| Eligibility |
|
| Entry Age (years) |
|
| Minimum |
18; 3 Months for Children
|
| Maximum |
65; 25 for Children
|
| Maximum Policy Renewal Age (years) |
80
|
| Sum Insured (Rs) |
|
| Maximum |
10 lakh for entry age upto 55 years and 5 lakh for higher age group
|
| Minimum |
2 lakh
|
| Policy Term (years) |
1
|
| Tax Benefit |
Premium paid is eligible for tax benefit under section 80D of the Income Tax Act
|
| Discount |
Family discount of 10% is applicable .
Premium discount on choosing voluntary deductible.
|
| No Claim Bonus |
5% cumulative bonus benefit for each claim free year, maximum up to 50%. CB would be passed for Sum Insured Rs 2,00,000 and above when continuously renewed. In case of a claim during the year, the cumulative bonus will be reduced by 10%
|
| Pre Policy Medical Check Up |
Not required below 46 years of age upto Sum Insured of Rs 10 lakh. Compulsory for 46 years and above. 100% reimbursement on acceptance of proposal.
|
| Grace Period for Policy Renewal |
15 days grace period is allowed to policyholder for payment of premium. If policyholder fails to make payment within the grace period, the 2 year or 4 year waiting period shall start afresh
|
| Co Payment Clause |
10% of the medical bills have to be borne by the policyholder himself for medical treatment in non empanelled hospital. Any applicant above 55 years of age will be required to pay 20% of medical bills each time medical services are accessed. Waiver of co payment clause is possible on payment of extra payment.
|
| Policy Termination |
Policyholder is allowed to terminate the policy at anytime by giving a 15 day written notice. In case no claim has been made under the policy, percentage of premium will be refunded
|
| Customer Service |
|
| Address |
Bajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006
|
| Mail to |
[email protected]
|
| Call to |
1800 225858(BSNL/ MTNL); 1800 1025858 (Bharti users- mobile/ landline) or 020 30305858
|
| Scope Of Cover |
| Cashless facility | Available at empanelled hospitals in India |
| Re-imbursement | In case policyholder opts for non empaneled hosiptal , expenses are re-imbursed withing 14 working days from date of submission of all records. Moreover, insurance company will bear the expenses in excess of 10% of total claim amount |
| Pre-post hospitalisation | Relevant medical expenses covered from 60 days prior and 90 days post hospitalisation |
| In-patient treatment | Covered |
| Pre-hospitalisation | Covered |
| Post-hospitalisation | Covered |
| Day Care Procedures | 130 day care procedures are covered subject to conditions |
| Emergency Ambulance | Covered; subject to maximum limit of Rs 1,000 |
| E-Opinion (Second opinion) in respect of a Critical Illness | Covered, for Sum Insured of Rs 5 lakh, Rs 7.5 lakh and Rs 10 lakh |
| Health Check Up | Covered; for a maximum amount of Rs 1000 at the end of 4 continuous claim free years |
| Exclusions and Waiting Period |
| Pre-existing disease | 4 years waiting periods applicable for Pre-existing diseases |
| No claim period | Any disease contracted during the first 30 days of commencement of the policy |
| Waiting Period | Certain diseases such as hernia, piles, cataract , sinusitis shall be covered after a waiting period of 2 years.Certain diseases such as joint replacement surgery , surgery for prolapsed inter vertebral disc (unless necessitated due to accident ), Surgery to correct deviated nasal septum and hypertrophied turbinate , congenital internal diseases or anomalies and laser treatment for correction of eye sight due to refractive error will have a waiting period of 4 years |
| Deductible | 10000 to 2.5 lakh |
| General Exclusions | Non allopathic treatment.AIDS and other related diseases.Cosmetic, beauty, weight reduction and other likely treatments.Use of alcohol or other addictive substances.War, participation in any criminal activity or any other related condition.Treatmenmt of any mental or related disease. |
