- 1 Bajaj Allianz Health Care Supreme Policy Introduction
- 2 Bajaj Allianz Health Care Supreme Policy Terms and Eligibility Conditions
- 3 Bajaj Allianz Health Care Supreme Policy Key features and Benefits
- 4 Bajaj Allianz Health Care Supreme Policy Inclusions
- 5 Medical Expenses Section (Mandatory)
- 6 Add On Benefits section (Optional):
- 7 Bajaj Allianz Health Care Supreme Policy Exclusions
- 8 Medical Expenses Section
- 9 Add On Benefits section
- 10 Bajaj Allianz Health Care Supreme Policy Customer care
- 11 Bajaj Allianz Health Care Supreme Policy Buying Procedure
- 12 Bajaj Allianz Health Care Supreme Policy Claim Procedure
- 13 Cashless Claims Procedure:
- 14 Reimbursement Claims Procedure:
- 15 Documents to be submitted for Claims:
- 16 Bajaj Allianz Health Care Supreme Premium calculator
- 17 Bajaj Allianz Health Care Supreme Plans
- 18 Bajaj Allianz Health Care Supreme FAQ’s
- 19 Bajaj Allianz Health Care Supreme Forms and Documents
- 20 About Bajaj Allianz Silver Health Insurance Plan
- 21 About Bajaj Allianz Star Package Health Insurance
- 22 About Bajaj Allianz Sankat Mochan Health Insurance Plan
- 23 About Bajaj Allianz Personal Accident Health Insurance Plan
- 24 About Bajaj Allianz Extra Care Health Insurance Plan
- 25 About Bajaj Allianz Surgical Protection Plan
- 26 About Bajaj Allianz Critical Illness Health Insurance
- 27 About Bajaj Allianz Premium Personal Guard Health
- 28 About Bajaj Allianz Health Guard Individual
- 29 About Bajaj Allianz Health Guard Family Floater
Bajaj Allianz Health Care Supreme Policy Introduction
Bajaj Allianz Health Care Supreme Policy is a Health Insurance Plan that take cares of the medical expenses at every stage of your life. Each stage of life brings different health care needs. Bajaj Allianz Health Care Supreme will fulfill all the health care needs of you and your family. Bajaj Allianz Health Care Supreme Policy gives you the protection, no matter what stage of life you are at. Bajaj Allianz Health Care Supreme is a Comprehensive plan which will take care of your priorities with, wide range of coverage. Two sections namely Medical Expenses Section and Add On Benefits section are covered under Bajaj Allianz Health Care Supreme Policy.
Bajaj Allianz Health Care Supreme Policy Terms and Eligibility Conditions
|Minimum Entry Age:||
|Maximum Entry Age:||
|Entry age for Dependent children:||
|Renewable till age:||
|Pre – medical checkup:||
|Documents Required during Renewal:||
Bajaj Allianz Health Care Supreme Policy Key features and Benefits
- Bajaj Allianz Health Care Supreme is a complete package policy with wide range of covers under single policy including maternity, sum insured restoration, Out patient Expenses etc.,
- Unique coverage like Air ambulance cover, physiotherapy expenses etc.,
- No restrictions on maximum entry age.
- Free Annual Preventive Health Check up irrespective of Claims history.
- Cumulative Bonus (CB) of 10% of Sum insured for each claim free year. Maximum CB would be 50% of sum insured on hospitalization section.
- 15 days Free look in period for new policies.
- You can avail Tax Benefit under 80 D section of Income Tax Act. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
- Cashless facility in around 3700 network hospitals across India (for claims under hospitalization Section)
- Discounts like Add On Cover discount, Family Discount, Claim Free Renewal Discount and Group Discount are available.
Bajaj Allianz Health Care Supreme Policy Inclusions
Bajaj Allianz Health Care Supreme Policy covers two sections, Medical Expenses section and Add On Benefits section.
Medical Expenses Section (Mandatory)
- Hospitalization Expenses: In-patient Treatment – Medical Expenses for Room rent, boarding expenses, Intensive care unit, Nursing, Consultation fees, Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, Diagnostic procedures, Medicines, drugs and consumables and the Cost of prosthetic and other devices or equipment if implanted internally during a Surgical Procedure.
- Pre hospitalization: Pre hospitalization expenses for 60 days before the Insured Person was Hospitalised.
- Post hospitalization: Post hospitalization expenses for 90 days after the Insured Person was discharged.
- Road Ambulance: Company will reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider. Covers up to Sum Insured under hospitalization section.
