Bajaj Allianz General Insurance Network Hospitals

• Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
• 10,000+ hospitals for cashless treatment
• Claim up to Rs. 55,000 deduction under section 80D**

Bajaj Allianz General Insurance is one of the top general insurance service providers in India. The company is renowned for its range of insurance products in multiple domains including health, travel, motor, commerce, etc. Bajaj Allianz offers a good number of products in the health insurance domain with plans suitable for individuals, families, and senior citizens. By subscribing to a health insurance plan, policyholders will have access to a range of benefits and financially protect themselves from various medical expenses. Bajaj Allianz is also renowned for its tie-ups with an extensive range of network hospitals in different parts of the country.

Bajaj Allianz Network Hospitals in Different States

Plans Offered by Bajaj Allianz

Some of the top health insurance plans offered by Bajaj Allianz are listed as follows:

• Bajaj Allianz Health Guard Individual Policy: This is a comprehensive health insurance plan designed specifically for individuals looking for health insurance coverage. This policy comes with sum insured options ranging from Rs.1.5 lakh to Rs.50 lakh, and it offers a host of benefits for policyholders. Some of the key benefits available in this policy include sum insured reinstatement benefit, preventive health checkup, convalescence benefit, etc.
• Bajaj Allianz Health Guard Family Floater Cover: This is the family floater variant of the individual Health Guard policy. The benefits and sum insured options are similar to that of the individual variant but a whole family can benefit from availing this policy. This floater cover can be availed for spouse, children, and dependent parents.
• Bajaj Allianz Extra Care Plus: This is a top-up policy offered by the company. Similar to other top-up policies, this cover can be utilized after the exhaustion of the chosen deductible limit. Deductible options available under this policy range from Rs.2 lakh to Rs.10 lakh. Customers can choose sum insured options from Rs.3 lakh to Rs.50 lakh and the deductible limit will be applied accordingly. As a top-up cover, this policy offers extra protection at an affordable price.
• Bajaj Allianz Silver Health Plan: This comprehensive health insurance cover is designed specifically for senior citizens in the country. This policy can be availed by people over the age of 46 years, and it can be renewed for life. Sum insured options for this policy range from Rs.50,000 to Rs.5 lakh based on the requirement of the policyholders. This plan comes with a host of health insurance benefits, which are designed specifically for the ailments commonly suffered by senior citizens.
• Bajaj Allianz Critical Illness Insurance: This is a critical illness plan that provides lump sum benefits following the first diagnosis of a named critical illness. Sum insured options for this critical illness cover range from Rs.1 lakh to Rs.50 lakh, and this policy provides protection against 10 major life-threatening conditions.
• Bajaj Allianz Women Specific Critical Illness Plan: This women-specific variant of the critical illness cover provides additional coverage for issues commonly faced by women. Conditions like breast cancer, ovarian cancer, uterine cancer, etc. are covered in this policy along with many other life-threatening conditions.
• Bajaj Allianz Global Personal Guard: This is a personal accident cover that provides global coverage for the insured. It offers lump sum benefit against the death or disability of the policyholder during an accident. This policy also has a range of add-on covers that provide additional coverage during the time of an unexpected accident. Sum insured options for this policy range from Rs.50,000 to Rs.25 lakh.

In addition to the policies listed here, Bajaj Allianz also offers many other plans that provide specific benefits like daily hospital cash. These policies ensure adequate coverage for policyholders against various medical threats and the financial issues associated with them.

Significance of Bajaj Allianz Network Hospitals

Bajaj Allianz has over 6,000 network hospitals in different locations throughout the country. This extensive network tie-up is among the highest in the industry. Policyholders can obtain significant advantages by undertaking medical treatment at these network hospitals. Cashless hospitalisation benefit is available only in these network hospitals associated with the company. Here, the claim settlement happens between the insurer and the medical facility that provides treatment.

One of the benefits of having network hospitals in multiple locations is the ability to reach customers even in some remote locations across the country. People living in rural areas can get treatment from the network hospitals located in their nearby towns or cities. If the network hospitals are not accessible, treatment can be obtained in a non-network hospital and reimbursement claims can be filed for those. However, cashless treatment in network facilities is the best bet for policyholders who cannot arrange money immediately for their medical expenses.

Types of Claims Executed at Bajaj Allianz Network Hospitals

Network hospitals associated with Bajaj Allianz provide both cashless treatment benefit as well as reimbursement settlement. Policyholders can make the claims according to their own specific requirement.

• Cashless treatment: Once the cashless treatment request is accepted, the claim settlement process happens between the insurer and the medical facility. All kinds of medical expenses related to hospitalisation are paid by the insurer till the maximum sum insured limit.
• Reimbursement claim: If cashless treatment is not possible due to some reason, the insured can pay for the hospitalisation expenses and then file a reimbursement claim after discharge. Along with the claim request form, the insured must submit all documents and proofs related to the expenses incurred during hospitalisation.

