BAJAJ ALLIANZ Health Insurance

Overview

Bajaj Allianz General Insurance Company Limited is one of India’s most trusted and preferred insurance vendor. The company is a joint venture between Bajaj Finserv Limited and Allianz SE, two companies that have garnered a solid reputation for domain expertise, professional business practices, stability and foresight. Bajaj is a commonly known brand in India, while Allianz SE is a globally known entity that is commended for its technical expertise and path breaking initiatives. In the very short duration that Bajaj Allianz Life Insurance has been a part of the health insurance scene in India, it has earned a staunch fan following, alongside the title of a market leader and preferred health insurance option amongst the discerning local customer base.

Why Compare Bajaj Allianz Health Insurance Plans on BankBazaar?

Health Insurance Products from Bajaj Allianz

The company’s health insurance portfolio includes the following products-

1. Health Guard Individual Policy
2. Health Guard Family Floater Option
3. Surgical Protection Plan
4. Premium Personal Guard
5. Extra Care
6. Critical Illness
7. Critical Illness
8. Silver Health Plan for Senior Citizens
9. Tax Gain Plan

Let’s analyze the merits of each health insurance product individually-

Health Guard Individual Policy

An all-round product that is suitable for the busy lives we lead today- providing peace of mind, a solid backup in case of untimely hospitalization, illness, injury or accident. This policy helps an individual face tough medical eventuality without too much worry and personal expenditure.

Features & Benefits

• An applicable family discount of 10%.
• Avail cashless hospitalization at 3700+ partner hospitals across India.
• Entry Age- 18 to 65 years, with lifetime renewal option. Children from 3-25 years can also be covered per this policy.
• Pre and post hospitalization expenses covers all medical instances from 60 days prior to and 90 days after hospitalization.
• Avail cumulative bonus of 10% for each claimless year, maximum upto 50% of insured sum.
• Medical test isn’t mandatory for persons under the age of 45 years.
• Pre-policy checkup (if required) will be conducted at an appointed diagnostic center. The expense incurred by the customer will be refunded in full if the proposal is accepted and policy issued.
• Free Health check-up at the end of 4 continuous claim free years.
• 130 Day Care procedures covered.
• Ambulance charges in emergency cases, to a limit of Rs.1000.
• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
• Free Look Period of 15 days- Did not like the policy? Cancel the policy within 15 days for a complete refund.
• Grace period of 30 days for every subsequent instance of policy renewal.
• You will not be charged a higher premium if there has been a claim in the previous policy.

Exclusions- What Incidents Aren’t Covered by the Policy?

• In the case of pre-existing diseases, a waiting period of 4 years will apply.
• Illness, injury or diseases contracted within 30 days from the commencement of the policy won’t be covered.
• Treatments consisting of non-allopathic medicine will not be covered.
• Certain diseases require a waiting period of 2 years before coverage, including hernia, piles, cataract and sinusitis.
• Coverage will not be extended for the following- Cosmetic, aesthetic or related treatments, treatments for use of intoxicating and/or addictive substances like alcohol, drugs etc.
• Joint replacement surgery that isn’t caused by an accident requires a waiting period of 4 years.
Congenital external are excluded permanently. Congenital internal have waiting period of 4 years.

Health Guard Family Floater Option

This policy ensures that you and your family are adequately protected in the case of a medical emergency. This all-round policy covers you and your family for such scenarios as hospitalization, doctor's consultation, diagnostic tests, medicines, ambulance, etc. Henceforth, do not worry about running out of cash when it comes to a medical emergency befalling you or your family.