- Air Ambulance: Covers, expenses for ambulance transportation in an airplane or helicopter for emergency life threatening health conditions, up to 10% of Hospitalization Sum Insured.
- Day Care Procedures: Covers medical expenses for Day care procedures taken as an inpatient in a hospital or a day care centre but not in the outpatient department.
- Out Patient Expenses: Covers Out Patient expenses for, Investigations and Medicines related to the illness / injury as prescribed by the specialist, Specialist Consultations, Dental Procedures – Root Canal Treatment, Extractions and Consultations for Psychiatric disorders.
- Organ Donor Expenses: Covers lump sum amount towards organ donor’s treatment for harvesting of the donated organ.
- Recovery benefit: Covers lump sum amount in the event of insured member hospitalised for a disease/illness/injury for a continuous period exceeding 7 days.
- Physiotherapy Expenses: Covers expenses incurred towards Physiotherapy treatment taken on Out patient Basis for illness/Injury contracted during the policy period.
- Sum Insured Reinstatement Benefit: In case Sum Insured under hospitalization expenses is exhausted, then it is agreed that 100% sum insured will be restored.
- Ayurvedic & Homeopathic treatment hospitalization Expenses: Covers In-patient Treatment – Medical Expenses for Ayurvedic & Homeopathic treatment: Nursing care, Room rent, boarding expenses, Consultation fees, Ayurvedic & Homeopathic treatment procedures, Medicines, drugs and consumables.
- Maternity Expenses: Covers Medical Expenses for the delivery of a baby. Covers up to Sum insured under Maternity cover, from 3rd year of policy.
- New Born Baby Cover: Covers medical expenses towards treatment of new-born baby while you are hospitalised as an inpatient for delivery for the hospitalization.
- Free Annual Preventive Health Check Up: After each renewal of Bajaj Allianz Health Care Supreme policy you will be entitled for a Free Annual Preventive Health Check up at empanelled Diagnostic centers.
Add On Benefits section (Optional):
- Ancillary Expenses Benefit:
- 1500/per day for each continuous 24 hours hospitalization.
- Maximum period of 30 days during each policy period and 6o days for floater policy.
- In case of admission in ICU, the benefit payable would be double, i.e., Rs.3000/day, max for 15 days during each policy period and 30 days for floater policy.
- Critical Illness Benefit:
- Coverage for 15 critical Illnesses.
- Survival Period 30 days.
- Coverage up to Benefit amount of Rs.1 Lac.
- Personal Accident cover:
- Death due to accident – 100% of Sum Insured.
- Permanent Total Disability – Highest compensation of 125% of Sum Insured.
- Permanent Partial Disability – As per the disability table.
- Transportation benefit up to Rs. 5,000/-.
- Children education benefit Rs.5,000/- Each of up to 2 Dependent Children.
- Ancillary Expenses Benefit:
For complete information about Inclusions, please refer Bajaj Allianz Health Care Supreme policy wordings and Bajaj Allianz Health Care Supreme brochure.
Bajaj Allianz Health Care Supreme Policy Exclusions
Exclusions under Bajaj Allianz Health Care Supreme Policy are,
Medical Expenses Section
- War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.
- Abuse of intoxicant substance like drugs and alcohol is excluded.
- Expenses arising from AIDS and related diseases are excluded.
- Any treatment received outside India is not covered under this policy.
- Venereal disease or any sexually transmitted disease or sickness.
- Experimental, unproven or non-standard treatment.
- Any fertility, sub fertility, impotence, assisted conception operation or sterilization procedure.
- Intentional self-injury.
- Any form of plastic surgery unless necessary for the treatment of cancer, burns or accidental Bodily Injury.
Add On Benefits section
- Any Critical Illness for which treatment or advice received from a physician before the start of the policy period.
- Any Critical Illness diagnosed within the first 90 days of the date of commencement of Bajaj Allianz Star Package policy.
- Occupational diseases.
- Radioactive contamination.
- Intentional self-injury and/or the use or misuse of intoxicating drugs and/or alcohol.
- Consequential losses of any kind or your actual or alleged legal liability.
- Accidental Bodily Injury that You meet with: Suicide, attempted suicide or self-inflicted injury or illness or Under the influence of drugs or liquor.
For complete information about exclusions under each section, please refer Bajaj Allianz Health Care Supreme Policy wordings and Bajaj Allianz Health Care Supreme Brochure.
