• Bajaj Allianz Tax Gain Insurance

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    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    Bajaj Allianz Tax Gain Insurance is a unique health insurance policy cover that offers a combination of family floater hospitalisation coverage, outpatient coverage (OPD), and senior citizen coverage under the same policy. As the name implies, this policy also helps in the tax management of the insured person. This policy comes in different plans based on the sum insured amount opted and the range of benefits available. The premium for this policy is affordably priced to ensure easy access to the middle income population of the country.

    Eligibility for Bajaj Allianz Tax Gain Insurance

    This policy comes with the following eligibility criteria for people looking forward to subscribe to this cover:

    • The entry age for this policy is between 18 years and 75 years.
    • For senior citizen plans, the entry age is between 56 years and 75 years.
    • Lifelong renewability option is provided for policyholders who have entered this cover within the above mentioned entry age.

    Features of Bajaj Allianz Tax Gain Insurance

    Some of the notable features of Bajaj Allianz Tax Gain Insurance can be listed as follows:

    • This policy comes with 3 different plans for hospitalisation & OPD coverage and a separate plan for senior citizens.
    • The maximum sum insured available under this policy is capped at Rs.3 lakh. The senior citizen cover is available with a single sum insured option of Rs.1 lakh.
    • The premium charges remain flat for this policy cover irrespective of the age of the insured person.
    • Pre-existing illnesses will be covered only after 48 months of continuous policy coverage.
    • Sickness hospitalisation will not be covered for the first 30 days of inception of the policy.
    • Certain conditions like benign prostatic hypertrophy, hysterectomy, hernia, cataract, etc. have a waiting period of 2 years.
    • A 10% copayment is required if the treatment is taken in a non-network hospital.
    • Pre-policy medical examination is required for people over the age of 45 years. Upon successful acceptance of the proposal, the company will reimburse 100% of the check up costs.
    • This is an annual policy that is available only under a 1-year term.
    • There is a free look period of 15 days for policyholders to review the terms and conditions of this policy. If they are not satisfied, they can cancel the policy and get refund on their premiums.
    • A grace period of 30 days is provided for policyholders to renew this cover even after the date of expiry.
    • The portability conditions are in line with IRDAI’s regulations on this issue. The company must be notified at least 45 days before the date of renewal in order to proceed with this.
    • The premium charges paid for this policy is eligible for tax relief as per Section 80D of the Income Tax Act.

    Benefits of Bajaj Allianz Tax Gain Insurance

    The range of benefits available under this policy can be given in the following table:

    Benefits Extent of Coverage
    Plan A Hospitalisation coverage - up to Rs.1 lakh OPD coverage - up to Rs.3,100 (based on the age of the insured)
    Plan B Hospitalisation coverage - up to Rs.2 lakh OPD coverage - up to Rs.6,500 (based on the age of the insured and the number of members covered)
    Plan C Hospitalisation coverage - up to Rs.3 lakh OPD coverage - up to Rs.9,500 (based on the age of the insured and the number of members covered)
    Plan D (senior citizen coverage) Hospitalisation coverage - up to Rs.1 lakh OPD coverage - up to Rs.13,000 (based on the age of the insured and the number of members covered)
    Day care treatment Coverage for up to 130 conditions
    Emergency ambulance cover Actual expenses up to Rs.1,000
    Free health check up Available after every 4 claim-free years
    Coverage for dentures, crutches, spectacles, etc. Available under the OPD coverage

    Exclusions of Bajaj Allianz Tax Gain Insurance

    The following list of exclusions apply to Bajaj Allianz Tax Gain Insurance:

    • Illnesses or injuries caused by war or warlike activities
    • Self-inflicted injuries or suicide attempt
    • Claims related to cosmetic or aesthetic treatments
    • Plastic surgery unless related to cancer or burns
    • Dental treatment unless necessitated due to an accident
    • Convalescence, general debility, and rest cure
    • Congenital diseases, birth defects, and anomalies
    • Expenses related to stem cell treatment or growth hormone therapy
    • Sexually transmitted diseases including HIV and AIDS
    • Cost of external medical devices exceeding the OPD limit
    • Expenses related to weight management treatments
    • Any non-medical expenses incurred during the time of hospital stay

    Claim Procedure

    The claim procedure begins with intimation to the company about an event. Policyholders can contact the company’s customer service department to intimate about the claim. Both cashless treatment facility and reimbursement claims are available under this policy. The company has extensive network tie-ups with over 6,000 hospitals across the country.

    For cashless treatment, pre authorisation must be obtained before treatment. Customers can send the authorisation request from the hospital through fax by filling out the forms. Upon receiving the request, the company will verify its validity and approve the request within a few hours.

    For reimbursement claims, the claim request must be filed after discharge from the hospital. While filing the claim request, it is necessary to submit various documents along with the claim form. These documents include the following:

    • Medical bills
    • Discharge summary
    • Cash receipts
    • Physician certificate
    • Diagnostic reports
    • Prescriptions/pharmacy receipts etc.

    Once these documents are submitted, the company will process the claim request and approve the reimbursement within a reasonable period of time.

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