Bajaj Allianz Star Package Health Insurance Plan

Bajaj Allianz Star Package Health Insurance Plan Introduction

Bajaj Allianz Star Package Health Insurance Policy is a unique package policy which provides protection against various risks faced by an individual under a single policy. Death, injury or sickness of the breadwinner, or indeed, any family member can create financial problems for your family. Bajaj Allianz Star Package policy insures you against these circumstances. Bajaj Allianz Star Package policy also provides protection for house hold contents and baggage insurance. Bajaj Allianz Star package policy has 8 sections. A person would have to opt for a minimum of 3 sections under Bajaj Allianz Star Package health insurance policy.

Bajaj Allianz Star Package Health Insurance Plan Terms and Eligibility Conditions

Entry age for Proposer and Spouse:	Minimum: 18 years Maximum: 65 years
Entry age for Dependent Children:	Minimum: 3 months Maximum: 25 years
Policy term:	Policy can be opted for 1 year/2 year/3 years.
Renewable till age:	Lifelong
Grace period:	30 days from the expiry date to renew the policy.
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.
Pre-policy medical checkup:	Required for age 46 years ad above.
Cancellation:	You may cancel Bajaj Allianz Star Package policy by giving atleast 15 days written notice the company.

Bajaj Allianz Star Package Health Insurance Plan Key Features and Benefits

• Free Look Period: If you are not satisfied with the Bajaj Allianz Sankat Mochan 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 Sankat Mochan Insurance policy with all your accrued benefits after due allowances for waiting periods.
• Revision or 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 Sankat Mochan policy is possible at any time in future with a intimation of 3 months to all the existing insured members.
• Tax Benefit: You can avail Tax benefit under Section 80D of the Income Tax Act on the premium paid towards Health Sections(Health Guard, Critical illness and Hospital Cash Only). For more information regarding Tax Benefits, visit www.taxqueries.in.
• Discounts:
  

  Sectional Discount	Long Term policy Discount
  10% discount applicable if 4 or 5 sections are opted.	10% discount applicable if policy is opted for 2 years.
  15% discount applicable if 6, 7 or 8 sections are opted.	15% discount applicable if policy is opted for 3 years.

Bajaj Allianz Star Package Health Insurance Plan Inclusions

Sections Covered under Bajaj Allianz Star Package Policy are

1. Hospital Cash
2. Health Guard
3. Critical illness
4. Personal Accident
5. Education Grant
6. Householders Contents
7. Traveling Baggage
8. Public Liability

Section I: Hospital Cash

• Pays a Daily benefit amount for incidental exenses during hospitalization period.
• Daily benefit amount is doubled for ICU admissions.
• Beefit is available for 30 days per policy period.
• This is a floater section where spouse and children can be covered.
• Spouse can be covered with 50% additional premium.
• Children can be covered with 25% additional premium per child.

Section II: Health Guard

• Medical expenses incurred during hospitalisation.
• Pre hospitalization expenses for 60 days.
• Post hospitalization expenses for 90 days.
• Ambulance charges Rs. 1000/- per hospitalization.
• 130 day care procedures are covered.
• 10% co-payment for admissions in non network hospital, this can be waived off with payment of additional premium.
• 10% No claim Bonus/Cumulative bonus for eavh claim free year, maximum up to 50%.
• This is a floater section where spouse and children can be covered.
• Spouse can be covered with 50% additional premium.
• Children can be covered with 25% additional premium per child.
• 20% Co-payment applicable for members of age group 56-65 years, opting Bajaj Allianz Star Package policy for first time.
• Add on covers on Health Guard section: (additional premium, in % of health guard premium)

Section III: Critical Illness

• On diagnosis of a listed critical illness and after completion of 30 days, a lumpsum benefit amount is paid.
• Insured member can utilize this amount for treatment of the disease, lifestyle changes etc.,
• Spouse can be covered with 50% additional premium.
• Children can be covered with 25% additional premium per child.

List of Critical Illnesses Covered:

1. First Heart Attack – Of Specified Severity
2. Open Chest CABG
3. Stroke Resulting In Permanent Symptoms
4. Cancer Of Specified Severity
5. Kidney Failure Requiring Regular Dialysis
6. Major Organ Transplant
7. Multiple Sclerosis With Persisting Symptoms
8. Surgery Of Aorta
9. Primary Pulmonary Arterial Hypertension
10. Permanent Paralysis Of Limbs
11. Neuro Surgery
12. Joint Replacement

Section IV: Personal Accident

1. Death: 100% of sum assured is payable.
2. Permanent Total Disability (PTD): 125% of the sum assured is payable.
3. Permanent Partial Disability (PPD)
4. Temporary Total Disability (TTD): 1 % of the sum assured per week, up to a maximum of 100 weeks is payable whichever is lesser.
5. Medical Expenses Reimbursement: If claim is accepted under Death, PTD, PPD and TTD then company will reimburse medical expenses upto 40% of valid claim amount or actual medical bills.

