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Health Insurance

Mediclaim Policy

HealthGuard

Key Features

This Time, Prioritise Your Health

Coverage Highlights

Comprehensive coverage for a worry-free tomorrow
  • Choose from Best of Plans

Choose from multiple plans to meet your requirements

  • Wide Sum Insured Options

Select adequate sum insured that suits you starting INR 3 lacs to INR 1 crore

  • Unlimited Reinstatement Benefit & Recharge

Get the option of unlimited reinstatement of sum insured even after it is exhausted after claims

  • Maternity & Newborn Care

Medical expenses related to delivery of baby and towards treatment of the new born baby are covered under select plans

  • Preventive Health Check-Up

Start receiving annual preventive health check-ups after 2/3 policy renewals as per the chosen plan

  • Online Discount

Get flat 5% discount when you buy a policy on our website or our Caringly Yours app

  • Zone Discount

Avail discounts of 20% for Zone B and 30% for Zone C depending on where you live

  • Fitness Discount & Wellness Discount

Avail up to 12.5% wellness discount for healthy habits on renewal

  • Note

Please read policy wording for detailed terms and conditions

Inclusions

What’s covered?
  • In-Patient Hospitalisation Treatment

Offers comprehensive in-patient hospitalisation cover for your planned surgery or an unexpected illness to help you focus on your recovery not on your expenses

  • Hospital Room Coverage

Covers the cost of standard air-conditioned room ensuring you get the best care in a comfortable setting

  • ICU Cover

Covers your critical care expenses while ensuring you receive the best treatment without any financial burden

  • Pre-Hospitalisation Medical Expenses

Provides coverage for medical expenses for 30 days leading up to your hospital stay, ensuring you're prepared for the unexpected

  • Post-Hospitalisation Medical Expenses

Covers your post-hospitalisation medical expenses, including follow-up treatments and consultations, for up to 60 days after discharge

  • Day Care Treatment

Ensures that through advanced procedures you get back on your feet in less than 24 hours

  • Organ donor expenses

Offers coverage for organ transplant as per the policy terms, supporting the costs involved in the treatment

  • AYUSH Hospitalisation Cover

Coverage for ayurvedic, yoga, Unani, Siddha, and homoeopathic (AYUSH) treatment on a doctor’s advice for treating illness or physical injury

  • Road Ambulance

Covers emergency ambulance services to ensure you get swift and safe transport to the nearest medical facility

  • Domiciliary Hospitalisation

Ensures you receive the necessary medical care in the comfort of your home

  • Modern Treatment Methods and Advancement in Technologies

Covers modern treatments, like robotic surgeries and stem cell therapy, ensuring you have access to the latest medical advancements

  • Floater & Individual Sum Insured

Option to cover your family members under shared SI in case of a floater plan or separate SI in case of an individual plan

  • Note

Please read policy wording for detailed inclusions

Exclusions

What’s not covered?
  • Investigation & Evaluation

Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded even if the same requires confinement at a hospital

  • Cosmetic or Plastic Surgery

Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an accident, burn(s) or cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured are not covered

  • Hazardous or Adventure sports

Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing, scuba diving, hand gliding, sky diving, and deep-sea diving, are not covered

  • Dietary Supplements & Substances

Cost of supplements that are purchased without a prescription by a certified doctor as a part of treatment, including vitamins, minerals and organic substances is not covered

  • Treatment for Self-Inflicted Acts

Medical expenses incurred as a result of self-harm, illegal actions, hazardous activities, etc. are not covered

  • Refractive Error

Expenses related to the treatment for correction of eyesight due to refractive error less than 7.5 dioptres are excluded

  • Unproven Treatments

Expenses related to any unproven treatment, services, and supplies in connection with any procedures or supplies that lack significant medical documentation to support their effectiveness stay uncovered

