Bajaj Allianz Extra Care Plus Plan

Bajaj Allianz's Extra Care Plus Plan provides additional coverage over and above your current healthcare plan. A sedentary lifestyle coupled with huge medical costs is the crucial driver for us to have an additional health plan in place. This plan comes with affordable premium rates thus making us prepared to manage the expenses arising out of accidents and unforeseen medical emergencies.

This has a wide variety of sum insured options for you to select from and customise it as per your medical needs. It comes with top-up benefits like emergency air ambulance cover, maternity expenses, free medical check-ups and many more.

Key Features and Benefits

• 

  Cashless claim facility

  The plan offers cashless facility through 5500+ registered network hospitals by Bajaj Allianz.

• 

  In-patient hospitalisation expenses

  Bajaj Allianz Extra Care Plus Plan covers in-patient hospital expenses which include:
  • Room rent/boarding and nursing expenses
  • ICU rent/ boarding and nursing expenses
  • Fees of medical practitioner, surgeon, anaesthetist, nurses and specialist Doctor
  • Operation theatre charges, anesthesia, surgical appliances, diagnostic tests, medicines, blood, oxygen and cost of prosthetic and other devices or equipment if implanted internally like pacemaker during a surgical process

• 

  Pre-hospitalisation expenses

  The insurance policy covers medical costs incurred due to an illness or injury 60 days immediately before hospitalisation.

• 

  Post-hospitalisation expenses

  The plan covers the medical costs incurred due to an illness or injury 90 days immediately after hospitalisation.

• 

  Day care procedures

  The plan covers medical expenses as listed in the policy brochure under inpatient hospitalisation treatment cover for day-care procedures/surgeries. The treatment should be taken as an inpatient in a hospital or day-care centre and not in the outpatient department.

• 

  Organ donor expenses

  The policy covers an organ donor's treatment up to the sum insured.

• 

  Emergency road and air ambulance cover

  • The insured under this policy gets ambulance expenses coverage of up to Rs. 3,000. The transportation cost is covered for moving between hospitals in a hospital ambulance or an ambulance provided by any ambulance service provider.
  • The plan covers expenses incurred against an aeroplane or helicopter for rapid ambulance transportation from the site of the first occurrence of the illness/accident to the nearest hospital.

• 

  Maternity and new-born baby cover

  The plan covers maternity and medical expenses of a new-born baby limited to a maximum of two deliveries or termination(s) or either, during the lifetime of the insured person as below:
  
  • Covers medical expenses for maternity including complications of maternity over and above the aggregate deductible limit as specified under the policy schedule.
  • Covers expenses towards lawful medical termination of pregnancy during the policy period.
  • Inpatient hospitalization expenses of pre-natal and post-natal hospitalization.

• 

  Tax benefits

  This plan offers income tax benefit as per Section 80D of the Income Tax Act on the premiums paid for this policy.

Bajaj Allianz Extra Care Plus
Policy Type	Individual/Family Floater
Entry Age	Minimum Entry age for proposer/ spouse/ dependent parents: 18 years Maximum Entry Age for proposer/ spouse/ dependent parents: 80 years Minimum Entry age for dependent Children - 3 months Maximum Entry Age for dependent Children - 25 years
Renewal	Lifetime Renewable For Dependent Children- Renewable up to 35 years
Tenure	One, two and three years
Sum Insured	Rs. 3 lakh - Rs. 50 lakh
Number of members covered	6 members (2 adults +4 children)

Health Insurance helps you to be stress-free while dealing with medical contingencies due to sickness and accidental injuries. The plans are available starting from Rs. 1783, with maximum coverage of Rs. 50 lakh.

• This policy covers only Indian residents.
• This policy can be opted by Non-Resident Indians also, provided the premium is paid in Indian currency and processed in Indian account only.

• To apply for the Bajaj Allianz Extra Care Plus, click on the 'Apply Now' button and fill in your basic and health details. Our representative will get in touch with you to provide further assistance.
• Ensure that the information given in the form is complete and accurate.
• You may be required to undergo a pre-policy medical examination at our network diagnostic centres.
• 100% of the cost of the pre-policy medical examination will be refunded if the policy is issued
• Policy schedule, policy wordings, cashless cards and health guide will be sent to your mailing address.

