BAJAJ ALLIANZ HEALTH GUARD INSURANCE

Bajaj Allianz Health Guard insurance policy offers comprehensive benefits at an affordable price that ensure you are covered for the larger expenses related to multiple illnesses or surgeries. It takes care of the medical treatment expenses incurred during hospitalisation resulting from severe illnesses or accidents.

 

Bajaj Allianz Health Guard Insurance Details

• Bajaj Allianz Health Guard policy is available for 1, 2 or 3 years and with two plans: Silver Plan and Gold Plan.
• Eligibility: 18 to 65 years old individuals (proposer, spouse, parents, sister, brother, father in law, mother in law, aunt and uncle). 3 months to 30 years, for dependent children and grandchildren.
• Bajaj Allianz Health Guard Individual Policy + Bajaj Allianz Health Guard Floater Policy.
• Individual + Floater sum-insured options.
• The individual option covers self, your spouse, dependent children, grandchildren, parents, sister, brother, father in law, mother in law, aunt and uncle. The floater option includes self, spouse and dependent children.
• Sum-insured options: 1.5, 2, 3, 4, 5, 7.5, 10, 15, 20, 25, 30, 35, 40, 45 and 50 lakh rupees.
• Initial waiting period for hospitalisation: 30 days (except for accidental injuries).
• Pre-existing diseases/illnesses are covered only after 36 months of continuous coverage and specified illnesses after 24 months.
• No medical tests up to 45 years (subject to no adverse health conditions).
• Pre-policy check-up is compulsory for individuals above the age of 45.
• Lifelong renewal facility (for dependent children and grand children-renewal up to 35 years).
• 15 days of Free-look period.

 

Bajaj Allianz Health Guard Policy: Major Benefits

• Cashless hospitalisation, wherever possible.
• 6,500+ strong network of hospitals across India.
• Pre-hospitalisation expenses for up to 60 days and post-hospitalisation up to 90 days.
• Takes care of in-patient hospitalisation expenses including room/nursing/boarding charges, Surgeon, Anaesthetist, Medical Practitioner, Consultant and Specialist's Fees, oxygen/blood/operation theatre/diagnostics/imaging modalities and costs of medicines or drugs.
• Ayurvedic and homoeopathic hospitalisation expenses, maximum 20,000/policy year (only with Gold Plan).
• Ambulance charges for emergency transportation to the hospital, maximum of 20,000 rupees/policy period.
• Daycare procedures.
• Organ donor expenses.
• Maternity expenses and Newborn baby cover (only with Gold Plan).
• Bariatric surgery cover (only with Gold Plan).
• Convalescence benefit: An amount of 5,000 rupees/policy year is paid when the insured gets hospitalised for a disease, illness or injury for a continuous period of over 10 days.
• Daily cash benefit of 500 rupees/day, maximum up to 10 days during every policy year for reasonable accommodation expenses in respect of one parent/legal guardian, to stay with any minor insured individual (under 12), provided the hospitalisation claim is paid under in-patient hospitalisation cover.
• Sum-insured reinstatement benefit.
• Free preventive health check-up every 3 years of the continuous policy period.
• Cumulative bonus, the limit of indemnity is increased by 10% of the base sum-insured/annum if the policy is renewed without anyclaim in the preceding year.
• The premium can be paid in annual, half-yearly, quarterly and monthly instalments.
• Copay discount of 10 or 20% on the policy premium, if opted voluntarily by the insured.
• Family discount of 10% if two eligible family members are covered under a single policy and 15% when more than two of any of the eligible family members are covered under a single policy.
• Direct in-house, fast and hassle-free claim settlement within 60 minutes.
• 30 days grace period for renewal after the date of expiry of your policy.
• Tax benefit and relief under Section 80D of the Income Tax Act.

 

