Bajaj Allianz Star Package- Family Floater Health Insurance
Objective
A special policy with an aim to provide a customised insurance plan depending on needs of a person.
Our View
An all-in-one plan which can be bought by those looking to purchase different policies covering against different conditions. Before buying evaluate your needs first to include all the required sections at once. A special advice is while filling proposal form for burglary or fire insurance (household contents), mention the details of all valuables that cost more than Rs 5,000 separately to enjoy an uninterrupted cover.
Suited for
This policy can be bought as an individual cover or as a family floater cover. It is more suitable for those looking to buy multiple policies for different conditions.
What does it do?
This plan gives you freedom to customise the policy as per your needs. It offers eight standalone policy benefits under one policy. Each policy benefit is defined as a Section which has its own exclusions as well. It is upto the proposer to select any of the sections depending on his needs. A minimum of three sections are mandatory to select. For instance, you may select three sections- health guard (covering inpatient treatment and related expenses), critical illness and personal accident section. The policy will charge premiums based on the sections opted. This single policy can become a comprehensive package if customised in a manner.
Pros
No sub-limit on room rent and other expenses.
Higher policy terms of two and three years provide relief from renewal process on an annual basis.
It offers discount on selecting four or more sections.
It saves policyholder from task of managing multiple policies.
Premium paid under this policy will enjoy tax benefits under Section 80D.
Cons
The policy cannot be renewed throughout lifetime.
There is a co-payment clause which means 10 per cent of the admissible claim amount will have to be borne by the insured member if treated in non-network hospital.
Individuals between age 50 and 60 years entering the policy for the first time have to bear 20 per cent of the admissible claim amount.
Eligibility
Entry Age (years)
Minimum
18; 3 months for children
Maximum
60; 25 for children
Maximum Policy Renewal Age (years)
60 for Hospital Cash benefit; 80 years for Health guard; 60 years for Critical Illness benefit; 65 for Education grant
Coverage Type
Individual/ family floater
Sum Insured (Rs)
Maximum
Hospital Cash(per day basis) 2500
Health Guard 5 lakh
Critical Illness 3 lakh
Personal Accident 5 lakh
Education Grant 5 lakh
Burglary/ Fire Insurance(Household Contents only) 4 lakh
Traveling Baggage 40000
Public Liability 5 lakh
Minimum
Hospital Cash(per day basis) 500/1000/2000
Health Guard 1.5 lakh/ 2 lakh/ 3 lakh
Critical Illness 1 lakh/ 1.5 lakh/ 2 lakh
Personal Accident 2 lakh/ 3 lakh/ 4 lakh
Education Grant 2 lakh/ 3 lakh/ 4 lakh
Burglary/ Fire Insurance(Household Contents only) 1 lakh/ 2 lakh/ 3 lakh
Traveling Baggage 10000/20000/30000
Public Liability 2 lakh/ 3 lakh/ 4 lakh
Policy Term (years)
1 or 2 or 3
Tax Benefit
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act
Discount
Section Discount on selecting more than 3 sections.
4-5 sections: 10% discount
6-8 sections: 15%
10% discount on selecting a 2 years policy term and 15% discount on selecting a 3 years policy term
No Claim Bonus
Health guard: 5% on each claim free year; maximum upto 50%. Applicable on Sum Insured of Rs 2 lakh and above.
Grace Period for Policy Renewal
15 days for Health Guard cover
Policy Termination
Both insurance company and Policyholder are allowed to terminate the policy at anytime by giving a 14 day written notice. The insurer will refund premium on pro rata basis depending upon policy period elapsed.