  • Sterility and Infertility

Expenses related to sterility and infertility, including any contraception, sterilisation and advanced reproductive technologies (such as IVF, ZIFT, GIFT, and ICSI), gestational surrogacy and reversal of sterilisation are not covered

  • Note

Please read policy wording for detailed exclusions

Additional Covers/Optional Covers

What else can you get?
  • Sum Insured Reinstatement

Choose one-time or unlimited reinstatements each policy year for tailored, continuous protection

  • Procedure-wise/Disease-wise Sublimit

Unlock your full sum insured for key procedures and diseases (with no limitations on critical care)

  • Super Cumulative Bonus

Choose from three flexible growth options that match your health goals, get sum insured raised up to 200% as per the policy terms

  • No Claim Discount

Get accumulated bonus (Cumulative Bonus/Super Cumulative Bonus) with an immediate 1.5% discount on your next Premium payment at renewal

  • Cashless Discount

Enjoy a 5% discount on your premium by choosing cashless claims at our network hospitals for no upfront payments. Reimbursement claims will require a 20% co-pay.

  • Accidental Death Shield

Get financial protection for your loved ones, ensuring they're cared for even when you can't be there due to personal accident

  • Health Prime Rider

Get coverage for in-person or online doctor consultation, dental wellness, emotional wellness, diet & nutrition consultations as per the chosen plan

Mediclaim Insurance

In a world where hospital bills can rise in the blink of an eye, a strong safety net becomes not just an option, but a necessity. That’s where a mediclaim policy steps in. It is a plan that covers your hospitalisation expenses, gives you peace of mind, and protects your savings.

Whether you're planning for unforeseen emergencies or seeking dependable medical insurance for parents, a mediclaim policy can ease the financial burden during tough times. Let’s explore everything you need to know about mediclaim health insurance and how Bajaj Allianz General Insurance Company can be your trusted partner in this journey.

What is a Mediclaim Policy?

A mediclaim policy is a type of health policy that reimburses you for medical expenses incurred during hospitalisation due to illness, disease, or an accident. It can be availed as an individual policy or as a family floater, ensuring protection for the entire family under a single sum insured.

Bajaj Allianz General Insurance Company offers a wide range of mediclaim health insurance options designed to meet the varying needs of individuals, families, and senior citizens, who require medical insurance for their parents with enhanced benefits and flexibility.

Key Features of Bajaj Allianz General Insurance Company’s Mediclaim Policy

Let’s take a closer look at the standout features of a Bajaj Allianz General Insurance Company’s Mediclaim Policy:

●     In-Patient Hospitalisation

It covers medical costs when you're admitted to a hospital for over 24 consecutive hours due to sickness or an accidental injury.

●     Pre and Post-Hospitalization

Expenses incurred 30 days before and 60 days of hospitalisation are reimbursed, provided they relate to the same medical condition.

●     Cashless Facility

Access over 18,400+ network hospitals where bills are settled directly with the provider, saving you from upfront payments during emergencies.

●     AYUSH Treatment

Coverage for alternative treatment systems like Ayurveda, Yoga, Unani, Siddha, and Homoeopathy.

●     No Third Party Administrator (TPA)

Bajaj Allianz General Insurance Company directly manages claim settlements, ensuring faster, smoother, and more transparent service.

Benefits You Deserve

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Region-Specific Premiums

Avail fair and local pricing for premiums as per the healthcare cost of 16 diffe

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Walk to Win

Enjoy up to 10% discount on policy renewal by completing regular step goals

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Super Cumulative Bonus

Get your Sum Insured raised by up to 50% every year up to 200% of Sum Insured

Benefits of Buying a Mediclaim Policy

Still wondering why you should buy mediclaim online? Here are some solid benefits of investing in mediclaim health insurance from Bajaj Allianz General Insurance Company:

1. Financial Protection Against Hospital Bills

A single surgery or extended ICU stay can cost lakhs. A mediclaim policy absorbs these costs, keeping your savings intact.

