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Arogya Sanjeevani Policy: Standard Health Insurance at Reasonable Premiums

Protecting you from the financial burden of hospitalization

Hospitalization care for you and your loved ones
Arogya Sanjeevani Standard Health Insurance Policy by Bajaj Allianz

Comprehensive benefits at affordable prices for you and your dear ones

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What’s in it for you?

Sum Insured options up to Rs. 5 Lakh

Coverage for AYUSH treatment

Payment of Premium on an installment basis

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Why choose Bajaj Allianz Arogya Sanjeevani Policy?

Taking care of something precious to you is a natural instinct. And, we know that your health is the most precious thing to you. You can win the world if you are fit and fine. But, you need a strong financial support if you have to take good care of your health, especially in case of an emergency like a serious illness or accident.

The Arogya Sanjeevani Policy by Bajaj Allianz Health Insurance will help you get that financial support and protect you from the financial burden at the time of hospitalization. With Arogya Sanjeevani health insurance, you can stop worrying about emptying your savings and deal with any medical emergency head-on.

With Arogya Sanjeevani Policy to support you, you don't ever have to worry about not having enough money for treatment in case things go wrong.

We offer a whole lot when it comes to Arogya Sanjeevani health insurance!

Key Features

The Arogya Sanjeevani Policy by Bajaj Allianz Health Insurance will help you get that financial support and protect you from the financial burden at the time of hospitalization. With Arogya Sanjeevani health insurance, you can stop worrying about emptying your savings and deal with any medical emergency head-on.

  • Extensive Coverage

    Arogya Sanjeevani health insurance policy covers you for*:

    a) Hospitalization:
    ✓    Room Rent, Boarding, Nursing Expenses
    ✓    Intensive Care Unit (ICU)/Intensive Cardiac Care Unit (ICCU)
    ✓    Road ambulance cover

    b)  Listed Modern Treatment Methods

    c)  All Day Care Treatments

    d)  AYUSH Treatment: Medical Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homeopathy systems of medicines during each Policy Year upto the limit of Sum Insured as specified in the Policy Schedule in any AYUSH Hospital.

    e)  Cataract Treatment: Medical Expenses incurred for treatment of Cataract

    *subject to limits

  • Medical Procedures Covered

    Arogya Sanjeevani health insurance policy covers the following procedures either as In-patient or as part of day care treatment in a hospital*:

    a) Uterine Artery Embolization and HIFU (High Intensity focused ultrasound)

    b) Balloon Sinuplasty

    c) Deep Brain Stimulation

    d) Oral Chemotherapy

    e) Immunotherapy - Monoclonal Antibody to be given as injection

    f) Intra vitreal injections

    g) Robotic surgeries

    h) Stereotactic radio surgeries

    i) Bronchical Thermoplasty

    j) Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)

    k) IONM – (Intra Operative Neuro Monitoring)

    l) Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.

    *subject to limits

  • Policy Type

    There are two types of Arogya Sanjeevani health insurance policies, both with a tenure of one year:

    a) Arogya Sanjeevani Policy, Bajaj Allianz General Insurance Company – Individual

    b) Arogya Sanjeevani Policy, Bajaj Allianz General Insurance Company – Family Floater

  • Premium Payment in Instalment

    Premium Payment can be made either in Full or in instalments- Half Yearly, Quarterly, Monthly.

  • Annual Policy

    You and your family members will be covered for a period of one year with Arogya Sanjeevani health insurance policy.

  • Lifetime Renewal

    Arogya Sanjeevani policy comes with lifetime renewal benefits.

  • Discounts

    Family Discount: 10% family discount shall be offered if 2 eligible Family Members are covered under a single Policy and 15 % if more than 2 of any of the eligible Family Members are covered under a single Policy. Moreover, this family discount will be offered for both new policies as well as for renewal policies.

    Online/Direct Business Discount: Discount of 5% will be offered in this product for policies underwritten through direct/online channel.

