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Individual Health Guard

Covering pre and post hospitalisation expenses for you

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Bajaj Allianz' Health Guard policy takes care of your hospitalization expenses and offers a wide coverage of pre and post hospitalisation expenses. Bajaj Allianz is the first insurance company to offer a sum insured of INR 10 lakhs.

features and benefits

FEATURES

You will have cashless facility at over 2300 hospitals across India.

  • You will have cashless facility at over 2300 hospitals across India

  • With Health Guard, you will have access to cashless facility at various empanelled hospitals across India as well

  • Pre and post hospitalization expenses will cover relevant medical expenses incurred for 60 days prior to and 90 days after hospitalisation

  • Covers ambulance charges in an emergency subject to a limit of INR 1000 /-

  • No tests required for members below the age of 45, up to a sum insured of INR 10 lakhs*

  • 10% co- payment applicable if treatment is taken in non-network hospitals

  • 20% co-payment applicable for members of age group 56 -65 years, if they are opting for this policy for the first time

  • Waiver on 10% co-payment is available on payment of additional premium

  • Pre-existing diseases will be covered after 4 years of continuous policy renewal with Bajaj Allianz

*(YES BANK Limited is a corporate insurance agent of Bajaj Allianz General Insurance Company Limited under Corporate Agent's license no.1977696 issued by Insurance Regulatory & Development Authority of India and does not underwrite the risk or acts as an insurer. The insurance is underwritten by Bajaj Allianz General Insurance Company Limited. This policy is issued to you by Bajaj Allianz General Insurance Company Limited and is subject to the terms and conditions governing such policy. The contract of insurance is between Bajaj Allianz General Insurance Company Limited and the insured).

BENEFITS

Our in-house Health Administration Team for hospitalisation claims will lower the turn-around time

  • Our in-house Health Administration Team for hospitalisation claims will lower the turn-around time

  • Access to over 2300 hospitals all over India for cashless facility

  • No sub-limits applicable on room rent and other expenses

  • Hassle-free claim settlement due to in-house claim administration

  • Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per existing IT law

  • Health Check up for maximum amount of INR 1000 /- at the end of 4 continuous claim-free years

  • Family discount of 10% will be applicable

COVERAGE

Sum insured from INR 1 lakh to INR 10 lakhs can be opted for a period of 3 months to 55 years

  • Sum insured from INR 1 lakh to INR 10 lakhs can be opted for a period of 3 months to 55 years

  • Sum insured from INR 1 lakh to INR 5 lakhs can be opted for a period of 56 months to 65 years Policy can be renewed up to 80 years*

  • In built E-opinion cover for sum insured INR 5 lakhs and above.

*(YES BANK Limited is a corporate insurance agent of Bajaj Allianz General Insurance Company Limited under Corporate Agent's license no.1977696 issued by Insurance Regulatory & Development Authority of India and does not underwrite the risk or acts as an insurer. The insurance is underwritten by Bajaj Allianz General Insurance Company Limited. This policy is issued to you by Bajaj Allianz General Insurance Company Limited and is subject to the terms and conditions governing such policy. The contract of insurance is between Bajaj Allianz General Insurance Company Limited and the insured).

Hospital Expenses

  • Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill

  • Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill

  • Doctor's Consultation Charges: Mandatory to provide the doctor's prescription and the doctor's bill and receipt

  • Diagnostic Tests: Mandatory to provide the Doctor's prescription advising tests, the actual test reports and the bill and receipt from the diagnostic centre

  • The claims team would assess the claim for completeness of documentation and admissibility. A written communication would be sent to the insured regarding requirement of documents if any or if the claim is deemed to be inadmissible as per the policy’s terms and conditions

  • In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document

Claim Procedure

The illness/claim should be reported to Bajaj Allianz General Insurance Company Ltd. with an immediate notification by telephone or in writing (email/letter).

  1. The illness/claim should be reported to Bajaj Allianz General Insurance Company Ltd. with an immediate notification by telephone or in writing (email/letter).

  2. On receipt of claim intimation, Bajaj Allianz General Insurance Company Ltd. will forward a claim form and check list for the documents to be submitted by the claimant.

  3. After receiving the claim form the claimant should submit the completed claim form, mentioning the following mandatory details:

    1. Details of the insured (Name/ Address/ Age/ Sex/ Contact No.)

    2. ID card number and the current policy number

    3. Hospitalization details (Date and time of admission and discharge)

    4. Details of other Mediclaim policies in force (if any)

    5. Signature of the claimant

  4. The other relevant documents to be submitted along with the claim form are as follows:

    1. A photocopy of your policy details prior to taking your Health Guard policy from Bajaj Allianz (if applicable)

    2. A photocopy of your present policy document with Bajaj Allianz

    3. First prescription from the doctor

    4. The Claim Form duly signed by the claimant or family member

    5. The Hospital Discharge Card

    6. The Hospital Bill giving a detailed break up of all expense heads mentioned in the bill. (For example - If INR 1,000/- has been charged towards medicines in the bill, the names of the medicines, the unit price and the quantity used should be mentioned. Similarly, if INR 2,000/- has been charged towards Laboratory Investigations, then the names of the investigations, the number of times each investigation has been performed and the rate should be mentioned. In this way clear break-ups have to be mentioned for OT Charges, Doctor's Consultation and Visit Charges, OT Consumables, Transfusions, Room Rent, etc.)

    7. The Money Receipt, duly signed, with a Revenue Stamp

    8. All Original Laboratory and Diagnostic Test Reports, such as X-Ray, E.C.G, USG, MRI Scan, Haemogram etc. (Please note that it is not mandatory to enclose the films or plates; a printed report for each investigation is sufficient)

    9. If the medicines have been purchased in cash and if this has not been reflected in the hospital bill, a prescription from the doctor and the supporting medicine bill from the chemist must be enclosed

    10. If the insured has paid in cash for Diagnostic or Radiology tests and it has not been reflected in the hospital bill, it is mandatory to enclose a prescription from the doctor advising the tests, the actual test reports and the bill from the diagnostic centre for the tests

    11. In case of a Cataract Operation, please enclose the IOL Sticker

Note: Only original documents should be enclosed (except for policy copy), duplicates and/or photocopies will not be entertained.

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