Bajaj Allianz Health Guard insurance

Bajaj Allianz Health Guard insurance benefits

• Below are some of the features and benefits of the Bajaj Allianz Health Guard Individual plan

  • Eligibility to buy Bajaj Allianz health guard insurance is 18yrs – 65yrs.
  • If both the parents are insured with Bajaj Allianz then children aged 3 months to 5 years are eligible to buy the policy.
  • No need for medical tests up to 45 years and above 46 years should undergo test as a mandatory.
  • Insured can avail cashless facility at over 2300 network hospitals.
  • Pre and post hospitalization medical expenses incurred 60 days prior to and 90 days after hospitalization is covered.
  • From 3 months to 55 years there is 1 to 10 lakhs coverage available subject to terms and conditions.
  • Policy can be renewed up to 80 years.
  • Hassle free claim settlement due to In-house claim administration.
  • In case of emergency ambulance charges are also covered up to Rs.1000.
  • No sub limits applicable on room rent and other medical expenses.
  • 10% co- payment if treatment is taken outside the network of hospitals.
  • Health Check-up for maximum amount of Rs.1000/- at the end of continuous four claim free years.
  • 130 daycare procedures are covered
  • Pre-existing conditions are covered after the 4 years of continuous renewal.

• Below are some of the features and benefits of the Bajaj Allianz Health Guard Family floater plan

  • Eligibility to buy Bajaj Allianz health guard insurance is 18yrs – 65yrs.
  • 3 months to 5 years children are eligible to buy the plan if both parents are holding bajaj allianz policy.
  • Policy can be renewed up to 80 years subject to terms and conditions. Medical tests are not required up to 45 years and for 46 years and above it is mandatory
  • Insured will have cashless facility cover at over 2300 network hospitals.
  • Pre and post hospitalization medical expenses incurred 60 days prior to and 90 days after hospitalization.
  • Coverage of 2 to 10 lakhs available for the insured belonging to 3 months to 55 years, terms and conditions apply.
  • Hassle free claim settlement due to In-house claim administration.
  • In case of emergency ambulance charges are also covered up to Rs.1000.
  • No sub limits applicable on room rent and other medical expenses.
  • 10% co- payment if treatment is taken outside the network of hospitals.
  • Health Check-up for maximum amount of Rs.1000 at the end of continuous four claim free years.
  • Covers all the family members under a single sum assured and single premium.
  • Coveres 130 daycare procedures
  • Pre-existing conditions are covered after 4 years of continuous coverage.

