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हेल्थ इन्श्युरन्स

Pradhan Mantri Jan Arogya Yojana in Gujarat

HealthGuard

महत्त्वाची वैशिष्ट्ये

An All-rounder Health Cover to Guard Your Family

Coverage Highlights

Get comprehensive coverage for your health
  • 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

  • प्रिव्हेंटिव्ह हेल्थ चेक-अप

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

  • ऑनलाईन सवलत

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

  • टीप

Please read policy wording for detailed terms and conditions

समावेश

What’s covered?
  • Hospitalisation & Day Care Expenses

Coverage for the cost of in-patient hospitalisation (including room rent type choices), all types of day care procedures, and surgeries

  • प्री आणि पोस्ट-हॉस्पिटलायझेशन खर्च

Pre-hospitalisation expenses (up to 60 days) and post-hospitalisation expenses (up to 90 days) are covered as per policy terms

  • अवयव दाता खर्च

Medical expenses for an organ donor’s in-patient treatment during organ harvesting are covered, provided the insured is the recipient of the donated organ

  • AYUSH Hospitalization cost

Coverage for ayurvedic, yoga, unani, siddha and homeopathic (AYUSH) treatment on a doctor’s advice for treating illness or physical injury

  • Maternity & Newborn Care

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

  • सम इन्श्युअर्ड रिइन्स्टेटमेंट

Exhausted sum insured exhausted or SI will be reinstated so that you can avail full coverage for your next claim in a policy year (as per policy terms) if needed

  • Recharge (For SI 5 Lacs Onwards)

If an unfortunate claim exhausts Sum Insured limit, the then additional amount of 20% Sum Insured (up to 25 INR lacs) will be available

  • संचयी बोनस

Sum Insured automatically increases at renewal by opted percentage if there is no claim in expiring period

  • 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

  • टीप

Please read policy wording for detailed terms and conditions

अपवाद

What’s not covered?
  • प्रारंभिक प्रतीक्षा कालावधी

Treatment expenses during the first 30 days except for treatment of accidental injuries

  • पूर्वी पासून असलेले रोग

Treatment expenses for pre-existing diseases such as diabetes, asthma, thyroid and other PED, are excluded until 36 months from date of your first Health Guard Policy

  • Specific Illness Treatment

Treatment expenses for specified illnesses, including hernia, gout, endometriosis, and cataract are excluded until 24 months from date of your first Health Guard Policy

  • मातृत्व खर्च

Treatment expenses related to maternity are excluded until 72 months from date of your first Health Guard Policy

  • Expenses for Medical Investigation & Evaluation

Medical expenses primarily for diagnostic procedures and medical evaluation unrelated to the current diagnosis or treatment

  • 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

  • Cosmetic Surgery Expenses

Treatment to change appearance unless it is for reconstruction required for a medically essential treatment or following an accident or burns

  • Treatment for Self-Inflicted Acts

Medical expenses incurred as a result of self-harm, as a result of intoxication, illegal actions, hazardous activities, etc.

  • Deductibles & Co-pays

Part of the claim will be borne by you if you have opted for deductibles or co-pay

  • टीप

Please read policy wording for detailed exclusions

अतिरिक्त कव्हर्स

What else can you get?
  • Air Ambulance Cover (Available for SI 5 Lacs & Above)

Covers expenses incurred for rapid ambulance transportation to the nearest hospital in an airplane or helicopter from the first incident site of illness or accident during policy period

  • Voluntary Aggregate Deductible

Covers medical expenses for in-patient hospitalisation beyond the voluntary aggregate deductible limit (INR 50,000/ INR 1,00,000/ INR 2,00,000/ INR 3,00,000) as opted as per policy terms for in-patient hospitalisation treatment

  • हेल्थ प्राईम रायडर

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

  • Respect Rider (Senior Care)

Senior citizens can avail emergency assistance with services such as SOS alert, doctor on call, and 24x7 ambulance service

  • Room Capping Waiver

Removes the room type restriction of "up to single private air-conditioned room" for Health Guard Gold and Platinum plans and provides coverage for actual room rent expenses without a limit

  • More Add-Ons

Explore more add-ons to enhance coverage

Health Insurance for All: PM-JAY Implementation in Gujarat

The Ayushman Bharat scheme, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a crucial initiative designed to provide health coverage to economically vulnerable families. In Gujarat, this scheme, popularly referred to as the Ayushman Bharat Card in Gujarat or Gujarat Ayushman card, brings quality healthcare services to millions of residents across the state. The scheme primarily targets the financially underprivileged, offering them insurance coverage for essential healthcare services at no cost. Bajaj Allianz General Insurance Company Limited is one of the insurers involved in facilitating the PMJAY scheme in Gujarat.

