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Bajaj Allianz Health Insurance

Bajaj Allianz General Insurance Company was started as a joint undertaking between Bajaj Finserv Ltd. and a European financial services company named Allianz SE. The company issued more than 4.7 lakh insurance policies in the last fiscal year 2016-2017.
Bajaj Health Insurance offers a number of affordable health insurance policies which are specially designed to safeguard you against increasing quality healthcare costs.


Advantages of buying a Bajaj Health Insurance Policy

  • You do not need to worry about the settlement of claim, as the company has a positive claim settlement
    history
  • More than 4 lakh policies were issued by the company in the financial year2016-17
  • As per the records, the average claim settlement time of Bajaj health insurance is 1 hour
  • You can avail cashless claim facility in more than 5700 hospitals across India
  • It’s easy and quick to purchase and renew Bajaj health insurance policy online

Comparison Table for Bajaj Allianz Health Insurance Plans:

Plan Name Entry Age Criteria Pre-existing diseases Pre-medical Test Sum Assured (Rs.)
Bajaj Allianz Individual Health Guard Insurance Plan 18 to  65 years 2 years After 45 years 1.5 lakhs-50 lakhs
Bajaj Allianz Family Health Insurance Plan 18 to  65 years 2 years After 45 years 1.5 lakhs -50 lakhs
Bajaj Allianz Extra Care Health Insurance Plan 91 days to 80 years 1 year After 55 years 3 lakhs -50 lakhs

 

Bajaj Critical Illness Plan 91 days to 80 years 30 days survival period 1 lakh-50 lakhs
Bajaj Silver Health Insurance Plan for Senior Citizens 46-70 years 1 year 50,000 -5 lakhs
Bajaj Allianz Global Personal Guard Policy (Accidental Cover) 18-70 years Not covered 50,000-25,00,00000

Bajaj Allianz Health Insurance Plans-

Concept of Zone Wise Premium in Bajaj Health Insurance Plan

Zone B Zone A
Rest of India apart from Zone A cities are classified as Zone B. Delhi / NCR, Hyderabad, Bangalore, Ahmedabad, Mumbai (Navi Mumbai, Thane and Kalyan)and Secunderabad, Kolkata, Vadodara and Surat
Bajaj Allianz health insurance policyholders paying premium rates mentioned in Zone B as availing healthcare treatment in Zone A cities which have to pay 20% of co-payment amount on the admissible claim amount (unless it is an accidental treatment). Those residing in Zone B can choose to pay the premium for Zone A. This way, the insured can avail treatment all over India without a co-pay condition. Bajaj Allianz health insurance policyholders paying premium rates mentioned in Zone A can avail PAN India treatment without any co-payment

Read policy documents for further details*

Check out the various Bajaj Health Insurance Plans

1. Bajaj Allianz Individual Health Guard Insurance Plan

This is a health insurance plan for individuals who want to reimburse their medical expenses. Have a quick rundown of the plan in the table below-

Features & Benefits
  • Entry age for health insurance cover is from 18 to  65 years
  • Entry age for a child ranges  from 3 months to 30 years
  • No pre-medical tests  required up to the age of 45 years
  • 10% of family discount up to 2 members and 15% up to 3 members
  • 4% of policy discount for 2 years and 8% for 3 years
  • Co-payment option with discount up to 20%
  • Up to Rs. 7500 of convalescence benefit every year

Lifelong renewability option

  • Free preventive health checkup benefit in every 3 years
  • Daily cash benefits and Health CDC benefit  ( please check policy docs. for details)
  • Extended family coverage option – including parents, grandparents, in-laws, dependent grandchildren and siblings
  • Tax saving under sec 80/D – up to Rs. 60,000
Inclusions Pre & post hospitalization expenses (90 days after and 60 days prior hospitalization)