• Bajaj Allianz medical insurance benefits

  Silver plan	Gold plan
  Sum Insured
  Up to 2 Lakhs	Up to 50 Lakhs
  In-patient Hospitalisation Treatment
  Covers boarding and nursing expenses, intensive care unit charges, surgeons and doctors fee, operation theatre charges etc. Admitted in ICU:We will pay up to actual expenses provided by Hospital. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees. Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, cost of Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically necessary.
  Eligibility
  Adult 18-65 Years	Dependent Children/Grandchildren:3 months – 30 Years
  Room, Boarding and Nursing Expenses
  Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower.	No sublimits
  Pre-Post Hospitalization:
  Up to 60 days prior and 90 days post hospitalization respectively
  Road Ambulance
  Up to maximum of Rs.20,000 per policy year
  Day Care Procedures
  Covered as per the policy terms and conditions.
  Pre-existing diseases
  Covered after 3 years of continuous renewal
  Organ Donor Expenses
  The company pays expenses towards organ donor’s treatment for harvesting of the donated organ, provided that The organ donor is any person whose organ has been made available in accordance and in compliance with THE TRANSPLANTATION OF HUMAN ORGANS (AMENDMENT) BILL, 2011 and the organ donated is for the use of the Insured Person, and Company has accepted an inpatient Hospitalisation claim for the insured member under In Patient Hospitalisation Treatment
  Convalescence Benefit
  In the event of insured hospitalised for a disease/ illness/ injury for a continuous period exceeding 10 days, We will pay benefit amount of Rs. 5,000 per policy year This benefit will be applicable annually for policies with term more than 1 year.
  Sum Insured Reinstatement Benefit
  The reinstated Sum Insured will be triggered only after the Inpatient Hospitalization Treatment Sum Insured inclusive of the Cumulative Bonus(If applicable) has been completely exhausted during the policy year; This benefit will be applicable annually for policies with term more than 1 year. The reinstated Sum Insured would be triggered only for subsequent claims made by the Insured Person. In case of relapse within 45 days, this benefit will not trigger This benefit is applicable only once in life time of Insured Person covered under this policy for claims regarding CANCER OF SPECIFIED SEVERITY and KIDNEY FAILURE REQUIRING REGULAR DIALYSIS as defined under the policy Additional premium would not be charged for reinstatement of the Sum Insured.
  Daily Cash Benefit for Accompanying an Insured Child
  Rs. 500 per day maximum up to 10 days
  Preventive Health Check Up
  Plan will reimburse the amount equal to 1% of the sum insured max up to Rs. 2000/- for each member in Individual policy during the block of 3 years. This benefit can be availed by proposer & spouse only under Floater Sum Insured Policies
  Ayurvedic / Homeopathic Hospitalisation Expenses
  Not Covered	Hospitalised for not less than 24 hrs then it is covered
  Maternity Expenses
  Not Covered	Covered
  Other benefits
  Any Medical Expenses incurred during the first 36 months during which You have the benefit of a Health Guard policy with Us in connection with: Joint replacement surgery Surgery for prolapsed inter vertebral disc (unless necessitated due to an accident) Surgery to correct deviated nasal septum Hypertrophied turbinate Congenital internal diseases or anomalies Treatment for correction of eye sight due to refractive error recommended by Ophthalmologist for medical reasons. Bariatric Surgery
  Sub-limits
  Room rent restricted to max 1% per day of Sum Insured opted. Cataract Limit per eye 20% of Sum Insured .	Cataract Limit per eye 20% of Sum Insured max up to Rs. 1lac. Bariatric Surgery restricted to 50% of the Sum insured, subject to maximum of Rs 5 lac. Maternity Expenses- From Sum insured Rs. 3lacs to Rs. 7.5lacs it is restricted to Rs. 15000 for normal delivery and Rs. 25000 for caesarean section and from Sum insured Rs. 10lacs to Rs. 50lacs it is restricted to Rs. 25000 for normal delivery and Rs.35000 for caesarean section.

• Bajaj Allianz Health Guard insurance claims procedure

  • Any illness / claim should be reported immediately to the Bajaj Allianz General Insurance company either by telephone or in writing (email/letter)
  • The health administration team will send the claims form to the insured along with the checklist of document to be submitted
  • The insured hands over the relevant medical documents (in original) mentioned in the check list along with the filled claims form.
  • Scrutiny of the medical bills and settlement of claim.

• Bajaj Allianz Health Guard insurance exclusions

  • All diseases/injuries existing at the time of proposing this insurance.
  • Any disease contracted during the first 30 days of commencement of the policy.
  • Certain diseases such as hernia, piles, cataract,sinusitis shall be covered after a waiting period of 2 years.
  • Non-allopathic medicine.
  • Congenital diseases.
  • All expenses arising from AIDS and related diseases.
  • Cosmetic, aesthetic or related treatment.
  • Use of intoxicating drugs and alcohol.
  • Joint replacement surgery (other than due to accident shall have a waiting period of four years).
  • Medical expenses where Inpatient care is not warranted and does not require supervision of qualified nursing staff and qualified medical practitioner round the clock
  • Treatment for any mental illness or psychiatric illness, Parkinson's Disease
  • Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus or Variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS.
  • Any treatment arising from or traceable to pregnancy, child birth including cesarean section and/or any treatment related to pre and postnatal care and complications arising out of Pregnancy and Childbirth.However this exclusion will not apply to Ectopic Pregnancy proved by diagnostic means and certified to be life threatening by the attending medical practitioner