Bajaj Health Guard Policy: General Exclusions

• Treatment arising from/traceable to pregnancy/childbirth, including cesarean section, any treatment related to pre/postnatal care and complications arising out of pregnancy/childbirth.
• Dental treatment comprising cosmetic surgery, dentures, dental prosthesis, implants, orthodontics, orthognathic surgery, jaw alignment or treatment for the temporomandibular (jaw) joint, or upper/lower jaw bone surgery and surgery related to the temporomandibular (jaw) unless necessitated by an acute traumatic injury/cancer and also requiring hospitalisation.
• Medical expenses where inpatient-care is not warranted and does not require supervision of qualified nursing staff/medical practitioner round the clock.
• Circumcision, unless required for the treatment of illness/accidental bodily injury.
• Cosmetic/aesthetic treatments of any description and treatment/surgery for change of life/gender.
• Any form of plastic surgery unless necessary for the treatment of cancer, burns/accidental bodily injury.
• The cost of spectacles/contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth and other external appliances/devices whether for diagnosis/treatment except for intrinsic fixtures used for orthopaedic treatments such as plates/K-wires.
• External medical equipment used at home as post hospitalisation care, including the cost of the instrument used in the treatment of Sleep Apnoea Syndrome (CPAP), Continuous Peritoneal Ambulatory Dialysis (CPAD) and Oxygen concentrator for Bronchial Asthmatic condition.
• Convalescence, general debility, rest cure, congenital external diseases/defects/anomalies, genetic disorders, stem cell implantation or surgery, or growth hormone therapy.
• Intentional self-injury (including but not limited to the use/misuse of intoxicating drugs/alcohol).
• Ailments requiring treatment due to use/abuse of substance/drug/alcohol and treatment for de-addiction.
• Any condition directly/indirectly caused by/associated with Human Immunodeficiency Virus or Variant/mutant viruses andany syndrome or condition of a similar kind commonly referred to as AIDS.
• Medical expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray/laboratory examinations or investigations.
• Vaccination/inoculation unless forming a part of post-bite treatment or if medically necessary and forming a part of the treatment recommended by the treating doctor.
• Any fertility/subfertility/infertility, sterility, erectile dysfunction, impotence, assisted conception operation and sterilization procedures.
• Vitamins/tonics/nutritional supplements unless forming part of the treatment for injury/disease as certified by the attending doctor.
• Experimental/unproven/non-standard treatment.
• Treatment for any other system other than modern medicine (also known as Allopathy).
• Weight management services/treatment related to weight reduction programmes, including treatment of obesity/treatment for arising direct/indirect complications of obesity.
• Treatment for any mental illness/psychiatric illness or Parkinson's disease.
• All non-medical items as per the list provided by IRDAI.
• Any treatment received outside India.
• War/invasion/acts of foreign enemies, hostilities (whether war be declared or not) [except for compelling the Government or any other person to do or abstain from doing any act as defined under the definition of Terrorist act], civil war/commotion/unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or local public authority.

 

Claims Procedure, Insurance Portability & Cancellation

• In case of an empanelled hospital, present the cashless card and register your claim through Bajaj Allianz 24 hours helpline: 1800 209 5858.
• Non-empanelled hospital, can directly make the payment, send the claim form, bills and hospitalisation documents to Bajaj Allianz for reimbursement.
• All claim documents must be forwarded to the Health Administration Team, Bajaj Allianz General Insurance Co. Ltd. 2nd floor, Bajaj Finserv Building, Behind Weikfield IT Park, Off Nagar Road, Viman Nagar-Pune - 411 014.
• Claim documents:

• Claim form with NEFT details.
• Cancelled cheque duly signed by the insured.
• Original/attested copies of discharge-summary/certificate/death-summary with surgical and anaesthetics notes.
• Attested copies of indoor case papers.
• Original/attested copies of final hospital bill with break up of surgical charges, surgeon's fees and OT charges.
• Original paid-receipt against the final hospital bill.
• Actual bills towards investigations/laboratory bills.
• Original/attested copies of investigation reports against investigations carried out.
• Original bills and receipts-paid for transportation from the registered ambulance service provider.
• Treating-doctor certificate to transfer the injured to a higher medical centre for further treatment (if applicable).
• Cashless settlement letter/other company settlement letter.
• First consultation letter for the current ailment.
• In the case of implant surgery, invoice/sticker.
• Aaadhar card and PANcard copies (not mandatory if the same is linked with the policy while issuance/in the previous claim).

• The insured can port the policy by submitting an appropriate application form to the insurance company at least 45 days before, no earlier than 60 days from the renewal date. All applicable benefits will be passed on to insured individuals who were holding similar retail health insurance policies of other non-life insurers.
• Bajaj Allianz Health Guard policy can be cancelled by the insurance company on the grounds of misrepresentation/fraud, moral hazard or non-disclosure of material facts (as stated in the proposal/claim form) at the time of claim and non-co-operation of the insured individual by serving a 15-days notice.
• A policyholder can also cancel it at any time, and the company allows refund after retaining premium at a short Period-rate, provided no claim has occurred up to the cancellation date.

 

Bajaj Allianz Health Guard Plan: FAQs

Q: Who pays the mandatory pre-policy check-up cost for those above the age of 45?

The 100% cost is refunded to the insured when the proposal is accepted, and the policy is issued.

Q: What are the health conditions for which pre-policy medical check-ups are advised even for individuals below the age of 45?

Diabetes, Hypertension, Lipid Disorders (a combination of any two or more), Obesity and Joint Disorders.

Q: How much ICU charges under in-patient hospitalisation treatment are covered by Bajaj Allianz Health Guard Gold plan?

Actual expenses provided by the hospital.

Q: Is there any grace period for making premium payments in instalments (wherever applicable)?

Yes, 15 days.

 

Bajaj Allianz Health Guard

• Bajaj Allianz General Insurance Company Limited is a joint venture between Bajaj Finserv Limited and Allianz SE. It is one of the more financially robust insurance companies in India, an award-winning health insurance provider admired for its affordable and customisable plans to protect you from hospital bills.
• Registered Office: Bajaj Allianz House, Airport Road, Yerawada, Pune-411006.
• IRDAI Registration No: 113, BAGIC CIN - U66010PN2000PLC015329|1800-209-0144, 1800-209-5858|Fax:020-30512246|bagichelp@bajajallianz.co.inlwww.bajajallianz.com.

 

Disclaimer:The information shared is only indicative. Please go through the actual Bajaj Health Guard policy wordings for details on risk factors, terms and conditions Orexplorewww.bajajallianz.combefore finalising the purchase.