What is PMJAY (Ayushman Bharat Yojana) in Gujarat?

The Ayushman Bharat in Gujarat, launched under the PMJAY, is an extensive health protection scheme catering to the healthcare needs of low-income families in both urban and rural areas. It aims to reduce the financial burden of healthcare by covering hospitalisation costs up to Rs. 5 lakh per year per family.

The Ayushman Bharat Card Gujarat enables beneficiaries to access cashless and paperless medical treatment at public and private hospitals across the state, with insurance providers like Bajaj Allianz General Insurance Company Limited facilitating the process, to ensure that quality healthcare is available to all, regardless of their financial situation.

Eligibility Criteria of PMJAY Health in Gujarat

To avail the benefits of the PMJAY Gujarat, residents must be from specified categories SC/ST, Lower Income Group or EWS. They should meet specific eligibility criteria based on socio-economic status. The eligibility is determined by the Socio-Economic Caste Census (SECC) data from 2011, and the scheme primarily covers:

- Families living in a single room with kucha walls and roof.

- Households without an adult member aged 16-59 years.

- Families with no able-bodied adult members.

- Landless households earning a livelihood through manual labour.

Features of PMJAY: Ayushman Bharat Yojana Scheme in Gujarat

The Ayushman Bharat Card Gujarat offers several key features that make it a lifesaver for economically vulnerable families. Some of the prominent features include:

- Cashless treatment at both public and private empanelled hospitals, including those supported by Bajaj Allianz General Insurance Company Limited.

- Coverage of up to Rs. 5 lakh per family per year for secondary and tertiary healthcare.

- No restrictions on the number of family members covered.

- Coverage for pre-existing conditions from day one.

- Transportation cost reimbursement during hospitalisation.

Benefits You Deserve

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विस्तृत कव्हरेज

Choose your coverage as per your requirement

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वेलनेस सवलत

Stay fit during the policy year and enjoy 12.5% discount on renewal

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Reinstatement Benefits

Unlimited reinstatement of the sum insured upto 100% SI after its depletion

Benefits of Ayushman Bharat Yojana in Gujarat

The Ayushman Bharat Yojana in Gujarat provides multiple benefits to ensure healthcare accessibility for low-income families:

- Free treatment at all empaneled hospitals across Gujarat.

- Coverage of over 1,400 medical conditions, including critical illnesses like cancer, heart diseases, and kidney issues.

- Access to follow-up care for all major treatments.

- Support for day-care procedures without the need for extended hospitalisation.

At-A-Glance

Compare Insurance Plans Made for You

प्लॅन्स
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हेल्थ गार्ड सिल्व्हर

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हेल्थ गार्ड गोल्ड

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Health Guard Platinum

Hospital & Day Care SI INR 1.5/ 2 Lacs INR 3 lacs to INR 50 lacs INR 5 Lacs to INR 1 Cr.
Room Limits Up to 1% of SI per day and ICU at actuals Single private AC room for sum insured of SI 3 Lacs to 7.5 Lacs | Actuals for SI 10 Lacs & above | ICU at Actuals Single private AC room for sum insured of SI 3 Lacs to 7.5 Lacs | Actuals for SI 10 Lacs & above | ICU at Actuals
Pre- & Post-Hospitalisation Pre: 60 days & Post: 90 days Pre: 60 days & Post: 90 days Pre: 60 days & Post: 90 days
Organ Donor, AYUSH, Modern Treatments सम इन्श्युअर्ड पर्यंत सम इन्श्युअर्ड पर्यंत सम इन्श्युअर्ड पर्यंत
रोड अ‍ॅम्ब्युलन्स INR 20,000/policy year INR 20,000/policy year INR 20,000/policy year
Preventive Check-Up 1% of SI (max up to 2,000) once in 3 years 1% of SI (max up to 5,000) once in 3 years 1% of SI (max up to 5,000) once in 2 years
Maternity & Newborn Care कव्हर्ड नसलेले As per limits specified As per limits specified
कॉन्व्हलेसन्स लाभ INR 5,000/policy year INR 5,000/policy year for sum insured up to INR 5 lacs | INR 7,500/policy year for sum insured of 7.5 lacs and above INR 5,000/policy year for sum insured up to INR 5 lacs | INR 7,500/policy year for sum insured of 7.5 lacs and above
सम इन्श्युअर्ड रिइन्स्टेटमेंट 100% of the base sum insured 100% of the base sum insured 100% of the base sum insured
वेलनेस सवलत Up to 12.5% wellness discount for healthy habits on renewal Up to 12.5% wellness discount for healthy habits on renewal Up to 12.5% wellness discount for healthy habits on renewal
More Covers See Policy documents for more details

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What Ayushman Bharat (PM‑JAY) Covers in Gujarat?

