    In Patient Hospitalisation

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

  • Pre & Post Hospitalization expenses

    Pre- & Post-Hospitalisation expenses

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

  • Organ donor expenses

    Organ donor expenses

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

  • Day care procedures

    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

    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

    Convalescence Benefit

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

  • Ayurvedic / Homeopathic expenses

    Ayurvedic and Homeopathic expenses

    We cover you for 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

    Maternity expenses and newborn baby cover

    Our health insurance plans cover you for maternity expenses and medical expenses towards the treatment of a newborn baby, subject to certain terms and conditions.

  • Daily Cash Benefit

    Daily Cash Benefit

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

While this may give you an idea of the insurance coverage, you should always check with the health insurance companies, to know more about the various additional benefits they offer. Also, to peruse the detailed list of inclusions & exclusions, refer to the health insurance policy wordings

 

Exclusions

The general exclusions of a health insurance policy are:

  • War:

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

  • Dental treatment:

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

  • External appliances/devices:

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

  • Intentional self-injury:

    Taking care of you is our topmost priority and we do not want to see you hurt, specially by self-inflicting injury. Thus, our policies do not offer coverage for intentional self-injury.

  • Plastic surgery:

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

  • Treatment outside India:

    Our insurance policies do not cover any treatment that you receive outside India.

Avoid These Mistakes While Buying a Medical Insurance Policy

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:

  • Skipping a Comprehensive Health Cover Due to Your Corporate Policy

    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 insurance coverage during probation. Corporate medical insurance policies usually offers low sum insured and does not provide comprehensive coverage. Hence, it is recommended to choose a comprehensive health insurance policy.

  • Opting for a Low Sum Insured

    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 bThus, buying a policy 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 an appropriate sum insured.

  • Choosing a Low-cost Plan Without Assessing Coverage

    Do not buy a policy just because it is available at a low premium. It is important to look at the coverage and benefits that the policy offers. 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 plan that is value-for-money and that can take care of the rising medical needs considering your lifestyle.

  • Buying Health Insurance Solely for Tax

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

Eligibility Criteria for Health Insurance in India

When it comes to buying a health insurance policy, several factors must be taken care of. The table below shows the common eligibility criteria that must be considered while selecting a suitable health insurance cover: 

 

Age criteria

Age is an important aspect that should be considered while buying a medical insurance plan. A health insurance plan can be bought for children, adults, and senior citizens.

There are dedicated plans as per the age of the individual. Usually, a standard plan covers individuals aged between 18 to 65 years of age.

Next, you have senior 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. When buying the health insurance policy, the insurer asks the applicant about the current medical condition such as kidney problems, blood pressure, and more. 

Smoking Habits

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

Medical Check-up

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

 

Factors That Affect Your Health Insurance Premium

Certain factors determine the premium of your policy are:

  • ✓ Selected Sum Insured: Your insurance premium also depends on the coverage you have opted for, and the sum insured selected by you.

  • ✓ Number of members covered: Your policy premium changes as you include more number of members to be insured, like in family floater health insurance plans.

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

  • ✓ Body mass index (BMI): BMI is the ratio of your height and weight. If your BMI is beyond the normal limit, then you might have to pay a higher insurance premium.

  • ✓ Medical history: 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: The premium might be on the higher side if you smoke or chew tobacco and tobacco-containing products.

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

The biggest impact on your medical insurance policy premium, however, is the coverage that you opt for. The broader 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 the estimated amount of premium that you need to pay towards your policy. The quick and easy steps to know your health insurance premium online are:

  • Step 1: Head to the online Health insurance premium calculator .

  • Step 2: Enter your personal details like your name, your date of birth, the insurance policy you want to buy and details of other family members whom you want to cover under the selected plan, your pin code, and contact number.

  • Step 3: Click on ‘Get My Quote’ button.

  • Step 4: Your premium details will be displayed where you can opt for co-payment as per your convenience, and then click on ‘Confirm Plan’ button to buy a suitable policy online.

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

 

Why You Should Compare Health Insurance Plans Online?

