BAJAJ ALLIANZ Health Insurance

Protect yourself and your loved ones from financial constraints which can occur due to health conditions. Health insurance plans from Bajaj Allianz Health Insurance come with family discount and lifetime renewability options.

Bajaj Allianz is a joint venture between India-based Bajaj Finserv Limited and European financial services company Allianz SE. Bajaj Allianz meets the needs of their customers by offering a wide variety of insurance products, which include health insurance plans. By combining global expertise with local experience, the company provides clients with customized products and transparent benefits, catering to every segment and age-income profiles.

Bajaj Allianz General Insurance Highlights

*For Year 2017-2018

How health insurance can help you save on tax?:

Assessee can get tax deduction on premiums paid towards a health insurance policy under Section 80D of the Income Tax Act, 1961. The tax benefit is available to assessee on health insurance premiums paid for self, spouse, children, and dependent parents. Tax benefit can be availed on premiums paid towards all types of health insurance plans. Premium paid via cash is not eligible for tax deduction. Premium paid towards critical illness riders can also be used for tax deduction.

• Tax deduction on premium paid for self, spouse, children, and parents can be availed up to Rs.25,000 per year, provided the age of the individual is below 60 years.
• For premiums paid towards senior citizen health insurance plans where the individual is above 60 years of age, the maximum tax deduction is capped at Rs.30,000.
• Therefore, you can avail up to Rs.55,000 tax deduction if you are below 60 years of age and your parents are above 60 years of age, and you pay the premium for both policies.
• For policyholders who are above 60 years of age and are paying health insurance premium for themselves and their parents aged above 60 years, the tax benefit is capped at Rs.60,000.
• Preventive health check-up costs can be used to get a tax benefit of up to Rs.5,000.

Bajaj Allianz Health Insurance Company has designed a unique policy called the Tax Gain Plan which is a floater health plan that covers hospitalisation and OPD (outpatient) expenses while helping you with tax management as well. Features and benefits of the Tax Gain Plan includes:

• Insurance coverage for ambulance fees in the case of an emergency for up to Rs.1,000.
• 130 day-care procedures covered under the policy.
• 10% co-payment of the claim payment if the treatment is sought in a non-network hospital. Co-pay can be waived for additional premium.
• Free health checkup for a block of 4 claim-free policy years. Any one insured member can opt for this benefit.
• The premium slab is the same for individuals aged between 18 to 55 years and 56 to 75 years.
• No waiting period for OPD expense cover.
• Dental treatment can be claimed under OPD expense cover.
• No hassle of going through a Third-Party Administrator (TPA) for claim processing.

Bajaj Allianz Health Insurance Renewal:

Bajaj Allianz Health Insurance policies can be renewed online through the insurer's website. To renew your policy, select the ‘Renew Online’ option on the insurer’s website and select the name/type of the insurance policy you currently have. Post this, you can enter your mobile number, email ID, policy number, etc. and proceed to renew your policy in a hassle-free manner.

Types of Health Insurance Policies Provided by Bajaj Allianz:

Bajaj Allianz:

Bajaj Allianz Individual Health Insurance Plan

Entry Age	Anyone between the age of 18 years and 65 years can avail this policy. Children above the age of 3 months and under 30 years can be covered under the policy.
Pre-hospitalisation and Post-hospitalisation expenses	The policy will cover pre-hospitalisation expenses for all expenses that occur 60 days before the start of the hospitalisation. Post-hospitalisation expenses will be covered for 90 days from the date of discharge from the hospital.
Tax Benefits	You can avail tax benefit for the amount you pay as premium for your policy according to Section 80D of the Income Tax Act. This benefit can be availed up to a maximum of Rs.1,00,000.
Sum Insured	The sum insured under this policy starts at Rs.1.5 lakh and can go up to Rs.50 lakh. You can choose the sum insured based on the extent of coverage you need.
Cashless Hospitalisation	You can avail cashless treatments at more than 6,000 network hospitals spread across India. This is, however, subject to certain terms and conditions.
Cumulative Bonus	You will be provided with a cumulative bonus benefit of 10% for every claim-free year. This can be accumulated to up to 100% as you accumulate the number of claim-free years.
Ambulance Cover	This policy will cover ambulance charges up to a maximum limit of Rs.20,000 per policy year.

Features of Bajaj Allianz Individual Health Insurance Plan

• The policy term can either be 1, 2, or 3 years based on the duration for which you need the protection.
• There is an option to cover your extended family under this policy. You can get coverage for your parents, grandparents, parents-in-law, grandchildren, and dependent siblings.
• This individual health insurance plan will cover any expenses incurred for day care treatments.
• A family discount of 10% is provided for two members of the family. This can go up to a maximum of 15% for 3 members of the family.
• Homeopathic and ayurvedic hospitalisation cover will be provided under the policy.
• A free health check-up is provided if you are insured for three years under the policy. This is irrespective of whether you make a claim or not during this period.
• Newborn baby expenses and maternity expenses will be covered under the policy.
• You are eligible for a convalescence benefit of up to Rs.7,500 for every policy year.
• You will be provided a discount if you opt for a long-term health insurance policy
• 4% discount for a 2-year policy
• 8% discount for a 3-year policy
• Organ donor expenses will be covered by the insurer up to the specified sum insured.
• Any costs incurred due to bariatric surgery will be covered under this policy.

Exclusions of Bajaj Allianz Individual Health Insurance Plan

• Any expenses incurred before the completion of 30 days from the date of issuance of the policy will not be covered under the policy.
• There is a fixed waiting period of 3 years that is applicable for some of the pre-existing ailments.
• There is a fixed waiting period of 3 years for bariatric surgery.
• PIVD and joint replacement treatments have a waiting period of three years.
• Diseases such as cataract, piles, sinusitis, and hernia will all be covered only after completion of a waiting period of 2 years.
• Treatments done for diseases caused by excessive use of alcohol or any other intoxicants will not be covered under the insurance policy.
• There is a 6-year waiting period for newborn baby and maternity expenses.

Bajaj Allianz Health Insurance Plan for Family – Health Guard

Bajaj Allianz Health Insurance Plan for Family – Health Guard is specifically made for people who are looking to buy a health insurance cover for the entire family with just one health insurance policy.

Entry Age	The proposer must be more than 18 years old and can be up to 65 years old. In the case of a child, the minimum entry age is 3 months. Children can be covered up to a maximum of 30 years of age.
Pre-hospitalisation and Post-hospitalisation Expenses	Pre-hospitalisation expenses are covered 30 days prior to the date of admission to the hospital. Post-hospitalisation expenses will be covered for 90 days from the date of discharge from the hospital.
Tax Benefits	You can avail tax benefits for the amount you pay as premium for the policy. You can avail a maximum benefit of Rs.1,00,000 under Section 80D of the Income Tax Act, 1961.
Sum Insured	There are a number of sum insured options available for you to choose from. The sum insured starts at Rs.1.5 lakh and can go up to Rs.50 lakh. You can choose the sum insured based on the extent of protection you need.
Cashless Hospitalisation	You can avail cashless hospitalisation facility in more than 6,000 network hospitals of Bajaj Allianz spread across India. Cashless claims are however subject to some terms and conditions. Refer to the policy document to know all the exclusions under the cashless facility.
Ambulance Cover	Ambulance charges will be covered by the insurer up to a maximum of Rs.20,000 every policy year.

