Objective

An online health insurance policy which is aimed at including low segment individuals under the umbrella of insurance. The objective of this policy is to indemnify against expenses during hospitalisation caused due to illness or an accident.

Suited for

This is a low cost, low benefits policy suited for a low-income individual who wish to mitigate some part of, if not whole, medical expenses at a time of health urgency.

What does it do?

This policy sticks to providing a very basic cover against inpatient hospitalisation. Like any traditional health policy it covers all general expenses incurred during admission to hospital. Emergency ambulance to transfer patient from home or accidental site to hospital and back from hospital to home is also provided. Apart from inpatient treatment, it covers specific 130 such procedures not requiring a 24-hour hospitalisation due to technological upgradation. A free health check up can be availed at the end of four continuous claim-free years.

Pros

Family discount of 5 per cent is available.
Premium paid towards this policy is eligible for tax benefit under section 80D of Income Tax Act.

Cons

The policy offers a maximum cover of Rs 1 lakh only.
All benefits have a ceiling limit which means any expense beyond that limit will be denied.

Our View

This policy is specially meant for low income segment. It is low on premium and offers a stingy coverage. Though it may not be sufficient to cover all hospitalisation expenses, it can share a part of the losses.
In view of rising medical expenses now a days, everyone must have at least a basic health insurance policy plus a cover for chronic diseases. The cover can be stretched to include out patient treatments and other day to day expenses at time of hospitalisation. There are far more comprehensive policies available in the market which provide a broad and better immunity to medical costs. This policy is thus not recommended for those who can afford a better one as the cover may not suffice. Moreover, each expense is capped to sum insured which is another limitation.

Eligibility

Entry Age (years)

Minimum

18; 3 Months for Children

Maximum

55

Maximum Policy Renewal Age (years)

75

Coverage Type

Individual Cover

Policy Term (years)

1

Sum Insured (Rs)

Maximum

1 lakh

Minimum

50000

Tax Benefit

Premium paid is eligible for tax benefit under section 80D of the Income Tax Act

Discount

Family discount of 5% is applicable

Pre Policy Medical Check Up

Not required upto 55 years

Policy Termination

Policyholder is allowed to terminate the policy at anytime by giving a 15 day written notice. In case no claim has been made under the policy, percentage of premium will be refunded

Customer Service

Address

Bajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006

Mail to

customercare@bajajallianz.co.in

Call to

1800 225858(BSNL/ MTNL); 1800 1025858 (Bharti users- mobile/ landline) or 020 30305858

Scope Of Cover

Cashless facility

Available at empanelled hospitals in India

Re-imbursement

In case policyholder opts for non empaneled hosiptal , expenses are re-imbursed withing 14 working days from date of submission of all records.

Pre-post hospitalisation

2% of admissible hospitalization expenses

Hospitalisation Expenses (Inpatient treatment)

Covered

Room, Board & Nursing Expenses

upto 1% Of Sum Insured per day*

ICU Expense

upto 2% Of Sum Insured per day*

*Room, board, nursing and ICU expenses can be taken upto maximum of 30% of Sum insured per illness/ injury

Surgeon, Anesthetist, Medical practitioner, Consultants, Specialist Fees

upto 30% of Sum insured per illness/ injury

Emergency Ambulance charges up to Rs 1000/-, Anesthesia, Blood, Oxygen, operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and any medical expenses incurred which is integral part of the operation

upto 40% of Sum Insured per illness/ injury

Day Care Procedures

130 day care procedures are covered

Emergency Ambulance

Covered; subject to maximum limit of Rs 1,000

Health Check Up

Covered; at the end of 4 continuous claim free years

Exclusions & Waiting Period

Pre-existing disease

2 years waiting period applicable for Pre-existing diseases

No claim period

Any disease contracted during the first 30 days of commencement of the policy

Waiting Period

Certain diseases such as gastric / duodenal ulcers, Surgery of varicose veins/varicose ulcers etc shall be covered after a waiting period of 1 year and some diseases such as cataract, hernia etc. will be covered after a waiting period of 2 years.Certain diseases such as joint replacement surgery will have a waiting period of 4 years.

General exclusions

Non allopathic treatmentAIDS and other related diseases.Cosmetic, beauty, weight reduction and other likely treatments.Use of alcohol or other addictive substances.War, participation in any criminal activity or any other related condition.Treatmenmt of any mental or related disease.