Section V: Education Grant

• In case of Accidental Death or Permanent Total Disability, sum insured would be payable towards the continuing education of the deceased’s children.
• Claim would be payable to the nominee.
• This Education Grant section can be opted by proposer only.

Section VI: Householders Contents

• The householders contents will be covered on the first loss basis @ 25% of the value at risk. Any valuable with value more than 5 % of the sum insured in this section is to be specifically declared at the time of proposing insurance.
• Or at the time of loss the amount payable will be restricted to 5% of the first loss sum insured.

Section VII: Traveling Baggage

• Bajaj Allianz Star Package policy pays you, in respect of any loss regarding your baggage while on tour or holiday.

Section VIII: Public Liability

• In some cases our actions can cause bodily injuries or property damage to third parties. Bajaj Allianz Star Package plan protects your legal liability for bodily injury or property damage o third parties.

For complete information on Inclusions please refer Bajaj Allianz Star Package Brochure and Bajaj Allianz Star Package Policy wordings.

Bajaj Allianz Star Package Health Insurance Plan Exclusions

Exclusions under 8 sections are given below.

Section I: Hospital Cash

• Pre-existing disease and related complications.
• 30 days waiting period for any illness/disease except for Accidental Bodily Injury.
• 1 year waiting period for cataract, back ache, hysterrectomy, fistulae, etc.,
• Any treatment not performed by a physician.
• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.

Section II: Health Guard

• Benefits will not be available for any pre-existing condition, until 48 months of continuous coverage have elapsed.
• 2 years waiting period for Endometriosis, Cataracts, Haemorrhoids, etc.,
• 4 years waiting period for joint replacement surgery, Hypertrophied turbinate, laser treatment, etc.,
• 30 days waiting period for any illness/disease except for Accidental Bodily Injury.
• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.

Section III: Critical Illness

• 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.

Section IV and V: Personal Accident and Education Grant

• Suicide, attempted suicide or self inflicted injury or illness.
• Any deliberate or intentional, unlawful or criminal act, error, or omission of the Insured.
• Any consequential losses of any kind, and/or any actual or alleged legal liability of the Insured.
• Any loss caused either directly or indirectly by nuclear energy, radiation.
• Curative treatments or interventions that the Insured performs or has had performed on his body.
• Pregnancy, resulting childbirth, miscarriage, abortion, or complication arising out of any of the foregoing.
• Influence of intoxicating liquor or drugs.

Section VI: Householders Contents

• Fire, excluding destruction or damage caused to the contents insured by:
  • Its own fermentation, natural heating or spontaneous combustion.
  • Its undergoing any heating or drying process.
  • Burning of property insured by order of any Public Authority.

Section VII: Traveling Baggage

• Loss or damage caused by or any process of cleaning, dyeing repairing or restoring to which the baggage is subjected.
• Loss or damage caused by moth, mildew or vermin.
• Loss or damage to any electrical machines, apparatus, fixtures arising from over running, excessive pressure, short circuiting, arcing, self heating or leakage or electricity from whatever cause.
• Loss or damage caused by mechanical derangement or over winding of watches and clocks.
• Loss of or damage to Jewellery or Valuables.
• Loss or destruction of or damage to baggage of a consumable nature.

Section VIII: Public Liability

• Any liability arising out of a deliberate, wilful or intentional act, error, omission, or non-compliance with any statutory provision.
• Transmission of any communicable disease or virus.
• Occupation or business, trade or employment.
• Liability arising out of the ownership, possession or use by or on behalf of the Insured or his family or Household Staff of any watercraft, hovercraft, air- or spacecraft.

Exclusions applicable to all 8 sections:

• Loss or damage caused by depreciation or wear and tear.
• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.
• Consequential loss of any kind or description.
• Act of foreign enemy, Rebellion, Insurrection military or usurped power of civil commotion or loot or pillage in connection herewith.

For complete list of exclusions refer Bajaj Allianz Star Package brochure and Bajaj Alliaz Star Package policy wordings attached below.

Bajaj Allianz Star Package Health Insurance Plan 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 -customercare@bajajallianz.co.in for any information or for clarifying your doubts.

