About Bajaj Allianz Health Insurance Company

Key highlights of Bajaj Allianz General Insurance Company Limited

Some of the key features of Bajaj Allianz General Insurance Company are as follows –

Customer base	More than 11 crores
Employees	9000+
Distribution network	More than 80,000 agents
Revenue earned in Q2 of FY 2023-24	Rs.7298 crores
Solvency ratio	391% (2022-23)

Awards and accolades won by Bajaj Allianz General Insurance Company Limited:

In its journey to become one of the largest insurance providers, Bajaj Allianz has won numerous awards. 

Some of them are as follows –

• The company received the award for Best Insurer in India 2020 bestowed by the IDC Financial Insights Innovation Awards
• Best Customer Experience and Best Brand Experience 2020 by CX Asia Excellence Awards
• Bajaj Allianz won the Gold Award in the Outlook Money Awards 2020
• In the third edition of the India Insurance Summit & Awards, Bajaj Allianz was recognized as the General Insurance Company of the Year 2020
• The IDC Financial Insights Asia Pacific also listed the company among the companies ranked as the Best Insurer in the Asia Pacific region

The Key Attributes of Bajaj Allianz Health Insurance Plans

The health insurance plans of the company are inclusive in their scope of coverage. Some of the common coverage benefits that are available under most Bajaj Allianz health insurance plans are as follows:

Features	Meaning
Inpatient-hospitalization cover	An inpatient hospitalization is a time during which a patient receives treatment for an illness or injury in a hospital. Hospitalization and treatment costs are covered if you are hospitalized for 24 hours or more
Pre-hospitalization cover	When you incur medical costs for the same illness or injury as the one for which you are hospitalized, medical costs incurred before hospitalization are covered for a certain number of days
post-hospitalization cover	Expenses incurred for recovery or post-operative care following treatment and discharge will be covered for a specific period
Day-care cover	In medicine, the term "day-care" refers to a treatment that is not performed overnight, i.e. it does not require 24-hour hospitalization. Treatments of this kind are covered by the plan
Ambulance cover	This category includes the costs associated with transporting patients by ambulance to the hospital.
Organ donor covers	The cost of the donor's hospitalization and subsequent surgery would also be covered by your insurance policy.
AYUSH cover	Ayurveda, Unani, Homeopathy, and Siddha are also included in Bajaj Allianz’s health insurance plans.
Domiciliary cover	Often, patients are hospitalized at home due to a lack of hospital beds or medical complications. Health plans from Bajaj Allianz cover these hospitalizations too.
Free health check-ups	As a Bajaj Allianz policyholder, you are also entitled to free health check-ups at regular intervals, so you can monitor and assess your health.
No claim bonus	If you don’t raise a claim in your Bajaj Allianz health insurance policy in a policy year, you earn a no-claim bonus.

Exclusions under Bajaj Allianz health insurance plans:

Bajaj Allianz health insurance plans have certain exclusions wherein claims are not paid. The exact exclusion list can be found in the policy wordings. The following items, however, are typically excluded:

• When you purchase a policy, any pre-existing conditions that exist at the time of purchase will be excluded for a specified period
• In some cases, after a waiting period of two years, certain illnesses and treatments might be covered. Among the examples are fissures, piles, joint replacements, cataracts, etc.
• Ailments that occur within 30 days after purchase are not covered by the insurance
• Neither cosmetic surgery nor weight loss surgery are covered by the policy.
• A claim that is due to war, nuclear threats, mutiny, rebellion, or similar reasons is excluded.
• In addition to adventure sports and hazardous activities, crimes and claims resulting from them are excluded from coverage
• Suicides, self-inflicted injuries, or abuse of alcohol or drugs are not covered
• Treatments that don't follow the doctor's advice or that are not scientifically backed are not covered
• You cannot get reimbursed for lenses, hearing aids, spectacles, etc.

Health plans offered by Bajaj Allianz:

Bajaj Allianz offers different types of health insurance plans for different coverage needs. The most popular plan of the company that is offered by PayBima is Health-Guard. Let’s have a look at the policy –

• Health-Guard Gold

An all-around health insurance policy, Health-Guard Gold is one of the two variants of Health-Guard. It offers customizable coverage benefits so that you can design the plan of your choice.  The highlights of the policy are as follows –

• Coverage for bariatric surgery

Health Card Gold allows coverage for bariatric surgeries needed to correct morbidly obese weight. The coverage is allowed up to 50 lakhs depending on the sum insured that you choose.

• Convalescence benefit

If you are hospitalized for a continuous period, you get a lump sum convalescence benefit. This lump sum benefit is paid in addition to your medical costs. The amount of coverage is allowed up to Rs 7,500 depending on the sum insured that you have selected. 

