Bajaj Allianz Health Guard Family Floater Policy

Bajaj Allianz Health Guard Family Floater Policy Introduction

Bajaj Allianz Health Guard Family Floater Policy is a complete health insurance policy for you and your family. It is designed to take care of the medical expenses incurred during hospitalization resulting from serious illness or accident. It covers a family on a floater basis i.e., the sum insured can be utilized to pay hospitalisation or other allowed expenses for any of the insured member under Bajaj Allianz Health Guard Family Floater Policy.

Bajaj Allianz Health Guard Family Floater Policy covers you and your family against medical expenses such as doctor’s consultation, hospitalization, diagnostic tests, medicines, ambulance, etc. Self, spouse and dependant children (maximum upto 4 children) can be covered under this policy. In this cover, common sum insured is shared by all family members.

Terms and Eligibility Conditions of Bajaj Allianz Health Guard Family Floater Policy

Entry age:	Minimum: 18 years; 3 Months for Children Maximum: 65 years; 25 years for Children
Policy term:	1 year
Sum assured:	Minimum: 2 lakhs Maximum: 10 lakhs (from age 3 months to 55 yrs); 5 lakhs (from age 56 yrs to 65 yrs)
Renewable till age:	Lifelong
Grace period:	30 days from the expiry date to renew the policy.
Pre-policy medical checkup:	Required for 46 years and above.
Documents Required for fresh policy:	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.
Documents Required during Renewal:	Policyholder do not have to fill the Proposal Form again at the time of renewal in case he/she renew the policy before renewal date or within the grace period of 30 days. Policyholder will require to apply for a fresh policy if he/she renew the policy beyond the renewal date.

Key Features of Bajaj Allianz Health Guard Family Floater Policy

• Free Look Period: If you are not satisfied with the Bajaj Allianz Health Guard Family Floater policy, you can cancel  the policy within 15 days of receipt of the policy documents, provided there has been no claim.
• Portability: If you are insured under any other health insurance policy of Non life insurer you can transfer to Bajaj Allianz Health Guard Family Floater policy with all your accrued benefits after due allowances for waiting periods.
• Revision/ Modification of the Policy: Revision or Modification of the policy is possible at any time in future, with appropriate approval from IRDA.
• Withdrawal of Policy: Withdrawal of Bajaj Allianz Family Floater Health Guard policy is possible at any time in future with a intimation of 3 months to all the existing insured members.
• Tax benefits: Under Bajaj Allianz Health Guard Family Floater policy, you can avail Tax benefit on the premium paid as per Section 80D of the Income Tax Act. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
• Cumulative Bonus/No claim bonus: You are eligible for Cumulative Bonus (CB) of 10% of sum insured for every claim free year. Maximum CB would be 50% of sum insured up to 5 claim free years. In case of a claim, the CB will be reduced by 10%.
• Free Health Check-up: Free Health Check-up is available at Bajaj Allianz empanelled Diagnostic Centre, at the end of block of every continuous 4 claim free years.
• Co-Payment Option: 10% co-payment is applicable for all claims from a non network hospital. 20% Co-payment applicable, If the policy is opted for the first time for insured person aged 56 years and above.

Inclusions in Bajaj Allianz Health Guard Family Floater Policy

Inclusions in Bajaj  Allianz Health Guard Family Floater Policy are,

1. Hospitalisation expenses incurred during hospitalisation.
2. Pre hospitalisation expenses for 60 days before the Insured Person was Hospitalised.
3. Post hospitalisation expenses for 90 days after the Insured Person was discharged.
4. Emergency Ambulance charges, Rs 1000/- per hospitalisation.
5. Daycare procedures are covered for listed 130 day care procedures subject to terms and conditions.