Procedure for Filing Claims with Bajaj Allianz

Cashless treatment request procedure:

• For cashless treatment, pre-authorisation has to be obtained from the company before the treatment begins. A pre-authorisation claim form can be obtained from the hospital and sent to the company through fax.
• Upon receipt of the request, the company will verify the details provided on the request form. If more details are required from the insured, the insurer will post a request for the same with the policyholder.
• After successful verification of the request, the company will provide the authorisation for cashless treatment. Medical treatment is provided till the maximum sum insured limit without any additional charges or deposits.
• If cashless treatment is not authorised for some reason, the customer may pay for the treatment expenses and file for a reimbursement claim.

Reimbursement claim procedure:

• The insurance company must be notified immediately in the event of an unexpected hospitalisation. Even during emergency hospitalisation, it is necessary to inform the company within 24 hours of hospitalisation.
• During the course of hospitalisation, the insured must collect all the documents related to hospitalisation. The claim request can be filed after discharge from the hospital.
• Along with the duly filled claim form, the insured must also submit various documents such as medical bills, pharmacy receipts, prescriptions, discharge summary, diagnostic reports, physician certificate, etc.
• Following the submission of these documents, the company will verify these documents and communicate its acceptance or rejection to the insured person. In case of rejection, the reason for rejection will be provided by the company.
• After the acceptance of the claim request, the settlement amount will be reimbursed within the maximum time mentioned in the policy schedule.

General Exclusions Applicable to Bajaj Allianz Health Insurance

Some of the notable exclusions applicable to Bajaj Allianz Health Insurance are listed as follows:

• Pre-existing diseases for 36 months of continuous policy coverage
• Illnesses contracted within the first 30 days of policy coverage (not applicable for renewals)
• Claims attributable to pregnancy, childbirth, and related complications
• Cosmetic or aesthetic treatments of all kinds
• Claims related to war or warlike operations
• Dental treatment or surgery unless necessitated by an accident
• Convalescence, general debility, or rest cure
• Intentional self-injury or injuries related to suicide attempt
• Cost of accessories such as spectacles, contact lenses, hearing aids, etc.
• Treatment of congenital diseases, birth defects, and anomalies
• Any kind of experimental or unproven treatment methods
• Medical expenses attributable to obesity or weight management treatments
• Medical treatments availed outside the country
• Expenses related to vitamins and tonics unless forming the core part of a treatment
• Hospitalisation for the main purpose of diagnosis
• External medical equipment used for post-hospitalisation care
• Non-medical expenses incurred during the time of a hospital stay

FAQs

1. Do I need health insurance even if I am young and healthy?

The purpose of health insurance is to protect the insured from unexpected medical expenses, which may arise due to illnesses or injuries. Even if someone is young and healthy, it is impossible to predict the occurrence of a medical threat. Considering the rising cost of medical treatment in India, one major hospitalisation could wipe out one’s entire savings. The best way to avoid this is by having a health insurance plan. Being young and healthy is all the more reason as to why one should buy health insurance. The cost of health insurance is extremely low for young people, and it is always better to have this protection by spending a little money on premiums.

2. Is it necessary to buy a critical illness policy even if I already have a health insurance plan?

Critical illness policies are fixed-benefit plans, and they are slightly different from regular health insurance plans. A mediclaim policy provides coverage for the actual medical expenses incurred, but a critical illness policy provides lump sum benefits that can be used for any purpose. Considering the fact that both these types of policies serve different purposes, one is not an alternative to another. Health insurance is an absolute must for everyone. If one has a family history of life-threatening diseases, a critical illness cover is certainly an added advantage.

3. What is a deductible in health insurance?

In health insurance, deductible refers to the fixed sum of money that must be exhausted before a health insurance plan becomes active. Once the deductible amount has been paid by the policyholder, the remainder of the claim amount is borne by the insurer.

4. What is the benefit of No Claim Bonus?

No Claim Bonus can be helpful in boosting the sum insured amount of a health insurance plan without any additional premium. No Claim Bonus refers to the additional sum insured amount provided by the insurer after every claim-free year. Bajaj Allianz provides No Claim Bonus of 10% of the sum insured amount every claim-free year subject to a maximum of 100%. Over a period of time without any claims, the sum insured amount can be boosted significantly with the help of this bonus.

5. What is day care treatment coverage?

Day care treatment refers to medical treatments that do not require at least 24 hours of hospitalisation. Certain procedures like chemotherapy, dialysis, radiotherapy, cataract surgery, tonsillectomy, etc., do not require over 24 hours of hospitalisation. Once the treatment is over, the patient can be sent to recover at home. Most health insurance policies in the market now provide coverage even for these procedures. Bajaj Allianz provides coverage for up to 130 day care procedures including the ones mentioned above.