    Note: this discount is not applicable for Employees who get employee discount

WHY BUY HEALTH INSURANCE WITH US?

EASY, HASSLE-FREE AND QUICK CLAIM SETTLEMENT

Cashless Claim Process (only applicable for treatment at a network hospital):

Cashless facility at network hospitals is available 24x7, throughout the year, without any interruption in service. The list of hospitals where cashless settlement can be availed is dynamic and liable to change without notice. You must check the hospital list before getting admitted. The updated list is available on our website and with our call center. Bajaj Allianz Health Card along with a government ID proof is mandatory at the time of availing cashless facility.

When you are opting for cashless claims, follow the steps given below:

  • Get the pre-authorization request form filled and signed by the treating doctor/hospital and signed by member/patient, at the hospital’s insurance desk.
  • Network hospital will fax the request to the Health Administration Team (HAT).
  • HAT doctors will examine the pre-authorization request form & decide on cashless availability, as per the policy guidelines.
  • Authorization letter (AL)/denial letter/additional requirement letter is issued within 3 hours depending on the plan and its benefits.
  • At the time of discharge, the hospital will share the final bill and discharge details with HAT and based on their assessment, final settlement will be processed. Also, the insured person has to verify and sign the discharge papers, pay for non-medical and inadmissible expenses.

Important points to note

  • In case of planned hospitalization, register/reserve your admission as per the network hospital’s procedure for admission in advance.
  • Admission at network hospital is subject to availability of a bed.
  • Cashless facility is always subject to your policy terms and conditions.
  • The policy does not cover the following:
    • Telephone
    • Food and beverages for relatives
    • Toiletries

    The cost of the above services have to be borne by you and paid directly to the hospital before discharge.

  • In-room rent nursing charges are included. However, if a higher cost room is used then the incremental charges will be borne by you.
  • In case the treatment is not covered as per the policy terms and conditions, your claim, cashless or reimbursement, will be denied.
  • In case of inadequate medical information, pre-authorization for cashless claim can be denied.
  • The denial of cashless facility does not mean denial of treatment and does not in any way prevent you from seeking necessary medical attention or hospitalization.

Reimbursement of pre/post hospitalization expenses

Relevant medical expenses incurred before admission and after discharge from the hospital will be reimbursed as per the policy. Prescriptions and bills/receipts of such services should be submitted to Bajaj Allianz General Insurance along with the duly signed claim form.

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Inform the Bajaj Allianz General Insurance HAT about the hospitalization.

Register your health insurance claim online.

To register your claim offline, please call us on our toll-free number: 1800-209-5858.

For reimbursement of claims the insured person may submit the necessary documents to the Health Administration Team (HAT) team within the prescribed time limit as specified below:

Type of Claim Prescribed Time Limit
Reimbursement of hospitalization, day care and pre hospitalization expenses Within 30 days of date of discharge of hospital
Reimbursement of post hospitalization expenses Within 15 days from completion of post hospitalization treatment

Documents required for reimbursement claim:

  • Duly completed claim form
  • Photo identity proof of the patient
  • Medical practitioner’s prescription advising admission.
  • Original bills with itemized break-up
  • Payment receipts
  • Discharge summary including complete medical history of the patient along with other details
  • Investigation / Diagnostic test reports etc. supported by the prescription from attending medical practitioner
  • OT notes or Surgeon’s certificate giving details of the operation performed (for surgical cases)
  • Sticker/Invoice of the Implants, wherever applicable.
  • MLR (Medico Legal Report) copy if carried out and FIR (First Information Report) if registered, wherever applicable.
  • NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque
  • KYC (identity proof with address) of the proposer, where claim liability is above Rs. 1 Lakh as per AML Guidelines.
  • Legal heir/ succession certificate, wherever applicable
  • Any other relevant document required by Company/ TPA for assessment of the claim

Complete set of claim documents needs to be forwarded to

Health Administration Team,
Bajaj Allianz General Insurance Co. Ltd.
2nd floor, Bajaj Finserv Building, Behind Weikfield IT Park, Off Nagar Road,Viman Nagar-Pune - 411 014.