Exclusions in Bajaj Allianz Health Guard Family Floater Policy

Exclusions in Bajaj  Allianz Health Guard Family Floater Policy are,

1. Any Pre-existing diseases will be covered after a waiting period of 4 years.
2. Any treatment within first 30 days of commencement of the policy will be excluded.
3. Joint replacement surgery (other than due to accidents) will be covered after a waiting period of 4 years.
4. Abuse of intoxicant substance like drugs and alcohol is excluded.
5. Some diseases like hernia, piles, cataract and sinusitis shall be covered after a waiting period of 2 years.
6. Congenital external are not covered. Congenital internal have waiting period of 4 years.
7. Treatment consisting of non-allopathic medicine, Cosmetic, aesthetic or related treatments are excluded.
8. Expenses arising from AIDS and related diseases are excluded.

For detailed list of exclusions refer Bajaj Allianz Family Floater Health Guard policy wordings and Bajaj Allianz Family Floater Health Guard Brochure.

Claim Procedure under Bajaj Allianz Health Guard Family Floater Policy

Intimation and Assistance:

1. Intimate the company within 48 hours in case of emergency hospitalization.
2. You can contact Bajaj Allianz through Toll Free Line at 1800-209-0144 or log on to their website www.bajajallianz.com for any information or for clarifying your doubts.

The process in case of a claim under Bajaj Allianz Health Guard Family Floater Policy,

Cashless Claims Procedure:

Reimbursement Claims Procedure:

Documents to be submitted for Claims:

• First Consultation letter from the Doctor.
• Duly completed claim form and NEFT Form signed by the Claimant.
• Original Hospital Discharge Card.
• Original 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 Money Receipt, duly signed with a Revenue Stamp.
• All original Laboratory and Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG, MRI Scan, Haemogram etc.
• In case of a Cataract Operation, IOL Sticker will have to be enclosed.
• Other documents as may be required by Bajaj Allianz to process the claim.

Bajaj Allianz Health Guard Family Floater Policy premium calculator

You can calculate the premium using Bajaj Allianz Family Floater Health Guard premium calculator. Policy period, Number of members, Age and Sum assured are required to calculate the premium.

Bajaj Allianz Health Guard Family Floater Policy Premium Rates

Premium rates exclusive of tax are given in below Bajaj Allianz Health Guard Family Floater premium table.

Frequently asked questions (FAQ) of Bajaj Allianz Health Guard Family Floater Policy

How will the premium charged?

The premium is charged as per the highest age in the family and as per the plan opted.

Example: If the proposal is of Self + Spouse for 2lacs, the proposer is wife of age 25 years and husband as dependant of 30 years , the premium would be calculated as per the highest age band, i:e husband’s age would be considered for premium calculation.

How many children can be covered under this policy?

Maximum 4 children can be covered under Bajaj Allianz Health Guard Family Floater policy.

Can I cover my parents & siblings in this policy?

You cannot cover parents or siblings in Bajaj Allianz Health Guard Family Floater policy. The family unit is Self + Spouse + 4 Children.

Do I get a mediclaim card ?

Yes, you will get mediclaim card along with your policy. You need this mediclaim card if you want to avail cashless hospitalisation cover.

What are the items in the hospital bill that are not claimable?

Service charges, Surcharge, Administration charges, Establishment cost, All Non-Medical Expenses, Registration charges, Private Nurse expenses, Laundry charge, Telephone calls, etc, are not claimable.

What is the minimum period of hospitalization required for the eligibility of the claim?

The minimum period of hospitalization is 24 hours unless it gets covered under the 130 day care procedures mentioned in the policy wordings.

When can I Increase the Sum Insured?

Sum Insured Enhancement can be done only at renewals. For enhancement of sum insured, fresh proposal form along with the renewal notice should be submitted.

Bajaj Allianz Health Guard Family Floater Policy Documents and Forms

Bajaj Allianz Health Guard Family Floater Brochure

Bajaj Allianz Health Guard Family Floater Policy Wordings

Bajaj Allianz Health Guard Family Floater Cashless Request Form

Bajaj Allianz Health Guard Family Floater Reimbursement Form

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