The Ayushman Bharat Card Gujarat covers the following healthcare services:

- Pre-hospitalisation expenses for up to 3 days.

- Post-hospitalisation expenses for up to 15 days.

- Costs of medicines and diagnostics.

- ICU services and non-intensive care.

- Surgical procedures and follow-up care.

What is not Covered Under PM-JAY in Gujarat?

The following are not covered under the PMJAY Gujarat scheme:

- Outpatient treatments not requiring hospitalisation.

- Cosmetic surgeries unless related to injury.

- Dental procedures unless linked to severe health issues.

- Surgeries purely for aesthetic purposes like fat grafting or rhinoplasty.

- Organ transplant procedures.

Step-by-Step Guide

To help you navigate your insurance journey

खरेदी कसे करावे

  • 0

    Visit Bajaj Allianz website

  • 1

    वैयक्तिक तपशील प्रविष्ट करा

  • 2

    हेल्थ इन्श्युरन्स प्लॅन्सची तुलना करा

  • 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

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    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

How to Register for the PMJAY Scheme Online in Gujarat?

The process of ayushman card online registration Gujarat is straightforward:

- Visit the official PMJAY website.

- Click on the ‘Am I Eligible’ tab and enter your mobile number.

- Submit the CAPTCHA and OTP received and enter your state details.

- If eligible, your name will appear in the beneficiary list.

Documents Required to Apply for Ayushman Bharat Yojana in Gujarat

To apply for the Ayushman Bharat Card Online Gujarat, you need the following documents:

- Aadhaar Card or PAN Card for identity proof.

- Income certificate to verify financial status.

- Caste certificate (if applicable).

- Mobile number and residential address details.

How to Know If You Qualify for PM-JAY Health Coverage

- To check your eligibility for the Gujarat Ayushman card:

- Visit the official Ayushman Bharat website.

- Enter your name, ration card number, or mobile number.

- You can also check your status by visiting a nearby Common Service Centre (CSC) or by contacting the PMJAY helpline.

Critical Illnesses Covered Under PM‑JAY in Gujarat H2

The PMJAY Gujarat scheme covers numerous critical illnesses, including:

- Cancer treatment, including chemotherapy.

- Cardiac surgeries like coronary artery bypass grafting.

- Orthopaedic surgeries like knee replacement.

- Neurological procedures like skull base surgery.

How to Download Your Ayushman Bharat Yojana Card Online in Gujarat?

To download the Ayushman Card Online Gujarat:

- Visit the Ayushman Bharat official portal.

- Log in with your credentials and use your Aadhaar Card to generate your card.

- The card can be downloaded and printed for future use

Ayushman Bharat Scheme Hospitalisation Process in Gujarat

The PMJAY Gujarat scheme ensures a hassle-free hospitalisation process for beneficiaries:

- Visit an empanelled hospital and provide your Ayushman Bharat ID.

- The Pradhan Mantri Arogya Mitra at the hospital will assist in verifying your eligibility and initiating the treatment process.

- The treatment is entirely cashless, and the network insurance provider such as Bajaj Allianz General Insurance Company Limited, directly settles the medical bills.*

* प्रमाणित अटी लागू

Critical Diseases Covered Under PM‑JAY in Gujarat

The PMJAY Gujarat covers a wide range of critical illnesses:

- Cardiovascular diseases, including angioplasty and stenting.

- Cancer treatment, including radiation therapy.

- Kidney-related treatments like dialysis.

- Complex surgeries, including organ transplants.

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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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FAQs

What is the process to get an Ayushman card in Gujarat?

The Ayushman Card Gujarat can be obtained online by visiting the official PMJAY portal, verifying eligibility, and downloading the card. Alternatively, you can visit a Common Service Centre (CSC) for assistance.

Do the beneficiaries have to pay anything to get coverage under the Ayushman Bharat health insurance scheme in Gujarat?

No, the Ayushman Bharat Yojana in Gujarat is entirely free for eligible families, covering treatment costs without requiring any out-of-pocket expenses.

Are diabetic patients covered under the PM Ayushman Bharat Yojana Scheme in Gujarat?

