Bajaj Allianz Elite Assure A Complete Guide

Bajaj Allianz Elite Assure is a comprehensive, nonlinked, familyfloater health insurance plan offered jointly by Bajaj Allianz General Insurance and Bajaj Finance. Designed for modern families, it combines high sum insured options with a wide range of benefits, making it an attractive choice for those seeking robust protection against medical expenses.

Key Features at a Glance

• High Sum Insured: Options ranging from 5Lakh up to 50Lakh.
• Cover for Whole Family: One premium for up to 4 members (spouse, children, parents).
• No Age Restrictions: Covers newborns from day one and senior citizens up to 75 years (subject to medical underwriting).
• Hospitalisation Cash Benefit: Up to 100% of the sum insured for pre and posthospitalisation.
• Critical Illness Cover: Optional rider for 30 critical illnesses.
• Free Health Checkups: Annual health checkup for all insured members.
• Tax Benefits: Premiums eligible for deduction under Section80D of the Income Tax Act.

Eligibility and Who Can Buy

The plan is available to Indian residents aged 0 75 years. A family can consist of a primary policyholder, spouse, up to two children (including stepchildren) and optional coverage for parents. The policy can be purchased online, through Bajaj Allianz agents, or at any Bajaj Finance branch.

Coverage Details

Hospitalisation Benefits

• Room rent up to 300% of the base sum insured per day (subject to policy limits).
• Pre and posthospitalisation expenses (up to 30 days each).
• Daycare procedures covered up to 100% of the sum insured.
• ED (Emergency department) expenses covered up to 5% of the sum insured.

OutPatient Department (OPD) Benefits

• Annual OPD limit of 5,000 per member (optional increase with rider).
• Covers doctor consultation, diagnostic tests, pharmacy bills, and physiotherapy.

Critical Illness Rider (Optional)

Provides a lumpsum payout on diagnosis of any of the 30 listed critical illnesses, such as cancer, heart attack, stroke, renal failure, and more. The rider can be purchased for an additional premium up to 10% of the base premium.

Other AddOn Benefits

• Home care nursing up to 2,000 per day for 30 days.
• Organ donor expenses up to 1,00,000.
• Ayush (alternative medicine) coverage up to 25,000 per year.
• Annual health checkup up to 2,000 for each member.

Premium Calculation

The premium is calculated based on:

• Age of the oldest member.
• Chosen sum insured.
• Number of family members covered.
• Optional riders (critical illness, maternity, etc.).

As a reference, a family of four (primary aged 35, spouse 33, two children 5 and 2) opting for a sum insured of 10Lakh can expect an annual premium of approximately 12,500 14,000 (including taxes and service charges). Exact rates vary with underwriting and any discounts offered at the time of purchase.

Claim Process Step by Step

1. Notify the insurer within 24 hours of admission or as soon as possible for outpatient claims.
2. Fill out the claim form (available on the website or via the mobile app).
3. Submit original medical documents, discharge summary, bills, and prescription copies.
4. The insurers claim team reviews the documents; most claims are settled within 57 business days.
5. If approved, the amount is directly transferred to the insureds bank account.

For cashless hospitalisation, the insured can use the network of over 9,500 empanelled hospitals. The hospital coordinates directly with Bajaj Allianz, and the patient receives treatment without paying upfront (subject to policy terms).

Benefits of Choosing Elite Assure

Limitations & Points to Consider

• Preexisting diseases are covered after a waiting period of 2 years (subject to policy wording).
• Abovesuminsured limit for certain sublimits (room rent, ICU, etc.) may apply.
• Critical illness rider is optional and requires additional premium.
• Policy renewal is guaranteed only up to the age of 75 for the oldest member.

How to Buy

Purchasing Elite Assure can be done in three easy ways:

1. Online: Visit the official Bajaj Allianz website, use the premium calculator, and complete the eKYC process.
2. Agent/Branch: Speak to a certified Bajaj Allianz agent or visit a Bajaj Finance branch for personalised assistance.
3. Mobile App: Download the Bajaj Allianz app, select Elite Assure, and follow the onscreen instructions.

Conclusion

Bajaj Allianz Elite Assure offers a robust, familycentric health insurance solution with high sum insured options, extensive hospitalisation benefits, and flexible addons. Its blend of cashless treatment, preventive health services, and optional critical illness cover makes it a strong contender for families looking for comprehensive protection without the need to manage multiple policies. As always, prospective buyers should compare the plan with other market offerings, read the policy wording carefully, and evaluate personal health needs before finalising the purchase.

For more details, policy documents, or to start a quote, visit the official Bajaj Allianz website or contact your nearest Bajaj Allianz office.