Bajaj Allianz is one of the private general insurance companies operating in India. In the health insurance domain, Bajaj Allianz has different types of plans suitable for the requirements of everyone. Bajaj Allianz Silver Health Plan is a health insurance policy exclusively developed for senior citizens in the country. Being a cover for senior citizens, this policy ensures that senior citizens are protected against various illnesses and rising healthcare costs. This policy is designed in such a way that the common health ailments of senior citizens are covered within the policy limits.
Eligibility for Bajaj Allianz Silver Health Plan
The eligibility criteria for Bajaj Allianz Silver Health Plan can be given as follows.
- The entry age of the policyholder must be between 46 years and 70 years.
- Lifetime renewal opportunity is available for this policy.
Features of Bajaj Allianz Silver Health Plan
Some of the key features of Bajaj Allianz Silver Health Plan can be listed as follows.
- This policy is available in different sum insured options ranging from Rs.50,000 to Rs.5 lakh.
- Pre-acceptance medical examination is mandatory for every policy irrespective of the entry age of the policyholder.
- Following the acceptance of the policy proposal, 100% of the medical examination costs will be reimbursed by the company.
- Test reports are valid for a period of 30 days from the date of examination.
- All pre-existing diseases can be covered after a waiting period of one year.
- For all diseases, there is an initial waiting period of 30 days from the date of commencement of the policy.
- For hospitalisation in non-network hospitals, 20% mandatory copayment is required for all policyholders.
- Copayment can be waived on payment of 15% loading on premium.
- A family discount of 5% is available if two or more members of a family are covered under the same policy.
- Certain illnesses such as cataracts, hernia, hydrocele, fistulae, benign prostatic hypertrophy, etc. have a waiting period of 1 year.
- The sum insured chosen at the time of enrollment can be enhanced at the time of renewal.
- There is a grace period of 30 days from the date of expiry for renewing this policy cover.
- There is a free look period of 15 days for policyholders to review the terms and conditions of the policy.
- Portability option is provided to customers, and they can transfer their policies to other service providers without losing any benefits.
- The premium amount paid for this policy is eligible for income tax benefit as per Section 80D of the Income Tax Act.
Benefits of Bajaj Allianz Silver Health Plan
This policy offers a range of benefits for senior citizens. Some of the key benefits of Bajaj Allianz Silver Health Plan can be given in the table.
||Up to the full sum insured limit
|Pre and post hospitalisation expenses
||Up to 3% of admissible hospitalisation expenses
|Emergency hospitalisation cover
||Up to Rs.1,000 per hospitalisation
|Coverage for pre-existing illness (from the second year onwards)
||Limited to 50% of the sum insured
||10% per claim-free year subject to a maximum of 50% of the sum insured
||Available after four continuous years of policy coverage
|Day care treatment
||Coverage for up to 130 procedures subject to terms and conditions
Exclusions of Bajaj Allianz Silver Health Plan
There are certain exclusions for which the company is not liable to provide any compensation. Some of the key exclusions under Bajaj Allianz Silver Health Plan can be listed as follows.
- Injuries or illnesses arising out of war, invasion, or warlike activities
- Any kinds of cosmetic or aesthetic treatments
- Convalescence, general debility, run down conditions, etc.
- Expenses related to spectacles, hearing aids, crutches, artificial limbs, dentures, etc.
- Dental treatment or surgery unless arising out of accidents
- Congenital diseases, birth defects, and anomalies
- Intentional self injuries or attempted suicide
- Expenses related to childbirth, pregnancy, and related complications
- Any treatment towards infertility or conception procedure
- HIV, AIDS, venereal diseases, or sexually transmitted diseases
- Hospitalisation only for examinations and investigation
- Vaccination or inoculation
- Vitamins and tonics unless forming a core part of the treatment
- Treatment through any procedure other than allopathy
- Surgery to correct deviated septum or hypertrophied turbinates
- Treatment for any kinds of psychiatric or mental illness
- Any expenses related to weight loss or obesity treatments
To initiate the claim process, customers must contact the company and intimate about the even of claim. The company can be intimated either through the official website or by calling the customer care’s toll free number.
Cashless treatment: For cashless claims, policyholders must obtain pre-authorisation from the company. The company’s customer care will guide you through the process. Pre-authorisation form can be obtained in the hospital itself. Once authorisation is obtained from the company, policyholders can get treatment till the sum insured limit without paying any money.
Reimbursement claims: Reimbursement claims can also be filed with the company after receiving treatment from a hospital. For reimbursement claims, policyholders must submit all the documents including medical bills and discharge certificates. Once the documents are submitted, the company will initiate the claim process. After the verification of all documents, the claim amount will be provided to the insured.