  • Policy term options of one, two and three years
  • Organ donor expenses covered
  • Bariatric surgery cover (after a waiting period of 3 years )
  • Maternity and newborn baby cover (after a waiting period of 6 years )
  • Ayurveda and Homeopathic treatment cover
  • Cashless claim facility in more than 5700 network hospitals across India(subjected to policy  conditions)
  • Ambulance charges covered up to Rs. 20000 per policy year
  • Reinstatement of sum insured
  • All day care treatment expenses will be compensated
Exclusions
  • Any disease or illness that is diagnosed in the initial 30 days from the inception
  • 2 years of mandatory waiting period on certain specified diseases like cataract, hernia etc. else treatment expenses will not be compensated
  • Pre-existing diseases will not be covered before a waiting period of 3 years
  • Prolapsed Inter-Vertebral Disc, Joint Replacement  treatment are only covered after a waiting period of 3 years
  • An illness or treatment for the overdose of drugs, alcohol consumption, and intoxication are not recompensed under any health insurance plan by Bajaj Allianz.
Sum Assured (Rs.)
  • Sum insured is minimum of Rs. 1.5 lakhs
  • Maximum up to Rs. 50 lakhs

2. Bajaj Allianz Family Health Insurance Plan

This is a health insurance plan for those who want to get their family’s health covered under single health insurance plan and provide them with the best medical treatment possible. Have a quick rundown of the plan details in the table below –

Features & Benefits
  • Entry age for health insurance cover is 18 to  65 years
  • Entry age for a child ranges  from 3 months to 30 years
  • No pre-medical tests  required up to the age of 45 years
  • 10% of family discount up to 2 members and 15% up to 3 members
  • 4% of policy discount for 2 years and 8% for 3 years
  • Co-payment option with discount up to 20%
  • Up to Rs. 7500 of convalescence benefit every year

Lifelong renewability option

  • Free preventive health checkup benefit in every 3 years
  • Daily cash benefits and Health CDC benefit  ( please check policy docs. for details)
  • Extended family coverage option – including parents, grandparents, in-laws, dependent grandchildren and siblings
  • Tax saving under sec 80/D- up to Rs. 60,000
Inclusions Pre & post hospitalization expenses (90 days after and 60 days prior hospitalization)

  • Policy term options of one, two and three years
  • Organ donor expenses covered
  • Bariatric surgery cover (after a waiting period of 3 years )
  • Maternity and newborn baby cover (after a waiting period of 6 years )
  • Ayurveda and Homeopathic treatment cover
  • Cashless claim facility in more than 5700 empanelled hospitals across India(subjected to policy  conditions)
  • Ambulance charges covered up to Rs. 20000 per policy year
  • Reinstatement of sum insured
  • All day care treatment expenses will be compensated
Exclusions
  • Any disease or illness that is diagnosed in the initial 30 days from the inception
  • 2 years of mandatory waiting period on certain specified diseases like cataract, hernia etc. else treatment expenses will not be compensated
  • Pre-existing diseases will not be covered before a waiting period of 3 years
  • Prolapsed Inter-Vertebral Disc, Joint Replacement  treatment are only covered after a waiting period of 3 years
  • An illness or treatment for the overdose of drugs, alcohol consumption, and intoxication are not recompensed under any health insurance plan by Bajaj Allianz.
Sum Assured (Rs.)
  • Sum insured is minimum of Rs. 1.5 lakhs
  • Maximum up to Rs. 50 lakhs

3. Bajaj Allianz Extra Care Health Insurance Plan

Extra Care Plus is a top-up health insurance policy that provides additional coverage to you even after you exhaust the total limit of sum assured of your existing medical policy. Hence, it insures wider cover to you and your family without paying too much. You can get this policy even if you don’t have a base medical insurance plan. Have a look at the plan details in the table below –