2. Access to Quality Healthcare

Enjoy worry-free treatments at top hospitals, including private multispecialty hospitals, without stressing about the bill.

3. Covers the Whole Family

Family floater plans make it economical to cover your spouse, children, and parents all at once.

4. Special Coverage for Seniors

Need solid medical insurance for parents? Bajaj Allianz General Insurance Company offers policies with no co-pay, higher sum insured options, and tailored benefits for senior citizens.

Download Policy Documents

Get instant access to policy details with a single click

Who Should Buy a Mediclaim Policy?

A mediclaim health insurance plan is suitable for:

●      Young professionals starting their financial journey.

●      Families seeking budget-friendly protection.

●      Senior citizens looking for dependable medical insurance for their parents.

●      Employees who want extra cover beyond what their corporate insurance offers.

No matter your life stage, there’s a Bajaj Allianz General Insurance Company’s mediclaim policy designed just for your needs.

How is Mediclaim Different from Health Insurance?

Mediclaim health insurance is a type of health policy, but it's more focused. Here’s how it differs:

Feature

Mediclaim Policy

Health Insurance Policy

Coverage

Hospitalisation, Pre- and Post-Hospitalisation, Modern Treatment Methods.

Hospitalisation + day care + critical illness + OPD

Claim Type

Reimbursement / Cashless

Reimbursement / Cashless / Lump sum (for critical illness)

Premium

Lower

Comparatively higher due to broader coverage

Add-ons

Limited

Offers optional coverage (maternity, global, etc.)

Scope

Narrower

Wider scope with more customisation

So, if your focus is on protection against hospitalisation costs only, a mediclaim policy offers great value. For broader needs, Bajaj Allianz General Insurance Company also offers comprehensive health policy options.

What is Not Covered?

Understanding the scope of your mediclaim policy from Bajaj Allianz General Insurance Company is crucial. While it offers valuable financial protection for hospitalisation, certain situations and treatments are typically not covered. Knowing these exclusions helps you manage expectations when you buy mediclaim online or utilise your existing mediclaim health insurance. Below are some key instances where coverage may not apply.

●      Hospital stays are primarily for investigations or diagnostic purposes only.

●      Admission is mainly for enforced rest, without active medical treatment.

●      Treatment for obesity or weight control programs.

●      Change-of-gender procedures.

●      Cosmetic or plastic surgery solely to alter appearance (unless reconstructive after accidents or burns).

●      Treatment for injuries from professional hazardous or adventure sports.

●      Treatment arising from illegal acts committed by the insured.

●      Treatment for alcoholism, drug, or substance abuse.

●      Treatments at health hydros or nature cure clinics for domestic reasons.

●      Dietary supplements unless part of hospitalisation or daycare.

●      Eye correction for refractive errors below 7.5 diopters.

●      Unproven medical treatments or services.

●      Treatment for sterility and infertility.

●      Medical expenses related to pregnancy and its complications.

●      Cosmetic dental procedures (unless due to accidental injury).

●      Medical expenses where inpatient care isn't required.

●      Treatment for war, invasion, or acts of foreign enemies.

●      Costs of spectacles, contact lenses, hearing aids, etc.

●      Certain congenital conditions, growth hormone therapy, and stem cell treatments (with specific exceptions).

●      Intentional self-injury.

●      Vaccination or inoculation.

●      Non-medical items as listed in the policy.

●      Treatment received outside India.

●      Treatment under systems other than modern medicine (allopathy) and AYUSH.

Why Buy Mediclaim Online?

Today, you can easily buy mediclaim online in just a few clicks. Here's why it makes sense:

●      No paperwork

●      Instant policy issuance

●      Premium calculators for better planning

●      Easy comparison of plans

●      Transparent terms and inclusions

●      24/7 support via chat, email, or toll-free calls

How to Choose the Right Mediclaim Policy?

Here are some factors to consider:

●     Coverage Needs

Assess whether you want basic hospitalisation or more benefits like modern treatments.

