Bajaj Allianz Individual Health Guard Plan | Health Insurance

All You Need To Know

OVERVIEW:

Under this plan, each family member can avail an individual sum insured. The individual health insurance plan covers the expenses incurred due to hospitalization, doctor’s consultation, ambulance services, treatment charges and pre and post-hospitalization expenses

FEATURES:

Organ donor expenses covered up to the sum insured
10% cumulative bonus benefit for each claim free year up to 100%
Covers Pre and Post hospitalization expenses incurred 60 days prior to and 90 days post hospitalization
Income Tax benefit is as per section 80-D
Bariatric surgery cover
Convalescence benefit up to Rs. 7500/- per year (subject to Sum Insured opted)
Ayurvedic and Homeopathic hospitalization cover
Free preventive health checkup every 3 years, irrespective of a claim
Maternity and new born baby expenses cover
Daily Cash Benefit for Accompanying an Insured Child (Rs. 500 per day maximum up to 10 days, up to age 12yrs)
Health CDC benefit – quick claim settlement through app**

Click Here to read the policy wording.

EXCLUSIONS:

A waiting period of 3 years will be applicable in the case of pre-existing diseases.
Any disease contracted during the first 30 days of commencement of the health insurance policy will be excluded from coverage.
Certain diseases such as hernia, piles, cataract and sinusitis shall be covered after a waiting period of 2 years.
For detailed list of exclusions, please refer FAQs or read product brochure carefully

ELIGIBILITY:

Entry age for proposer is 18 years to 65 years. The policy can be renewed for lifetime.
Entry age for child is 3 months up to 30 years
No medical tests up to 45 years of age , subject to clean proposal form

CLAIMS PROCESS:

To register your claim online, click here. or register your claim on the phone, please dial our Toll Free Number: 1800-209-5858

Commission on General Insurance

FAQs

What are the sum insured options under the Individual health guard policy?
The sum insured options for the Individual health guard policy varies from Rs. 1.5 lakhs to Rs. 50 lakhs.

What are the Common exclusions in the policy?

A waiting period of 3 years will be applicable in the case of pre-existing diseases.
Any disease contracted during the first 30 days of commencement of the health insurance policy will be excluded from coverage.
Certain diseases such as hernia, piles, cataract and sinusitis shall be covered after a waiting period of 2 years.
Waiting period of 3 years for Joint replacement, PIVD
Treatment for use of intoxicating and/or addictive substances like alcohol, drugs etc. will not be covered
Waiting period of 3 years for bariatric surgery
Waiting period of 6 years for maternity/new born baby expenses
Please note: For details, please refer to the product brochure for policy terms and conditions

What is the Cashless Claims Process?

Customer approaches Bajaj Allianz Network Hospital for cashless treatment
Hospital verifies customer details & sends the Preauthorization Form duly completed, by fax to Bajaj Allianz – HAT (Health Administration Team)
Bajaj Allianz – HAT, verifies preauthorization request details with benefits & conveys decision to the provider

Approved
Authorization letter is sent to the provider
Provider treats the patient without any deposit till discharge

Query
Query letter is sent to the provider asking for additional information
Required additional information received from the Provider
Bajaj Allianz – HAT, verifies preauthorization request details with benefits & conveys decision to the provider

Denial
Denial letter is sent to the provider.
Provider treats patient as cash paying.

Customer may file the claim for reimbursement

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Bajaj Allianz Individual Health Guard