Features & Benefits
  • Entry age is from 91 days up to 80 years
  • Floater policy for your dependant family members
  • Cashless facility available in more than 5700 network hospitals in India (subject to policy terms and conditions)
  • Avail aggregate ( check policy documents for the same)
  • No pre-policy medical tests required up to the age of 55 years (subjected to clean proposal form)
  • Pre-existing disease covered after 1 year from inception
  • 15 days of free look period
  • Avail free health check-up facility
  • Maternity expenses including complications after 1 year of waiting period
  • Tax saving benefit under Section 80 D of the IT Act
  • Health CDC benefit
Inclusions
  • In-patient hospitalization expenses – room rent, ICU, operation theatre charges, surgical equipment charges, anesthesia, diagnostic tests etc.
  • Pre and post hospitalization cover, 60 days prior to hospitalization or 90 days post hospitalization
  • Organ donor expenses
  • Road ambulance cover
  • All day care expenses & treatments
  • Optional or additional air ambulance cover ( check policy details)
  • Exclusions
  • Any claim amount falling within deductible limit
  • Pre-existing disease will not be covered until 1 year of policy term and in case of continuous policy renewal without break, waiting period clause shall not be applicable ( check with insurance provider for details)
  • Any disease that is diagnosed during the first 30 days from the date of policy purchase ( except accidental injuries)
  • Medical expenses on the new born baby
  • Dental treatment or injury ( until it requires hospitalization or is an accidental case)
  • Illnesses or injuries arising due to war conditions, nuclear attacks, terrorist activities, rebellion etc.
  • AIDS/HIV and other sexually transmitted diseases
  • Self-inflicted injuries and conditions of depression and mental disorders
  • Health treatment for drug intoxication and overdose of alcohol consumption
  • For initial 12 months any joint replacement surgery, hernia operation, piles treatment etc. will not be covered
  • Check policy brochure for detailed exclusions
Sum Assured (Rs.)
  • Ranging from 3-50 lakhs
  • Aggregate deductibles from 2-10 lakhs

4. Bajaj Critical Illness Plan

Critical illness is defined as a life-threatening disease or condition under which the insurance company is liable to pay a lump sum amount to the insured person for medical treatment cost, which is much higher than other illnesses. Have a look at the policy benefits details below –

Features & Benefits
  • Easy in-house claim process facility
  • 10 major critical illnesses are covered Entry age is from 91 days up to 80 years
  • Easy lifetime renewable process
  • Survival period of 30 days is required
  • Lump sum payment of insured amount
  • Donor expenses incurred on an organ transplant surgery, are covered within India & abroad ( subjected to the sum assured limit)
  • Tax saving benefit under Sec.80/ D of the IT Act
  • Health CDC benefit
Illnesses covered
  • Cancer
  • Major Organ Transplant
  • Kidney Failure
  • Stroke
  • Permanent Limb Paralysis
  • Multiple Sclerosis
  • Coronary Artery Bypass Surgery
  • First Heart Attack (Myocardial Infarction)
  • Aorta Graft Surgery
  • Primary Pulmonary Arterial Hypertension
Exclusions
  • Any acute illness that is diagnosed during the first 90 days from the date of policy purchase
  • Treatment arising due to pregnancy conditions and childbirth
  • Illnesses or injuries arising due to war conditions, nuclear attacks, terrorist activities, rebellion etc.
  • AIDS/HIV and other sexually transmitted diseases
  • Self-inflicted injuries and conditions of depression and mental disorders
  • Health treatment for drug intoxication and overdose of alcohol consumption
  • General exclusions – Military or naval operations, any consequential losses, profits or business operations
  • Check policy brochure for detailed exclusions
Sum Assured (Rs.)
  • For age group of 6-60 years the sum insured range is from Rs. 1 lakh to 50 lakhs
  • For age group of 61-65 years the sum insured range is from Rs. 1 lakh to 5 lakhs

5. Bajaj Silver Health Insurance Plan for Senior Citizens

Senior citizens who have crossed the age of 60 years are more vulnerable to health ailments. Providing health security and appropriate health treatment to them is imperative. If you also love your parents and want to secure them for later years or you are a senior citizen yourself, have a quick run-down at the policy details in the table below –