Features of Bajaj Allianz Health Insurance Plan for Family – Health Guard

• You need not undergo a medical test before availing the policy up to the age of 45 years. This is however subject to you submitting a clean proposal form.
• There is a policy term option of either 1, 2, or 3 years. You can choose the length of the policy based on the duration you need the protection for.
• Bajaj Allianz offers discounts if you opt for a long-term policy. A discount of 4% is applicable for a 2-year policy and a discount of 8% is applicable if you avail a policy for 3 years.
• A discount of 10% is provided by the insurer for every claim free year. This can be accumulated to up to 100% based on the number of claim-free years.
• You can avail a discount of up to 20% if you opt for the co-payment option.
• Convalescence benefit is provided up to Rs.7,500 every policy year.
• Bariatric surgery will be covered under this policy.
• Homeopathic and Ayurvedic hospitalisation will be covered under this policy.
• This policy will cover all organ donor expenses up to the sum insured limit chosen by the proposer.
• Newborn baby expenses and maternity expenses will be covered under the policy.
• Bajaj Allianz offers a free health checkup every three years you avail the policy. This checkup will be available irrespective of whether you make a claim during the three years.
• You can use the Bajaj Allianz Insurance Wallet App to use the Health Claim by Direct Click (CDC) benefit. This helps in saving a lot of money and time spent while making a claim.

Exclusions of Bajaj Allianz Health Insurance Plan for Family – Health Guard

Listed below are some of the exclusions in the Bajaj Health Insurance Plan for Family – Health Guard:

• Any claims made or diseases contracted before the completion of 30 days from the date of issuance of the policy will not be covered under the policy.
• There is a waiting period of 3 years if you wish to make claims for any pre-existing diseases.
• Diseases like piles, hernia, sinusitis, and cataract will be covered after the completion of 2 years from the date the policy was issued.
• You will have to wait for three years if you wish to make claims related to PIVD and joint replacement.
• A waiting period of 3 years is applicable for claims relating to bariatric surgery.
• You can make claims for newborn baby and maternal expenses only after the completion of 6 years from the date the policy was issued.

Bajaj Allianz Global Personal Guard Policy

Bajaj Allianz Global Personal Guard Policy is a global insurance policy that can be of great use when you travel abroad.

Entry Age	The minimum entry age for this policy is 18 years. You can avail this policy up to the age of 70 years. Children can be covered from the age of 3 months up to 25 years of age.
Sum Insured	The minimum sum insured amount you can opt for under this policy is Rs.50,000. You can opt for a maximum cover of Rs.25 lakh under the policy. Choose the sum insured based on the extent of protection you need. The premium of the policy will vary based on the sum insured you choose.
Base Cover (Mandatory)	Permanent Partial Disability Permanent Total Disability Death
Add on Cover (Optional)	Optional Cover I – Air Ambulance Cover Optional Cover II – Accidental Hospitalisation Expenses Optional Cover III - EMI Payment Cover Optional Cover IV – Children Education Benefit Optional Cover V – Coma Due to Accidental Bodily Injury Optional Cover VI – Hospital Cash Benefit Optional Cover VII – Loss of Income due to Disability from Accident Optional Cover VIII - Road Ambulance Cover Optional Cover IX – Travel Expenses Benefit Optional Cover X – Adventure Sports Benefit Optional Cover XI – Fracture Care Optional Cover XII - Loan Protector Cover

Features of Bajaj Allianz Global Personal Guard Policy

• This is a single insurance policy that provides 3 base covers and 12 optional covers.
• You are given the flexibility to choose any policy based on your needs. It is mandatory to choose at least one cover in the list of base covers. You can also choose two or all three sections of the base cover.
• You can choose any of the optional covers based on the type of coverage you need. There is no limit on the amount of additional optional covers you can opt for.
• This insurance policy provides many industry first covers like disappearance and loan protector cover, air ambulance, EMI payment cover, and adventure sports cover.
• Long term options are there in this policy with coverage duration options of 1 year, 2 years, and 3 years. Insurance companies generally offer discounts if you opt for long term policies. Contact the insurer to know more about the same.
• You can download the Bajaj Allianz Insurance Wallet App and make use of the Health Claim by Direct Click (CCD) feature. You can make claim requests of up to Rs.20,000 using this app.

Bajaj Allianz Extra Care Plus Policy

Bajaj Allianz Extra Care Plus Policy is top-up cover and can be very useful after you exhaust the sum insured in your health insurance policy. The important thing to remember is that this policy can be availed even without owning a basic health insurance policy.

Entry Age	The entry age for this can be any age between 91 days to 80 years.
Sum Insured	The sum insured options under this policy start at Rs.3 lakh and can go up to Rs.50 lakh. The aggregate deductibles under this policy will range between Rs.2 lakh and Rs.10 lakh
Pre-hospitalisation and Post-hospitalisation Expenses	Pre-hospitalisation expenses will be covered for up to 60 days before the date of hospitalisation. Post-hospitalisation expenses will be covered for up to 90 days from the date of discharge from the hospital.
Tax Benefit	You can avail tax benefits for the amount you pay as premium for this policy according to Section 80D of the Income Tax Act.
Cashless Hopsitalisation	You can opt for the cashless facility at more than 6,000 network hospitals of Bajaj Allianz spread across the country. Cashless claims have a number of terms and conditions. It is advisable to go through the policy document before making a cashless claim.

Features of Bajaj Allianz Extra Care Plus Policy

• There is no need for any pre-policy medical screening if you are under the age of 55 years. This will however depend on the proposal form. The insurer will ask for medical records in case they wish to check some details in the proposal form.
• A floater policy option is available to cover self, spouse, dependent children, and dependent parents under one health insurance policy.
• Pre-existing illness will be covered after the completion of 1 year from the date the Extra Care Plus policy was issued.
• Bajaj Allianz Extra Care Plus policy will cover any cost incurred for all day care treatments.
• There is an option available for lifetime renewal of this policy.
• This policy has a free-look period of 15 days.
• Emergency road ambulance expenses will be covered under the policy.
• Bajaj Allianz provides a free health checkup for everyone buying the Extra Care Plus policy.

Waiting Period and Exclusions of Bajaj Allianz Extra Care Plus Policy

• Benefits of the policy will not be provided for any pre-existing diseases until the completion of 12 months from the date the policy was issued. The coverage must be continuous for 12 months if you wish to avail coverage for pre-existing illnesses.
• Any medical expense or disease incurred within the completion of 30 days from the date of commencement of the policy will not be covered under the policy. There is however an exclusion in case it is an accidental injury.
• Claims will not be settled by Bajaj Allianz for the following types of claims for the first 12 months of the policy:
• Cataracts
• Hydrocele
• All types of sinuses
• Endometriosis
• Any surgery for skin ailments
• Diabetes and any other complications related to the same
• Surgical procedure for intervertebral disc disorders
• Dysfunctional uterine bleeding
• Any type of gastric or duodenal ulcers
• All types of Hernia
• Hysterectomy
• Stones in the biliary and urinary systems
• Hypertension and any disorder related to it
• Cardiovascular disease and any related disorders
• Fibromyoma
• All joint replacement procedures
• The insurer is not liable to make any payment as maternity expenses during the first 12 months since the date of commencement of the policy. This 12-month waiting period will not be applicable if you are continuously renewing the Extra Care Plus policy without any break in insurance.

Bajaj Allianz Health Insurance Critical Illness

Bajaj Allianz Health Insurance Critical Illness is designed to make sure that you are financially protected in case you encounter a critical illness. Buying this insurance policy will ensure that you receive a good amount of cash as a lump sum payment to help deal with the critical illness.