Comparing medical insurance policies helps to choose the best one that takes care of the healthcare needs. Selecting a health insurance policy is often regarded as 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 policies online:

 

  • Accessible & Time-saving:

    Every important piece of information related to your policy is available in just a few clicks. It also helps to save you time wherein you need to speak to the insurance agent with accurate and reliable information under one umbrella.

 
  • 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 for it. Moreover, online premium payment will help to get a policy at an affordable rate.

 
  • Compare Multiple Plans With Ease:

    The ability to compare health insurance plans online is convenient and hassle-free. You can view the plans, and compare their features, benefits, and premiums side-by-side. Moreover, when it comes to buying or renewing your policy, it can be done digitally without any hassle of paperwork.

 
  • Check Customer Reviews:

    With a plethora of health insurance plans available in the market, online reviews help to choose the insurer, and also, look for the claim settlement ratio of that company. Selecting an insurer that has a good reputation in the market ensures a swift claim settlement.

 

Health Insurance Claim Procedure

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

  • Cashless health insurance claim settlement

    The treatment for your ailment under a cashless claim is possible without paying anything from your pocket. However, this benefit is available only if you are admitted to a network hospital.

    The medical bill will be directly settled by the network hospital with your insurer as per the terms and conditions mentioned in your policy. Most of the health insurance companies in India provide a health card that can be used to avail cashless treatment at one of the network hospitals.

  • Reimbursement health insurance claim settlement

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

  • Planned hospitalisation

    If your health insurance policy covers medical procedures such as cataract surgery, then you can use the cashless claim facility to get the surgery done without having to pay anything. All you need to do is fill out a pre-authorisation form at a network hospital and they will send this form to your insurance provider, who will verify the required details and give approval for the cashless treatment.

  • Emergency hospitalisation

    In case of an emergency, like an accident, you can use the health card provided by your insurance company and submit it along with the pre-authorisation letter. If the approval comes through, you can avail cashless claims benefit. If not, then you can go for the reimbursement claim settlement process.

  • Health CDC

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

What are Network Hospitals in Health Insurance?

A network hospital is a hospital that has an agreement signed with your health insurance company. This tie-up between the hospital and your 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 claim, so that you don’t have to pay for the treatment upfront.

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

  • You can relax when the payment of your medical bill is taken care of by your health insurance provider.

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

Tax Benefits of Health Insurance

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

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

The premium paid qualifies for a deduction of up to ₹ 25,000 under Section 80D in each financial year. If either your parents or any one of them is a senior citizen, then the deduction goes up to ₹ 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 as of 2021-22:

Individuals Covered

Premium Paid

Tax Exemption

 

Self, Children & Family

Parents

 

Individual & parents who are less than 60 years of age

₹ 25,000

₹ 25,000

₹ 50,000

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

₹ 25,000

₹ 50,000

₹ 75,000

Individuals, parents & family more than 60 years of age

₹ 50,000

₹ 50,000

₹ 1,00,000

Members of HUF & Non-resident Individual

₹ 25,000

₹ 25,000

₹ 25,000

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

What is a Mediclaim Policy?

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

Mediclaim policy is the insurance coverage that shields against the medical expenses due to hospitalisation. A mediclaim policy financially protects in case of illness/accident requiring hospitalisation. You can continue to receive its benefits by paying the premiums on time.

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 the expenses of your medical treatment exceed the Sum Insured opted by you, then you will have to pay the amount over the such Sum Insured on your own. Thus, you should opt for plan with a higher Sum Insured.

 

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

 

✓ 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 instance, many policies have a fixed waiting period before they provide coverage for pre-existing diseases.

 

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

 

✓ Co-payment: Co-payment or co-pay is a fixed percentage of the claim amount that you need to pay before the insurance company pays for the same. You can opt for the co-payment clause when you buy or renew your health insurance policy. Since it is the amount that you need to pay from your own pocket, it helps to reduce the 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, the policyholder, need to pay every time you raise an insurance claim. A plan with a high deductible can be beneficial if your visits to a doctor/hospital are less frequent. Also, a higher deductible also helps to lower the overall insurance premium.