• Maternity coverage 

Health-Guard Gold plans to offer maternity coverage for both normal and cesarean deliveries including the newborn baby cover. The coverage is available up to Rs 25,000 for normal delivery and up to Rs 35,000 for cesarean delivery depending on the sum insured selected in the plan.

• Cumulative Bonus:

Cumulative Bonus means increasing the limit of indemnity by 10% of the base sum insured if you renew your health care plan without any break. The cumulative benefit is available in both the Health-Guard Gold and Silver Variant. The maximum bonus would be 100% of the base sum insured and would be limited to 10 years. 

• Health-Guard Silver:

Health-Guard Silver policy provides a comprehensive range of benefits insurance coverage for expenses relating to surgery/ illnesses. In addition to the above-mentioned benefits of the Health-Guard Gold plan, it also takes care of all the expenses incurred in medical treatment during hospitalization resulting from a serious illness. The highlights of the plan-

• Floater Sum Insured

Health-Guard Silver allows individual as well as floater sum insured options. This means that both health insurance premiums and the sum insured in the plan would be shared amongst all the family members and you don’t need to invest individually. 

• Sum Insured Reinstatement Benefit

You can reinstate 100% of the base sum insured specified under Inpatient Hospitalisation if the inpatient hospitalization along with bonuses is exhausted. The benefit would be applicable only once during every policy year. 

• Wellness Benefits

Health-Guard Silver offers a wellness discount at the time of each renewal subject to certain eligibility conditions. Discounts ranging from 5% to 10% are allowed depending on the number of eligibility conditions fulfilled by you. Wellness discount as the name suggests offers a discount if you take care of your well-being. It is applicable for 25 years and above.  

• Daily cash for accompanying an insured child

If a minor-insured child is hospitalized and a parent accompanies the child to the hospital, a daily cash benefit is paid per day of hospitalization to meet the corresponding non-medical costs. This benefit however will be applicable for policies with terms of more than one year. 

Here’s a schedule showing a comparative analysis of each of the two plans offered by the company- 

Features	Health-Guard Gold Plan	Health Care Silver Plan
Inpatient hospitalization	Covered up to up to 10 Lakhs depending on the sum insured	Covered up to 1% of the sum insured per day
Pre- and post-hospitalization	Covered with 60 days pre-hospitalization and 90 days post-hospitalization	Covered with 60 days pre-hospitalization and 90 days post-hospitalization
Road Ambulance	Covered up to Rs 20,000 per policy year	Covered up to Rs 20,000 per policy year
Bariatric Surgery Cover	Covered up to 50% of the sum insured or Rs 5 Lakh, whichever is lower	Covered up to 25% of the sum insured
AYUSH cover	Covered up to Rs 20,000 per policy year	Not covered
Organ Donor expenses	Covered up to 50 lakhs depending on the sum insured	Covered up to 1.5 lakh/2 lakh depending on the sum insured
Day Care procedures	Covered	Covered
Room Rent	Covered from 3 lakhs to 7.5 lakhs	Covered up to 1% of the sum insured
Cataract Surgery	Covered – 20% of the sum insured up to Rs 1 lakh	Covered – 20% of the sum insured
Mental Illness	Covered up to 25% of the sum insured or 2 lakhs whichever is lower.	Covered up to 25% of the sum insured
Preventive Health Check-up	Covered up to Rs 5,000	Covered up to Rs 2,000
Modern Treatment Methods and Advancements in Technologies	Up to 50% of the sum insured or a maximum of Rs 5 lakhs, whichever is lower	Up to 50 % of the sum insured
Sum Insured Reinstatement Benefit	Covered	Covered
Maternity cover	Covered up to 35,000 depending on the sum insured	Not covered
New Born Baby Cover	Covered	Not covered
Convalescence benefit	Covered up to Rs 7500	Covered up to Rs 5,000
Daily Cash Benefit for Accompanying an Insured Child	Rs 500 per day with a maximum of 10 days during each policy year	Rs 500 per day with a maximum of 10 days during each policy year
Cumulative Bonus	Available	Available
Pre-existing waiting period	36 months
Entry age	Minimum- 18 years and Maximum- 65 years For dependent children- 3 months to 30 years on a floater basis
Term of the plan	1, 2 or 3 years
Sum assured	Rs 3 Lakhs, Rs 4 Lakhs, Rs 5 Lakhs, Rs 7.5 Lakhs, Rs 10 Lakhs, Rs 15 Lakhs, Rs 20 Lakhs, Rs 25 Lakhs, Rs 30 Lakhs, Rs 35 Lakhs, Rs 40 Lakhs, Rs 45 Lakhs or Rs 50 Lakhs	Rs 1.5 Lakhs or Rs 2 Lakhs
Premium payment frequency	Monthly Quarterly Half-yearly Annually (for Long Term Policies)
Renewal Benefit	Lifelong Renewal Benefit

What is the procedure for buying Bajaj Allianz Health Insurance Policy?