Entry Age	The minimum age limit for availing this policy is 6 years. You can get coverage using this insurance policy up to a maximum age of 59 years.
Sum Insured	The sum insured under this policy ranges from Rs.1 lakh to Rs.50 lakh. You can choose the sum insured based on the coverage amount suitable for your requirements.
Tax Benefits	You can avail tax benefits of up to Rs.1 lakh under Section 80D of the Income Tax Act, 1961.
Premium	The premium to be paid for the policy starts at Rs.200. The premium of the policy will vary based on your age and the amount of sum insured you opt for.
Critical Illness covered	Cancer Stroke Kidney Failure Major Organ Transplant First Heart Attack (Myocardial Infarction) Permanent Paralysis of Limbs Coronary Artery Bypass Surgery Primary Pulmonary Arterial Hypertension Aorta Graft Surgery Multiple Sclerosis with Persisting Symptoms

Features of Bajaj Allianz Health Insurance Critical Illness

• The amount will be paid by the insurer only after the diagnosis is done and it meet all the required criteria. This is provided the insured survives 30 days from the date of diagnosis of the critical ailment.
• The insured person will be receiving the payment as lump sum so that he/she can use the amount for the treatment as and when it is required.
• There are some expenses like donor expenses in a transplant procedure which are generally not covered in a normal health insurance policy. In case you opt for this policy, you can use the lump sum amount to make payments towards such expenses.
• You can use the Bajaj Allianz Insurance Wallet App to make use of the Health Claim by Direct Click benefit. You can easily upload all the necessary documents and settle all the claims quickly through the app.

Exclusions of Bajaj Allianz Health Insurance Critical Illness

• Any critical illness that was contracted before availing the policy or critical illness for which treatment, advice, or care was recommended will be excluded from coverage.
• Death of the insured occurring before the completion of 30 days from the date of diagnosis.
• Any critical illness listed under the policy diagnosed before the completion of 90 days from the date the policy was issued.
• Any type of treatment arising due to pregnancy or childbirth. This includes birth defects and caesarean section.
• Participation in military or naval operations carried out by armed forces where the use of arms is ordered by the military authorities to counter rebels and terrorists.
• Invasion, war, terrorism, civil war, revolution, act of foreign enemy, and terrorism. Any claim incidents occurring during all these situations will be excluded from coverage under the health insurance policy.
• Any type of consequential loss will be excluded from coverage.

Bajaj Allianz M-Care Health Insurance Policy

Bajaj Allianz M-Care Health Insurance Policy is a health insurance policy specifically designed for covering all the common vector-borne diseases.

Entry Age	Anyone who wishes to be covered under this policy will have to be at least 18 years old. You can be a maximum of 65 years old at the time availing the policy. There are no age restrictions if you want to cover children under this policy. You can avail cover for children as soon as the child is born.
Cashless Hospitalisation	You have the option to avail cashless hospitalisation benefits at all the Bajaj Allianz network hospitals. This is however subject to some terms and conditions. Refer to the policy document to know more details about the same.
Sum Insured	The sum insured under this policy starts at Rs.10,000 and can go up to a maximum of Rs.75,000. Choose the sum insured based on the amount of coverage you require.
Vector-borne diseases covered	Following are all the vector-borne diseases that are covered under this policy: Malaria Dengue Fever Chikungunya Kala Azar Filariasis (only once in the lifetime of the insured) Zika Virus Japanese Encephalitis These diseases will be covered but are subject to some factors like the exclusions under the policy, sum insured limit, and other terms and conditions mentioned in the policy schedule.

Features of Bajaj Allianz M-Care Health Insurance Policy

• M-Care health insurance policy is available as a floater policy for the proposer, dependent children, spouse, or dependent parents.
• A discount of 20% is provided to the customer in case the insurance is purchased from the Bajaj Allianz website.
• This policy has a lifetime renewal benefit option available.
• There is a free look period 15 days is provided in this policy. You can decide to not continue with this policy in this duration.

Exclusions and Waiting Period of Bajaj Allianz M-Care Health Insurance Policy

• Treatment for any other diseases other than the list of vector-borne diseases listed in the policy.
• No coverage will be provided if you are admitted in the hospital for less than 24 hours.
• Treatment and diagnosis done outside the India will be excluded under the policy. This exclusion however does not apply if the treatment is done in the following countries:
• Dubai
• Singapore
• USA
• Japan
• New Zealand
• Canada
• Switzerland
• Hong Kong
• Malaysia
• Countries of the European Union

• Any vector-borne diseases contracted within the first 15 days from the date of commencement of the policy will not be covered under the policy. This exclusion will not be applicable if the policyholder has renewed the insurance policy without a break and have not made any claims during all the previous policies.
• In case the policy is purchased after contracting any of the vector-borne diseases that have been listed under the policy, a waiting period of 60 days is applicable for from the date of the previous admission for the ailment. If a benefit is paid by the insurer and the policyholder renews the policy, a 60-day waiting period is applicable for the ailment the company paid the claim for. The waiting period will start from the date of previous admission.
• In case the policy is renewed before the completion of 60 days from the date of admission of the previous claim, a 60-day cooling period is applicable for making claims for the ailment. You can however make claims for all the other vector-borne diseases during this waiting period.
• In case the policy is renewed after the completion of 60 days from the date of admission of the previously made claim, a waiting period of 15 days is applicable for all the vector-borne diseases listed in the policy.

Bajaj Allianz Health Care Supreme

Bajaj Allianz Health Care Supreme is a comprehensive health insurance policy that provides wide coverage to ensure all your healthcare needs of you and your family are covered at every stage of life.

Entry Age	The entry age for the spouse, proposer, and parents starts at 18 years of age. There is no maximum age limit under this policy for adults. The minimum entry age for children starts at the age of 3 months. Children can be covered up to a maximum age of 25 years under this policy.
Sum Insured	The sum insured under this policy starts at Rs.5 lakh and can go up to Rs.50 lakh.
Hospitalisation Cover	Hospitalisation expenses will be covered under the policy and there are no limits in place for room rent and other expenses incurred as hospitalisation costs.
Cashless Hospitalisation	You can avail cashless hospitalisation facility in more than 6,000 network hospitals spread across India.
Tax Benefit	You can avail tax benefit for the amount paid as premium under Section 80D of the Income Tax Act.

Features of Bajaj Allianz Health Care Supreme

• You can choose any add-on covers like critical illness and personal accident cover to help enhance the coverage provided by the policy.
• Air ambulance cover is one of unique features provided by Bajaj Allianz. A maximum of 10% of the Hospitalisation Sum Insured can be used for expenses incurred for emergency ambulance transportation in a helicopter or an airplane.
• There is no limit on the coverage for day care procedures.
• In a situation where the sum insured listed under hospitalisation is exhausted, the sum insured reinstatement will ensure that 100% of the sum insured is restored.
• New born baby cover and maternity benefit can be availed starting from the 3rd year of the policy. Any expenses up to the sum insured under maternity cover will be covered under the policy.
• There are no limits on the Homeopathic and Ayurvedic Hospitalisation expenses under this policy.
• Psychiatric and dental treatments will be covered under the outpatient expenses section in the policy.
• You will be provided a free annual checkup every year at the time of policy renewal. You can avail this free checkup irrespective of your claim history.
• You can avail a separate family floater policy if you wish to cover your dependent parents.
• You can enhance the sum insured if you wish to only at the time of policy renewals.

Add-on Covers Available with Bajaj Allianz Health Care Supreme

You can purchase add-on covers along with the Bajaj Allianz Health Care Supreme policy to make sure you receive complete protection in case there is a need for hospitalisation. Some of the popular add-on covers available for the policy have been listed below:

Personal Accident Cover

• 100% of the sum insured will be provided in case of death of the insured due to an accident.
• 200% of the sum insured in case of permanent total disability of the insured.
• In case of permanent partial disability due to an accident, compensation will be provided based on the disability table.
• A children education benefit of Rs.5,000 for a maximum of 2 dependent children can be availed as part of this add-on.
• You will be provided with transportation benefit up to a maximum of Rs.5,000.