 

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

 

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

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

 

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

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

 

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

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

Difference Between Health Insurance & Mediclaim Insurance

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

 

Parameters Health Insurance Mediclaim Policy
Coverage

A health insurance plan offers coverage for hospitalisation, pre- & post-treatment expenses, ambulance charges, etc.

Offers cover for hospitalisation, 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.

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

Add-on Cover

Offers multiple add-ons.

No add-on covers are available.

Critical Illness Cover

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

Cover for critical illness isn’t available. 

Benefits of Buying Medical Insurance at an Early Age

Buying medical insurance at an early age is beneficial as you can then be somewhat less worried about paying any medical bills. When you start earning early, it's important to save for the future. 

 

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

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

  • In case of any pre-existing disease, your waiting period will end early and not compromise your health at the time of the treatment.

  • At a young age, you are less likely to fall ill or be prone to diseases. Thus, at this time, the insurance premiums tend to be rather cost-effective.

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

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

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

When you are young, you tend to be less vulnerable to any chronic illness or diseases. Having said that, 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, and other such factors, health is a major concern. Having comprehensive health insurance coverage will help to take care of the medical treatment expenses during an emergency.

Documents Required to Buy Health Insurance in India

1.     Passport-sized photographs

2.     Policy proposal form

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

✓    Voter’s ID

✓    Aadhaar card

✓    Passport

✓    Electricity bill

✓    Driving license

✓    Ration card

 

4.     Age proof: Any of the following documents suffice as your age proof:

✓    Passport

✓    Aadhaar card

✓    Birth certificate

✓    PAN card

✓    10th and 12th class mark sheet

✓    Voter’s ID

✓    Driving license

 

5.     Identity Proof: Any of the documents mentioned below can be used as your identity proof:

✓    Aadhaar card

✓    Driving license

✓    Passport

✓    PAN card

✓    Voter’s ID

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

STEPS TO BUY ONLINE HEALTH INSURANCE PLANS

 

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

  • Step 1

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

  • Step 2

    Select the health insurance policy that you want to buy.

  • Step 3

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

  • Step 4

    Click on ‘Get My Quote’ button.

  • Step 5

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

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

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

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

IMPORTANCE OF TIMELY HEALTH INSURANCE RENEWAL

Insurance renewal is essential to maintain the continuity of the coverage provided by your health insurance policy. Thus, renewal must be made before your insurance plan expires. If you fail to renew your policy even after it expires, then the insurer will provide you a grace period of 30 days for health insurance renewal . However, during this period of 30 days, you will not be covered for any health insurance claims. Lastly, if you miss renewing the policy even during the grace period, then any accumulated benefits such as the NCB (No-Claim Bonus), waiting period, etc. are lost.

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 insurance provider without losing the benefits of your existing insurance policy. So, if you are not satisfied with your current medical insurance plan, or you are looking for something more in your policy, then you can change your insurer, or avail a different policy from the same insurance company with all the credits that you gained in your current policy.

 

You have the following options when you decide to switch your health insurance policy:

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

 

Health insurance portability criteria:

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

      ✓    Previous health insurance policies

      ✓    Claim experience in detail

      ✓    Proposal form

      ✓    Age proof

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

      ✓    Any other document as requested by the insurer

Written By: Bajaj Allianz - Updated on: 11th January 2023

 

CUSTOMER STORIES

 

Average Rating:

 4.75

(Based on 3,912 reviews & ratings)

 

ASHISH JHUNJHUNWALA

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

SUNITA M AHOOJA

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

Reni George

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

Satish Chand Katoch

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

Ashish Mukherjee

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

Jaykumar Rao

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

 

HEALTH INSURANCE FAQS

 

 

 

   Is it necessary to buy health insurance in India?

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

    What do I get with Bajaj Allianz’s Health Insurance policy?

With our Health Insurance policy, you enjoy coverage for pre- and post-hospitalisation 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!

   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, make buying a policy online a better alternative.

   How can I save taxes with Health Insurance?


