• Bajaj Allianz Health Insurance Claims Procedure

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    Health insurance is an important aspect of everyone’s personal finance because it helps protect one from unnecessary burdens of medical bills. The claim process of Bajaj Allianz Health Insurance is relatively easy and hassle-free, allowing for easy reimbursement or cashless treatment at any hospital across the nation. With over 5100 hospitals in its list of networked healthcare institutions, Bajaj Allianz Heath Insurance aims to make health insurance accessible to everyone.

    Incurred Claim Ratio for Bajaj Allianz Health Insurance:

    ICR or Incurred Claim Ratio is a standard measure across the insurance market of how well an insurer is performing. The incurred claim ratio for Bajaj Allianz Health Insurance is shown in the table below –

    For 2015-16:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    28773 16472 57.25

    For 2014-15:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    69512 51152 73.59

    A value from 50% to 80% is a good figure concerning ICR (Incurred Claim Ratios). Bajaj Allianz in 2014-15 and 2015-16 had a claim ratio of around 83% and could have been under pressure to meet claims, but it now has a claim ratio that is within the appreciated limits. Thus, any kind of claims will not be taxing the financials of Bajaj Allianz in any condition.

    Claim Scenarios:

    Claim scenarios happen with cashless treatment as well as reimbursement cases. Both options for Bajaj Allianz are mentioned below.

    Cashless Treatment:

    Bajaj Allianz has tie-ups with many hospitals across the nation and that helps in availing cashless treatment. The bills generated in such cases are sent across to Bajaj Allianz and the policyholder or the claimant doesn’t need to pay anything.

    Procedure to File a Claim (Planned/Emergency Hospitalisation):

    1. Member card should be carried on person, or the policy number and member ID should be provided at the network hospital
    2. One would need to furnish personal details and policy ID or member ID to the hospital’s insurance desk and fill up the Pre-Authorisation form in the customer’s section
    3. Once the balance details are filled up by the hospital, the Pre-Authorisation form will be faxed to Bajaj Allianz
    4. The Bajaj Allianz in-house medical team will review the case and documents received and intimate the guardian and hospital in case of approval, pending approval or rejection
    5. In case of pending approval cases, Bajaj Allianz will contact the hospital to furnish more details and in cases of rejection, a claim reimbursement process needs to be followed

    Claims Process for Cashless Treatment:

    1. Post the filling up of the pre-authorisation form, the requisite details will be verified by the hospital and the TPA
    2. Upon submission of the pre-authorisation form, all communications will be taken care of by Bajaj Allianz pertaining to the settlement of the bill
    3. If in case some expenses are not covered or are beyond the scope of the policy, the same will be intimated to the patient before or post release from hospitalisation

    Reimbursement of Treatment Expenses:

    Reimbursement needs to be done if treatment has been availed at a non-network hospital or cashless claim has been rejected. The following process will need to be followed in such cases.

    Procedure to File a Claim:

    1. The details required during this procedure will be the following –
      • Policyholder’s name
      • Claimant’s name and customer ID
      • Details of the hospital
      • Details of diagnosis and treatment
      • An approximation of the claim amount
      • Date of admission
    2. Collection of all related documents from the hospital to be done

    Documents Required:

    The claim form can be downloaded from Bajaj Allianz’s website and along with the filled up form, the following documents need to be provided –

    1. The original copy of the claim form, fully filled and duly signed
    2. Government approved valid photo ID proof
    3. Referral letter from medical practitioner advising hospitalisation
    4. Letter from medical practitioner detailing the list of tests, medications and consultations if any
    5. Original copies of bills, receipts and discharge card from the hospital or the medical practitioner
    6. Original copies of bills or receipts from pharmacies or druggists involved
    7. Original copies of tests and reports done along with payment receipts
    8. Indoor case papers
    9. If applicable, the First Information Report and the Final Police Report
    10. Original copy of the post mortem report, if conducted

    The above list of documents are the bare minimum necessities. Bajaj Allianz might require additional documentation as and when needed.

    The above mentioned list of documents and the claim form needs to be sent via post to the address at the office of Bajaj Allianz General Insurance.