Bajaj Allianz Star Package Health Insurance Plan Buying Procedure

Documents required for buying Bajaj Allianz Star Package Health 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 Star Package Proposal Form

Bajaj Allianz Star Package Health Insurance Plan Claim Procedure

The process in case of a claim under Bajaj Allianz Star Package policy,

Cashless Claims Procedure

(Applicable for Section II Health Guard Only)

Reimbursement Claims Procedure

(Applicable for Section I Hospital Cash, Section II Health Guard, Section III Critical Illness, Section IV Personal Accident and Section V Education Grant)

Documents to be submitted for Claims

For Section I Hospital Cash:

• Hospital Cash Claim Form duly signed by the insured.
• Copy of Discharge Summary / Discharge Certificate.
• Copy of Final Hospital Bill.

For Section II Health Guard:

• 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.

For Section III Critical Illness:

• Critical Illness Claim Form duly signed by the insured.
• Copy of Discharge Summary / Discharge Certificate.
• Copy of Final Hospital Bill.
• Policy copy.
• First consultation letter for Illness.
• Medical certificate for the duration of illness.
• All required Investigation Reports as per the Illness.
• Medical certification from specialist (if required).

For Section IV and V Personal Accident and Education Grant:

• Death Cover:
  • Duly Completed Personal Accident Claim Form signed by nominee.
  • Copy of address proof (Ration card or electricity bill copy).
  • Legal heir certificate containing affidavit and indemnity bond both duly signed by all legal heirs. .and notarized (If nominee name not mentioned on policy schedule.).
  • Attested copy of Death Certificate.
  • Burial Certificate (wherever applicable).
  • Attested copy of Statement of Witness, if any lodged with police authorities.
  • Attested copy of FIR / Panchanama / Inquest Panchanama.
  • Attested copy of Post Mortem Report (if performed).
  • Attested copy of Viscera report if any.
  • Photo identity proof.
• Permanent Partial /Total Disablement cover:
  • Duly Completed Personal Accident Claim Form signed by insured.
  • Attested copy of disability certificate from certified Civil Surgeon of a Government Hospital stating percentage of disability.
  • Attested copy of FIR. (If required).
  • All X-Ray / Investigation reports and films supporting to disablement.
• Temporary Total Disablement:
  • Duly Completed Personal Accident Claim Form signed by insured.
  • Medical fitness certificate from treating doctor mentioning the type of disability and period of rest with date of fitness.
  • Leave certificate from the employer for disablement period.
  • Attested copy of FIR.(If required).
  • All X-Ray reports and films.

Bajaj Allianz Star Package Claim forms and Neft form

Bajaj Allianz Star Package Health Insurance Plan Premium calculator

You can calculate the premium using Bajaj Allianz Star Package premium calculator. Policy period, Number of members, Age and Sum assured are required to calculate the premium.

Bajaj Allianz Star Package Health Insurance Plan Premium rates

Annual Premium Tables (Premium exclusive of Service tax) for all 8 sections are given below.

Section I: Hospital Cash

Section II: Health Guard

Section III: Critical Illness

Section IV: Personal Accident

Section V: Education Grant

Section VI: Householders Contents

Section VII: Traveling Baggage

Section VIII: Public Liability

Bajaj Allianz Star Package Health Insurance Plan FAQ’s

What will be the renewal age?

Under normal circumstances, lifetime renewal benefit is available under the policy except on the grounds of fraud, misrepresentation or moral hazard.

How many sections have to be opted under this policy?

Minimum 3 sections have to be opted.

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.

What about Payout basis?

• Payout under Health Guard, Household contents, Travel baggage, Public Liability section is on Indemnity basis.
• Payout under sections Hospital Cash, Critical Illness, Personal Accident, Education Grant is on benefit basis.

Bajaj Allianz Star Package Forms and Documents

Bajaj Allianz Star Package Brochure

Bajaj Allianz Star Package Customer Information Sheet

Bajaj Allianz Star Package Policy Wordings

About Bajaj Allianz Health Care Supreme Policy

About Bajaj Allianz Silver Health Insurance Plan

About Bajaj Allianz Sankat Mochan Health Insurance Plan

About Bajaj Allianz Personal Accident Health Insurance Plan

About Bajaj Allianz Extra Care Health Insurance Plan

About Bajaj Allianz Surgical Protection Plan

About Bajaj Allianz Critical Illness Health Insurance

About Bajaj Allianz Premium Personal Guard Health

About Bajaj Allianz Health Guard Individual

About Bajaj Allianz Health Guard Family Floater