BAJAJ ALLIANZ Health Insurance

Bajaj Allianz General Insurance Highlights _{Updated on 25 Mar 2019}

*For Year 2017-2018

Overview of Bajaj Allianz Health Insurance:

Bajaj Allianz General Insurance Company Limited is one of India’s most trusted and preferred insurance providers. 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. 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 wide consumer base alongside being a market leader and a much-preferred health insurance provider.

Why Bajaj Allianz Health Insurance?

Bajaj Allianz Health Insurance has one of the highest incurred claim ratios among private insurance providers in India. Health insurance policies provided by Bajaj Allianz gives you access to the best healthcare treatments and services possible while ensuring you are financially protected. The insurance company offers a wide range of health insurance products to protect its customers against increasing healthcare costs. Here are some reasons why you should choose Bajaj Allianz Health Insurance as your insurance provider:

• The insurer provides customised health insurance policies to meet the varying needs of its customers, including policies that are specially catered towards individuals, families, senior citizens, personal accident covers, and women-specific health insurance policies.
• Bajaj Allianz Health Insurance covers pre and post-hospitalisation expenses, room rent, cashless hospitalisation, ambulance fees, etc.
• Get cashless treatment at more than 5,700 network hospitals.
• Get tax deductions on premiums paid towards a health insurance plan under Section 80D of the Income Tax Act, 1961.
• Bajaj Allianz Health Insurance understands the value of the customer's time and therefore, aims to settle claims in as short a duration as possible. On an average, a typical health insurance claim is settled within an hour.
• Another key feature of this insurer is that customers get comprehensive health cover at competitive prices.
• The insurer also has an in-house health administration team.
• With Bajaj Allianz Health Insurance plans, you can get exclusive value-added services.
• More than 1.4 lakh claims have been processed in FY2015-16.

  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:

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

1. Bajaj Allianz Health Guard Individual Policy

2. Bajaj Allianz Health Guard Family Floater Option Plan

3. Bajaj Allianz Silver Health Plan for Senior Citizens

4. Bajaj Allianz Critical Illness for Women Plan

5. Bajaj Allianz Personal Guard – Accident Health Insurance Policy

6. Bajaj Allianz Global Personal Guard Policy

7. Bajaj Allianz Critical Illness Plan

8. Bajaj Allianz Extra Care Policy

9. Bajaj Allianz Health Care Supreme Plan

10. Bajaj Allianz Hospital Cash Daily Allowance Policy

11. Bajaj Allianz Star Package Plan

12. Bajaj Allianz Health Ensure Plan

13. Bajaj Allianz Personal Accident Insurance Policy

14. Bajaj Allianz Premium Personal Guard Plan

15. Bajaj Allianz Extra Care

16. Bajaj Allianz Tax Gain Plan

Bajaj Allianz Individual Health Guard Plan::

The Health Guard policy from Bajaj Allianz is available in two variants – the Silver Plan and the Gold Plan. This policy is designed to provide a cover against all your healthcare-related spends that might occur in the event of a hospitalisation, serious illness, accident, etc. Certain key features of this policy are listed in the table below.

Bajaj Allianz Health Guard Family Floater Plan:

Bajaj Allianz Surgical Protection Plan:

Bajaj Allianz 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.

Bajaj Allianz Health Insurance Extra Care:

The Extra Care Health Insurance Policy from Bajaj Allianz will help you to extend the coverage provided by the base policy, during times when you require prolonged hospitalization.

Bajaj Allianz Health Insurance Critical Illness Plan:

This policy will help you insure yourself against the risk of critical illnesses, just like you would insure your car or house. The policy provides a cover against 10 major critical illnesses.

Bajaj Allianz Extra Care Plus Policy:

The Extra Care Plus Policy is purchased as a top-up to a regular health insurance cover offered by Bajaj Allianz. Thus, if the sum insured of the base policy is exhausted, this top-up policy will provide you additional coverage. A few important features of this add-on policy are listed below.

Bajaj Allianz Health Care Supreme Plan:

The Health Care Supreme Plan from Bajaj Allianz will provide both you and your family a comprehensive cover against various medical needs, with a high sum insured and a wide coverage. Thus, this policy can help you save on expenses that you may otherwise have to incur in the event of a medical emergency. The benefits and features of this policy are mentioned in the table below.

