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Health Insurance Plans For Family: Health Guard Health cover for you and your family

Customised family health insurance plans

Safeguard yourself and your family

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What’s in it for you?

Pre and post hospitalisation cover

Free health check-up

Sum insured options from Rs 1.5 lakh to Rs 50 lakh

Why choose Bajaj Allianz Family Health Insurance?

Medical expenses don’t show up with a warning. Your best bet to avoid spending your hard-earned life savings towards hospital bills is a robust health insurance policy.

With the Bajaj Allianz Family Health Insurance plan, each of your family members can avail an individual sum insured or you can opt for a Family Floater Plan. Your family enjoys cover from expenses incurred due to hospitalisation, doctor’s consultation, ambulance services, treatment charges and pre and post hospitalisation expenses.

We offer a whole lot when it comes to Family Health Insurance

Key Features

What makes Bajaj Allianz Family Health Insurance policy special? Read on to know more about the features of this policy:

  • Multiple sum insured options

  • Immediate family cover

    This policy covers you, your spouse and your children.

  • Ayurvedic and homoeopathic treatment

    Under the Gold Plan, the policy covers in-patient hospitalisation expenses (up to Rs 20,000) incurred in a recognised Ayurvedic/homoeopathic hospital where the admission period is not less than 24 hours.

  • Daycare procedures cover

    Medical expenses incurred during the treatment of listed daycare procedures or surgeries are covered under this policy.

  • Convalescence benefit

    In case of continuous hospitalisation of more than 10 days, you will be eligible for a benefit payout of Rs 5,000 per year, provided that the hospitalisation claim is admissible.

  • Bariatric surgery cover

    Under the Gold Plan, bariatric surgery is covered under medical advice, subject to certain terms and conditions.

  • Sum insured reinstatement

    In case your sum insured along with the cumulative bonus (if any) has been completely exhausted during the policy year, we will reinstate it.

  • Pre and post hospitalisation

    The policy covers medical expenses 60 days immediately before and 90 days immediately after hospitalisation.

  • Road ambulance cover

    You can avail emergency ambulance services up to Rs 20,000 at the time of admission or discharge.

  • Organ donor expenses cover

    Expenses towards organ donor’s treatment for harvesting of the donated organ are covered under this policy.

  • Daily cash benefit

    A daily cash benefit of Rs 500 per day, for up to 10 days during each policy year, will be payable as accommodation expenses for one parent/legal guardian to stay with a minor insured under the policy, for an admissible claim.

  • Maternity/newborn baby cover

    Maternity expenses and medical expenses towards treatment of a newborn baby are covered under the policy subject to certain terms and conditions. This feature is available under the Gold Plan.

Personalised health insurance plans to protect you and your loved ones.

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EASY, HASSLE-FREE AND QUICK CLAIM SETTLEMENT

Claim by Direct Click (CDC)

Bajaj Allianz General Insurance has introduced an app based claim submission process known as Health Claim by Direct Click.

This facility allows you to register and submit claim documents through the app for claims up to Rs 20,000.

What you need to do:

  • Register your policy and card number in the Insurance Wallet App.
  • Register your policy and health card number in the app.
  • Register the claim.
  • Fill the claim form and arrange for the hospital-related documents.
  • Upload the documents using the app menu.
  • Submit the claims for further processing.
  • Get confirmation within a few hours.
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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. You must check the hospital list before getting admitted to the hospital. Hospitals that provide cashless settlement are liable to change their policy without notice. The updated list is available on our website and with our call centre. 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, the process is as follows:

  • Get the pre-authorisation request form filled and signed by the treating doctor/hospital and signed by you or a family member, at the hospital’s insurance desk.
  • The network hospital will fax the request to HAT.
  • HAT doctors will examine the pre-authorisation request form and decide on cashless availability, as per the policy guidelines.
  • Authorisation letter/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.

Important points to note:

  • In case of planned hospitalisation, 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 charges 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 authorisation 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 hospitalisation.

Reimbursement of pre/post hospitalisation 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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Reimbursement claim process (in case of a non-network hospital)

  • Inform the BAGIC HAT team about the hospitalisation. To register your claim online click here To register your claim offline, please call us on our toll-free number: 1800-209-5858.
  • After discharge, you or a family member must submit the following documents to the HAT within 30 days: Duly filled and signed claim form with mobile number and email ID. Original hospital bill and payment receipt. Investigation report Discharge card Prescriptions Bills of medicines and surgical items Details of pre-hospitalization expenses (if any) In-patient papers, if required.
  • All documents to be sent to HAT for further processing and based on the assessment, the final settlement will be done within 10 working days.
  • Post hospitalisation claim documents must be sent within 90 days from the date of discharge.

Documents required for reimbursement claim:

  • Original pre-numbered hospital payment receipt duly sealed and signed.
  • Original prescriptions and pharmacy bills.
  • Original consultation papers (if any).
  • Original investigation and diagnostic reports along with original bills and payment receipt for the investigation done within and outside the hospital.
  • If you or a family member availed a cashless claim but did not utilise it, a letter from the hospital stating so.
  • A letter from the treating doctor mentioning incident details (in case of an accident).
  • Hospital registration certificate and hospital infrastructure on the letterhead.
  • A cancelled cheque bearing IFSC code and name of the insured.
  • Indoor case paper copy attested from the hospital from the date of admission to the date of discharge with detailed medical history and doctor’s notes with temperature, pulse and respiration charts.
  • X-ray films (in case of a fracture).
  • Obstetric history from treating doctor (in maternity cases).
  • FIR copy (in accident case).
  • Additional requirements for some special cases: In case of a cataract operation, lens sticker with a bill copy. In case of a surgery, implant sticker with a bill copy. In case of a heart-related treatment, stent sticker with a bill copy.