Critical Illness Benefit

• This benefit will offer coverage for 15 critical illnesses listed in the policy.
• There are two sum insured options available: Rs.5 lakh and Rs.10 lakh. You can choose the one that best suits your needs.
• There is a 30-day waiting period applicable in this policy. The insurer will be paying the sum insured only after the insured survives 30 days after contracting the disease.
• A 90-day waiting period is applicable for this policy. Claims can be made only after the completion of this time period.

Ancillary Expenses Benefit

• You can avail this benefit for a maximum of 30 days for every policy period.
• This benefit can be availed two times in case there is a need for admission in the ICU.
• There are three plans available under this benefit:

Ultimo Plan

• Ultimo Plan offers a sum insured of Rs.2,500 per day.
• The plan offers a sum insured of Rs.75,000 if you opt for the individual sum insured option.
• The plan offers a sum insured of Rs.1,50,000 if you opt for the floater sum insured option.

Smart Plan

• Smart Plan offers a sum insured of Rs.2,000 per day.
• The plan offers a sum insured of Rs.60,000 if you opt for the individual sum insured option.
• The plan offers a sum insured of Rs.1,20,000 if you opt for the floater sum insured option.

Vital Plan

• Ultimo Plan offers a sum insured of Rs.1,000 per day.

• The plan offers a sum insured of Rs.30,000 if you opt for the individual sum insured option.
• The plan offers a sum insured of Rs.60,000 if you opt for the floater sum insured option.

Exclusions for Bajaj Allianz Health Care Supreme

There is a standard two-year waiting period applicable for all preexisting diseases. Listed below are the exclusions for the add-on covers in the insurance policy:

• Exclusions for Personal Accident Cover

The insurance company is not liable to make claim payments if the claims arise due to any one of the following events:

• Claims arising due to breaking the law with criminal intentions.
• Claims made due to suicide or attempted suicide.
• Claim incidents taking place while participating in dangerous sports activities.
• Any type of consequential losses.
• Claims arising due to acts of war, invasion, revolution, rebellion, mutiny, insurrection, seizure, arrest, capture, detainment or restraint, civil war, acts of foreign enemies, nationalisation or requisition or confiscation or damage done under the order of the government or any public authority.

Exclusions for Critical Illness Cover

The insurance company is not liable to make claim payments if the claims arise due to any one of the following events:

• Any critical illness that was existing before the policy was availed.
• Any critical that was diagnosed before the completion of 90 days from the date the policy was issued.
• Any expenses that arise from treatment of HIV or any other illness related to HIV will not be covered. This will include AIDS along with the many other HIV related diseases.
• Any type of consequential losses will be excluded from coverage.

Exclusions for Hospital Daily Cash Allowance Cover and Hospitalisation Cover

The insurance company is not liable to make claim payments if the claims arise due to any one of the following events:

• War or any act of war by making use of a chemical, nuclear, or biological weapon. Expenses incurred for treating any type of radiation.
• Circumcision unless it is required for treating a bodily injury or an illness.
• Any type of cosmetic or aesthetic treatment and procedures done for change of gender.
• Intentional self-harm resulting in injury.
• Any type of plastic surgery unless it is required for the treatment of burns, cancer or any other bodily injury.
• Diseases that require treatment due to excessive use of alcohol or any other intoxicant. Treatments done for de-addiction will also not be covered under the policy.
• Congenital external diseases, genetic disorders, convalescence, stem cell surgery or implantation, or growth hormone therapy.
• Any treatment related to weight reduction and weight management services.
• Medical expenses incurred due to hospitalisation for diagnostic treatments. This will include x-rays and any such laboratory investigations and examinations.
• Buying any type of nutritional supplements unless they are a part of treatment done for treating a disease or an injury.
• Treatment done by using any other treatment method other than allopathy. This however does not include homeopathic and ayurvedic treatments.
• Impotence, fertility, assisted conception operation, sterilisation procedure, and sub-fertility treatment procedures will be excluded from coverage.

Bajaj Allianz Silver Health Plan for Senior Citizens

Healthcare costs generally tends to increase with the increase in age. These costs might become a burden if the costs increase to a very high amount.Bajaj Allianz Silver Health Plan for Senior Citizens is designed to make sure you are secured in case you require expensive medical treatment.

Tax Benefit	You can avail tax benefit of up to Rs.1 lakh per annum for the amount you pay as premium for the policy according to Section 80D of the Income Tax Act, 1961.
Hospitalisation Expenses	Hospitalisation expenses will be covered under the policy. A coverage of 3% of the Pre-hospitalisation and Post-hospitalisation expenses will be covered.
Ambulance Charges	Ambulance charges will be covered in case of an emergency. You can avail a maximum benefit of Rs.1,000 as ambulance charges.
Discounts	A cumulative bonus of 10% is provided to the limit of indemnity for every claim free year. This bonus be a maximum limit of 50%. You will be eligible for a free health checkup at a designated Bajaj Allianz Diagnostic Center if you are insured for 4 consecutive years without making a claim. Family discount of 5%.

Features of Bajaj Allianz Silver Health Plan for Senior Citizens

• You can avail cashless facility across all the network hospitals spread across the country.
• Treatment can also be availed in hospitals other than the network hospitals. The expenses in this case will be reimbursed before the completion of 14 days from the date of submission of the documents.
• A co-payment of 20% will have to paid by the insured if the treatment is done in a non-network hospital. You can avoid paying a co-payment if you pay a small additional premium.
• All pre-existing diseases will be covered after the completion of 1 year from the date the policy was availed.
• Coverage of pre-existing diseases from the second year of the policy is limited to 50% of the Limit of Indemnity per policy year.
• You can use the Bajaj Allianz Insurance Wallet App to get the Health Claim by Direct Click benefit. This enables you to make easy claim requests through the app and get quick claim settlements.

Exclusions of Bajaj Allianz Silver Health Plan for Senior Citizens

• All pre-existing illnesses will not be covered before the completion of 1 year from the date of commencement of the policy.
• All diseases contracted within the first 30 days from the date the policy was issued.
• Any expense arising from the treatment of AIDS or any related diseases.
• Aesthetic or cosmetic treatment.
• Any treatment need arising due to excessive use of alcohol or any other intoxicant.
• Treatment that is not done using allopathic medicine.
• Diseases like cataract, piles, hernia, benign prostatic hypertrophy, and hysterectomy will be covered after the completion of a 1-year waiting period.

Bajaj Allianz Star Package – A 360 Degree Protection Plan

Bajaj Allianz Star Package is a family floater policy that will protect your family from the different risks they may face. This provides a wide range of cover in just a single insurance policy.

Entry Age	The entry for this policy is between 18 years and 65 years. Children aged between 3 months to 5 years can be added to the coverage with both parents. Children with a minimum age of 6 years and a maximum age of 25 years can be covered under the policy if one parent is covered under the policy.
Tax Benefits	You can avail tax benefit for the amount you pay as premium according to Section 80D of the Income Tax Act, 1961. You can avail a maximum benefit of Rs.1 lakh per annum.
Discounts	You can avail a discount of 10% on the amount you pay as premium if you opt for 4 or more of the listed sections. You can avail a discount of 15% if you choose more than 6 sections in your plan. You can avail a discount of 10% on the amount you pay as premium if you opt for a policy duration of 2 years. You are eligible for a discount of 15% on the premium paid if you opt for the policy for 3 years.

