• Bharti AXA Health Insurance Network Hospitals

    Find the state-wise list of network hospitals for BHARTI AXA GENERAL INSURANCE.

    Search for details of BHARTI AXA GENERAL INSURANCE network hospitals in India.

    Bharti AXA General Insurance Company Ltd is a joint venture between Bharti Enterprises and AXA, and they currently have 87 branch offices around the country. Bharti Enterprises is a pioneer in the Indian telecom space, with multiple innovations to their credit. The AXA Group is a leader in asset management and insurance, offering services to 103 million clients in 64 countries across the globe.

    Bharti AXA General Insurance has been honoured with multiple awards in the past, some of them being, the Tech Initiative of the Year award at the Asia Insurance Industry Awards 2014 and the BFSI: Best Insurance Company in the Private Sector - General 2014 award. The company aims to redefine industry standards by providing innovative and comprehensive insurance solutions to customers. The health insurance plans provided by Bharti AXA include the following:

    • SmartHealth Insurance Policy - This plan is available in three versions, with varying sum insured of Rs.2 lakh, Rs.3 lakh, and Rs.5 lakh. For senior citizens in the age group of 56 to 65 years, medical tests will be necessary for the purchase of the policy. The plan variants that offer sum assured of Rs.3 lakh and Rs.5 lakh have critical illness cover that provides a compensation when the insured is diagnosed with any of the 20 pre-defined critical illnesses. The policy variants also cover domiciliary hospitalisation and day care treatments up to certain limits.

    Bharti AXA Health Insurance Cashless Network Hospitals

    A health insurance company usually has tie-ups with various network hospitals where policyholders can avail treatment on a cashless basis. The policyholder will be required to inform the insurer of the hospitalisation, and provide a valid ID card at the hospital to avail cashless services. The treatment offered will be similar to that at a non-network hospital, but the procedure for settlement of the medical bills differ. In the case of cashless claims, the health insurer directly connects to the network hospital and settles the bills. This way, the insured can avail treatment without having to pay for the expenses at the time of discharge. The cost of medical facilities will subsequently be deducted from the annual sum insured of the health insurance policy of the patient.

    Bharti AXA has a vast network of affiliate hospitals across the country that provide cashless hospitalisation services to customers in a hassle-free manner.

    What are the types of claims that can be done at Bharti AXA Health Insurance network hospitals?

    The following types of claims can be executed at Bharti AXA network hospitals:

    • Cashless Claims - If the policyholder avails treatment at a network hospital, he/she is not required to pay for the medical expenses, up to the sum assured under the policy. The insurance company liaises with the network hospital and settles the bills, without any involvement from the insured.
    • Reimbursement Claims - If the policyholder is hospitalised at any hospital, he/she can pay the cost of treatment at the time of discharge. Subsequently, he/she can raise a claim under the policy for the reimbursement of these expenses. The insurance company reviews the claim and, if found valid, offers timely reimbursement.

    How do you file claims at Bharti AXA Health Insurance network hospitals?

    The claim process for a cashless hospitalisation is as follows:

    • The insured furnishes his/her health insurance ID card at the hospital insurance desk and requests for cashless hospitalisation.
    • The hospital sends the completed cashless claims request form to the insurer.
    • The insurance company validates the request with the policy terms and conditions and responds to the hospital.
    • If the request is approved by the insurer, they settle the bills directly with the hospital. If the request is rejected (due to insufficient coverage under the policy), the hospital will be informed of the same. The insured can then avail treatment and request for a settlement as in the case of a reimbursement hospitalisation claim.

    The claim process for reimbursement hospitalisation is as follows:

    • The facility for reimbursement claims is available at both network hospitals and non-network hospitals. The insurance company should be intimated within 48 hours after hospitalisation.
    • The insured avails treatment, pays the bills, and raises a claim for the settlement of expenses.
    • The insurer reviews the claim documents and releases the payment accordingly.
    • If the claim is rejected, the policyholder will be informed of the decision with the relevant reasons.

    Procedures offered/covered in Bharti AXA Health Insurance network hospitals across India

    The Bharti AXA health insurance policy includes day care treatments that do not require 24 hours of hospitalisation, such as chemotherapy, dialysis, lithotripsy, eye surgery, radiotherapy, dental surgery, tonsillectomy, curettage and dilation, hydrocele surgery, and hernia repair surgery . Domiciliary hospitalisation for more than 3 days is also covered.