Yes, diabetes and related complications are covered under the PMJAY Gujarat scheme.

How long is Ayushman valid in Gujarat?

The Ayushman Bharat Card Gujarat is valid for the lifetime of the beneficiary, provided they remain eligible under the scheme's criteria.

What should I do if the hospital refuses to treat a beneficiary under the Ayushman Bharat Scheme in Gujarat?

In case of refusal, contact the PMJAY helpline or the Pradhan Mantri Arogya Mitra present at the hospital. They will help resolve the issue and ensure you receive the required treatment

Is cancer covered under the Ayushman Bharat Yojana Scheme in Gujarat?

Yes, cancer treatment, including chemotherapy and surgeries, is covered under the Ayushman Bharat in Gujarat scheme.

Is health insurance cover under the Ayushman Yojana scheme in Gujarat enough?

For most secondary and tertiary healthcare needs, the coverage of Rs. 5 lakh provided under the PMJAY Gujarat is sufficient.

How to update data in PMJAY in Gujarat?

Visit the official PMJAY portal and log in with your credentials to update your data or visit a nearby CSC for assistance.

How to change the mobile number in PMJAY in Gujarat?

Log in to the PMJAY portal and update your mobile number under the profile section.

Does PMJAY in Gujarat cover people above the age of 80 years?

Yes, the PMJAY Gujarat scheme provides coverage to all eligible individuals, including those above 80 years of age.

Does the PMJAY scheme in Gujarat offer coverage to farmers?

Yes, farmers falling under the specified socio-economic criteria are covered under the Ayushman Bharat Yojana in Gujarat.

Does Ayushman Bharat in Gujarat cover orthopaedic treatment?

Yes, orthopaedic treatments, including surgeries and rehabilitation, are covered under the PMJAY Gujarat scheme.

How can I find my Household ID number for PMJAY in Gujarat?

You can find your Household ID by visiting the PMJAY portal and entering your details or by visiting a CSC.

How to make a PMJAY card in Gujarat?

The Ayushman Card Gujarat can be made by visiting the official PMJAY portal, checking eligibility, and downloading the card.Is the Ayushman card free in Gujarat?

Is the Ayushman card free in Gujarat?

Yes, the Ayushman Bharat Card Gujarat is provided free of cost to eligible beneficiaries.

Is there any age limit for the Ayushman Card in Gujarat

 

The Ayushman Bharat in Gujarat scheme has transformed the healthcare world by offering essential medical coverage to those in need. With comprehensive benefits and a hassle-free application process, it continues to ensure that healthcare remains accessible to all.

तुमच्या आरोग्यासाठी मेडिकल इन्श्युरन्स का आवश्यक आहे?

मेडिकल इन्श्युरन्स अनपेक्षित वैद्यकीय खर्चापासून आर्थिक संरक्षण प्रदान करते. तुमची सेव्हिंग्स कमी न करता दर्जेदार आरोग्यसेवेचा ॲक्सेस सुनिश्चित करते.

How many dependent members can I add to my family health insurance pla

तुम्ही पॉलिसीच्या अटींनुसार तुमचे पती / पत्नी, मुले, पालक आणि इतर अवलंबून असलेले जोडू शकता, सर्वसमावेशक कुटुंबाचे कव्हरेज सुनिश्चित करू शकता.

Why should you compare health insurance plans online?

ऑनलाईन तुलना तुम्हाला तुमच्या गरजा आणि बजेटसाठी अनुकूल असलेला सर्वोत्तम प्लॅन शोधण्यास मदत करते, कव्हरेज आणि लाभांची स्पष्ट समज देते.

Why should you never delay the health insurance premium?

प्रीमियम विलंबामुळे पॉलिसी लॅप्स होऊ शकते, कव्हरेज लाभ आणि आर्थिक संरक्षण गमावू शकते आणि पॉलिसी रिन्यू करण्यात अडचणी येऊ शकतात.

How to get a physical copy of your Bajaj Allianz General Insurance Com

इन्श्युरर कडे फिजिकल कॉपीची विनंती करा किंवा ईमेलद्वारे प्राप्त झालेल्या डिजिटल पॉलिसी डॉक्युमेंटची प्रिंटआऊट घ्या.

Is there a time limit to claim health cover plans?

नामंजूर होणे टाळण्यासाठी आणि वेळेवर प्रोसेसिंग सुनिश्चित करण्यासाठी पॉलिसीच्या अटींनुसार निर्धारित वेळेत क्लेम केले पाहिजेत.

