Bajaj Allianz Surgical Protection Plan

Bajaj Allianz Surgical Protection Plan

Bajaj Allianz Surgical Protection Plan Introduction

Bajaj Allianz Surgical Protection Plan provide you with financial assistance in case of illness or accidental injuries leading to hospitalization. Surgical Benefit Cover, which is an integral component of Bajaj Allianz Surgical Protection Plan takes care of the expensive medical treatment in a hospital and provide you with a fixed benefit amount for specified surgeries.

Bajaj Allianz Surgical Protection Plan also offers an optional value added covers such as Hospital Cash Daily Allowance, Critical Illness and Personal Accident, in addition to the Surgical Benefit Cover. Based on your requirements, you can include these optional covers in your Bajaj Allianz Surgical Protection policy and avail a comprehensive coverage.

Types of Policy:

• Individual Surgical Protection Plan Policy
• Group Surgical Protection Plan Policy

Terms and Eligibility Conditions of Bajaj Allianz Surgical Protection Plan

Entry age for Self, Spouse and Dependent Parents:	Minimum: 18 years Maximum: 65 years
Entry age for Dependent Children:	Minimum: 3 months Maximum:  25 years
Policy term:	1 year
Renewable till age for Self, Spouse and Dependent Parents:	lifetime renewals
Renewable till age for Dependent Children:	35 Years
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.

Bajaj Allianz Surgical Protection Plan Sum Insured options

• Sum Assured for Surgical Benefit Cover: Minimum: Rs. 1,00,000/-; Maximum: Rs. 10,00,000/-

• Sum Assured for Add On Covers:
  • Hospital Cash Daily Allowance cover: Rs. 1500/- Day, Rs. 45000/- per policy period.
  • Critical Illness cover: Rs. 1,00,000/-
  • Personal Accident cover: Rs. 5,00,000/-

Key Features and Benefits of Bajaj Allianz Surgical Protection Plan

• Bajaj Allianz Surgical Protection plan can be opted in addition to the hospitalisation policy.
• Comprehensive coverage for around 600 surgeries, with guaranteed benefit amount.
• Bajaj Allianz Surgical Protection plan is the only benefit plan with cashless facility in around 3700 network hospitals all over India.
• Self, spouse, dependent children and dependent parents can be insured in a single policy.
• You can avail Income Tax Benefit under Section 80D of the Income Tax Act on the premium paid for Bajaj Allianz Surgical Protection Plan. For more information regarding Income Tax Benefits, visit www.taxqueries.in.
• Cashless facility can be availed in more than 3600 network hospitals for Surgical Benefit Cover.
• Loading is applicable under this policy.
• Discounts: Discounts like Good Health discount, Family discount, Online policy discount are available under Bajaj Allianz Surgical Protection Plan.
• Free Look Period: If you are not satisfied with the Bajaj Allianz Critical illness policy, you can cancel  the policy within 15 days of receipt of the policy documents, provided there has been no claim.
• 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 Critical illness policy is possible at any time in future with an intimation of 3 months to all the existing insured members.
• Migration: The insured can opt for migration of policy to other similar products of Bajaj Allianz at the time of renewal.

Inclusions in Bajaj Allianz Surgical Protection Plan

Bajaj Allianz Surgical Protection Plan covers 2 Sections they are,

1. Surgical Benefit Cover.
2. Add On covers.
   1. Hospital Cash Daily Allowance.
   2. Critical Illness Cover.
   3. Personal Accident Cover.

1. Surgical Benefit Cover: Surgical Benefit Cover is mandatory under Bajaj Allianz Surgical Protection plan. In case the insured person has to undergo a surgery for an illness or accidental bodily injury sustained during the policy period, then the company will pay a specified benefit amount of the Sum Insured. The payable proportion shall be determined on the basis of the grade of the surgery as shown in below table.

Grade of the Surgery	List of Covered Surgeries
Grade 1- Supra-Major Surgeries	Heart Bypass Surgery, Heart- Lung Transplant, Total Knee Replacement, Kidney Transplant, Chest Wall Resection, Liver Transplant etc.
Grade 2- Major Surgeries	Back and Neck Surgery (Spinal Fusion), Plate and Screw Fixation of Arm Bones, Open Bladder Surgery, Lung Volume Reduction Surgery etc.
Grade 3- Sub- Major Surgeries	Anterior cruciate ligament surgery, Appendectomy (Removal of Appendix), Cataract Surgery, Liver Biopsy, Laryngoscopy, Open rotator cuff repair, Stapedectomy etc.
Grade 4- Day Care Procedures	Bronchoscopy, Circumcision, Dilatation and Curettage etc
Grade 5- Minor Surgeries	Bone Marrow Biopsy, Carpal tunnel release Surgery, Cyst or abscess drainage etc