Customer Service
Address
Bajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006
Mail to
[email protected]
Call to
1800 22 5858(BSNL/ MTNL); 1800 209 5858 (Any mobile/ landline) or 020 30305858
Additions to the Plan
| Scope of Cover | ||
| Cashless facility | Available at empanelled hospitals in India | |
| Re-imbursement | In case policyholder opts for non empanelled hospital with a Co-payment clause of 10% | |
| Minimum three sections (any) are mandatory | ||
| Section I | Hospital Cash | |
| Daily Cash Amount | Covered; maximum of 30 days (including ICU treatment) per policy period regardless of number of confinements to the hospital. | |
| ICU Benefit | Covered; double the daily cash amount for a maximum of 7 days per policy period | |
| Section II | Health Guard | |
| In patient treatment | Covered | |
| Pre-post hospitalisation | Relevant medical expenses covered from 60 days prior and 90 days post hospitalisation | |
| Day Care Procedures | 130 day care procedures are covered | |
| Add on Coverage (requires payment of extra premium) | ||
| Ambulance Expenses | Covered; upto maximum of Rs 1000 per valid hospitalisation | |
| Accommodation to Relative | Rs 500 per day for 10 days | |
| Organ transplant expenses of donor | Covered upto Rs 1 lakh | |
| Accidental Emergency, reconstructive Surgery (in case of accident), Physiotherapy, Medical evacuation | covered upto Rs 50000 | |
| Burial, Cremation Expenses | Covered; Rs 25000 | |
| Medical expenses for accidental hospitalisation | Covered; twice the Health Guard Sum Insured | |
| Free medical checkup | Covered; after 4 claim free years | |
| Section III | Critical Illness | Covered; pays a lump sum amount provided insured person survives 30 days after confirm diagnosis of critical illness. It covers critical illnesses namely: First Heart Attack, Coronary Artery Disease Requiring Surgery, Cancer, Kidney Failure (End-stage renal disease), Major Organ Transplantation, Multiple Sclerosis, Surgery of Aorta, Primary Pulmonary Arterial Hypertension, Paralysis, Neuron Surgery and joint replacement |
| Section IV | Personal Accident | |
| Accidental death | Covered; 100% of Sum Insured | |
| Cost of transporting remains from hospital to cremation ground/ residence | Covered; 2% of Sum Insured or Rs 5000, whichever is lower | |
| Permanent Total disability | Covered; 125% of Sum Insured | |
| Permanent Partial Disability | Covered; pays predefined percentage of sum insured | |
| Temporary Total Disability | Weekly payment of 1% of the Sum Insured maximum upto 100 weeks | |
| Medical Expenses | reimburses upto 40% of the admissible claim | |
| Section V | Education Grant | payable in case of Accidental Death and Permanent Total Disability for continuing education of children |
| Section VI | Burglary and Fire | |
| Standard Fire Policy(including earthquake) and burglary for household contents only | covers loss or damage to household property.Covered on the first loss basis @ 25% of the value at risk. Items with value more than 5% of Sum Insured have to be specially disclosed in the proposal form. | |
| Section VII | Traveling Baggage | |
| Loss, damage or theft of baggage while traveling anywhere in the world | Covered | |
| Section VIII | Public Liability | |
| Bodily injury or damage to property of third party | Covered | |
| Exclusions and Waiting Period | ||
| Hospital Cash | Pre-existing diseases and related complications.Hospitalisation within 30 days from the commencement of policy.Certain diseases will be covered from second year and onwards.Pregnancy/ childbirth Surgery/ dentalNatural perilsAccidents due to drunken driving | |
| Health Guard | Pre-existing diseases will be covered after waiting period of 4 years.Some diseases such as hernia, piles, sinusitis, cataract shall be covered after a waiting period of 2 years.Medical expenses for treatment of any disease or illness diagnosed within 30 days of commencement of policy.dental/ spectacles/ contact lenses or hearing aids.non allopathic medicine, congenital diseases, all expenses arising from AIDS, cosmetic, aesthetic, intoxicating drugs/ alcohol, joint replacement surgery(unless caused by an accident) | |
| Critical Illness Policy | Pre existing critical illnessAny illness diagnosed during first 90 days from commencement date of the policy. | |