    Claims process for Reimbursement Cases:

    Once the filled claim form along with the relevant documents is received by Bajaj Allianz, the claims process is initiated and the following happens –

    1. The in-house medical team of Bajaj Allianz reviews the case and documents received
    2. The case if approved, will cause the reimbursement of funds to be processed and the procedure will be completed within a week and a fortnight. Intimation of the same will be sent to the claimant
    3. In case the request has incomplete information, the same will be intimated to the claimant and requisite details will be requested to ensure claim resolution at the earliest
    4. In case of request rejection, the reason will be mentioned for the same and an intimation sent to the claimant. If there are further documents to strengthen the case, the same will be studied and the claim can be reopened for review

    This Insurance Company has not partnered with BankBazaar.com. For more details, please visit its website/branch office. The trademarks, logos and other subject matters of intellectual property belong to their respective owners.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Bajaj Allianz Health Insurance Claims Procedure Reviews

  • Page 1 of 14 1 2 3 4 5
    • Bajaj Allianz Health Insurance
      "Best insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken Health insurance with Bajaj allianz,the premium amount is not paid my me as its offered by the company.The policy coverage is six lakhs including the family members.This is covered mediclaim as well as health insurance.The policy was taken two years back and no claim experience.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 20, 2018
    • Bajaj Allianz Health Insurance
      "Good Insurance"
      0.5 5.0/5 "Blown Away!"
      I have taken a Mediclaim plan with Bajaj. I have had a good claim experience with them. They gave the amount pretty easily. Even in case of my relatives experience Baja readily payed about Rs.75000 for the treatment. The number of network hospital in it are pretty good.
      Was this review helpful? 0
      , mumbai
      Reviewed on Feb 16, 2018
    • Bajaj Allianz Health Insurance
      "Good service"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health Insurance with Bajaj Allianz ,the premium amount is 12,000, its a one time payment.They cover including the dependants the policy coverage amount is five lakhs ,they give 100% for cashless treatment.I pay my premium with my EMI card of bajaj allianz.
      Was this review helpful? 0
      , jaipur
      Reviewed on Feb 15, 2018
    • Bajaj Allianz Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Bajaj allianz general insurance company. Coverage value is around 2 lakh Rupees. Response time is best one with the Bajaj allianz general insurance company.
      Was this review helpful? 0
      , pune
      Reviewed on Feb 13, 2018
    • Bajaj Allianz Health Insurance
      "Average service"
      0.5 2.0/5 "Expected more"
      I have taken a health insurance with Bajaj,the service was good with Bajaj. The benefits is single benefits and the payment will be deducted from my credit card. Also they provided me with some good offers from top hospitals but still I never claimed any service from Bajaj,it was a average service from Bajaj health insurance service.
      Was this review helpful? 0
      , pune
      Reviewed on Feb 09, 2018
    • Bajaj Allianz Health Insurance
      "Best policy to use"
      0.5 4.0/5 "Great!"
      I hold a health insurance policy with Bajaj Insurance from last 1 month and it is a good insurance policy. This policy has to be renewed every year and i pay a premium of Rs 700 on monthly basis. I have not taken any cash less treatment and i do not have claim experience with this insurance I have a coverage of Rs 1 lakh which is satisfactory.
      Was this review helpful? 0
      , chennai
      Reviewed on Feb 09, 2018
    • Bajaj Allianz Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I have taken a Health insurance policy from Bajaj Allianz. It's an accidental health insurance. The final premium amount that I paid is around Rs. 2,895 for the period of 6 months and sum assured to me is around Rs. 1,40,000. I am satisfied with the policy but customer service I am not satisfied.
      Was this review helpful? 0
      , pune
      Reviewed on Feb 07, 2018
    • Bajaj Allianz Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Bajaj Insurance from last 3 years, i paid a one time premium of Rs 9000 which is valid for next 9 years. I do not have claim experience so far and i i have not taken any cashless treatment with this insurance. I am happy with the coverage amount of Rs 2 lakhs for this insurance.
      Was this review helpful? 0
      , vadodara
      Reviewed on Jan 31, 2018