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

On the premiums paid for self, spouse, children, and your parents, you can avail a deduction of ₹ 25,000 per annum against your taxable income (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 ₹ 50,000.

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

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

   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 insurance policy.

   What is covered by health insurance?

Health insurance offers coverage for hospitalisation, expenses including pre- & post-hospitalisation expenses, doctor’s consultation fees, and in-patient expenses.

   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 for paying rising medical costs. Health insurance is a solution to deal with hospitalisation and pay hefty medical expenses, should they arise. So, health policies are your cover against unexpected health-related costs that may threaten to deplete your savings.

   What do you mean by entry age and exit age?

Entry age specifies that you should be at least of a certain age, so that you can get coverage under a health insurance policy. 

Exit age, on the other hand, 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 policies.

   What is a ‘Free-look Period’?

Health insurance companies in the country grant you a free-look period, during which, you can analyse the policy that you have purchased. Your insurance policy can be cancelled in this period if you think that such a plan is not suitable for you without paying any cancellation fee.

   Who are considered to be ‘dependents’?

Your children, spouse, parents, and parents-in-law can be added as dependents in your health insurance policy.

   What is ‘Co-payment’? What are ‘deductibles’?

Co-payment is the fixed percentage of the claim amount that you need to pay for every insurance claim. 

Deductible, on the other hand, is a fixed amount that you need to pay when you raise a health insurance claim.

   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 be replenished to cover you for the next hospitalisation 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.

   What is the benefit of day-care in health insurance?

With technological advancement, you are not required to get hospitalised for procedures like Septoplasty or lithotripsy. But the medical expenses related to these procedures are expensive. It is beneficial to have health insurance plans with day-care coverage, so that you are covered for these kinds of surgeries or medical procedures where the hospitalisation is for not more than 24 hours.

   What is 'any one illness’?

Any one illness refers to a 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.

   How does insurance help 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 insurance claim. The expenses related to this health check-up are borne by your insurer.

   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 plan (more than 1 year), then you can get great discounts.

   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 the employer is enough to cover you.

✓ If you have health insurance, then all your medical expenses are covered.

✓ You need to be hospitalised for at least 3 hours to get the benefit of your health insurance policy.

✓ You do not need health insurance if you are fit.

✓ Smokers cannot purchase health insurance.

 

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

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

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

   Which are the expenses that are included in the sub-limit amount?

Sub-limit is the maximum amount that your health insurance policy will pay towards your medical expenses. Sub-limits are usually placed on charges such as room rent, post-hospitalisation, ambulance charges, oxygen supply, doctor’s fees, diagnostic tests, and the like.

   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.

    What is the difference between Family Floater & Individual Health Insurance Policies?

Individual health insurance policies have 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 policy.

   Which health insurance plans are available for women?

Bajaj Allianz offers special health insurance plans that take care of medical expenses related to the health issues faced by women. Our critical illness plan for women is a special policy for women. It covers against the risk of 8 critical illnesses like burns, breast cancer, and vaginal cancer.

   What is the waiting period and the Sum Assured for maternity insurance plans in India?

A waiting period of 72 months is applicable for the coverage of maternity expenses. If you opt for Sum Insured in the range of ₹ 3 lakhs to ₹ 7.5 lakhs, then the coverage is restricted to ₹ 15,000 for normal delivery and ₹ 25,000 for a caesarean delivery, and if you opt for a Sum insured in the range of ₹ 10 lakhs to ₹ 50 lakhs, then it is restricted to ₹ 25,000 for normal delivery and ₹ 35,000 for c-section delivery. The waiting period for Maternity coverage for every product will differ based on the terms and conditions of the product.

   How can I get a new member added to my existing family floater health insurance?

You can fill out a health declaration and endorsement form along with the additional premium to cover a new member of any existing family floater insurance policy.

    How do I make changes to 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.

   How can I check the status of my policy?

You can check the status of your policy online. Log on to our website with your user ID and password and enter the details of your policy – (policy number) to check the status. Alternatively, you can download our ‘customer portal’ app and check your policy status.

    Can I buy more than one Health insurance policy?