 

Bajaj Allianz Hospital Cash Daily Allowance Policy:

Most health insurance policies cover medical expenses incurred by the policyholder during hospitalisation. However, certain other incidental expenses remain uncovered. The Hospital Cash Daily Allowance Policy provides the insured individual a certain sum of money on an everyday basis to help him/her take care of any expenses that may arise. The key features of this policy are mentioned in the table below.

 

Bajaj Allianz Star Package Plan:

The Star Package Plan is a one-of-a-kind health insurance policy that in addition to providing a comprehensive risk cover also provides a range of other benefits. This policy is available on a family floater basis. The key features of this policy are mentioned in the table below.

 

Bajaj Allianz Health Ensure Plan:

The Health Ensure Plan from Bajaj Allianz is available on both an individual and a family floater basis. This policy provides a comprehensive health cover to the proposer and his/her family at a competitive premium rate. Some of the key features of this plan are mentioned in the table below.

Bajaj Allianz Personal Accident Insurance Policy:

The Personal Accident Insurance Policy from Bajaj Allianz provides a risk cover to the insured and his/her dependents against the financial repercussions of the one’s death or accidental disability. The policy is offered with 3 coverage options. Policyholders can also choose to purchase other add-ons.

 

Bajaj Allianz Silver Health Plan for Senior Citizens:

This is that has been designed specifically for senior citizens. It offers the option to opt for up to 20% co-pay or a cashless policy.

Bajaj Allianz Critical Illness for Women Plan:

This Critical Illness Insurance Plan from Bajaj Allianz is especially catered towards women. This policy covers up to 8 critical illnesses and congenital disability, and also provides certain additional benefits along with the policy.

Bajaj Allianz Personal Guard – Accident Health Insurance Policy:

The Personal Guard - Accident Health Insurance Policy provides a cover against accidental death and disability due to an accident. The policy also offers add-on covers to policy buyers, which can be purchased for an additional premium.

 

Bajaj Allianz Global Personal Guard Policy (Individual):

The Global Personal Guard Policy from Bajaj Allianz provides a comprehensive cover against death and permanent disability (both total and partial). Also, along with this policy the insured member can purchase up to 12 optional covers. The main features and benefits of this plan are listed in the table below.

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.

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.

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.

Incurred Claims Ratio of Bajaj Allianz Health Insurance for the Year 2017-18

Net Earned Premium (in Crore)	Net Claims Paid (in Crore)	Incurred Claims Ratio (in %)
Rs.1,331.60 crore	Rs.1,033.47 crore	77.61%

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.

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 policies also come with longer tenure options.

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

   The sum insured is the maximum amount of money that the health insurance provider is liable to pay. Thus, in most cases, anything over the sum insured limit will have to be borne by the policyholder. Premiums will vary according to sum insured.

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. 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. Thus, if you undergo cashless treatment at a hospital, you will have to bear minimum out-of-pocket expenses.

   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, unless otherwise mentioned in the policy.

11. What is Bajaj Allianz Health CDC?

    Health CDC is an app feature in Bajaj Allianz Insurance Wallet App through which policyholders can make claim requests up to Rs.20,000. As the whole process is paperless, it saves the customer money and effort while receiving regular updates of the claim status.

12. What is the toll free number of Bajaj Allianz Health Insurance?

    The insurer’s toll-free numbers can be viewed on the Bajaj Allianz website.

    What is Bajaj Allianz Health Insurance Top Up?

    Bajaj Allianz offers a health insurance top up plan called the Health Extra Care Plus Policy. It serves as an additional cover to the base health insurance policy.

13. How to claim Bajaj Allianz Health Insurance?

    Health insurance claims can be registered online through the Bajaj Allianz website. To register your claim on the phone, the policyholder/nominee will have to call the toll-free number of the insurer. Claim forms can be downloaded from the Bajaj Allianz website.

    • For cashless claims:
      • Insured member has to display his or health card at the network hospital desk for cashless treatment.
      • The network hospital will verify the identification of the insured member and submit a pre-authorisation request form to the insurer.
      • Bajaj Allianz will verify the details and approve or reject the request.
      • Upon receiving approval, the network hospital will provide cashless treatment to the insured member.
      • Upon rejection, the network hospital will provide cash-paying treatment to the insured member. The customer can file reimbursement claim.
    • For reimbursement claims:
      • Intimate the insurer within 24 hours of hospitalisation.
      • After discharge, submit all the original medical documents such as discharge summary, prescription, doctor's reports, pharmacy bills, hospital bills, etc. along with the duly-filled claim form to the insurer.
      • The insurer will verify the furnished documents and approve or reject the claim accordingly.

14. 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.