    Additionally, the policy covers a number of critical illnesses such as:

    • Cancer
    • Coronary Artery Disease
    • Heart Valve Surgery
    • First Heart Attack
    • Coronary Artery Bypass Surgery
    • Stroke
    • Surgery to Aorta
    • End Stage Lung Disease
    • Kidney Failure
    • Aplastic Anaemia
    • Coma
    • End Stage Liver Failure
    • Major Organ or Bone Marrow Transplantation
    • Major Burns
    • Fulminant Hepatitis
    • Multiple Sclerosis
    • Primary Pulmonary Hypertension
    • Motor Neurone Disease
    • Bacterial Meningitis
    • Terminal Illness

    Exclusions under Bharti AXA Health Insurance network hospital services

    The standard exclusions to the Bharti AXA policies are as follows:

    • Expenses for treatment that occurs within 30 days from the inception of the policy is not covered. However, this is not relevant to subsequent renewals of the policy.
    • The following ailments will be excluded for the first two years of the policy:
      • Laser surgery of the eyes
      • Hysterectomy or myomectomy (except due to malignancy)
      • Curettage and dilation
      • Fistula in anus, sinusitis, hernia, hydrocele, hemorrhoids
      • Joint replacement (except due to accidents)
      • All internal and skin tumors that are not malignant
      • Dialysis for chronic renal failure
      • Ulcers and gastric erosions
    • The following are permanently excluded from the coverage:
      • Routine examinations of the eye, ear, and the cost of spectacles
      • Dental treatments
      • Sex change operations and circumcision
      • Birth control procedures, cesarean section, fertility treatment, hormone replacement therapy
      • AIDS and related diseases
    • Naturopathy treatment
    • Pre-existing illnesses are covered only after two years from the inception of the policy.

    FAQs – Frequently Asked Questions:

    1. How many claims can I make during a policy year?

      There is no limit on the number of times you can make claims in a policy year. However, the sum of the claim amounts cannot exceed the policy sum insured.

    2. What is claim settlement ratio?

      Claim settlement ratio is the fraction of claims settled against the total number of claims reported throughout the year. The claim settlement ratio of Bharti AXA health insurance was 94% in 2012.

    3. How is the premium calculated for Bharti AXA health insurance policy?

      The premium of Bharti AXA health insurance policy is determined by the following factors:

      • The option of sum insured chosen
      • The number of family members covered under the policy
      • The age of the oldest person in the family who is covered under the policy
      • The type of policy opted for, i.e., Basic, Premium, or Optimum
    4. What are pre and post hospitalisation expenses?

      Pre and post hospitalisation costs refer to expenses incurred during the period before and after hospitalisation for any ailments or injury sustained.

    5. What is domiciliary hospitalisation? How is it covered?

      Domiciliary hospitalisation refers to the treatment done at home (for a period that exceeds 3 days) for illnesses or injuries, which would have otherwise required hospitalisation. This is relevant in a situation where the patient cannot be moved to a hospital or when there is a lack of space at the hospital.

    6. Bharti AXA covers the cost of treatment and expenses for domiciliary hospitalisation, if qualified nurses are employed and there is an attending medical practitioner. The cover is capped at a maximum of 10% of the sum insured and is paid if the treatment continues beyond 3 days.

    7. What are the tax benefits offered by the plan?

      All premiums paid towards the Bharti AXA health insurance policy are liable for tax benefits under Section 80D of the Income Tax Act, 1961. The deductions allowed are as mentioned below:

      • For Self and Family:

      Maximum deduction of Rs.25,000 annually

      Maximum deduction of Rs.30,000 annually if you are a senior citizen.

      • For Parents:

      Maximum deduction of Rs.30,000 annually on premium payments for senior citizens.

    8. I am already in possession of a life insurance plan. Do I still need to buy a health insurance policy?

      A life insurance coverage protects the dependents of the policyholder from losses that may arise from an untimely death or accidental disability. The payout of a life insurance policy is made after the death of the insured or at the time of policy maturity. On the other hand, a health insurance policy protects the policyholder from ill-health or diseases by covering the expenses of treatment availed. There are no payouts made at the time of policy maturity. Health insurance also needs to be renewed on a yearly basis.

    9. I am already covered under the health insurance policy provided by my employer. Do I need to buy individual health insurance separately?

      The employer’s health insurance will not be effective in the event of a job change or retirement. In the transition period between jobs, you will be exposed to health risks that may prove to be very costly. Transfer of the health insurance benefits from the old employment to the new company may not be possible, as well. Moreover, the employer’s health insurance may not have extensive coverage or effective protection against pre-existing diseases. So, it is advisable to purchase a separate health insurance policy to provide you optimum coverage.

    10. Is it possible to buy more than one health insurance policy?

      Yes, this is possible. In the event of a claim, each insurance company will pay a proportion of the expenses, as per the coverage under each scheme.

    11. Will my health insurance policy cover me for treatment abroad?

      No, the Bharti AXA health insurance policy only covers hospitalisation expenses in India.


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