Features & Benefits

• Avail cashless hospitalization at 3700+ partner hospitals across India.
• Entry Age- 18 to 65 years, with lifetime renewal option. Children from 3-25 years can also be covered per this policy.
• Pre and post hospitalization expenses covers all medical instances from 60 days prior to and 90 days after hospitalization.
• Avail cumulative bonus of 10% for each claimless year, maximum up to 50% of insured sum.
• Medical test isn’t mandatory for persons under the age of 45 years.
• Pre-policy checkup (if required) will be conducted at an appointed diagnostic center. The expense incurred by the customer will be refunded in full if the proposal is accepted and policy issued.
• If you choose your own diagnostic center for the pre-policy checkup, the costs incurred will be reimbursed within 14 working days after the submission of all requisite documents.
• Free Health check-up at the end of 4 continuous claim free years, or reimbursement up to Rs.1000 (collectible by one individual from the family).
• 130 Day Care procedures covered.
• Ambulance charges in emergency cases, to a limit of Rs.1000.
• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
• Free Look Period of 15 days- Did not like the policy? Cancel the policy within 15 days for a complete refund.
• Grace period of 30 days for every subsequent instance of policy renewal.
• You will not be charged a higher premium if there has been a claim in the previous policy.

Exclusions- What Incidents Aren’t Covered by the Policy?

• In the case of pre-existing diseases, a waiting period of 4 years will apply.
• Illness, injury or diseases contracted within 30 days from the commencement of the policy won’t be covered.
• Treatments consisting of non-allopathic medicine will not be covered.
• Certain diseases require a waiting period of 2 years before coverage, including hernia, piles, cataract and sinusitis.
• Coverage will not be extended for the following- Cosmetic, aesthetic or related treatments, treatments for use of intoxicating and/or addictive substances like alcohol, drugs etc.
• Joint replacement surgery that isn’t caused by an accident requires a waiting period of 4 years.
• Congenital external are excluded permanently. Congenital internal have waiting period of 4 years.
Acquired Immune Deficiency Syndrome (AIDS) and related ailments.

Surgical Protection Plan

This is a unique policy that provides you a fixed benefit amount for specific surgeries thereby allowing you to take the load of expensive surgical procedures without too much of a problem. Alongside the Surgical Benefit Cover, the Surgical Protection Plan brings you a host of other add-on covers such as Hospital Cash Daily Allowance, Critical Illness and Personal Accident.

Features & Benefits

• Complete coverage for 600+ surgeries, with guaranteed benefit amount.
• Avail cashless hospitalization at 3700+ partner hospitals across India. This policy can be chosen alongside the hospitalization policy.
• Very affordable premium rates.
• A total of 11 plans are available per the Rs.1 lakh- 10 lakh sum insured options under surgical benefit section.
• Medical test isn’t mandatory for persons under the age of 45 years.
• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
• Free Look Period of 15 days- Did not like the policy? Cancel the policy within 15 days for a complete refund.
• Grace period of 30 days for every subsequent instance of policy renewal.
In-house claims processing by Health Administration Team of Bajaj Allianz

Additional Covers

Benefits under Hospital Cash Daily Allowance

• For a continuous 24 hours hospitalisation incidence, Rs.1500/per day is allocated.
• Maximum period of 30 days during each policy period
• In case of admission in ICU, the benefit payable would be double, i.e., Rs.3000/day, max for 15 days during each policy period
• Exclusions- Use of intoxicant substances like drugs and/or alcohol, War or act of war, nuclear, chemical or biological weapon and radiation of any kind, Non-allopathic treatment, Cosmetic or aesthetic treatments, self-injury, Fertility, sub fertility, impotence, assisted conception operation or sterilization procedures and treatments related to weight reduction programs

Benefits under Critical Illness Cover

• Comprehensive cover for 15 critical illnesses.
• Survival Period 30 days.
• Coverage applicable up to Benefit amount of Rs.1 Lakh.
• Exclusions- Preexisting illness, critical illness diagnosed within first 90 days from commencement of the policy, AIDS and related conditions.