The following mandatory documents will be needed to purchase the policy:

 

• Photograph of the Applicant
• Age proof such as birth certificate, Voter’s ID, PAN card, passport etc.
• Identity proof such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
• Income Proof such as Form 16, salary slips, employment certificate etc.
• Address proof such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
• Medical Test that the insurer requires you to undergo

Cashless Claims
Cashless treatment is only available at a network hospital registered with Bajaj Allianz. To avail of the cashless treatment, the following procedure must be followed:

• Approach the network hospital with your policy details.
• The hospital will verify the details provided by you and send a pre-authorization form to the insurer.
• The insurer will verify the pre-authorization request and convey the policy coverage and other details to the hospital.

Planned Hospitalization

• Insured member should intimate such admission at least 72 hours before the planned admission.
• Emergency Hospitalization- Insured member or his representative should intimate such admission within 24 hours of such admission.
• The insurer will send you or the network hospital, a pre-authorization letter. The pre-authorization letter, the id card issued to you along with this policy and any other information or documentation that the insurer has specified must be produced to the network hospital identified in the pre-authorization letter at the time of your admission to the same.
• If the procedure above is followed, you will not be required to directly pay for the medical expenses above the aggregate deductible in the network hospital.
• Original bills and evidence of treatment in respect of the same shall be left with the network hospital.

Reimbursement claim

If pre-authorization under cashless claim procedure mentioned above is denied by the insurer or if treatment is taken in a hospital other than a network hospital or if you do not wish to avail the cashless facility, then the following procedure must be followed:

 

• You or someone claiming on your behalf must inform us in writing immediately within 48 hours of hospitalisation
• The hospital all the documents to the insurer
• In the event of the death of the insured person, someone claiming on his behalf must inform the insurer in writing immediately and send a copy of the postmortem report (if any) within 30 days.
• The insurer shall not indemnify you for any period of hospitalisation of fewer than 24 hrs, except for daycare procedures.
• The insurer shall make claim payment in Indian rupees only.

• A consultation letter from the doctor
• Duly completed claim form and NEFT form signed by the claimant
• Original hospital discharge card
• Original hospital bill giving a detailed break up of all expense heads mentioned in the bill with clear break-ups for OT charges, doctor’s consultation and visit charges, OT consumables, transfusions, room rent, etc.
• Original money receipt duly signed with a revenue stamp.
• 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.
• Claim settlement letter from any other insurer (if any) in case of partial settlement
• In cases of suspected fraud/misrepresentation, the insurer may call for any additional document(s) in addition to the documents listed above.
• Aadhar Card & PAN card Copies (Not mandatory if the same is linked with the policy while issuance or in the previous claim)Aadhaar card & pan card copies (not mandatory if the same is linked with the policy while issuance or in the previous claim).

1. Dental treatments and cosmetic surgeries
2. Cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth except for intrinsic fixtures used for orthopaedic treatments such as plates and K-wires.
3. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
4. Medical Expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations
5. Vaccination or inoculation unless forming a part of post-bite treatment or if medically necessary and forming a part of the treatment recommended by the treating doctor.
6. Plastic surgery unless necessary for the treatment of cancer, burns or accidental bodily injury.
7. Treatment for any mental illness or psychiatric illness, Parkinson's disease.
8. Waiting Period:

i. Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered.
ii. Any treatment arising from or traceable to pregnancy, child birth including cesarean section and/or any treatment related to pre and postnatal care and complications arising out of Pregnancy and Childbirth until 12 months continuous period has elapsed since the inception of the first Extra Care Plus with the insurer.
iii. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 12 months of continuous coverage after the date of inception of the first Extra Care Plus policy with the insurer.

Note: Refer to the policy brochure to know further exclusion in details.'

BFL Helpline Number –  08698010101

Bajaj Allianz General Insurance Helpline Number:1800-209-0144 /1800-209-5858

E-mail –  wecare@bajajfinserv.in

Mailing address: Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.

 

*For claim related issues please refer your policy document or certificate of insurance (COI).