| Personal Accident & Education Grant | Suicide, self-inflicted injury, pre-existing physical or mental defects, alcoholic, influence of drugs, AIDS or related diseases etc. | |
| Traveling Baggage | Theft from car except from fully enclosed saloon cars having all the doors, windows and other opening securely locked, loss or damage to jeweler or valuables.Loss by any carrier under contract and Loss to money securities, gold and silver ornaments, travel tickets, cheque, draft, jeweler, share certificates and articles of consumable nature | |
| Public Liability | Arising out of deliberate or willful or International noncompliance with any statutory provisions, connected with fines, penalties, in connection with any motor vehicles, watercraft, hovercraft or spacecraft | |
| Co Payment Clause | Health Guard: Individuals between age group 56-60 years taking the policy for the first time have to bear 20% of the admissible expenses. further in case of treatment in a non empanelled hospital, 10% of admissible claim has to be borne by policyholder | |
Cost Details
| Annual Premium Option under Hospital Cash (Section I) | ||||
| Age (in years) | Daily Cash Benefit (in Rs) | |||
| 500 | 1000 | 2000 | 2500 | |
| upto 25 | 250 | 300 | 600 | 800 |
| 25-40 | 400 | 600 | 850 | 1100 |
| 40-50 | 650 | 900 | 1700 | 2600 |
| 50-55 | 900 | 1300 | 2800 | 3500 |
| 56-60 | 1200 | 1800 | 3600 | 4600 |
| Indicative premiums; exclusive of service tax. | ||||
| Under family floater policy, it can cover spouse with 50% additional premium and children with 25% additional premium | ||||
| Annual Premium Option under Health Guard (Section II) | ||||
| Age (in years) | Sum Insured (in Rs) | |||
| 1.5 lakh | 2 lakh | 3 lakh | 5 lakh | |
| upto 25 | 1882 | 2338 | 3306 | 5244 |
| 25-40 | 2532 | 3283 | 4430 | 6156 |
| 40-50 | 3272 | 4309 | 6065 | 9576 |
| 50-55 | 5028 | 6703 | 8380 | 15236 |
| 56-60 | 7696 | 10260 | 12826 | 17879 |
| Indicative premiums; exclusive of service tax. | ||||
| Under family floater policy, it can cover spouse with 50% additional premium and children with 25% additional premium. | ||||
| Premium Rates for Add On Coverage | |
| Add on Coverage (requires payment of extra premium) | Additional Premium |
| Accommodation to Relative | 0.25 |
| Organ transplant expenses of donor | 0.25 |
| Accidental Emergency, reconstructive Surgery (in case of accident), Physiotherapy, Medical evacuation | 0.1 |
| Burial, Cremation Expenses | 0.1 |
| Medical expenses for accidental hospitalisation | 0.25 |
| Deductible Discount | |
| Deductible Amount (in Rs) | Discount on premium (%) |
| 10000 | 10 |
| 15000 | 15 |
| 25000 | 17.5 |
| 50000 | 20 |
| 75000 | 22.5 |
| 100000 | 25 |
| 150000 | 27.5 |
| 200000 | 30 |
| 250000 | 32.5 |
| Annual Premium Option for Critical Illness Cover (Section III) | ||||
| Age (in years) | Sum Insured (in Rs) | |||
| 1 lakh | 1.5 lakh | 2 lakh | 3 lakh | |
| 6.-25 | 200 | 300 | 400 | 600 |
| 26-40 | 425 | 638 | 850 | 1275 |
| 41-45 | 800 | 1200 | 1600 | 2400 |
| 46-50 | 1200 | 1800 | 2400 | 3600 |
| 51-55 | 1750 | 2625 | 3500 | 5250 |
| 56-60 | 3000 | 4500 | 6000 | 9000 |
| Indicative premiums; exclusive of service tax | ||||
| For family floater coverage, an additional premium of 50% for spouse and 25% for children below 25 years of age has to be paid. | ||||
| Annual Premium Option for Personal Accident Cover (Section IV) | ||||
| Sum Insured (in Rs) | 2 lakh | 3 lakh | 4 lakh | 5 lakh |
| Premium | 375 | 563 | 750 | 938 |
| Indicative premiums; exclusive of service tax | ||||
| Annual Premium Option for Education Grant Benefit (Section V) | ||||
| Sum Insured (in Rs) | 2 lakh | 3 lakh | 4 lakh | 5 lakh |
| Premium | 120 | 180 | 240 | 300 |
| Indicative premiums; exclusive of service tax | ||||
| Annual Premium Option for Burglary / Fire Insurance (Household Contents) (Section VI) | ||||
| Sum Insured (in Rs) | 1 lakh | 2 lakh | 3 lakh | 4 lakh |
| Premium | 400 | 800 | 1200 | 1600 |
| Indicative premiums; exclusive of service tax | ||||
| Annual Premium Option for Travelling Baggage Cover (Section VII) | ||||
| Sum Insured (in Rs) | 10000 | 20000 | 30000 | 40000 |
| Premium | 200 | 400 | 500 | 800 |
| Indicative premiums; exclusive of service tax | ||||
| Annual Premium Option for Public Liability Cover (Section VIII) | ||||
| Sum Insured (in Rs) | 2 lakh | 3 lakh | 4 lakh | 5 lakh |
| Premium | 100 | 150 | 200 | 250 |
| Indicative premiums; exclusive of service tax | ||||
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