Features of Bajaj Allianz Star Package – A 360 Degree Protection

This is a unique health insurance product that provides coverage under the following 8 sections:

Health Guard

1. This plan protects the family in the case of an accident and provides cashless benefit for all the hospitalisation expenses incurred.
2. Pre-hospitalisation for 60 prior to the date of admission to the hospital. Post-hospitalisation expenses will be covered for 90 days from the date of discharge from the hospital.
3. Ambulance charges will be covered for up to Rs.1,000 per hospitalisation.
4. You will be eligible for a free medical checkup after the completion of 4 years without any claims.
5. You can avail tax benefits of up to Rs.35,000 can be availed according to Section 80D of the Income Tax Act.

Hospital Cash

1. Hospital cash is designed to reduce the financial burden on you and your family in case of a hospitalisation. This section will provide cash benefits for every 24 hours spent in the hospital to make it easier to handle the hospitalisation costs.
2. Daily allowance is allocated for the different expenses that must be dealt with in a hospital.
3. There are many coverage options available in the section for you to choose from. Rs.500 / Rs.1,000 / Rs.2,000 / Rs.2,500 per day are the different options available to choose from. You will be paid this amount for every 24 hours admitted in the hospital.
4. 30 days of hospitalisation will be covered under this policy for every policy year. This coverage will be doubled for a maximum of 7 days if the insured is admitted in a hospital.
5. This coverage will apply even if the spouse or children are admitted in the hospital.

Critical Illness

1. The insured will be paid a lump sum amount if he/she is diagnosed with any critical illness listed in the policy. The lump sum amount can even be used to pay donor expenses in case of a transplant surgery as these costs are generally not covered in a health insurance policy.
2. The insured will receive the lump sum amount after he/she meets all the criteria that have been specified in the policy. The insured will have to survive 30 days after the diagnosis of the critical illness to receive the lump sum payment.
3. Suitable treatment can be planned as per your convenience as the insurer will make a lump sum payment.
4. Listed below are all the critical illness that are covered under this section:
5. Cancer
6. Stroke
7. Kidney Failure
8. Paralysis
9. Coronary Artery Bypass Surgery
10. First Heart Attack (Myocardial infarction)
11. Primary Pulmonary Arterial
12. Aorta Graft Surgery
13. Multiple Sclerosis
14. Aorta Graft Surgery
15. Neuro Surgery
16. Major Organ Transplant

Personal Accident

1. This section will provide against the following incidents to the insured person:
2. Temporary Total Disability
3. Accidental Permanent Partial Disability
4. Accidental Permanent Total Disability
5. Accidental Death

Education Grant

1. In case of permanent total disability or accidental death of the insured, a payment will be made to the assignee.
2. This amount is paid to help continue the education of the surviving children of the deceased.

Household Contents

1. The insured will be covered for any damages or losses incurred due to burglary or an attempt to burglary
2. This section will cover any losses or damages incurred due to any one of the following reasons:
3. Lightning
4. Impact damage
5. Explosion and implosion
6. Aircraft damage
7. Missile testing
8. Bush fire
9. Earthquake
10. Act of God perils
11. Riots, strikes, and malicious damage
12. Leakage of automatic sprinkler system
13. Rockslide, landslide, and subsidence
14. Fire

Travelling Baggage

1. Traveling baggage cover will provide coverage for your personal baggage while traveling anywhere in India. This includes destruction, accidental loss, or any type of damage to the personal luggage.

Public liability

1. This will provide coverage from any legal liability that might come from damage to property or bodily injury to any third party.

Exclusions of Bajaj Allianz Star Package – A 360 Degree Protection

• Any pre-existing diseases and any complications related to the same.
• Hospitalisation for any disease before the completion of 30 days from the date of commencement of the policy.
• Dental treatments and any related surgeries are not covered under the policy. There is an exception for this only in case if the treatment is required because of an accident.
• Pre-existing diseases will only be covered only after the completion of 4 years from the date of commencement of the policy.
• Treatments related to childbirth and pregnancy. This includes caesarean section.
• Natural calamities such as earthquake, volcanic eruptions, avalanche, or any other such hazard.
• Any treatment to be done due to accident caused by drunk driving.
• Any critical illness that was diagnosed before the start of the policy and for which treatment was recommended.
• Any illness that is diagnosed before the completion from the date of commencement of the policy.
• Diseases such as sinusitis, piles, cataract, and hernia will be covered after the completion of theh waiting period of 2 years.
• Any self-inflicted injury, suicide, alcoholism, pre-existing mental or physical defects, and complications arising due to the use of drugs.
• Any liability that may come up that is not complying with the policy agreement will be excluded from coverage.

Bajaj Allianz Health Ensure Insurance

Entry Age	Any one above the age of 18 years can avail this policy. There is no maximum age limit if you wish to avail this policy.
Pre policy medical checkup	You need not take pre-policy medical tests up to the age of 50 years. This is however subject to submission of a clean proposal form.
Pre-hospitalisation and Post-hospitalisation expenses	Both Pre-hospitalisation and Post-hospitalisation expenses will be covered under this policy.
Sum Insured	For an individual policy, the sum insured starts at Rs.50,000 and can go up to Rs.10 lakh. In case of a floater policy, the sum insured starts at Rs.2 lakh and can go up to Rs.10 lakh.
Discounts offered	You can avail a long-term policy discount of 4% if you are opting for a policy duration of 2 years. You can avail a long-term policy discount of 8% if you are opting for a policy duration of 3 years.

Features of Bajaj Allianz Health Ensure Insurance

• In patient hospitalisation treatment will be covered under this policy.
• Expense incurred for using road ambulance will be covered under the policy.
• Organ donor expenses will be covered.

• All day care procedures will be covered.
• Hospitalisation expenses incurred while using homeopathic and allopathic treatment methods.

Waiting Periods of Bajaj Allianz Health Ensure Insurance

Type of treatment	Waiting period
Hypertrophied turbinate, joint replacement surgery etc.	48 months
Certain diseases like hernia, any type of sinus, hysterectomy, etc.	24 months
Pre-existing medical conditions	24 months
Surgery done for varicose ulcers and varicose veins, hydrocele, any type of duodenal or gastric ulcers, etc.	12 months
All types of treatments excluding accidental injuries	30 days

Bajaj Allianz Tax Gain Plan Health Insurance Policy

Bajaj Allianz Tax Gain Plan health insurance policy is a unique family floater health insurance policy that will cover hospitalisation expenses and outpatient (OPD) expenses in just one policy. The policy will also aid in tax management apart from the coverage offered.

Entry Age	One can purchase a single policy and get coverage under one policy until the age of 75 years.
Ambulance Charges	Ambulance charges will be covered in case of an emergency. This cover is provided up to a maximum of Rs.1,000.
Tax Benefit	You can avail tax benefits for the amount you pay as premium according to Section 80D of the Income Tax Act.
Cashless Hospitalisation	Cashless hospitalisation facility is available in more than 6,000 of the network hospitals spread across the country.

Features of Bajaj Allianz Tax Gain Plan Health Insurance Policy

• 130 different day care procedures will be covered under the policy. This coverage is however subject to terms and conditions. Refer to the policy document to know more about the same.
• You will have to pay 10% of the total claim amount if you avail the treatment in any non-network hospital. You can waive this co-payment by paying a small additional amount as premium.
• You will be provided a free medical check-up after the completion of 4 claim-free policy periods. This benefit can be availed by any one of them insured under this policy.
• The premium slabs will remain the same for all the people in the age group between 18 years and 75 years.
• There are no waiting periods on making any outpatient claim.
• You can avail dental treatments and make claims under the outpatient section.
• Costs incurred for crutches and spectacles can be claimed under outpatient treatment.

