Bajaj Allianz Health Guard Insurance Plan

Bajaj Allianz's Health Guard is a holistic health insurance policy that covers the treatment expenses incurred during hospitalisation resulting from serious illness or accident. The policy offers comprehensive benefits at an affordable price that suits all your needs. It helps you stay financially prepared for any medical emergencies. There are two plans covered in this policy, the silver and gold plan.

Key Features And Benefits

Here are the key features and benefits under the policy:

  • In-patient hospitalisation expenses

    The policy covers in-patient hospitalisation expenses if you are hospitalised on the advice of a doctor, as defined under the policy. The need for hospitalisation is because of illness or accidental bodily injury sustained or contracted during the policy period.

  • Pre-hospitalisation expenses

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

  • Post-hospitalisation expenses

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

  • Daily cash benefit for accompanying an insured child

    Avail of daily cash benefit of Rs. 500 for up to 10 days as accommodation charges, under each policy year. The coverage is offered for in-patient hospitalisation treatment. It is applicable on policies with a term of more than one year.

  • Sum insured reinstatement benefit

    The policy offers 100% reinstatement on the sum insured if the in-patient hospitalisation treatment cover gets exhausted during the policy term.

  • Preventive health check-up

    The policy offers free health check-up after the completion of three policy years. The insurer will reimburse the amount equal to 1% of the sum insured of up to Rs. 2,000 for each member in the individual policy, during the block of three years. You may call the insurer on the toll-free numbers: 08698010101/1800-209-0144/1800-209-5858 for the arrangement of the health check-up.

  • Ayurvedic/homeopathic hospitalisation expenses

    The policy covers ayurvedic/homeopathic hospitalisation treatment expenses for more than 24-hour in-patient hospitalisation to a maximum of Rs. 20,000 per policy term.

  • Day care procedures

    Get coverage for medical expenses as listed in the policy brochure under in-patient hospitalisation treatment cover for day-care procedures/surgeries taken as an inpatient in a hospital or day care centre but not in the outpatient department.

  • Convalescence benefit

    The insured can avail of Rs. 5,000 per policy year in the event of hospitalisation for treatment of a disease/illness/injury. The coverage is given for hospitalisation of a continuous period that exceeds 10 days, provided the hospitalisation claim is accepted under inpatient.

  • Organ donor expenses

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

  • Emergency road ambulance cover

    The policy offers ambulance expenses up to Rs. 20,000 during the policy period.

  • Maternity_New-born baby cover_image

    Maternity and new-born baby cover

    Get coverage for maternity and medical expenses of a new-born baby.

  • Tax benefits

    Get income tax benefit as per section 80D of the Income Tax Act for the premium paid towards this policy.

Policy Details

Here are the details of the policy:

Bajaj Allianz Health Guard Insurance Plan
Policy type Individual (self only)/family floater
Entry age Children – 18 years
Adults – 65 years
Renewal Lifetime renewable
For dependent children- renewable up to 35 years
Policy term One, two and three years
Sum insured Health Guard–Silver plan: Rs. 1.5 lakh and Rs. 2 lakh
Health Guard–Gold plan: Rs. 3 lakh- Rs .50 lakh

Plans Available

The plans are available starting from Rs. 2,973 and offers a maximum coverage of Rs. 50 lakh.

How To Purchase The Policy

Here are the steps to purchase the policy:

  • To apply for the policy, click on the 'Apply Now' button and fill in your basic and health details. The insurer’s representative will get in touch with you to provide further assistance.
  • Ensure that the information given in the form is complete and accurate.
  • Make the fee payment online using your preferred mode of payment
  • Complete the process by clicking 'Buy Now', you can also request for a call back

Note:
  • You may be required to undergo a pre-policy medical examination at the insurer’s network diagnostic centre.
  • 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.

How To Process A Claim

Here how you can process a claim:

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-authorisation form to the insurer.
  • The insurer will verify the pre-authorisation request and convey the policy coverage and other details to the hospital.