●     Family Members

Opt for an individual or family floater depending on how many people need coverage.

●     Sum Insured

Choose a sum insured that reflects current healthcare costs in your city.

●     Cashless Network

Always check if your preferred hospitals are in Bajaj Allianz General Insurance Company's network.

Bajaj Allianz General Insurance Company’s Mediclaim Claim Process

You can raise claims in two ways:

1. Cashless Claim (Preferred)

●      Available at any Bajaj Allianz General Insurance Company’s network hospital.

●      Requires a pre-authorisation form before admission.

●      Bills are settled directly by the insurer.

2. Reimbursement Claim

●      Applicable for non-network hospitals.

●      You pay the bills first, then file a claim with all documents.

●      Settlement usually occurs within 15–30 days.

Step-by-Step Guide

To help you navigate your insurance journey

How to Buy

  • 0

    Visit Bajaj Allianz website

  • 1

    Enter personal details

  • 2

    Compare health insurance plans

  • 3

    Select suitable coverage

  • 4

    Check discounts & offers

  • 5

    Add optional benefits

  • 6

    Proceed to secure payment

  • 7

    Receive instant policy confirmation

How to Renew

  • 0

    Login to the app

  • 1

    Enter your current policy details

  • 2

    Review and update coverage if required

  • 3

    Check for renewal offers

  • 4

    Add or remove riders

  • 5

    Confirm details and proceed

  • 6

    Complete renewal payment online

  • 7

    Receive instant confirmation for your policy renewal

How to Claim

  • 0

    Notify Bajaj Allianz about the claim using app

  • 1

    Submit all the required documents

  • 2

    Choose cashless or reimbursement mode for your claim

  • 3

    Avail treatment and share required bills

  • 4

    Receive claim settlement after approval

How to Port

  • 0

    Check eligibility for porting

  • 1

    Compare new policy benefits

  • 2

    Apply before your current policy expires

  • 3

    Provide details of your existing policy

  • 4

    Undergo risk assessment by Bajaj Allianz

  • 5

    Receive approval from Bajaj Allianz

  • 6

    Pay the premium for your new policy

  • 7

    Receive policy documents & coverage details

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Documents Required to Purchase a Mediclaim Policy

●      Age proof (Aadhaar, Voter ID, Passport).

●      Identity proof.

●      Duly filled application form.

●      Medical history (if required).

Why Choose Bajaj Allianz General Insurance Company for Mediclaim? 

Bajaj Allianz General Insurance Company stands out as a trusted provider for your mediclaim policy due to several key strengths:

●      Award-Winning Customer Service: Experience consistently high-quality and supportive assistance.

●      Transparent and Fast Claim Processing: Benefit from a straightforward and efficient process when you need your mediclaim health insurance.

●      Flexible Premium Payment Options: Manage your health policy costs with convenient payment choices.

●      Wide Range of Health and Mediclaim Policy Variants: Find the perfect plan to suit your needs, including options for medical insurance for parents.

●      Strong Network of Cashless Hospitals Across India: Access quality treatment without upfront payment at 18,400+ facilities nationwide.

●      Easy Portability and Migration Options: Seamlessly switch to Bajaj Allianz General Insurance Company if you're looking to buy mediclaim online or move from another insurer.

Conclusion: Secure Tomorrow, Today 

Medical emergencies don’t come with a warning. A mediclaim policy ensures that when they strike, your financial stability doesn’t take the hit. Whether you're planning for your own health or need medical insurance for parents, Bajaj Allianz General Insurance Company offers dependable, flexible, and affordable coverage.

With seamless digital processes, cashless treatment options, and expert customer support, it’s never been easier to buy mediclaim online. So why wait? Invest in your health today with a Bajaj Allianz General Insurance Company mediclaim policy and let peace of mind be your constant companion.

What Our Customers Say

Excellent Service

Bajaj Allianz provides excellent service with user-friendly platform that is simple to understand. Thanks to the team for serving customers with dedication and ensuring a seamless experience.