Premium Table for Bajaj Allianz Tax Gain Plan Health Insurance Policy

Plans	Hospitalisation Cover and Sum Insured / Floater Sum Insured	Flat Premium (excluding service tax)
Plan A	Rs.1 lakh	Rs.4,449
Plan B	Rs.2 lakh	Rs.8,899
Plan C1	Rs.2 lakh	Rs.13,349
Plan C2	Rs.3 lakh	Rs.13.349
Plan D	Rs.1 lakh	Rs.17,799

Bajaj Allianz Premium Personal Guard Health Insurance Policy

Bajaj Allianz Premium Personal Guard Policy provides coverage in case of death or damage to the insured because of an accident. One big benefit of this policy is that it offers a high sum insured ranging between Rs.10 lakh and Rs.25 lakh.

Features of Bajaj Allianz Personal Guard Health Insurance Policy

• This policy will provide coverage in case of temporary total disability, permanent partial disability, permanent total disability, and death.
• Hospitalisation expenses incurred because of hospitalisation due to an accident.
• The insurer will provide accidental hospitalisation expenses in case you get admitted to a hospital.
• A cumulative bonus of 10% will provided by the insurer for each claim-free year. This can be accumulated up to a maximum of 50% for every consecutive claim-free year.
• You will be given a free-look period of 15 days from the date of commencement of the policy. You can cancel the policy any time during this period if you are not satisfied with the coverage provided by the policy.
• Higher premiums will not be quoted even if you have made claims in your previous policy.

Exclusions of Bajaj Allianz Personal Guard Health Insurance Policy

Listed below are some of the most common exclusions under this health insurance policy. You can refer to the policy document if you wish to know the complete list of exclusions.

• Any accidental injury incurred while under the influence of alcohol or any other intoxicant.
• Accidental bodily injury caused due to suicide, attempt to suicide, or any self-inflicted injury or illness.
• Any accidental bodily injury that is caused by the insured person.
• Accidental injuries incurred while breaking the law with criminal intentions.
• Any injury because of curative treatments done either by you or by someone else on your body.
• Any accidents incurred while mounting, dismounting, or traveling in a balloon or an aircraft not as a passenger. This must be a licensed aircraft and can be anywhere in the world.
• Being a passenger, co-passenger, or driver in a motor vehicle part of motor racing or trial runs.
• Accidents or bodily injury while being part of military, air force, or naval operations either in the form of military exercises without a break or directly engaging with the enemy. This is irrespective of whether it is foreign or domestic.
• Any type of consequential loss will not be covered under this policy.
• Losses incurred because of nuclear energy or any type of radiation.
• Any sexually transmitted diseases will be excluded from coverage.
• Pregnancy, childbirth and any other complications that may come up due to the same will not be covered.
• Losses incurred because of wars, civil wars, revolution, rebellion, invasion, or damage by or because of the order of a government or a public local authority.
• HIV or any ailments and diseases related to HIV. This will include AIDS and any other dervative and variations of the same.

Bajaj Allianz Extra Care Health Insurance Policy

Bajaj Allianz Extra Care is a health insurance policy that will offer extended coverage and will make sure that you do not exhaust your money and will always be covered for all medical expenses.

Entry Age	Any one between the age of 3 months and 70 years can avail this policy. This policy offers lifetime renewal option. Children between the age of 3 months and 5 years can be added to the policy if both parents are insured under the policy. Children between the age of 6 years and 18 years can be covered under the policy if one of the two parents are insured under the policy. Children aged between 18 years and 25 years can be covered as a dependent or self-proposer.
Pre-hospitalisation and Post-hospitalisation expenses	Pre-hospitalisation expenses will be covered for 60 days before the date of commencement of hospitalisation. Post-hospitalisation expenses will be covered for 90 days from the date of discharge from the hospital.
Pre acceptance medical tests	You need to take any medical tests before availing the policy if you are under the age of 55 years.
Tax Benefits	You can avail tax benefits of up to Rs.1 lakh for the amount you pay as premium for the policy according to Section 80D of the Income Tax Act.
Sum Insured	There are three sum insured options: Rs.10 lakh, Rs.12 lakh and Rs.15 lakh. You can choose the sum insured based on the extent of coverage you need.
Premium	The premium for the policy starts as low as Rs.2,500.

Features of Bajaj Allianz Extra Care Health Insurance Policy

• This policy can be purchased as an add-on policy along with any health insurance policy.
• There is a free look period of 15 days. If you are not satisfied with the policy and the coverage offered, you can cancel the policy before the completion of 15 days from the date of purchase of the policy.
• Bajaj Allianz Extra Care is a floater policy. This means there will be one sum insured and premium set for the entire family.
• You will be provided a grace period of 30 days from the date of completion of the policy to renew the policy. It will count as a continuous policy even if you renew the policy in these 30 days.
• You can make use of the Bajaj Allianz Insurance Wallet App and use the Health Claim by Direct Click feature. You can make claim requests of up to Rs.20,000 using the app.

Exclusions of Bajaj Allianz Extra Care Health Insurance Policy

• Any disease that was existing before the purchase of the policy will be covered only after the completion of 4 years from the date of commencement of the policy.
• Any type of congenital diseases and disorders will be excluded from coverage.
• Any type of disease that is contracted within the completion of 30 days from the date of commencement of the policy.
• Treatment done using any other form of medicine other than allopathy.
• Joint replacement surgeries will be covered only after the completion of a 4-year waiting period. Coverage will be provided if the surgery is needed due to an accident.
• Any expense that arises due to treatment of AIDS or any other related diseases.
• Treatment needed due to excessive use of alcohol or any other type of intoxicant.
• Any costs incurred related to fertility, sub-fertility, sterlisation procedure, or assisted conception procedure will be excluded.

Bajaj Allianz Critical Illness Cover for Women

This is critical illness cover designed specifically for women. This health insurance policy will provide coverage from 8 critical illnesses.

Features of Bajaj Allianz Critical Illness Cover for Women

Congenital Disability Benefit

• 50% of the sum insured will be paid by the insurer under this plan in case the child is born with any of the congenital diseases mentioned below. This is provided the child survives the first 30 days from the date of diagnosis of the congenital disease. This benefit will be provided for the first two children. This cover will not be applicable if the birth of the child takes place after the proposer attains the age of 40 years.

Listed below are the congenital diseases and defects covered under the policy: Tracheo-esophageal fistula

• This is an abnormal connection between the trachea and the esophagus.
• This procedure is generally suggested for a newborn baby by copious salivation associated with coughing, choking, and the cyanosis conicident during the start of feeding.
• In case this is diagnosed, surgery will have to be done immediately in order to allow the baby to swallow food.

Congenital cyanotic heart disease

• Congenital cyanotic heart disease is caused because of a hole between the two bottom ventricles of the heart Ventricular Septal Defect.
• There is a possibility the right ventricular tract becomes narrow at the pulmonary valvular stenosis.
• The right ventricular valve will increase in size that will cause a boot shaped appearance in the chest x-ray.
• This is the most common cyanotic heart defect and is the main reason for blue baby syndrome.

Spina bifida

• “Split spine” is a birth defect that is caused by the complete closure of the neural tube during the developmental stage. This results in the incomplete formation of the spinal cord.
• Common locations for the malformations will include the sacral and lumbar areas of the spinal cord.
• There is an option to surgically close the spina bifida after the birth of the child. The nerve damage done is however permanent. The normal functioning of the affected part of the spinal cord is not restored even with the surgery.
• The most significant part of the spina bifida is the myelomeningocele. This causes disability in most of the affected individuals.