2. Add On Covers: 

1. Hospital Cash Daily Allowance:
   • The Company will pay 1500/per day for each continuous and completed period of 24 hours of Hospitalization, subject to a maximum period of 30 days during each policy period.
   • If the insured person is admitted in the ICU, then the company will pay Rs. 3000/- for each continuous and completed period of 24 hours hospitalisation, subject to a maximum of 15 days during the policy period.
2. Critical Illness Cover:
   • Survival Period 30 days.
   • Coverage up to Benefit amount of Rs. 1 Lakh.
   • Coverage for 15 critical Illnesses listed below.
     1. Cancer of specified severity
     2. First heart attack – of specified severity
     3. Coma of specified severity
     4. Kidney failure requiring regular dialysis
     5. Stroke resulting in permanent Neurological sequelae
     6. Major organ /Bone marrow transplant
     7. Multiple sclerosis with persisting symptoms
     8. Aplastic Anemia
     9. End stage Lung Disease
     10. End stage Liver failure
     11. Parkinson’s disease
     12. Surgery to Aorta
     13. Alzheimer’s Disease
     14. Primary Pulmonary Hypertension
     15. Major Burns
3. Personal Accident Cover: As part of this Personal Accident cover, the insured person will be entitled for the following coverage.
   1. Death Cover
   2. Permanent Total Disability (PTD) Cover
   3. Permanent Partial Disability (PPD) Cover
   4. Transportation Benefit
   5. Children’s Education Benefit

For additional information of Inclusions refer Bajaj Allianz Surgical Protection brochure and Bajaj Allianz Surgical Protection Plan policy wordings.

Exclusions in Bajaj Allianz Surgical Protection Plan

Exclusions for Surgical Benefit Cover and Hospital Cash Daily Allowance Cover:

• Any treatment undertaken within 90 days of the commencement of the Policy Period.
• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.
• Under the influence of drugs or liquor.
• Any Surgery which is not listed in the Bajaj Allianz Surgical Protection policy wordings.

Exclusions Under Critical Illness Cover:

• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.
• HIV and/or any HIV related illness including AIDS and/or mutant derivatives or variations there of however caused.
• Any critical illness diagnosed within the first 90 days.
• Misuse of intoxicating drugs and/or alcohol.

Exclusions Under Personal Accident Cover:

• Accidental Bodily Injury that You meet with:
  • Suicide, attempted suicide or self-inflicted injury or illness.
  • Under the influence of drugs or liquor.
  • Arising from the insured person(s) committing any breach of law with criminal intent.
  • Participating as the driver, co-driver or passenger of a motor vehicle during racing or trial runs.
  • Arising out of your participation in any naval, military or air force operations.
  • Any curative treatments or interventions that you carry out on your body, etc.
• Consequential losses of any kind or your actual or alleged legal liability.
• Venereal or sexually transmitted diseases,  HIV and/or any HIV related illness including AIDS and/or mutant derivatives or variations there of however caused.
• Pregnancy, resulting childbirth, miscarriage, abortion, or complications arising out of any of these.
• War, civil war, revolution, invasion, act of foreign enemies, Nuclear energy, radiation, etc.,.

For total list of Exclusions refer Bajaj Allianz Surgical Protection brochure and Bajaj Allianz Surgical Protection Plan policy wordings.

Buying Procedure of Bajaj Allianz Surgical Protection Plan

1. Fill the proposal form stating your personal details and health profile completely and accurately.
2. Pre-policy medical examination is required based on age, at their network diagnostic centers and  such tests shall be valid for a maximum period of 30days only.
3. If your proposal is accepted, then the company will issue the Bajaj Allianz Surgical Protection policy.
4. If the policy is issued the company will refund you 100% of the cost of the pre-policy medical examination.

Claim Procedure under Bajaj Allianz Surgical Protection Plan

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 Surgical Protection plan,

Cashless Claims Procedure:

Reimbursement Claims Procedure:

Claims Procedure for Personal Accident Cover:

• If you meet with an accident and injure any part of your body, you or someone claiming on your behalf must inform the company in writing immediately and in any event within 14 days.
• Consult a Doctor and follow the advice and treatment that he recommends.
• If required, you must have Yourself examined by company’s medical advisors.
• You or someone claiming on Your behalf must give the documentation within 30 days of diagnosis as per the claims documents list specified below.

Documents to be submitted for Claims:

Bajaj Allianz Surgical Protection Plan premium calculator

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

Bajaj Allianz Surgical Protection Plan Premium Rates

The below shown premium table is for male upto 50 years. For full and detailed information of  Bajaj Allianz Surgical Protection plan premium rates refer Bajaj Allianz Surgical Protection Brochure and Bajaj Allianz Surgical Protection Policy wordings.

Frequently asked questions (FAQ) of Bajaj Allianz Surgical Protection Plan

 When can I enhance my Sum Insured? 

Sum Insured enhancement will be allowed only at the time of renewals.

Who can be covered as dependants under the Policy?

Under Surgical Protection Plan, you can cover your spouse, your dependent children and dependent parents.

What is meant by Surgery or Surgical Procedure?

Surgery or Surgical Procedure means a manual and/or operative procedure(s) required for the treatment of an illness or injury, correction of deformities and defects, diagnosis and cure of diseases, relief of suffering or prolongation of life, performed in a Hospital by a Medical Practitioner.

Bajaj Allianz Surgical Protection Plan Documents and Forms

Bajaj Allianz Surgical Protection plan brochure

Bajaj Allianz Surgical Protection plan cis

Bajaj Allianz Surgical Protection plan Policy wordings

Bajaj Allianz Surgical Protection plan Proposal form

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