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Amagond Vittappa Arakeri

Mumbai

4.5

27th Jul 2020

Swift Claim Settlement

I am extremely happy and satisfied with my claim settlement, which was approved within just two days—even in these challenging times of COVID-19. 

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Ashish Jhunjhunwala

Vadodara

4.7

27th Jul 2020

Quick Service

The speed at which my insurance copy was delivered during the lockdown was truly commendable. Hats off to the Bajaj Allianz team for their efficiency and commitment!

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Sunita M Ahooja

Delhi

5

3rd Apr 2020

Outstanding Support

Excellent services during COVID-19 for your mediclaim cashless customers. You guys are COVID warriors, helping patients settle claims digitally during these challenging times.

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Arun Sekhsaria

Mumbai

4.8

27th Jul 2020

Seamless Renewal Experience

I am truly delighted by the cooperation you have extended in facilitating the renewal of my Health Care Supreme Policy. Thank you very much!

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Vikram Anil Kumar

Delhi

5

27th Jul 2020

Quick Claim Settlement

Good claim settlement service even during the lockdown. That’s why I sell Bajaj Allianz Health Policy to as many customers as possible.

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Prithbi Singh Miyan

Mumbai

4.6

27th Jul 2020

FAQ's

Can I buy a mediclaim policy without a medical test?

Yes, you can buy mediclaim online without undergoing a medical test if you're within a certain age bracket and opting for a lower sum insured. However, Bajaj Allianz General Insurance Company may require medical tests for individuals above a specific age or when selecting a high coverage amount to ensure the policy fits your health profile.

What is the waiting period for pre-existing conditions?

Most mediclaim health insurance plans from Bajaj Allianz General Insurance Company come with a waiting period of 1 to 3 years for pre-existing conditions. If you have maintained continuous coverage or migrated from another health policy, your waiting period may be reduced, subject to underwriting rules and IRDAI portability norms.

Can I include maternity coverage in my mediclaim policy?

Maternity coverage is not included by default in a standard mediclaim policy, but Bajaj Allianz General Insurance Company allows you to opt for it as an add-on. Note that maternity benefits usually come with a waiting period and are applicable only after a specific policy tenure. Always review the policy wording before selecting this benefit.

What if I miss the due date for my mediclaim premium?

If you miss the premium due date, Bajaj Allianz General Insurance Company offers a 30-day grace period to renew your health policy without losing continuity benefits such as waiting periods and pre-existing disease coverage. However, claims raised during the grace period may not be entertained, so it's best to renew before the expiry date.

How do I file a mediclaim?

Filing a claim is easy. You can avail of the cashless facility at any Bajaj Allianz General Insurance Company’s network hospital by submitting a pre-authorisation form. If treated at a non-network hospital, pay the bills upfront and file for reimbursement with supporting documents. For assistance, call 1800 209 5858 or visit www.bajajallianz.com.

Can I get coverage for parents under a mediclaim policy?

Yes, Bajaj Allianz General Insurance Company offers medical insurance for parents through individual or floater mediclaim policy options. These plans provide specialised benefits like higher sum insured options, coverage for age-related illnesses, and minimal paperwork. It's a thoughtful way to safeguard your parents’ health while managing rising healthcare costs efficiently.

Is there any tax benefit for buying a mediclaim policy?

Absolutely. The premium paid for your mediclaim health insurance qualifies for tax deduction under Section 80d of the Income Tax Act. You can claim deductions up to INR 25,000 for self and family, and an additional INR 50,000 for parents aged 60 and above, making it a smart financial and health move.

Are day care procedures covered in a mediclaim policy?

Yes, Bajaj Allianz General Insurance Company covers a wide range of day care procedures in its mediclaim health insurance procedures that don't require 24-hour hospitalisation due to medical advancements. This includes surgeries like cataract, chemotherapy, and dialysis. The complete list is included in the policy document, so you can plan your treatment accordingly.