Down’s syndrome

• Single palmar fold
• Muscle hypo-tonia (also referred to as poor muscle tone)
• A protruding tongue. This is caused by an enlarged tongue or due to the presence of a small oral cavity.
• Oblique eye fissures with skin folds present in the eye corners
• Down syndrome can cause abnormalities that can have an impact on any part of the body. There is a possibility a person with down syndrome can have a round face and a broad head.
• Most of the individuals contracted with down syndrome are contracted with mental retardation ranging from the mild to moderate range.

Cleft Palate with or without cleft lip

• Cleft palate can be defined as a condition in which the two plates that form the skull are not joined completely.
• The cleft causes the formation of a hole in the roof of the mouth and results in the connection of the mouth directly to the nose cavity.
• This cleft lip can be corrected by a surgery right after the birth of the child.

Loss of Job

In case the insured person is losing their job before the completion of 3 months from the date of diagnosis of the critical illness. The policy will be making you a payment of Rs.25,000 to help cover the loss of employment. Voluntary resignation from service will not be considered for this payment.

Children Education Bonus

In case you are diagnosed with a critical illness, the insurance policy will pay a Children’s Education Bonus for helping out with the future education of the children (irrespective of the number of children). This amount will be restricted to Rs.25,000 for all the children combined.

Exclusions of Bajaj Allianz Critical Illness Cover for Women

Listed below are some of the exclusions that are applicable for critical illness cover for women:

• Any critical illness that was diagnosed before the commencement of the policy which claims could have been made with an earlier policy.
• Any treatment that can be traced back to pregnancy or any other complications related to pregnancy, and childbirth postpartum complications. This exclusion will however not apply for Congenital Disability Benefit mentioned in the policy. Refer to the policy document to know more about the same.
• All sexually transmitted diseases or any medical condition that is caused by or is related to Lymphadenopathy Associated Virus or Human T-Cell Lymphotropic Virus type III or medical condition commonly referred to as AIDS.
• Diseases contracted due to radioactive contamination.
• any type of consequential losses. This will include any type of losses due to loss of opportunity, loss of profit, loss of gain, or any other such losses that are purely financial in nature.
• Any natural calamity. This will include natural hazards such as earthquakes, volcanic eruptions, avalanche, hurricane, or any other such type of natural hazard.
• Suicide, attempted suicide, or any form of self-inflicted injury.
• Any injury caused due to the use of alcohol or any other intoxicant.
• Damages caused due to any natural calamity. This will include earthquake, avalanche, hurricane, volcanic eruptions, or any type of natural hazard.
• Any type of consequential losses will not be covered under the policy. This will include loss of opportunity, loss of profit, business interruptions, and any other type of financial losses.
• Any act of war irrespective of whether it has been declared or not. Any act of a foreign enemy, terrorist activities, strikes, riots, and lockouts resulting in losses will be excluded from coveage.

Bajaj Allianz Premium Personal Guard

Bajaj Allianz Premium Personal Guard will provide you protection from death or bodily injury caused due to an accident. You will be provided coverage for all accidents and will be provided a high sum insured ranging between Rs.10 lakh and Rs.25 lakh.

Entry Age	You should have a minimum age of 18 years if you wish to avail this policy. You can avail this policy of up to 65 years. All the dependent children can be covered from the age of 5 years and up to 21 years.
Policy Period	Premium Personal Guard is an annual policy
Renewability	You have the option of lifetime renewability under this policy. This is provided there are no cases of fraud and misinterpretation.
Who are covered under the policy	Spouse, children, and self can be covered under the policy
Who are eligible to buy this policy	This policy is provided to people who belong to risk class I. People who fall under this risk level includes accountants, doctors, architects, teachers, administrative or managing functions, or other such occupations.
Free Look Period	You have a free-look period of 15 days from the date of commencement of the policy to see if you are satisfied with the policy. You can cancel the policy during this period provided no claims have been made. This option is not available at the time of policy renewal.

Features of Bajaj Premium Personal Guard

• Permanent Partial Disability

In case you suffer permanent partial disability due to an accident. The percentage of the sum insured that has been put aside for permanent partial disability would be paid by the insurer. The claim to be made in case of death, permanent partial disability, permanent total disability will be restricted to 25% in case the claim is made for your child. The claim will be restricted to 50% in case the claim is made for your spouse.

The following table provides more details about the percentage of sum assured you will be applicable for in case of permanent partial disablement:

Foot at the ankle	50%
A large toe	5%
Any other toe	2%
Sense of taste	5%
A thumb	20%
An index finger	10%
Any other finger	5%
Hearing of one ear	30%
Hearing of both ears	75%
A foot at the ankle	40%
A leg up to mid-calf	45%
A leg up to beneath the knee	50%
A leg up to mid-thigh	60%
a leg above mid-thigh	70%
A hand at the wrist	55%
Sense of smell	10%
An arm beneath the elbow joint	60%
An arm above elbow joint	65%
An arm at the shoulder joint	70%

• Permanent Total Disability

In case of personal total disability of the of the insured due to an accident, the claim amount will be paid based on the amount of coverage you receive. The claim to be made in case of permanent total disability will be restricted to 50% for claims made for your spouse.

• Death

100% of the sum insured will be paid to the nominee mentioned in the policy in case of death of the proposer due to an accident.

• Children’s Education Bonus

In case of permanent total disability or death of the policy proposer, a one-time payment of Rs.5,000 will be paid to the children insured under the policy. This amount is restricted to Rs.5,000 per child and up to 2 dependent children. This payment is made to help with the cost of education.

• Transporting mortal remains

In a situation you have made a claim due to the death of you or any family member covered under the policy, the insurance policy will cover the cost of transporting the remains of you or your family member from the place of death to the hospital or to the cremation ground. The amount of coverage provided under this policy is restricted to either 2% of the sum insured or Rs.5,000, whichever is lower.

• Hospital confinement allowance

Payment of Rs.1,500 to Rs.2,500 based on the type of plan you have chosen. This is restricted to a maximum of 30 days of hospitalisation during a policy period.

• Cumulative Bonus

For every year without making a claim, you will be eligible for a bonus of 10% called the cumulative bonus. You can accumulate a cumulative bonus of up to 50% of the sum insured. This can be accumulated up to 5 claim free years. In case you make a claim, the bonus will be reduced by 10% during the next policy renewal.

Exclusions under Bajaj Premium Personal Guard

• Any accidental injury that you may incur with due to:
• Driving under the influence of alcohol or any other intoxicant.
• Suicide, attempt to suicide, or any other type of self-inflicted injury or illness.
• Engaging in ballooning or aviation. This will include mounting, dismounting, traveling in any aircraft or balloon as anything else other than a passenger. This will include any standard type of aircraft that has been licensed in any part of the world.
• Treatments or interventions that you may have done on your body on your own.
• Taking part as a passenger, co-driver, or driver of a motorcycle as part of the racing or trial runs.
• Taking part in any military, navy, or air force operation. Injury incurred can be both due to war games and due to directly engaging with the enemy
• Sexually transmitted diseases
• Nuclear radiations and anything related to nuclear energy
• HIV (Human Immunodeficiency Virus) or any ailment related to HIV. This will include AIDS (Acquired Immuno Deficiency Syndrome) and any other derivatives or variations of the same.
• Pregnancy, childbirth, abortion, miscarriage, and any other complications that come up due to any of these reasons.
• Any consequential losses of any type.

