Objective

A special policy with an aim to provide a customised insurance plan depending on needs of a person.

Suited for

This policy can be bought as an individual cover or as a family floater cover. It is more suitable for those looking to buy multiple policies for different conditions.

What does it do?

This plan gives you freedom to customise the policy as per your needs. It offers eight standalone policy benefits under one policy. Each policy benefit is defined as a Section which has its own exclusions as well. It is upto the proposer to select any of the sections depending on his needs. A minimum of three sections are mandatory to select. For instance, you may select three sections- health guard (covering inpatient treatment and related expenses), critical illness and personal accident section. The policy will charge premiums based on the sections opted. This single policy can become a comprehensive package if customised in a manner.

Pros

No sub-limit on room rent and other expenses.
Higher policy terms of two and three years provide relief from renewal process on an annual basis.
It offers discount on selecting four or more sections.
It saves policyholder from task of managing multiple policies.
Premium paid under this policy will enjoy tax benefits under Section 80D.

Cons

The policy cannot be renewed throughout lifetime.
There is a co-payment clause which means 10 per cent of the admissible claim amount will have to be borne by the insured member if treated in non-network hospital.
Individuals between age 50 and 60 years entering the policy for the first time have to bear 20 per cent of the admissible claim amount.

Our View

An all-in-one plan which can be bought by those looking to purchase different policies covering against different conditions. Before buying evaluate your needs first to include all the required sections at once. A special advice is while filling proposal form for burglary or fire insurance (household contents), mention the details of all valuables that cost more than Rs 5,000 separately to enjoy an uninterrupted cover.

Eligibility

Entry Age (years)

Minimum

18; 3 months for children

Maximum

60; 25 for children

Maximum Policy Renewal Age (years)

60 for Hospital Cash benefit; 80 years for Health guard; 60 years for Critical Illness benefit; 65 for Education grant

Coverage Type

Individual/ family floater

Policy Term (years)

1 or 2 or 3

Sum Insured (Rs)

Maximum

Hospital Cash(per day basis) 2500
Health Guard 5 lakh
Critical Illness 3 lakh
Personal Accident 5 lakh
Education Grant 5 lakh
Burglary/ Fire Insurance(Household Contents only) 4 lakh
Traveling Baggage 40000
Public Liability 5 lakh

Minimum

Hospital Cash(per day basis) 500/1000/2000
Health Guard 1.5 lakh/ 2 lakh/ 3 lakh
Critical Illness 1 lakh/ 1.5 lakh/ 2 lakh
Personal Accident 2 lakh/ 3 lakh/ 4 lakh
Education Grant 2 lakh/ 3 lakh/ 4 lakh
Burglary/ Fire Insurance(Household Contents only) 1 lakh/ 2 lakh/ 3 lakh
Traveling Baggage 10000/20000/30000
Public Liability 2 lakh/ 3 lakh/ 4 lakh

Tax Benefit

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

Discount

Section Discount on selecting more than 3 sections.
4-5 sections: 10% discount
6-8 sections: 15%
10% discount on selecting a 2 years policy term and 15% discount on selecting a 3 years policy term

No Claim Bonus

Health guard: 5% on each claim free year; maximum upto 50%. Applicable on Sum Insured of Rs 2 lakh and above.

Grace Period for Policy Renewal

15 days for Health Guard cover

Policy Termination

Both insurance company and Policyholder are allowed to terminate the policy at anytime by giving a 14 day written notice. The insurer will refund premium on pro rata basis depending upon policy period elapsed.

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 22 5858(BSNL/ MTNL); 1800 209 5858 (Any mobile/ landline) or 020 30305858

Scope of Cover

Cashless facility

Available at empanelled hospitals in India

Re-imbursement

In case policyholder opts for non empanelled hospital with a Co-payment clause of 10%

Minimum three sections (any) are mandatory

Section I

Hospital Cash

Daily Cash Amount

Covered; maximum of 30 days (including ICU treatment) per policy period regardless of number of confinements to the hospital.