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LET'S SIMPLIFY HEALTH INSURANCE

What is Arogya Sanjeevani health insurance policy?

Arogya Sanjeevani is a health insurance policy that protects you from the financial burden at the time of hospitalization. It enables you to live your life the way you please without worrying about not having enough money for treatment in case things go wrong.

Can family members be insured under the Arogya Sanjeevani policy?

Yes, with Arogya Sanjeevani Policy, You can get coverage for yourself, your legally wedded spouse, dependent children, parents, parents in laws under the both individual and floater option

What are the sum-insured options under the standard health insurance?

Please refer the table below to understand the SI options under the standard health insurance:

S.no Coverage Sum Insured (Minimum) Sum Insured (Maximum) Remarks
1 Hospitalization Rs. 1,00,000 Rs. 5,00,000

1. Room Rent, Boarding, Nursing Expenses- 2% of the sum insured subject to maximum of Rs.5000/-, per day

2. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) - 5% of the sum insured subject to maximum of Rs.10,000/-, per day

3. road ambulance maximum of Rs. 2000/- per hospitalization

2 AYUSH Treatment Rs. 1,00,000 Rs. 5,00,000  
3 Cataract Treatment 25% of Sum Insured or Rs.40,000/-, whichever is lower, per each eye in one policy period.  
4 Pre Hospitalization Up to and within Hospitalization Sum Insured 30 days
5 Post Hospitalization 60 days
6 Modern Treatment Methods 50% of Hospitalization SI

1. Uterine Artery Embolization and HIFU (High Intensity focused ultrasound)

2. Balloon Sinuplasty

3. Deep Brain Stimulation

4. Oral Chemotherapy

5. Immunotherapy – Monoclonal Antibody to be given as injection

6. Intra vitreal injections

7. Robotic surgeries

8. Stereotactic radio surgeries

9. Bronchical Thermoplasty

10. Vaporization of the prostrate (Green laser treatment or holmium laser treatment)

11. IONM – (Intra Operative Neuro Monitoring)

12. Stem Cell Therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be cover

Which medical expenses are covered under the Arogya Sanjeevani policy?

Hospitalization, Pre-hospitalization and post-hospitalization expenses are covered under the Arogya Sanjeevani policy.

How do I avail Arogya Sanjeevani Health Insurance?

You can buy Arogya Sanjeevani health insurance with steps mentioned below:

  • 1. Visit our website (www.bajajallianz.com) for details.
  • 2. Fill the proposal form stating your personal details and health profile.
  • 3. We will process your proposal. Based on the information provided, you may be required to undergo pre-policy medical examination (the cost to be borne by you) at our network diagnostic centers.
  • 4. Depending on our evaluation if your proposal is accepted, then we will issue the policy after the receipt of single premium.
  • 5. If the policy is issued we will refund you 100% of the cost of the pre-policy medical examination.
  • 6. The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent on your mail ID mentioned on the proposal form.

Please note that you can pay the premium for this policy in installments, which can be paid annually, half-yearly, quarterly or monthly basis.

How do I check eligibility for the standard health insurance plan?

You are eligible to avail this standard health insurance plan if:

  • 1. You /Your legally wedded Spouse /Parents/ Parents In law are in the age group of 18 years to 65 years
  • 2. Your dependent children are in the age group of 3 months to 25 years

Please note that if your children are above 18 years of age and are financially independent, they will be ineligible for coverage in the subsequent renewals.

What are the Sub-limits under the Sum Insured?

The sub-limits under Arogya Sanjeevani health insurance policy are:

Annual Policy Benefit/Procedure Sub-limit
Per day Room rent- Normal 2% of Sum Insured subject to a maximum of Rs. 5000/-
Per day ICU/ICCU expenses 5% of Sum Insured subject to a maximum of Rs. 10,000/-
Cataract surgery 25% of Sum Insured or Rs. 40,000/- whichever is lower for each eye
Road Ambulance Rs. 2000/- per hospitalization
Modern Treatment Methods 50% of sum insured

When can I enhance my Sum Insured?