All original claim documents need to be submitted to the following address:

Health Administration Team

Bajaj Allianz House, Airport Road, Yerawada, Pune-411006

Mention your Policy Number, Health Card Number and Mobile Number clearly on the face of the envelope.

Note: Keep a photocopy of the documents and courier reference number for your records.

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LET'S SIMPLIFY HEALTH INSURANCE

What is the Health Administration Team?

The Health Administration Team comprises of doctors and paramedics who are responsible for health underwriting and claims settlement. It is a single window assistance to all the health insurance policyholders for healthcare-related services. This in-house team resolves issues related to health insurance customers. The team ensures faster claim settlement as a single point of contact and is effective for quick resolution of customer queries.

What are the basic coverages under the Family Health Insurance plan?

The key components covered under our Family Health Insurance plan are quite comprehensive. You get cover from pre and post hospitalisation, medical bills, ambulance charges and a lot more.

As a policyholder, what affects my health insurance/mediclaim premium?

Here are a few factors that will affect how much you pay towards a health insurance premium:

  • Your age and that of the eldest family member, in case of family floater health guard.
  • Sum insured
  • Your physical condition (health) and that of all insured members.
  • In case of few products with add-on covers, the premium also depends on the coverage taken under the health insurance policy.

Who can be covered under the Family Health Insurance policy?

Under the Family Floater Health Insurance plan, you can cover yourself, your spouse and up to 4 dependent children. For parents and in-laws, you can opt for a separate health insurance policy.

What is the zone-wise premium?

Zone A

Delhi/NCR, Mumbai including (Navi Mumbai, Thane and Kalyan), Hyderabad and Secunderabad, Bangalore, Kolkata, Ahmedabad, Vadodara and Surat.

Health insurance policyholders paying Zone A premium rates can avail treatment all over India without any co-payment.

Zone B

The rest of India apart from Zone A cities are classified as Zone B.

Policyholders paying zone B premium rates and availing treatment in Zone A city will have to pay 20% co-payment on admissible claim amount. This co-payment will not be applicable for accidental hospitalisation. Those residing in Zone B can choose to pay a premium for Zone A and avail treatment all over India without any co-payment.

Our happy customers!

Rama Anil Mate Mumbai

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

Suresh Kadu Mumbai

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

Ajay Bindra Mumbai

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

Don’t wait for a medical emergency to knock on your door!

Get a Quote

On-the-go claim settlement through Health CDC.

That’s not all, here are additional benefits with your Family Health Insurance policyOur family medical insurance provides various benefits for you and your loved ones:

Renewability

This policy comes with the benefit of lifetime renewal.

Tax saving

Avail income tax benefit under Section 80D of the Income Tax Act. Read more

*On opting for Family Health Insurance policy for yourself, your spouse, children and parents, you can avail Rs 25,000 per annum as a deduction against your taxes (provided you are not over 60 years). If you pay a premium for your parents who are senior citizens (age 60 or above), the maximum health insurance benefit for tax purposes is capped at Rs 50,000. As a taxpayer, you may, therefore, maximise tax benefit under Section 80D up to a total of Rs 75,000, if you are below 60 years of age and your parents are senior citizens.  If you are above the age of 60 years and are paying a medical insurance premium for your parents, the maximum tax benefit under Section 80D is, then, Rs 1 lakh.

Hassle-free claim settlement

We have an in-house claim settlement team that ensures a quick, smooth and easy claim settlement process.... Read more

We have an in-house claim settlement team that ensures a quick, smooth and easy claim settlement process. Also, we offer cashless claim settlement at more than 6,500+ network hospitals across India. This comes in handy in case of hospitalisation or treatment wherein we take care of paying the bills directly to the network hospital and you can focus on recovering and getting back on your feet.

Preventive health check-up

Free preventive health check- up at the end of a continuous period of 3 years during which your Family Health Insurance plan is active.

Portability benefit

If you and your loved ones are insured under any other family health insurance policy, you can switch to... Read more

If you and your loved ones are insured under any other family health insurance policy, you can switch to this policy with all  accrued benefits after due allowances for waiting periods and enjoy the available benefits of the policy.

Long-term policy

This policy can be purchased for a period of 1, 2 or 3 years.

Discount on policy

Avail long term policy discount of 4% for 2 years and 8% for 3 years.

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

Important points to note before buying Family Health Insurance

  • Inclusions
  • Exclusions

Pre and post hospitalisation

Covers pre and post hospitalisation expenses, the occurrence of which must be 60 days prior to hospitalisation or 90 days after hospitalisation.

Family cover

Covers your entire family including parents, parents-in-law, grandchildren and dependent siblings.

Ambulance charges

Covers ambulance charges, subject to a limit of Rs 20,000 in a policy year.

Daycare

Covers expenses for all listed daycare treatments.

Organ donor expenses

Covers organ donor expenses sum insured.

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A waiting period of 3 years will be applicable in case of pre-existing diseases.

Any disease contracted during the first 30 days of commencement of the health insurance policy ...

Read more

Any disease contracted during the first 30 days of commencement of the health insurance policy will be excluded from the coverage. However, accidental injuries are covered during the waiting period.

Diseases such as a hernia, piles, cataract and sinusitis will be covered after a waiting period of 2 years.
A waiting period of 3 years is applicable for bariatric surgery, joint replacement and prolapsed intervertebral disc.

Treatment for use of intoxicating and/or addictive substances such as alcohol, drugs, etc will not be covered.

A waiting period of 6 years for maternity/newborn expenses.

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Customer Stories

Juber Khan
Rama Anil Mate

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

Juber Khan
Suresh Kadu

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

Juber Khan
Ajay Bindra

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

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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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.

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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