Benefits under Personal Accident Cover

• Covers 100% of the sum insured, amounting to Rs.500000.
• If due to an accident, Permanent Total Disability is the result, a compensation of 125% of sum insured amounting to Rs.625000.
• In case of Permanent Partial Disability (due to an accident), the compensation is paid as per the set disability table.
• For up to 2 dependent children, the policy includes Children Education benefit of Rs.5000. Transportation benefits up to Rs.5000.
• Exclusions- Suicide, attempted suicide or self-inflicted injury, breach of law with criminal intent, while engaging in dangerous sports activities and consequential losses of any kind or your actual or alleged legal liability.

Premium Personal Guard Policy

A robust health insurance policy, the Premium Personal Guard covers the insured against bodily injury or death caused due to accident and offers high sum assured ranging from Rs.10-25 lakh.

Features & Benefits

• Avail cashless hospitalization at 3700+ partner hospitals across India.
• Entry Age- 18 to 65 years, with lifetime renewal option. Children from 5-21 years can also be covered per this policy.
• Avail cumulative bonus of 10% for each claimless year, maximum up to 50% of insured sum.
• Medical test isn’t mandatory for persons under the age of 45 years.
• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
• Free Look Period of 15 days- Did not like the policy? Cancel the policy within 15 days for a complete refund.
• Grace period of 30 days for every subsequent instance of policy renewal.
• You will not be charged a higher premium if there has been a claim in the previous policy.

Exclusions- What Incidents Aren’t Covered by the Policy?

• Suicide, attempted suicide or self-inflicted injuries and illness.
• Injury sustained under the influence of alcohol and/or drugs.
• Injury sustained while indulging in anti-social or criminal activity.
• Participating in a wide range of dangerous sports.
• Curative treatments and interventions carried out on your body.
• Participation in any naval, military or air force operations leading to injury or illness.
• Your consequential losses of any kind or your actual or alleged legal liability.
• Acquired Immune Deficiency Syndrome (AIDS) and related sexually transmitted ailments.
• Pregnancy, childbirth, miscarriage, abortion, or complications arising out of any of these.
• Wartime conditions, nuclear energy, radiation etc.

Extra Care

This is a robust health insurance plan that allows you to extend your existing health insurance cover to compensate for special circumstances that may arise due to prolonged hospitalization.

Features & Benefits

• Avail cashless hospitalization at 3700+ partner hospitals across India.
• Entry Age- 3 months to 70 years, with lifetime renewal option.
• Pre and post hospitalization expenses covers all medical instances from 60 days prior to and 90 days after hospitalization.
• Affordable premium, starts at Rs. 2500.
• Medical test isn’t mandatory for persons under the age of 55 years.
• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
• Free Look Period of 15 days- Did not like the policy? Cancel the policy within 15 days for a complete refund.
• Grace period of 30 days for every subsequent instance of policy renewal.
• You will not be charged a higher premium if there has been a claim in the previous policy.

Exclusions- What Incidents Aren’t Covered by the Policy?

• In the case of pre-existing diseases, a waiting period of 4 years will apply.
• Illness, injury or diseases contracted within 30 days from the commencement of the policy won’t be covered.
• Treatments consisting of non-allopathic medicine will not be covered.
• Certain diseases require a waiting period of 2 years before coverage, including hernia, piles, cataract and sinusitis.
• Coverage will not be extended for the following- Cosmetic, aesthetic or related treatments, treatments for use of intoxicating and/or addictive substances like alcohol, drugs etc.
Joint replacement surgery that isn’t caused by an accident requires a waiting period of 4 years.
• Fertility procedures, impotence related, assisted conception operation or sterilization procedures.

Critical Illness

Insure yourself against the risk of critical illnesses just like you would insure your car or house. Be secure with the knowledge that you are prepared for all future medical eventualities.

Features & Benefits

• Entry Age- 6 to 65 years.
• Based on the age and sum insured, a pre-policy medical examination may be required.
• Very affordable premium rates.
• Sum insured options of Rs. 100000/- to Rs. 5000000/- for age group of 6 yrs. to 60 yrs.
• Sum insured options of Rs. 100000/- to Rs. 500000/- for age group of 61 yrs. to 65 yrs.
Illness Covered- Cancer, Coronary Artery Bypass Surgery, First Heart Attack (Myocardial Infarction), Kidney Failure, Major Organ Transplant, Stroke, Aorta Graft Surgery, Primary Pulmonary Arterial Hypertension, Symptoms of primary pulmonary hypertension, Multiple Sclerosis, Paralysis of the limbs.