Yes, you can buy more than one health insurance policy. However, handling them usually becomes cumbersome. We recommend you buy a single policy with a high sum insured instead of buying multiple policies with a low sum insured.

   What if I want to renew my health insurance policy after one year?

You can renew your policy after one year. But, if there has been a break in your health insurance renewal, then you might need to contact the customer support team, who can guide you to take the necessary steps.

   Will I need to undergo a medical check-up 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 insurance renewal, or if you have upgraded the coverage of your medical insurance plan at the renewal, then you might be required to undergo a medical check-up.

   I am already having health insurance and want to increase its 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.

   If my policy is not renewed on time before the expiry date, will I be denied its 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 during the grace period, then you might have to start from scratch to get yourself covered.

   Is it possible to transfer my policy from one insurance company to another without losing the renewal benefits?

Yes, the portability feature in health insurance policies allows you to switch your insurance company.

   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 may ask you to undergo certain medical tests depending upon the medical history submitted and the health insurance policy opted for.

   Who pays for the medical examination?

You, the policyholder, have to bear the cost of the medical examination before buying a health insurance policy. It can also be reimbursed by the insurer, depending on policy terms and conditions.

   Is my health insurance policy valid Pan-India?

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

   What are the fine prints which I should know before buying a health policy?

Before you buy a health insurance policy, you should take care of the following things:

✓ Look for the exact coverages provided by your health insurance policy.

✓ Take note of waiting periods and exclusions.

✓ Do not hide anything from your insurance provider, like pre-existing illnesses.

✓ Check the online processes of the insurance company.

✓ Thoroughly enquire about topics like policy cancellation, policy lapse, and policy renewal with your insurer.

✓ Have a good look at the break-up of your health insurance premium and clear all your doubts before making the payment.

 

   What do you mean by a health card?

Health insurance companies in India provide you a health card with your insurance policy, which you can use at network hospitals to avail the benefit of cashless treatments.

   Will a duplicate policy be issued if I lose the original policy?

Yes, you can request a duplicate medical insurance policy if you lose the original one. However, you might have to pay a fixed amount to get a duplicate copy of your health insurance policy.

   How do I cancel my health insurance policy?

If you have just purchased your health insurance policy, you can cancel it during the free-look period without paying any cancellation fee. But you will have to pay the premium on a pro-rata basis for the number of days the policy was active.

You can also cancel your health insurance policy before its expiry instead of renewing it.

You might also be eligible for some benefits if you surrender the policy after renewing it without any break for a certain fixed number of years. You can contact your insurance provider and know the complete details to cancel your medical insurance plan.

 

 

   How much coverage do I need?

The coverage amount depends on your lifestyle, medical background, pre-existing diseases, family members, annual income, residential address, and age.

   Tell me about the pre- and post-hospitalisation medical expenses that you cover.

Pre-hospitalisation expense is a result of tests and medication required to be undertaken and consumed respectively prior to the hospitalisation for the treatment. Similarly, post-hospitalisation expenses can be for recovery and medicines that need to be taken after the treatment at the hospital. Pre- and post-hospitalisation coverage is for 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 hospitalised for further treatment, if required. These expenses incurred before hospitalisation are called pre-hospitalisation expenses. Post-hospitalisation expenses include all expenses or charges incurred by you after being discharged, or after hospitalisation treatment is done. For example, the consulting physician may prescribe certain tests to ascertain your progress or recovery after surgery.

   What do you mean by Domiciliary Hospitalisation? What does it cover?

Domiciliary Hospitalisation refers to a situation where you are undergoing any treatment, or are under medical care at home instead of the hospital, and yet considered as hospitalised by the insurer. You might be seeking at-home treatment because there are no hospital beds/rooms available, or because you are not in a condition to be shifted to a hospital for the treatment.

The domiciliary hospitalisation covers you for the expenses related to the treatment you receive for an Illness/disease/injury at home, instead of a hospital.

   What are the non-payable items under your health insurance plans?

Non-medical items such as hair removal cream, hand wash, cosy 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 the policy wordings carefully.

   Do health insurance policies offer coverage to diabetes patients?

