Having kickstarted operations in 2008, Bharti AXA General Insurance now has more than 4,500 network hospitals spread across the country, where policyholders can avail the benefit of the cashless claim settlement facility. Just by entering the state and the city where they reside, policyholders can locate the nearest network hospital on the website of the insurer.
What are the benefits of choosing a Bharti AXA network hospital?
Listed below are the key benefits of receiving treatment at a Bharti AXA network hospital:
- Coverage for medical expenses including pre-hospitalisation and post-hospitalisation expenses up to Rs.1 crore.
- Till date, Bharti AXA General Insurance has issued more than 1.3 million policies and has a claim settlement ratio of 98.27%.
- Coverage for maternity expenses after a brief waiting period.
- At a Bharti AXA network hospital, the medical or hospitalisation expenses will be settled between the insurer and the network hospital – up to the sum assured of the policy and based on its terms and conditions.
- No cap on room rent expenses for select plans and the benefit of hospital cash to meet daily non-medical expenses.
- Coverage for organ donor expenses up to the sum assured of the policy.
What procedures are covered under Bharti AXA cashless claim facility?
Listed below are some of the procedures or treatments that are carried out at the network hospitals of Bharti AXA:
- Myocardial Infarction – for first heart attack
- Cancer of specified severity
- Coronary artery disease
- Open heart replacement
- Aorta surgery
- Stroke resulting in permanent symptoms
- Kidney failure which results in the requirement of dialysis
- End stage liver and lung failure
- Organ and bone marrow transplant
- Third degree burns
- Coma of specified severity
- Bacterial meningitis
- Fulminant hepatitis
Bharti AXA health insurance plans also offer coverage for home nursing expenses, ambulance expenses, physiotherapy charges, transportation of mortal remains of the insured person, coverage for AYUSH treatments, domiciliary hospitalisation, and day care treatments.
What procedures are not covered under the Bharti AXA cashless claim facility?
Listed below are some treatments that are not covered under the Bharti AXA cashless claim facility:
- Coverage for treatments between 30 days and 60 days from the start of the policy.
- Circumcision unless it is required in a critical illness surgery.
- Coverage for dental treatment unless it is required in the treatment of a critical illness.
- Any fertility treatment, birth control treatment, hormone replacement therapy, etc.
- Eye and ear examinations, coverage for contact lenses and hearing aids, laser surgery, etc.
- Any treatment related to HIV or AIDS.
- Treatment related to obesity, alcohol or drug abuse, sex change operations, etc.
- Coverage for any sort of vaccinations or inoculations.
- Self-medicated treatments.
- Critical illnesses or treatment required following war, invasion, terrorist activity, riot, strike, etc.
- Any disease caused due to radioactivity or nuclear war.
- Coverage for laboratory examinations.
- Coverage for treatment if the insured person was injured following participation in any sort of extreme sport.
- Any sort of experimental treatment.
How do you file a cashless claim at a Bharti AXA network hospital?
Policyholders must follow the steps mentioned below to file a cashless claim at a network hospital of Bharti AXA health insurance:
- To avail the benefit of the cashless claim settlement facility, policyholders have to locate the nearest network hospital of Bharti AXA health insurance. This can be done on the website of the insurer.
- For either planned hospitalisation or emergency hospitalisation, the insured person has to get a pre-authorization form filled by the practicing doctor. The form can be procured from the website of the insurer or at the insurance desk at the network hospital.
- Along with the pre-authorisation form, the insured person has to submit all relevant documents that have been requested by the claim settlement team.
- The claim settlement team of Bharti AXA will carry out the pre-authorisation within 6 hours for emergency hospitalisation and within 48 hours in the case of planned hospitalisaton.
- Once the cashless claim has been approved by the claim settlement team of Bharti AXA, the expenses will be settled between Bharti AXA and the network hospital. The policyholder will have to make any payments only if:
- The medical bills exceed the sum assured of the policy.
- If there are any non-medical expenses.
- If a particular treatment is not covered by the policy.
- If there are any excess or deductibles.
- If the authorised amount under the policy is less than the actual bill amount.
Policyholders have to keep in mind that if the cashless claim settlement option is rejected by Bharti AXA health insurance for some reason, he/she can opt for the reimbursement claim settlement. For this, the policyholder will have to submit the medical bills and other relevant documents to the insurer following discharge from hospital. Following verification and approval, the policyholder will be reimbursed the cost of the medical expenses up to the sum assured of the policy or the authorised amount for a particular treatment.
- How long should an insured person be admitted in hospital to receive medical coverage under a certain health insurance plan offered by Bharti AXA health insurance?
To receive coverage for hospitalisation expenses, policyholders or those insured under the policy have to be hospitalised for a minimum of 24 hours. This is applicable for both planned hospitalisation as well as emergency hospitalisation.
- Is there any coverage for procedures that are less than 24 hours under health insurance policies offered by Bharti AXA health insurance?
For treatments that would be less than 24 hours, they are categorised under day care treatments. Health insurance policies offered by Bharti AXA offer treatments for more than 140-day care procedures.
Are root canal surgeries covered under the health insurance policies offered by Bharti AXA?
No, the health insurance policies offered by Bharti AXA do not offer coverage for dental treatments unless in the case of accidental dental injury.
- Is it possible to make use of the health insurance plan offered by Bharti AXA and another plan from a different insurer to cover hospitalisation expenses?
Yes, it is possible to cover hospitalisation expenses from 2 different policies provided that you have met the terms and conditions as set by both insurers.
Do the health insurance policies offered by Bharti AXA have surrender and death benefits?
No, the health insurance policies offered by Bharti AXA health insurance offer only coverage for hospitalisation expenses and do not have surrender and death benefits.