Exclusions- What Incidents Aren’t Covered by the Policy?

• Critical Illness at the time of conception of the policy or diagnosed within 90 days from the start of the policy tenure.
• Death within 30 days from the point of diagnosis of the critical illness.
• Participation in any naval, military or air force operations leading to injury or illness.
• Your consequential losses of any kind or your actual or alleged legal liability.
• Acquired Immune Deficiency Syndrome (AIDS) and related sexually transmitted ailments.
• Pregnancy, childbirth, miscarriage, abortion, or complications arising out of any of these.
• Wartime conditions, nuclear energy, radiation etc.

Silver Health Plan for Senior Citizens

This is a health insurance plan that has been designed specifically for senior citizens. It offers the option to opt for up to 20% co-pay or a cashless policy. It is available to anyone between the ages of 46 years and 70 years and offers lifetime renewal options. The plan offers cover for up to 130 day care procedures and has a waiting period of 2 years for pre-existing diseases. It even has a network of over 5,000 hospitals where policyholders can enjoy cashless treatment. It will also offer cover for both pre and post hospitalisation expenses.

Bajaj Allianz Tax Gain Plan:

Bajaj Allianz Tax Gain Plan is a unique scheme that Bajaj Allianz has introduced to save tax and gain OPD benefits at the same time. This unique product is loaded with benefits and is a Family floater health policy which covers both hospitalization expenses and outpatient (OPD) expenses under one policy. What’s more, it will help you to manage your tax efficiently as well.

The attractive features of this product include:

• Tax benefit under section 80 D of IT Act
• Hospitalization and OPD expenses are covered on floater basis
• Once four years continuous renewal is completed with Bajaj Allianz, all pre-existing diseases will be covered under the scheme.
• Every 4 claim free policy periods, you can avail free Health Check-up at designated Bajaj Allianz Empanelled.
• Family Floater for self & Spouse
• The plan accommodates Senior citizens with a separate plan that covers both hospitalization and OPD benefits.
• Income Tax benefit under Sec 80D of the IT Act on the premiums paid.

Value Added Services from Bajaj Allianz

Bajaj Allianz General Insurance Company is a private sector general insurance provider in India. It is a conglomeration between Bajaj and Allianz of India and Germany respectively. It offers some of the most attractive products in the health insurance segment. The deals are made sweeter with the addition of value added services that provide additional benefits over and above the policy terms.

There are a variety of ‘extras’ available with health insurance products from Bajaj Allianz. These include special offers and discounts for people with Bajaj Allianz cards (EZEEE, Jiyo Fit, and Health Insurance Card etc.). With a Bajaj Allianz-issued health card, heavy discounts welcome you at networked fitness and health centres throughout.

The value added services are applicable on four distinct sub-categories of healthcare:

1. Healthcare and related products
2. Eye care
3. Dental care
4. Pharmacy

Bajaj Allianz has tie-ups with more than 25 health and wellness centres in this category. The offers mostly provide discounts of up to 20% in the networked centres for procedures such as appointments, vaccination, diagnostic products, Ayurvedic and Homeopathic treatments and consultations, doorstep healthcare services etc. Several spas and equipment outlets also provide discounts to Bajaj Allianz health card holders. Major networked centres include Health Vistas, Doorstep Health Services, Health Magic, Dr Batras, Tattva Spa, Charaka Pharma etc.

Bajaj Allianz also offers Doctor On Call (BADOC) service wherein unlimited consultations and communication with doctors are provided at nominal yearly subscriptions.

Currently, Bajaj Allianz has a tie-up with Lawrence & Mayo through which it provides free eye tests for health card holders and their family members; 7.5% discount on frames, contact lenses, sunglasses, etc.; and 12.5% discount on designer watches and pens.