Yes, diabetes patients are covered under health insurance policies. 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

   Are diagnostic charges like MRI, X-Ray, or any other body scans covered under health insurance policies?

Yes, health insurance in India covers some medical tests and scans as per the terms and conditions mentioned in your policy for in-patient hospitalisation.

   Do health insurance plans cover maternity?

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

   Do insurance policies cover outpatient expenses also?

Yes, outpatient expenses are covered under medical insurance plans, either with mandatory hospitalisation of 24 hours or as a top-up in the form of OPD cover.

   What treatments do day-care health insurance 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 haemorrhoids

✓    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 the lens of the eye

You can refer to your policy document for a detailed list of day-care procedures.

    Is dental treatment covered under health insurance in India?

Dental treatment is 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 in the case of any accidental bodily injury to natural teeth and requiring hospitalisation.

   Do health insurance policies cover homoeopathy treatments?

Health insurance policies that cover AYUSH treatments also cover homoeopathic treatments. Check the same with your health insurance provider, or refer to the policy wording to know whether the coverage is included in your policy or not.

   Which illnesses are covered under critical illness insurance?

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

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

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

✓ You will not be able to customize the corporate plan as per your insurance requirements and health conditions.

✓ The coverage ends as soon as you resign from the company.

✓ Corporate plans from your employer will no longer offer coverage after retirement.

✓ Corporate plans have very little scope for planning your future.

✓ You are covered for a smaller sum insured as compared to private health insurance policies.

Thus, you should also buy an individual medical insurance plan that suits your budget as well as your health insurance requirements.

   Can I increase the insurance coverage at the time of policy renewal?

Yes, you can increase your medical insurance policy’s coverage during its renewal stage. At this time, you might be required to submit a few documents and pay an additional premium for enhancing the coverage of your policy.

   Can I add my elderly parents to my medical insurance policy?

No, our plans do not allow to add elderly parents to your existing coverage. However, you can buy our Silver Health plan, which is a special health insurance product designed for senior citizens.

 

 

   What factors determine my Health Insurance premium amount?

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

✓ Your age

✓ Pre-existing diseases

✓ Add-on covers (optional)

   How do I estimate the cost of health insurance in India?

Health insurance calculator is a nifty tool that can help you estimate the premium of your policy. This health insurance calculator is available for free on Bajaj Allianz’s website and the quote generated from it can be used for future reference.

   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

✓ ECS

✓ Online payment using Debit/credit card and net banking facility

   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.

✓ A revision in premium by the regulator (the insurance company will inform you about this well in advance of your policy renewal).

✓ Change in taxes, duties, and cess as per government laws.

   How does smoking affect health insurance premiums?

You might have to pay a higher premium towards your policy if you smoke. In addition, you might be required to undergo a few medical tests before your policy’s coverage begins.

   What if I forget to pay my health insurance premium?

You should pay the premium before the policy due date, so that there is a continuity of the health insurance coverage. However, if you are unable to pay before the policy expires, then you can use the grace period, provided by the insurer, to renew your medical insurance policy. But, if you do not renew your policy even during the grace period, then your insurance plan will lapse, and you will not be covered for any medical emergencies.

   What is GST and how does it impact health insurance?

GST is Goods and Service Tax. It was first launched in 2017 and it replaced all the erstwhile indirect taxes such as service tax, VAT, and customs. 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 to health insurance policies was 15%, and now it is 18%.

   Can I pay health insurance premiums monthly?

All the health insurance policies do not accept the payment of the premium on an instalment basis. However, with policies like Arogya Sanjeevani, you can pay health insurance premiums on an instalment basis – yearly, half-yearly, quarterly, and monthly – as per your convenience.

 

 

   What is claim settlement ratio?

Claim settlement ratio 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 claim settlement ratio, the better is the insurance company’s pay-out.

   How to check the status of my Health Insurance claim?

You can track the status of your health insurance claim using our mobile app, “Caringly Yours”, using our online claim settlement portal, or by calling our customer care.

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

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

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

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

   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 ₹ 20,000 within 20 minutes.