Bajaj Allianz Health Care Supreme Policy Customer care
Assistance: You can contact Bajaj Allianz through Toll Free Line at 1800-209-0144 or log on to their website www.bajajallianz.com or E-mail -firstname.lastname@example.org for any information or for clarifying your doubts.
Bajaj Allianz Health Care Supreme Policy Buying Procedure
Documents required for buying Bajaj Allianz Health Care Supreme plan:
- Policyholder need to fill up an ‘Application form/ proposal form’ with accurate medical history along with ‘address proof’.
- Medical examination may be required in some cases, based on the sum assured and the age of the person.
Bajaj Allianz Health Care Supreme Policy Claim Procedure
The process in case of a claim under Bajaj Allianz Health Care Supreme policy,
Cashless Claims Procedure:
(Applicable only for Hospitalization Expenses Section)
Reimbursement Claims Procedure:
(Applicable for all sections)
Documents to be submitted for Claims:
|Documents to be submitted for Medical Expenses section & Ancillary Expenses cover||Documents to be Submitted for Critical illness|
|First Consultation letter from the Doctor||Duly completed Claim Form duly signed by the insured|
|Duly completed claim form signed by the Claimant||Copy of Discharge Summary / Discharge Certifcate|
|Hospital Discharge Card ( Not applicable for Out Patient Expenses & Physiotherapy Expenses Section)||Copy of Final Hospital Bill|
|Hospital Bill giving detailed break up of all expense heads mentioned in the bill. Clear break ups have to be mentioned for OT Charges, Doctor’s Consultation and Visit Charges, OT Consumables, Transfusions, Room Rent, etc.||Original Policy copy|
|Money Receipt, duly signed with a Revenue Stamp||First consultation letter for Illness|
|All original Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc||Medical certifcate for the duration of illness (if required)|
|In case of a Cataract Operation, IOL Sticker will have to be enclosed||All required Investigation Reports as per the Illness (If required)|
|Other documents as may be required by Bajaj Allianz to process the claim||Letter from the employer clarifying the type of work|
|Documents to be submitted for Personal Accident Claim|
|Death Claims||PTD, PPD & TTD Claims|
|Duly completed claim form signed by the Claimant||Duly completed claim form signed by the Claimant|
|Attested copy of Death Certifcate||Attested copy of FIR / Panchanama / Inquest Panchanama|
|Attested copy of Post Mortem Report, if conducted||Copy of Medico Legal Certifcate|
|Attested copy of Viscera/ Chemical Analysis Report (If Viscera is preserved)||Copy of discharge summary towards hospitalization immediately after injury|
|Diatoms report from forensic lab in case of death on account of drowning (if sample preserved)||X-ray Films/ Investigation reports supporting the diagnosis|
|Attested copy of statement of witness (if any)||Disability certificate from the Government Authority certifying Insured’s disability|
|Burial certifcate (wherever applicable)||Other documents as may be required by Bajaj Allianz to process the claim|
|Legal heir certificate containing affidavit and indemnity bond both duly signed by all legal heirs and notarized is mandatory to process the claim||Leave certifcate from the employer|
|Insured’s / Claimant’s photo-identity proof|
|Insured’s / Claimant’s address proof|
|Other documents as may be required by Bajaj Allianz to process the claim|
Bajaj Allianz Health Care Supreme Premium calculator
You can calculate the premium using Bajaj Allianz Health Care Supreme premium calculator. Policy period, Number of members, Age and Sum assured are required to calculate the premium.
Bajaj Allianz Health Care Supreme Plans
Bajaj Allianz Health Care Supreme FAQ’s
Give me the list of the tests to be conducted?
Full Medical report, Urine Routine, Complete Blood Count, Fasting Blood Sugar, ECG, HbA1c, Lipid Profile, Serum Creatinine, SGOT, SGPT and GGTP.
Give me the list of 15 critical illnesses that are covered?
List of Critical Illness covered under the policy:
- Cancer Of Specified Severity
- First Heart Attack – Of Specified Severity
- Coma Of Specified Severity
- Kidney Failure Requiring Regular Dialysis
- Stroke Resulting In Permanent Neurological Sequelae
- Major Organ /Bone Marrow Transplant
- Multiple Sclerosis With Persisting Symptoms
- Aplastic Anemia
- End Stage Lung Disease
- End Stage Liver Failure
- Parkinson’s Disease
- Surgery To Aorta
- Alzheimer’s Disease
- Primary Pulmonary Hypertension
- Major Burns
Give me the complete information on discounts available?