    • Bajaj Allianz Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      Bajaj Finserv has recommended the health insurance policy so I took from Bajaj Allianz. I never had claim experience. They said 100% cashless services are available and need not to pay anything. The policy coverage was 20L for the entire family.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jan 28, 2018
    • Bajaj Allianz Health Insurance
      "Average service"
      0.5 3.5/5 "Pretty good"
      It was a good experience with Bajaj health insurance service. The benefits was for my whole family and the payments were generally through online. Bajaj use to update me regarding their new schemes and offers. It was totally a nice service from Bajaj health insurance department.
      Was this review helpful? 0
      , pune
      Reviewed on Jan 25, 2018
    • Bajaj Allianz Health Insurance
      "Average policy to use"
      0.5 3.0/5 "Satisfactory"
      Got the health insurance policy with the BAJAJ ALLIANZ GENERAL INSURANCE company. I got this policy along with the bajaj consumer durable loan , basically it was a accidental coverage policy. It covers the medical coverage of Rs,1lakh. I have paid Rs.2500 to get this policy.
      Was this review helpful? 0
      , salem
      Reviewed on Jan 18, 2018
    • Bajaj Allianz Health Insurance
      "Better policy "
      0.5 5.0/5 "Blown Away!"
      Got the health insurance policy with the Bajaj allainz around 8 months ago. This policy covers 4members in my family. This policy gives the medical coverage up to 5lakhs and the rental of the hospitality . The cashless treatment option is available with this policy.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 15, 2018
    • Bajaj Allianz Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have taken a health insurance with Bajaj Allianz.The policy is running for past few years.The premium amount is 1700 paid annually through an ECS.I got 100% covered as cash less treatment including family members.Customer service is good to approach.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jan 12, 2018
    • Bajaj Allianz Health Insurance
      "Not a good Experience"
      0.5 1.0/5 "Really Bad"
      I have Mediclaim plan with them. Claim experience with it has been bad. They increased the premium price. The price they offered was far higher from what was there in their own website. They have not given the hard copy and soft copy until now and I took it in September. They are offering a Coverage of Rs.2 lakhs.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 06, 2018
    • Bajaj Allianz Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I have taken a health insurance with Bajaj Allianz.The service is good and make payment through online.I get a good policy coverage.The customer service do respond on time.I pay premium amount of 15,000.I closed the health insurance because i dint get much benefits.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jan 06, 2018
    • Bajaj Allianz Health Insurance
      "Its good"
      0.5 5.0/5 "Blown Away!"
      I have not much interacted with Bajaj Allianz customer care, but they have explained it clearly about the health insurance. Many time I have claimed my policy for my regular check up, they got tie up with good hospital. They are providing medical coverage including critical disease. They gave me coverage of Rs. 5 lakhs. for annual premium.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 29, 2017
    • Bajaj Allianz Health Insurance
      "Okay"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Bajaj allianz general insurance company. I have got the claim reimbursement from them, where I have got around 60% of the cost of treatment as return back. I am happy with the Bajaj allianz general insurance company.
      Was this review helpful? 0
      , bangalore
      Reviewed on Dec 26, 2017
    • Bajaj Allianz Health Insurance
      "Good Insurance"
      0.5 5.0/5 "Blown Away!"
      I have been paying Rs.3000 annually for this Health Insurance and the coverage I have been given is pretty good. They have given Rs.2 Lakhs as the coverage for me and my Family. The Cashless options is available in this Plan. The number of Network hospital is also pretty good.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Dec 20, 2017
    • Bajaj Allianz Health Insurance
      "Average service"
      0.5 3.5/5 "Pretty good"
      I have taken Health Insurance with Bajaj Allianz.I pay a premium amount of 7000 once in a year.The policy coverage amount is two lakhs.I pay my premium through online.I don't have any claim experience with them and i don't recommend.The website is easy to understand and navigate.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Dec 19, 2017
    • Bajaj Allianz Health Insurance
      "Good Health Cover"
      0.5 4.0/5 "Great!"
      When I got admitted in hospital, initially I paid some amount, then I took approval I got cash less treatment. Even they reimbursed the payment which I paid. They got tie up with good network hospital, totally I have medical cover of Rs. 2 lakhs.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Dec 18, 2017
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