• Bharti AXA Smart Health Insurance Policy

    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**

    Bharti AXA is a general insurance company that offers a range of insurance products for its customers. In the health insurance domain, the company offers multiple insurance products for people with different requirements. Bharti AXA Smart Health Insurance Policy is a comprehensive health insurance cover that provides protection against a range of medical expenses. This policy can be availed as an individual cover as well as a family floater cover depending upon one’s requirements.

    Eligibility for Bharti AXA Smart Health Insurance Policy

    The following eligibility criteria applies to policyholders who wish to take Bharti AXA Smart Health Insurance Policy:

    • The age of the proposer must be between 18 years and 65 years.
    • Dependent children can be covered from the age of 91 days.
    • For children less than 5 years of age, at least one of the parents must be enrolled in this policy cover.
    • Unemployed beneficiaries can be covered as dependents till the age of 23 years.
    • Lifelong renewability option is available under this cover once entered.
    • This cover can be taken on a family floater basis for self, spouse, and 2 dependent children.

    Features of Bharti AXA Smart Health Insurance Policy

    Some of the notable features of Bharti AXA Smart Health Insurance Policy can be listed as follows:

    • This policy is available in multiple sum insured options up to Rs.5 lakh based on the specific requirements of the policyholder.
    • The sum insured amount can be enhanced only at the time of renewal subject to the discretion of the insurer.
    • Pre-existing illnesses can be covered only from the 5th year after 4 subsequent renewals without a break.
    • There is a general waiting period for the first 30 days from the date of inception of the policy cover. This waiting period does not apply for subsequent renewals.
    • Claims related to critical illnesses have a waiting period of 60 days from the date of inception of the policy cover.
    • Pre hospitalisation medical expenses are covered for up to 30 to 40 days based on the sum insured amount chosen.
    • Post hospitalisation medical expenses are covered for up to 60 days from the date of discharge from the hospital.
    • This is an annual policy that must be renewed every year to enjoy continuous coverage.
    • For sum insured amount over Rs.3 lakh, pre policy medical checkup is required for people with entry age above 45 years. The company will reimburse 50% of the checkup costs if the proposal is accepted.
    • Policyholders can cancel the policy during the 15-day free look period without incurring any premium charges.
    • Policyholders have the option of migrating from their existing insurers through the portability guidelines issued by the IRDAI. In this case, the company must be notified at least 45 days ahead of the date of renewal.
    • Tax relief can be obtained on the premium amount paid towards this policy as per Section 80D of the Income Tax Act.

    Benefits of Bharti AXA Smart Health Insurance Policy

    The benefits available under Bharti AXA Smart Health Insurance Policy can be given as follows:

    Benefits Extent of Coverage
    Inpatient hospitalisation expenses Covered up to the sum insured limit
    Day care treatment Covered up to the sum insured limit
    Domiciliary hospitalisation Up to 10% of the sum insured limit for situations in which the patient cannot be removed to the hospital
    Renewal discount (no claim bonus) 5% of additional sum insured amount for every claim free year subject to a maximum of 25%
    Health checkup Up to 1% of the sum insured amount once every 4 claim-free years
    Inpatient physiotherapy Up to 1% of the sum insured amount
    Accompanying person expenses Rs.250 for up to 5 days (after a 3-day deductible)
    Dread disease recuperation benefit against critical illness Rs.200 to Rs.300 per day based on the sum insured amount chosen
    Critical illness coverage (optional) Additional 100% of the chosen sum insured amount available for reimbursement against hospitalisation expenses
    Hospital cash allowance (optional) Rs.250 to Rs.350 per day based on the sum insured amount chosen

    Exclusions of Bharti AXA Smart Health Insurance Policy

    Some of the notable exclusions of this policy can be listed as follows:

    • Cosmetic or aesthetic treatments of all kinds
    • Dental treatment unless necessitated due to an accident
    • Claims related to pregnancy, childbirth, birth control, etc.
    • Sexually transmitted diseases and venereal diseases
    • Expenses related to routine examinations
    • Cost of spectacles, hearing aids, crutches, and other medical accessories
    • Expenses related to the treatment of obesity and weight management
    • Expenses related to vitamins and tonics unless forming the core part of treatment
    • Intentional self-injury or suicide attempt
    • Claims that can be attributed to alcohol or drug abuse
    • Injuries sustained while breaking the law with criminal intent
    • Illnesses or injuries attributable to war or warlike activities
    • Treatments for mental illness and psychological disorders
    • Any kind of experimental or unproven treatment
    • Claims related to non-allopathic medical treatment
    • Medical treatment taken outside the country
    • Hospitalisation for the purpose of diagnosis or investigation
    • Illnesses or injuries caused by exposure to nuclear materials and radiation
    • Non-medical expenses incurred during the time of hospital stay

    Claim Procedure

    Cashless treatment can be availed in the 4,500+ network hospitals located in different parts of the country. You can check the company website to know the network hospital located near your place of residence. The company claims to approve pre authorisation requests within 6 hours of emergency hospitalisation and 48 hours of planned hospitalisation. Once the cashless treatment request is authorisation, the company will compensate the network hospital directly for the medical expenses incurred.

    Reimbursement claims must be initiated within 7 days after discharge from the hospital. The company will require the insured to file various documents and proofs related to the hospitalisation. This may include medical bills, physician certificate, diagnostic reports, discharge summary, etc. These documents must be filed within 30 days from the date of discharge. The company will provide its response regarding the acceptance or rejection of the claim within a maximum of 30 days. Rejection of claims will be accompanied by a suitable reason. If the claim is accepted, the company will provide the settlement amount within a maximum of 7 days.

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