Dental freebies cover discounts such as consultation, scaling, root canaling, oral x-rays and other related treatments. The discounts range from 5%-50% depending on the networked clinic and policy terms. Some of the major dental outlets where Bajaj Allianz customers can expect special rates include Vasan Dental Care, Beyond Smiles, Dentistree Clinics, Sai Dental Clinic, and others.

For pharmaceuticals such as drugs, Bajaj Allianz health card holders stand to receive discounts up to 30% on various products such as OTC drugs, generic drugs, cosmetics, surgical items, critical care drugs, and others. Major networked institutions include Doorstep Health Services, Bony Medicals, Religare Wellness, Frank Ross Pharmacies, Vardhaman Health Specialities, ABC Medical Stores, and other reputed pharmaceutical companies.

Bajaj Allianz Health Insurance FAQs

1. What is the difference between health insurance and life insurance?

Life insurance involves providing monetary support to a deceased insured’s family. Also, under certain plans, the policy holder gets a payout on survival till the maturity of the policy. Health insurance, on the other hand, covers expenses in case of hospitalization for treatment of health issues suffered by the customer. The customer doesn’t get any payout at maturity of the policy. Also, health insurance policies have to be renewed annually.

2. I already have an employer-sponsored health cover. Should I get my own policy?

Private policies are important as job sponsored policies tend to lack continuity. If you change jobs, you will be exposed to risk during the transition period, and there’s the chance that your new employer won’t provide health insurance coverage. Also, as you switch jobs, your insurer will most likely change, and whatever track record you had built will be lost, if in case health insurance portability in not an option.

Employer sponsored covers offer limited coverage, while having your own policy allows you to cover not only yourself but your family as well. Also, riders can be opted for to enhance protection if employee group schemes do not provide comprehensive coverage.

3. What is the importance of a pre-policy medical checkup?

For all customers above 45 years (lower limit may change depending on provider and plan) medical checkups are important to gauge the previous health issues suffered by customers so that they are provided coverage accordingly, implying that they may have to pay more premium when suffering some pre-existing diseases. For policy renewals medical checks are generally not required.

4. What is the general term for health insurance policies?

In general, health insurance policies are provided for 1 year time period (including Bajaj Allianz), though some firms also provide 2 year policies.

5. What do you mean by coverage amount or sum insured?

Also known as “sum assured” or “sum insured”, the final claim amount to be paid out is the coverage amount. Premiums vary according to sum assured.

6. What if family members are staying in different places and want to be covered under the same policy?

Health insurance policies are applicable throughout India. In general, it is advisable to get insured in a place where there are network hospitals of the provider. This helps in getting cashless treatments at designated facilities. In case there are no network hospitals in your area, reimbursements are provided in due time.

7. Are MRI, X-ray and other diagnostic charges covered by health insurance policies from Bajaj Allianz?

All types of diagnostic tests are covered under your health insurance policy, as long as the costs are related to hospitalization of not less than 1 night. OPD prescribed diagnostic tests are usually not covered.

8. What is Cashless Hospitalization?

Cashless Hospitalization refers to the cashless settlement of hospitalization expenses, which are adjusted by a network hospital of Bajaj Allianz on the basis of the insurance policy without any cash being paid by the policyholder.

The settlements are done by authorized Third Party Administrators (TPA). Prior approvals are a must, except for cases of emergency where post approvals can be done.

9. Is there a limit on number of health insurance policies for an individual?

There is no limit on the number of health insurance policies a person can take out. An individual may have two health insurance policies from different providers, and in case of hospitalization the overall costs will be split between them.

10. Is it possible to avail health insurance from Bajaj Allianz if I am not an Indian citizen but am staying in the country?

Yes, foreigners are allowed to avail health insurance policies from Bajaj Allianz with coverage limited to India.

Examples of Network Hospitals in Major Cities

*Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.