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

   When should I make a claim?

You should raise 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 preserve the benefit of NCB (No-Claim Bonus) when you renew your medical insurance policy.

   What is the maximum number of claims I can make in a year?

You can make any number of valid health insurance claims during a policy period (generally, a year). However, the number of times you file a claim depends upon the exhaustion of your sum insured.

   What is cashless mediclaim?

When you avail treatment for your illness/injury in a network hospital, you are eligible for cashless mediclaim. With cashless mediclaim, your medical bill will be directly paid by your health insurance company to the network hospital. However, the cost of non-medical items and other non-payable items as per your policy terms will have to be borne by you.

   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. This health card contains your policy number, name of the insurance company, and the type of health insurance policy. You will also have to fill up a pre-authorisation form that will be sent by the network hospital to the insurer. On verification of these documents, the claim will be directly settled by your insurer to the hospital.

   If I avail cashless facility, will you pay the entire amount, or will I be required to bear a 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 policy terms.

   What happens to my policy after a claim is filed and settled?

After your claim is filed and settled, your insurance coverage will reduce by the amount that has already been compensated for.

For example, if your policy was issued in January with ₹ 5 lakh coverage and if you claimed an amount of ₹ 3 lakh in July, then a balance of ₹ 2 lakh is available to you between August-December.

   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 claim during the policy year. But you will be eligible for NCB (No-Claim Bonus), which will reduce the premium amount when you renew your policy. Also, you will be eligible for a cumulative bonus, which lets you enjoy the benefit of the increased sum insured by paying the same premium as the previous policy year.

   What is TPA?

TPA stands for Third Party Administrator. It is an organization that processes claims on behalf of the health insurance company. It acts as an intermediary between you and the insurance company for processing and settling your claims.

   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 submit the related documents to them.

   How many times can I claim Convalescence Benefits?

Convalescence Benefits can be claimed only once during a policy year.

   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 treatment.

   Can I get Reimbursements in case of treatment at non-network hospitals?

Yes, you can submit your medical bills along with other documents to file a reimbursement claim if you avail of treatment at a non-network hospital.

   Do I have to pay the difference if the actual expenses are more than the coverage?

Yes, if the actual expenses exceed the coverage opted for by you, you will have to pay the difference amount.

   What is the Health Administration Team?

The Health Administration Team (HAT) comprises 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 for the policyholders. The team ensures faster claim settlement as a single point of contact. It is effective for the quick resolution of customer queries by health insurance experts. It also controls claim settlements and customer service, given its in-house capabilities.

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

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

✓ Claim filed for intentional self-injury.

✓ In case of misrepresentation, fraud, non-disclosure of material facts, or non-cooperation from the insured’s end.

✓ Claim filed for coverage of the pre-existing diseases before the waiting period gets over.

✓ In case of a claim filed for any of the exclusions mentioned in the policy document.

 

 

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

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

   Will my family members be covered for the 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 hospitalisation expenses (under In-Patient Hospitalisation) as per policy terms & conditions related to COVID-19.

   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 the IRDAI, will be excluded from COVID-19 coverage.

   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 policy provides coverage for out-patient hospitalisation. Please contact your insurer and get clarification on these coverages under your health insurance policy.

   Will my travel history abroad affect the admissibility of claims under the policy?

No, your travel history abroad will not affect the admissibility of the claim under your health insurance policy if you are hospitalised in India.

   How can I intimate my claim after hospitalisation?

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

✓ With our “Caringly Yours” app, you can register health insurance claims up to ₹ 20,000 via a paper-less procedure – Health CDC (Claim by Direct Click) available on our “Caringly Yours” App.

✓ You can give us a missed call 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 by visiting our online claim portal, where you can enter some of your basic details such as your policy number and quickly make a claim.

   Are any waiting periods applicable to claims under COVID-19?

Yes, a standard waiting period of 30 days is applicable to claims under health insurance for COVID-19.

   Will I be allowed to enhance my sum insured?

You will be able to enhance your Sum Insured during the renewal process of your policy as per underwriting terms and conditions.

 

Disclaimer

I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

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