ICU Benefit

Covered; double the daily cash amount for a maximum of 7 days per policy period

Section II

Health Guard

In patient treatment

Covered

Pre-post hospitalisation

Relevant medical expenses covered from 60 days prior and 90 days post hospitalisation

Day Care Procedures

130 day care procedures are covered

Add on Coverage (requires payment of extra premium)

Ambulance Expenses

Covered; upto maximum of Rs 1000 per valid hospitalisation

Accommodation to Relative

Rs 500 per day for 10 days

Organ transplant expenses of donor

Covered upto Rs 1 lakh

Accidental Emergency, reconstructive Surgery (in case of accident), Physiotherapy, Medical evacuation

covered upto Rs 50000

Burial, Cremation Expenses

Covered; Rs 25000

Medical expenses for accidental hospitalisation

Covered; twice the Health Guard Sum Insured

Free medical checkup

Covered; after 4 claim free years

Section III

Critical Illness

Covered; pays a lump sum amount provided insured person survives 30 days after confirm diagnosis of critical illness. It covers critical illnesses namely: First Heart Attack, Coronary Artery Disease Requiring Surgery, Cancer, Kidney Failure (End-stage renal disease), Major Organ Transplantation, Multiple Sclerosis, Surgery of Aorta, Primary Pulmonary Arterial Hypertension, Paralysis, Neuron Surgery and joint replacement

Section IV

Personal Accident

Accidental death

Covered; 100% of Sum Insured

Cost of transporting remains from hospital to cremation ground/ residence

Covered; 2% of Sum Insured or Rs 5000, whichever is lower

Permanent Total disability

Covered; 125% of Sum Insured

Permanent Partial Disability

Covered; pays predefined percentage of sum insured

Temporary Total Disability

Weekly payment of 1% of the Sum Insured maximum upto 100 weeks

Medical Expenses

reimburses upto 40% of the admissible claim

Section V

Education Grant

payable in case of Accidental Death and Permanent Total Disability for continuing education of children

Section VI

Burglary and Fire

Standard Fire Policy(including earthquake) and burglary for household contents only

covers loss or damage to household property.Covered on the first loss basis @ 25% of the value at risk. Items with value more than 5% of Sum Insured have to be specially disclosed in the proposal form.

Section VII

Traveling Baggage

Loss, damage or theft of baggage while traveling anywhere in the world

Covered

Section VIII

Public Liability

Bodily injury or damage to property of third party

Covered

Exclusions and Waiting Period

Hospital Cash

Pre-existing diseases and related complications.Hospitalisation within 30 days from the commencement of policy.Certain diseases will be covered from second year and onwards.Pregnancy/ childbirth Surgery/ dentalNatural perilsAccidents due to drunken driving

Health Guard

Pre-existing diseases will be covered after waiting period of 4 years.Some diseases such as hernia, piles, sinusitis, cataract shall be covered after a waiting period of 2 years.Medical expenses for treatment of any disease or illness diagnosed within 30 days of commencement of policy.dental/ spectacles/ contact lenses or hearing aids.non allopathic medicine, congenital diseases, all expenses arising from AIDS, cosmetic, aesthetic, intoxicating drugs/ alcohol, joint replacement surgery(unless caused by an accident)

Critical Illness Policy

Pre existing critical illnessAny illness diagnosed during first 90 days from commencement date of the policy.

Personal Accident & Education Grant

Suicide, self-inflicted injury, pre-existing physical or mental defects, alcoholic, influence of drugs, AIDS or related diseases etc.

Traveling Baggage

Theft from car except from fully enclosed saloon cars having all the doors, windows and other opening securely locked, loss or damage to jeweler or valuables.Loss by any carrier under contract and Loss to money securities, gold and silver ornaments, travel tickets, cheque, draft, jeweler, share certificates and articles of consumable nature

Public Liability

Arising out of deliberate or willful or International noncompliance with any statutory provisions, connected with fines, penalties, in connection with any motor vehicles, watercraft, hovercraft or spacecraft

Co Payment Clause

Health Guard: Individuals between age group 56-60 years taking the policy for the first time have to bear 20% of the admissible expenses. further in case of treatment in a non empanelled hospital, 10% of admissible claim has to be borne by policyholder