Can I switch from another insurer to Bajaj Allianz General Insurance Company?

Yes, you can port your existing mediclaim policy from another insurer to Bajaj Allianz General Insurance Company without losing accumulated benefits. Under IRDAI guidelines, you must apply at least 45 days before the renewal date. Portability ensures you retain continuity benefits like pre-existing disease waiting periods, making the transition smooth and hassle-free.

Does health insurance offer options for covering my whole family?

Yes, many health insurance plans offer family coverage. However, the exact definition of 'family' can differ between providers. Generally, family health insurance covers you, your spouse, and dependant children (up to 2); you may need to get seperate policies for parents.

What are the common inclusions of health insurance?

Health insurance commonly covers hospitalisation costs, medical treatments, emergency services, and expenses related to pre- and post-hospitalisation care. Coverage for daycare procedures is also frequently included in health insurance plans; however, specific policy inclusions may vary from one plan to another.

Are pre-policy medical examinations common in health insurance?

Yes, many health insurance providers asks for pre-policy medical examinations for certain age groups, when applying for higher amount of coverage, or in other scenarios. Such examinations help insurers assess your current health conditions and potential risks. The specific tests and requirements can vary based on the provider and the policy chosen.

Do health insurance providers offer discounts for healthcare workers?

Health insurance providers may offer discounts on special concessions to healthcare workers on special occasions. The availability and specific details of these discounts can vary between insurers and different policies.

Is there any co-payment at the time of raising claims in health insurance?

If you have opted for the co-payment option in your policy, you will be required to bear part of your hospitalisation expenses based on the policy terms.

To whom should I submit claim documents, third party administration or my insurance provider?

You can submit your claim documents to the third-party administrator (TPA) managing your claim process or directly to your insurer depending on the procedure specified by your insurance provider.

Why do some health insurance policies include co-payment requirements?

Health insurance policies may include co-payment requirements to strike a balance between affordability and comprehensive coverage.

How can I raise my health insurance claim after hospitalisation?

You can file your claim after hospitalisation in case of an emergency hospitalisation. However, you must notify your insurance provider or third-party administrator (TPA) as soon as possible; the usual timeline for informing the insurer or third-party administrator is within 24 hours of being hospitalised. Make sure to gather all necessary documents, including medical bills, reports, and discharging summary for your claim. Once you are done with all of the paperwork, submit the completed claim form and supporting documents to your insurer. Remember to consult your specific policy documents for detailed procedures and deadlines.

What are the standard renewal terms for health insurance plans?

Many health insurance plans offer long-term or lifetime renewal, requiring for consistent annual renewals and adherence to policy terms. However, policy renewal might get denied in case of misrepresentation, fraud, or non-compliance. Thus, it is important to renew your insurance plan within the insurer's provided grace period. Contact your insurance provider for specific renewal details.

If there is any claim in my existing policy, is there any exclusion during renewal of my policy?

Depending on your policy teams a 60-day cooling off period may be applicable if the policy is renewed within 60 days from the date of admission of the previously paid claim. However, usually there isn't a waiting period for other listed vector-borne diseases. In case, the policy is renewed post 60 days from the date of admission of the previously paid claim, a fresh waiting period of 15 days may be applicable for all listed vector-borne diseases.

Can I enhance my sum insured during policy renewal?

You may be able to apply for sum insured enhancement during policy renewal depending on the guidelines shared by your insurance provider. You may have to submit a fresh proposal form to your insurance provider. Based on the terms and conditions you may get enhanced sum insured.

What is the process of renewing health insurance plans?

Here is a simple guide to help you in your policy renewal: 1. Login to the app 2. Enter your current policy details 3. Review and update coverage if required 4. Check for renewal offers 5. Add or remove riders 6. Confirm details and proceed 7. Complete renewal payment online 8. Receive instant confirmation for your policy renewal
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