Bajaj Allianz Medical Insurance Policy

Health is the most valuable asset we possess, and a comprehensive medical insurance plan can protect it from unexpected expenses. Bajaj Allianz offers a suite of health cover products designed for individuals, families, and senior citizens. This page provides an indepth look at the key features, benefits, eligibility, and claim process of the Bajaj Allianz Medical Insurance Policy.

Why Choose Bajaj Allianz Health Cover?

• Nationwide Network: Over 9,000 hospitals across India, including many premier private facilities.
• Cashless Hospitalisation: Direct settlement with network hospitals, reducing outofpocket stress.
• Flexible Sum Insured: Options ranging from 2lakh to 50lakh, customizable as per your needs.
• Renewable for Life: No age limit for renewal, provided premiums are paid on time.
• Additional Covers: Coverage for day care procedures, AYUSH treatments, domiciliary care, and more.

Key Policy Variants

1. Bajaj Allianz Health Guard

A universal plan suitable for individuals and families. It includes:

• Inpatient hospitalisation (room rent, ICU, doctor fees, diagnostics).
• Preexisting disease cover after a waiting period of 24 years.
• Annual health checkup allowance (up to 1,000).
• Free coverage for newborns for the first 90 days.

2. Bajaj Allianz Critical Illness Care

Offers a lumpsum payout on diagnosis of any listed critical illness (over 30 conditions). The payout can be used for treatment, travel, or any other purpose.

3. Bajaj Allianz Senior Citizens Health Insurance

Specifically designed for persons aged 60years and above. Highlights include:

• Higher sum insured options up to 30lakh.
• No copayment clause.
• Coverage for preexisting conditions after a 2year waiting period.
• Free coverage for domiciliary treatment and posthospitalisation care.

Core Benefits

Cashless Hospitalisation

When admitted to a network hospital, you can avail cashless treatment by presenting your Bajaj Allianz Health Card and a preauthorization form. The insurer settles the bill directly with the hospital, subject to policy limits and terms.

Cover for PreExisting Diseases

Preexisting illnesses are covered after a waiting period of 24 months (or 48 months for certain chronic conditions). The policy also offers a Reduced Waiting Period option at an additional premium.

Day Care Procedures

Advanced medical procedures that do not require 24hour admission are fully covered, subject to a maximum of 10% of the sum insured per annum.

AYUSH & Alternative Treatments

Up to 10% of the sum insured can be claimed for AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homeopathy) treatments, provided a doctors prescription is submitted.

Hospital Daily Cash (HDC)

An optional addon that provides a fixed amount (5001,500 per day) for each day of hospitalisation, helping cover nonmedical expenses like food and transport.

Eligibility & Enrollment

The policy can be purchased by Indian residents aged between 18years and 75years (for senior citizen plans up to 80years). No medical examination is required for sums insured up to 5lakh; higher limits may need a medical questionnaire or a physical checkup.

How to Buy

1. Visit the official Bajaj Allianz website or a certified insurance broker.
2. Select the desired plan and sum insured.
3. Fill in personal details, health history, and nominee information.
4. Pay the premium online via credit/debit card, net banking, or UPI.
5. Receive the policy document and health card via email within 24hours.

Claim Process Step by Step

Cashless Claim

1. Inform the hospitals admission desk that you have a Bajaj Allianz policy.
2. Submit a filled PreAuthorization Form (PAF) along with your health card.
3. The insurers claim team validates the request and issues a preauthorization number.
4. The hospital provides treatment and settles the bill directly with Bajaj Allianz.
5. You receive an acknowledgment and a copy of the settled claim for your records.

Reimbursement Claim (NonNetwork Hospital)

1. Pay the hospital bill at the time of discharge.
2. Collect original receipts, diagnostic reports, discharge summary, and prescription.
3. Log in to the Bajaj Allianz portal and select Submit Claim.
4. Upload the documents and fill in the claim form.
5. The insurer processes the claim (usually within 710 business days) and transfers the reimbursable amount to your bank account.

Important Exclusions

• Cosmetic surgery not related to an accident or disease.
• Preexisting diseases within the waiting period.
• Selfinflicted injuries or injuries sustained under the influence of alcohol/drugs.
• Experimental or unapproved medical procedures.
• Dental treatments unless part of a hospitalisation claim.

FAQs

Q: Can I add my family members later?

Yes. You may increase the sum insured for your spouse or children during the policy year by paying the additional premium, subject to underwriting approval.

Q: What is the No Claim Bonus (NCB) offered?

For every claimfree year, the sum insured is automatically increased by 5% (capped at 25% of the original sum insured) without any extra premium.

Q: How does the policy handle COVID19 treatment?

All Bajaj Allianz health policies cover COVID19 treatment under the standard hospitalisation benefit, including ICU stay, tests, and medications, as long as the admission is to a network hospital.

Q: Is there a moratorium for preexisting diseases after a claim?

No. Once a claim is settled, the waiting period for preexisting diseases is not reset. However, future claims for the same condition are covered, subject to policy terms.

How to Get the Best Value

• Choose the right sum insured: Estimate your annual medical expenses and add a safety margin for unexpected events.
• Utilise addons wisely: Hospital Daily Cash and AYUSH cover are inexpensive addons that can significantly reduce outofpocket costs.
• Maintain a healthy lifestyle: Many Bajaj Allianz policies offer a premium discount for nonsmokers and individuals with a BMI in the normal range.
• Renew on time: Missing the renewal date can lead to a lapse, causing loss of continuity and higher premiums later.

Contact & Support

For queries, policy servicing, or claim assistance, you can reach Bajaj Allianz through the following channels:

• Phone: 18002662665 (tollfree)
• Email: customercare@bajajallianz.com
• Live chat: Available on the official website (MonFri, 9am6pm)
• Mobile App: Bajaj Allianz Health download from Google Play or Apple App Store.