PayBima.com makes it easy for you to purchase health insurance policies for Bajaj Allianz by following the steps below:

• Choose the health plan that best fits your needs:

Visit PayBima's official website by clicking the link above to find the most suitable plan for you under 'health insurance’.

• Detailed information must be filled out:

PayBima will ask you to complete a form containing the requested medical and personal information to calculate your premium based on your eligibility and coverage requirements. You must supply the following information: name of dependents, sum assured, age, gender, pin code of your location, and contact information. The policy can also be purchased with a personalized consultation from PayBima.

• Comparison of plans:

PayBima will display all the plans that suit your coverage and eligibility requirements after receiving all the details. You will also be able to see Bajaj Allianz's health insurance plans. The coverage of the plans and their premiums can be easily compared, so you can find the policy that is right for you.

• Fill out the online form:

You would have to fill out a proposal form by providing your details correctly after you have finalized your policy. Please provide accurate details when you fill out the proposal form to avoid any issues at the time of claiming.

• You'll need to pay the premium:

The purchase of your health insurance policy is complete once you make the payment of the premium. As long as you don't make any adverse declarations about your lifestyle habits or medical history in the proposal form, the insurance company will issue you the policy instantly.

• A medical screening might be needed:

Certain factors, such as your age, lifestyle, medical history, and coverage, may require you to undergo pre-entrance health screening. In cases of high health risk, pre-entrance health screening is required for safety measures. Medical screenings can be obtained at any of the insurer's network hospitals after which the policy would be issued.

The process of renewing Bajaj Allianz's health insurance policy: PayBima's website makes it possible to purchase and renew health insurance policies. The coverage you currently have will continue as long as you renew your policy on time with Bajaj Allianz. If you provide your policy number and other information, you can renew your health insurance policy online. During renewal, you can review your plan details and make any necessary changes. The premium amount might change if you make changes in the coverage. PayBima can be contacted via email at paybima.care@mahindra.com or via telephone at 1800 267 67 67 for more information about renewing your Bajaj Allianz health insurance plan.

What is the process for filing a claim for Bajaj Allianz Health Insurance?

A claim for Bajaj Allianz health insurance can be made through PayBima in a very simple and easy manner. Following is a description of the process:

• Locating network hospital:

In addition to reimbursement, Bajaj Allianz General Insurance also offers cashless claim facilities. If you wish to avail of the cashless claim facility, you must first locate the nearest network hospital via the insurance company's website. On the insurance company's website, you can find a list of the hospitals with which it has a relationship.

• Admission:

Your ID card and health card can be presented after locating the nearest networked hospital as proof to get admitted. You should also inform the company of your claim to get it registered.

• Pre-authorization Claim form:

To receive a cashless settlement of a health claim, you must submit a pre-authorization claim form. The insurance company's website provides the form for downloading, or you can avail of it from the hospital. The pre-hospitalization form should be submitted at least three to four days before a planned hospitalization. If you are hospitalized in an emergency, you can submit the form within 24 hours.

• Cashless approval:

Insurers approve cashless facilities based on pre-authorized claim forms. The networked hospital will begin treatment once the insurer approves the claim. The insurance company will handle and pay all the bills related to the treatment.

• Reimbursement Claim Facility:

If you do not get approval for a cashless claim or you are admitted to a non-networked hospital, then your claim will be settled on a reimbursement basis. The insurance company must be notified in such cases before admission. Following hospital discharge, you will be required to settle all the bills, for which you can receive reimbursement by filling out the claim form and enclosing all the original receipts, bills, and medical records. Upon assessing your claim and validating your documents, the company will reimburse you. Customers of PayBima can benefit from quick and easy claim settlements. For help with your claim settlement, you can contact PayBima at 1800 267 67 67 or email at paybima.care@mahindra.com.

To get a successful settlement of a claim, certain documents are required. Included in these documents are:

• The claim form, filled and signed
• Your bank account details, like a canceled cheque, for reimbursement claims
• Aadhaar Card, PAN Card, Birth Certificate, etc. are all acceptable forms of ID proof of the insured
• In the case of cashless claims, a pre-authorization form is required
• To claim reimbursement, original medical documents, receipts, consultation notes, prescriptions, and hospital reports must be provided.

Review of Bajaj Allianz General Insurance Company Limited

• With more than 20 years of experience, Bajaj Allianz has emerged as a top general insurance provider in the country 
• The company has established digital offices through which it has reached more than 1000 Tier 1 and Tier 2 cities in India
• The combined ratio of the company in the first quarter of the financial year 2021-22 stood at 103.4% which is an impressive figure
• The company is tied up with more than 6500 hospitals across India for a speedy settlement of your health insurance claims
• The company boasts of a claim ratio of 98% which makes it trustworthy when it comes to claiming settlement. 

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