Sum insured can be changed (increased/ decreased) only at the time of renewal or at any time, subject to underwriting by the Company. For any increase in SI, the waiting period shall start afresh only for the enhanced portion of the sum insured.

Is there any co-payment at the time of claims?

Yes, a mandatory 5% co-payment would be applied when you choose this policy.

If the Insured seeks admission in a hospital, then a 5% co-payment would apply on all Hospitalization expenses incurred, excluding consumables & medicines.

Our happy customers!

Rama Anil Mate

The online health insurance policy renewal on your website is excellent, user-friendly, and smooth.

Suresh Kadu

Bajaj Allianz’s executive has provide an extreme support and would like to appreciate the same. Kudos.

Ajay Bindra

Bajaj Allianz's executive very nicely elaborated the benefits of the policy. She has very good communication skills and explained very well.

Arogya Sanjeevani health insurance for handling your financial burden during hospitalization

You can even cover your extended family like in-laws.

THAT’S NOT ALL, HERE ARE THE ADDITIONAL BENEFITS WITH YOUR AROGYA SANJEEVANI HEALTH INSURANCE

The Arogya Sanjeevani health insurance Plan Provides Extensive Coverage With Multiple Benefits:

Renewability

Lifetime Renewal benefit is available under this policy.

Hassle-free claim settlement

With our cashless and reimbursement claim settlement process, we make your filing, tracking and claim settlement process very smooth and convenient.

Premium Payment in Instalment

Premium can be paid on instalment basis- Annual, Half yearly, Quarterly or Monthly.

No Pre-policy check-up till 45 years of age

For new proposals, you do not have to undergo any medical test up to 45 years of age.

Cumulative Bonus

Cumulative Bonus will be increased by 5% in respect of each claim free policy year (no claims are reported), provided the policy Read more

Cumulative Bonus will be increased by 5% in respect of each claim free policy year (no claims are reported), provided the policy is renewed with the company without a break subject to maximum of 50% of the sum insured under the current policy year.

Free Look Period

The Insured or Insured Person(s) shall be allowed a period of fifteen days from date of receipt of the Policy to review the terms Read more

The Insured or Insured Person(s) shall be allowed a period of fifteen days from date of receipt of the Policy to review the terms and conditions of the Policy, and to return the same if not acceptable.

Claim settlement ratio of around 90% in the last 6 months.

Important points to note before buying Arogya Sanjeevani health insurance

  • Inclusions
  • Exclusions

Pre and post hospitalization cover

Covers pre and post hospitalization expenses up to 30 and 60 days respectively.

Road Ambulance Expenses

Includes the expenses incurred on road ambulance subject to a maximum of Rs. 2000/- per hospitalization.

Pre-policy check-up cost

100 % cost of pre-policy check-up would be refunded if the proposal is accepted & policy is issued.

Day Care Treatment Expenses

Covers expenses for all Day Care treatments.

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 Any disease contracted during the first 30 days of commencement of the health insurance policy will be excluded from coverage, except injuries caused due to an accident.

In case of pre-existing diseases, a waiting period of 48 months will be applicable.

A waiting period of 24 months is applicable for diseases such as a hernia, piles, Hysterectomy and Tympanoplasty.

Treatment taken outside the geographical limits of India will be excluded from coverage.

A waiting period of 48 months is applicable for treatment for joint replacement unless arising from accident.

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Customer Stories

Juber Khan
Sundar Kumar Mumbai

Easy online buying of health insurance policy with no manual intervention required.

Pooja Mumbai

Bajaj Allianz very informative and helpful representatives.

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The policy issue was very quick and simple. User friendly interface.

Thank You for Your Interest in Bajaj Allianz Insurance Policy, A Customer Support Excecutive will call you back shortly to assist you through the Process.

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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.

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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