Zone Wise Premium for Bajaj Allianz Health Insurance Policy

Zone A

Zone B

This includes Delhi, Hyderabad, Mumbai (includes Navi Mumbai, Kalyan, and Thane), Kolkata, Bangalore, Surat, Vadodara, Secunderabad, and Ahmedabad. All the policyholders who are paying the Zone A premium can avail treatment all over the country without making any co-payment

All the rest of India apart from the Zone A cities will be classified as a Zone B city. All the policyholders paying the Zone B premiums rates will have to pay 20% copayment on the total claim amount if the treatment is availed in a Zone A city. This co-payment is not applicable in case it is an accidental hospitalisation. People who are living in Zone B can opt to pay the Zone A premium and avail treatment all over the country without paying any co-payment.

Bajaj Allianz Health Insurance Network Hospitals:

Policyholders of Bajaj Allianz Health Insurance Policies can avail cashless treatment at over 5,700 network hospitals across the country. In the time of need, customers will be relieve to have their financial burden reduced. Keeping this in mind, Bajaj Allianz has partnered with a number of hospitals to provide excellent healthcare services to its customers. To locate a network hospital in your place of residence, select your state and city from the drop-down box on the online Network Hospital Locator. You will immediately get a list of network hospitals with contact details.

Find cashless network hospitals nearby:BAJAJ Allianz Health Insurance Network Hospitals

How to File a Claim With Bajaj Allianz?

Cashless Claim:

Visit a network hospital of the insurer to avail cashless treatment. Intimate the insurer within 24 hours of an emergency hospitalisation and in the case of a planned hospitalisation, 48 hours prior to your hospitalisation.

• Display your health card at the network hospital help desk. The hospital will verify your details and submit a duly-filled and signed pre-authorisation request form to the insurance company or it’s Third-Party Administrator (TPA) via fax.
• Bajaj Allianz will verify the pre-authorisation request and send an approval letter to the hospital.
• The hospital will proceed with the cashless treatment for the insured member without any deposit until discharge.
• If the cashless claim is denied, the insured member can get treated and file for a reimbursement claim after discharge.

Reimbursement Claim:

After discharge from the hospital, collect the hospital bills, discharge summary, and other medical documents from the hospital.

• Submit the reimbursement claim form to the insurer along with the original medical documents such as discharge summary, medical reports, hospital bills, pharmacy bills, prescriptions, etc.
• An approval letter will be sent to the insured after thorough verification of the submitted documents.
• If additional documents are required, the insurance company will ask for it. Claim will be closed without payment after 45 days for not submitting relevants documents and the claim closure will be sent to the insured.
• The claim amount will be sent through cheque or ECS to the insured member after approval.

Bajaj Allianz Health Insurance Customer Care:

For policy-related queries, call the insurer on their dedicated toll-free number or email the insurer. You can also locate the nearest Bajaj Allianz branch using the Branch Locator feature on the insurer's website. For policy-related queries, you can chat with an insurance agent via their chat bot BOING on the Bajaj Allianz website. You can also check the list of network hospitals online through the Bajaj Allianz website by entering the state, city, and hospital type or name.

How to renew Bajaj Allianz Health Insurance online?

You will have to make sure to renew your health insurance policy before the expiry date. Failing to do can cause your policy to lapse. Bajaj Allianz Health Insurance policies can be renewed online through the insurer’s website or offline by paying cash at the nearest branch office. For online method, renewal payment can be made using net banking, credit card, or debit card.

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.

About Bajaj Allianz General Insurance

Bajaj Allianz General Insurance is a joint venture between Allianz SE and Bajaj Finserv Limited. This is a combination of the strength and stability of Allianz SE established worldwide and the trust the Bajaj brand name commands in India. The company has managed to attract quite a large customer base and managed to earn their trust in a comparatively shorter time.

Bajaj Allianz Health Insurance FAQs

1.What is meant by a third-party administrator?

A third-party administrator provides specialised health care and is approved by the Insurance Regulatory Development Authority (IRDA). A third-party administrator will be providing a number of services such as claim processing, cashless hospitalisation, networking with hospitals, and timely settlement of claims.

2.What is the difference between Critical illness policies and health insurance policies?

A health insurance will offer will reimburse any medical expenses incurred during the policy period. Critical illness insurance on the other hand is a benefit policy. This means that the insurer will make a lumpsum in case you contract any of the critical illnesses. Under the critical illness policy, the insurer will have no control over the way the lumpsum amount. The insured can do anything with the lumpsum amount.

3.Can I claim reimbursements under health insurance for treatments done at home?

Treatments done from home falls under domiciliary hospitalisation. Almost all the health insurance companies will offer coverage for treatments done at home if it is because of any one of the following reasons:

• If the health of the patient is in such a condition that he/she cannot be shifted to a hospital.
• In case of absence of a bed in any of the hospitals. This is applicable only if the ailment to be treated is covered under the policy.

This is subject to some terms and conditions on the amount of coverage provided and the diseases covered under the policy.

4.How does an insurance company determine if an illness is a pre-existing disease?

At the time of applying for a health insurance policy, you will have to provide information about all the illnesses you have contracted in your lifetime. You should also convey the insurer if you are undergoing treatment for all disease at the time of availing the policy.

The insurer will then discuss with their medical panel to determine if the illness was a pre-existing disease or a newly contracted one. It is important to convey all the diseases you are suffering from at the time of buying the policy. Intentional non-disclosure of facts can lead to big problems in the future when you make a claim.

5.What will happen to the claim if the policyholder dies while treating the disease?

In case of cashless hospitalisation, the claim will be settled by the insurer directly with the network hospital. In case the treatment is not being done in a network hospital, the total claim amount will be paid to the nominee mentioned in the insurance policy.

In case the policyholder did not nominate any nominee for the insurance policy, the insurance company will want a succession certificate from the court of law before they disburse the claim amount.

6.What are the main factors that determine the premium I need to pay for a health insurance policy?

The age of the proposer and the amount of coverage are the two main factors that help determine the premium to be paid. Younger people generally tend to get the lowest annual premiums as they are considered to be much healthier when compared to the older people. Older people might have to pay a higher insurance premium as they are more prone to illness and health problems.

7.Can I avail coverage for all the members of my family even if we are not residing in the same geographical area?

Yes, it is possible to cover all the members of the family under a single policy. The health insurance will be valid across the country. It is advisable to check if there are network hospitals situated near wherever you and your family reside. This will be helpful as you can make cashless claims in these hospitals.

In case there are no network hospitals nearby, you will have to opt for reimbursement method of settling claims.

8.I already have a life insurance policy. Is it necessary to buy a health insurance policy?

Yes, it is advisable to buy a health insurance policy even if you already own a life insurance policy. This is because both policies serve different purposes. A health insurance policy will ensure that you are covered for any major expense you incur due to your health. This policy will ensure that you are not put in tough spot financially in case of sudden and unavoidable medical expense.

9.What are some of the common exclusions in a health insurance policy?

All the health insurance policies have some restrictions and exclusions in place. Some of the most common exclusions have been listed below:

• Cosmetic surgeries, dental treatments, and AID are some of the permanent exclusions under the policy. The policy will not cover these claims irrespective of the duration of the policy.
• Exclusions like sinusitis and cataract are some of the temporary exclusions. These diseases will not be covered during the first year of the policy but will be covered in the following years.
• Any medical condition that is a consequence of a disease that existed before the purchase of the policy. Any preexisting illness in a health insurance policy is generally covered after the completion of 4 years from the date of commencement of the policy.

You can refer to the policy document if you wish to know the complete list of exclusions and the details of how insurers cover preexisting illnesses.

10.What will happen in case I cancel my health insurance policy?

In case you cancel your health insurance policy, the coverage you were receiving will stop starting from the date the policy was canceled. The premium paid will be refunded on short period cancellation rates. You can refer to the policy document if you wish to know more about policy cancellation.