What exactly are pre-existing conditions in an Individual Health Insur

तुमचा वैयक्तिक हेल्थ इन्श्युरन्स प्लॅन खरेदी करण्यापूर्वी तुमच्याकडे असलेल्या वैद्यकीय स्थिती म्हणजे पूर्व-विद्यमान स्थिती होय. यासाठी कव्हरेजसाठी प्रतीक्षा कालावधी किंवा अपवाद आवश्यक असू शकतात. तुमच्या हेल्थ रेकॉर्ड बाबत पारदर्शक राहा.

इन्श्युरर माझे हॉस्पिटल बिल कसे भरणार आहे?

इन्श्युरर रिएम्बर्समेंटद्वारे हॉस्पिटलचे बिल कव्हर करतात (तुम्ही अपफ्रंट देय करता आणि नंतर परतफेड मिळवता) किंवा कॅशलेस हॉस्पिटलायझेशन (इन्श्युरर नेटवर्क हॉस्पिटल्ससह थेट बिल सेटल करतो).

Are there any tax advantages to purchasing Individual Health Insurance

वैयक्तिक हेल्थ इन्श्युरन्स प्रीमियम अनेकदा इन्कम टॅक्स ॲक्टच्या (इंडिया) च्या सेक्शन 80D अंतर्गत टॅक्स कपातीसाठी पात्र असतात.

मला पर्सनल मेडिकल इन्श्युरन्सची आवश्यकता का आहे?

पर्सनल मेडिकल इन्श्युरन्स आजार, अपघात किंवा हॉस्पिटलायझेशनमुळे उद्भवणाऱ्या अनपेक्षित वैद्यकीय खर्चापासून आर्थिक संरक्षण प्रदान करते. हे मनःशांती प्रदान करते आणि तुमच्या सेव्हिंग्सचे संरक्षण करते.

मला हेल्थ इन्श्युरन्स प्लॅन्स कसे रिन्यू करता येतील?

छोट्या छोट्या गोष्टींवरून तणाव घेण्याची गरज नाही. तुमची लाईफ इन्श्युरन्स पॉलिसी रिन्यू करण्याची सोपी आणि वेगवान पद्धत म्हणजे ती ऑनलाईन करणे. तुमचे हेल्थ इन्श्युरन्स कव्हर टॉप अप केल्यामुळे मोठ्या वैद्यकीय खर्चांपासून तुम्हाला स्वातंत्र्य मिळते.

हेल्थ इन्श्युरन्स रिन्यूवल प्रीमियम कसे कॅल्क्युलेट केले जाते?

आम्हाला माहित आहे की हेल्थ इन्श्युरन्स पॉलिसीच्या कठीण अटी आणि शर्ती वाचणे कायमच सोपे नसते. त्यामुळे, हे तुमचे उत्तर आहे. तुमचा रिन्यूअल प्रीमियम तुमचे वय आणि कव्हरेज यांच्यावर आधारित असतो. नेहमीप्रमाणेच, तुम्ही हेल्थ इन्श्युरन्समध्ये लवकरात लवकर गुंतवणूक करून जास्तीत जास्त चांगला वापर करू शकता.

मी माझी कालावधी संपलेली हेल्थ इन्श्युरन्स पॉलिसी रिन्यू करू शकतो/ शकते का?

Yes, of course. Life can get really busy and even things as important as renewing your health insurance plan can get side-lined. With Bajaj Allianz, we turn back the clock to give a grace period where you can renew your expired policy. For 30 days from the expiry date, you can still renew your health cover with ease. Now, you can run the race at yo

मला हेल्थ इन्श्युरन्स ऑनलाईन रिन्यू करता येईल का?

नक्कीच! तुम्हाला तुमचा हेल्थ इन्श्युरन्स काही वेळा क्लिक किंवा टॅप करून रिन्यू करायचा आहे. तुम्ही हेल्थ इन्श्युरन्स पॉलिसी ऑनलाईन रिन्यू करू शकता आणि तुमच्या कुटुंबासाठी तसेच मित्रांसाठी नवीन पॉलिसी घेऊ शकता. अधिक माहितीसाठी येथे क्लिक करा.

Will I be able to transfer my health insurance policy from another pro

हो, IRDAI नियमावलीनुसार दोन प्रोव्हायडर्स मध्ये इन्श्युरन्स पोर्टेबिलिटी शक्य आहे. यात आधी अस्तित्वात असलेल्या आजारांसाठी प्रतीक्षा कालावधींशी संबंधित संचयी बोनस आणि क्रेडिट यांचे लाभांचे ट्रान्सफर समाविष्ट आहेत.

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