Features & Benefits
  • Entry age is 46-70 years
  • Coverage for pre-existing illnesses from the 2nd year of the policy term
  • In-house claim settlement team
  • Reimbursement within 15 days for treatment taken in non-network hospitals
  • Cashless treatment can be availed
  • 15 days of free look period is available
  • If your premium amount is up to Rs. 15,000, you are eligible for tax exemption benefits
Inclusions
  • Includes 130 daycare procedures
  • 5% of family discount is available
  • Covers hospitalization expenses
  • Pre and post hospitalization cover, 60 days prior to hospitalization or 90 days post hospitalization 3% of the total acceptable hospitalization charges
  • Ambulance cover up to Rs.1000 per claim
  • 50% of sum assured will be paid from the second year, in case of pre-existing health conditions
  • All daycare expenses & treatments
  • Optional or additional air ambulance cover ( check policy details)
Exclusions
  • One year of waiting period for pre-existing diseases
  • Illnesses or injuries arising due to war conditions, nuclear attacks, terrorist activities, rebellion etc.
  • AIDS/HIV and other sexually transmitted diseases
  • Cosmetic surgeries or aesthetic treatment
  • Self-inflicted injuries and any treatment due to depression and mental disorders
  • Health treatment due to a drug overdose, consumption of alcohol, and intoxication
  • Any treatment apart from Allopathy
  • For initial 1 year any joint surgery, fistula, stones in urinary system, endometriosis, hernia etc. will not be covered
  • Check policy brochure for detailed exclusions
Sum Assured (Rs.)
  • Sum assured options range from Rs.  50,000, 1lakh, 1.5 lakhs, 2 lakhs, 3 lakhs, 4 lakhs and 5 lakhs

6. Bajaj Allianz Global Personal Guard Policy (Accidental Cover)

Features & Benefits
  • ·Entry age is 18-70 years
  • Premium amount is calculated irrespective of the age of the insured person
  • 360-degree protection in accidental cases
  • Lifelong Renewability
  • Health CDC (claim by direct click benefit) through the app
Inclusions
  • Optional or additional air ambulance cover, adventure sports cover ( check policy documents for details)
  • Base coverage to death, total disability and partial disability which stays permanently
  • Additional cover can be taken for – accidental hospitalization expenses, air ambulance, adventure sports, coma resulting from accidental injuries, child education,  fracture, EMI payment cover, loan protection benefit, loss if income or job due to disabilities and road ambulance cover
Exclusions
  •  Any pre-existing disabilities resulting from previous accidental injuries
  • Any vaccination charges unless it is required for accidental treatment or injuries
  • Dental surgery unless required as a result of injury
  • Any form of experimental or self-treatment
  • Treatment taken overseas will not be compensated under Bajaj health insurance plan
  • Cosmetic surgeries, plastic surgeries or any aesthetic treatment
  • Self-inflicted injuries and injuries resulting due to depression and mental disorders
  • Injuries resulting due to drug overdose, consumption of alcohol, and intoxication
Sum Assured (Rs.)
  • Sum assured options range from Rs.  50,000 to Rs.25,00,00000

Claim Process of Bajaj Allianz Health Insurance Plans

Bajaj Allianz Cashless Claim Settlement Process is as follows –

  • You go to one of the network hospitals for treatment.
  • The hospital will verify the details filled by you in the preauthorization form and send it to Bajaj Allianz health insurance department.
  • After verifying the preauthorization request details with policy coverages, the decision is conveyed to the healthcare provider.
  • If approved, your treatment will continue without any cash deposits till the discharge date.
  • If any additional details are required, then Bajaj Allianz will ask the same from the hospital and then approve your claim
  • If disapproved, then the same information will be sent to the hospital and you will need to make the payment for treatment on your own.

Claim settlement process for reimbursement

  • After discharge from the hospital, you need to keep all the documents with you along with medical tests, payments, bills etc.
  • Your documents will be sent for verification to the Bajaj health insurance team
  • If additional documents are required the insurer will inform and you need to submit them timely.
  • If submitted timely, your claim will be processed within 15 days after intimation date
  • If not submitted on time, then your claim request will be closed within 45 days.

Bajaj Health Insurance Tax Exemption Benefits

Along with a health cover, you can mine tax benefit worth Rs. 60000 under Section 80/D of the Income Tax Act, 1961. You will get tax exemption against the premium amount that you pay every year. Listed below are some tax-saving benefits of Bajaj Allianz health insurance policy –

  • If you are less than 60 years of age and are paying the premium for yourself, children, spouse and parents, then you can avail tax deduction benefits up to Rs 25,000 per annum.
  • The tax benefit limit is kept at Rs. 30,000 if you are paying a premium for your elderly parents (above 60 years)
  • If you are less than 60 years of age and are paying the premium amount for your elderly parents (above 60 years),  your tax exemption limit is up to Rs 55,000
  • If you are 60 plus and paying policy premium for Bajaj health insurance of your parents, you shall get a tax exemption benefit of Rs 60,000. It is only applicable if you are still a taxpayer at this age.