Planned hospitalisation

  • Insured member should intimate the insurer at least 72 hours before the planned admission to a hospital.
  • In case of emergency hospitalisation, the insured or his/her representative should intimate the insurer within 24 hours of admission.
  • The insurer will send you or the network hospital a pre-authorisation letter. The pre-authorisation letter, ID card issued to you along with this policy and any other information or documentation specified by the insurer must be produced to the network hospital identified in the pre-authorisation letter at the time of your admission.
  • If the above procedure 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, until the claim is settled.

Reimbursement claims

If pre-authorisation under cashless claim procedure mentioned above is denied by the insurer or if treatment at a non-network hospital or if you do not wish to avail of the cashless facility, then the following procedure must be followed:

  • You or someone claiming on your behalf must inform the insurer in writing immediately within 48 hours of hospitalisation.
  • Provide all the hospital documents to the insurer.
  • In the event of insured person’s death, someone claiming on his/her behalf must inform the insurer in writing immediately and send a copy of the post-mortem report (if any) within 30 days.
  • The insurer will not compensate for any period of hospitalisation which is less than 24 hours, except for daycare procedures.
  • The insurer shall make the claim payment in Indian rupees only.

List Of Documents Required For Claim

Here are the mandatory documents required to raise a claim:

  • Claim form with NEFT details and cancelled cheque duly signed by the insured
  • Original/attested copies of discharge summary/discharge certificate/death summary with surgical and anaesthetics notes
  • Attested copies of indoor case papers
  • Original/attested copies of final hospital bill with the breakup of surgical charges, surgeon's fees, or charges etc.
  • Original paid receipt against the final hospital bill
  • Original bills towards investigations done/laboratory bills
  • Original/attested copies of investigation reports against investigations done
  • Original bills and receipts paid for transportation from the registered ambulance service provider
  • Treating doctor certificate to transfer the injured person to a higher medical centre for further treatment (if applicable)
  • First consultation letter for the current ailment
  • In case of implant surgery, invoice and sticker
  • Aadhaar card and PAN card copies (not mandatory if the same is linked with the policy while issuance or in the previous claim)

Major Policy Exclusions

Here are some of the exclusions under the policy:

  1. Treatment for ailments suffered due to use or abuse of any substance, drug or alcohol and treatment for de-addiction
  2. Dental treatments and cosmetic surgeries
  3. Human Immunodeficiency Virus (HIV) or variant/mutant viruses or any syndrome/condition of a similar kind also known as AIDS
  4. Plastic surgery unless necessary for the treatment of cancer, burns or accidental bodily injury
  5. Treatment for any mental illness or psychiatric illness, Parkinson's disease
  6. 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
    1. Waiting Period

      Here’s the waiting period to seek benefits for the following conditions:

      • Bariatric surgery cover is subject to a waiting period of 36 months from the date of first commencement of this policy
      • For maternity expenses, the waiting period is 72 months from the date of issuance of the first policy
      • Pre-existing condition, ailment or injury have a waiting period of 36 months of continuous coverage, after the date of inception of the first health guard policy

      Note: Refer to the policy brochure to know further exclusions in detail.

Claim/Assistance Contact Details

For claim/assistance, you can contact the insurer/us through one of the following ways:

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 to your policy document or Certificate of Insurance (COI).

Bajaj Allianz Health Guard Frequently Asked Question (FAQs)

Q. What are the sum insured options available in Bajaj Allianz Health Guard Policy?

There are multiple sum insured options in Bajaj Allianz Health Guard Policy. The sum insured options offered under the Silver Plan are Rs. 1.5 lakh and Rs. 2 lakh. Health Guard Gold Plan offers sum insured starting from Rs. 3 up to Rs. 50 lakh, as per the policy chosen.

Q. What is the entry age for Bajaj Allianz Health Guard Policy?

The entry age for Bajaj Allianz Health Guard Policy is 18 to 65 years for proposer, spouse, parents, sister, brother, father-in-law, mother-in-law, aunt, or uncle. It is 3 months to 30 years for dependent children/grandchildren.

Q. What does the Bajaj Allianz Health Guard Silver Plan cover?

Bajaj Allianz Health Guard Silver Plan is designed to suit all the healthcare needs of a family. This plan covers the following benefits:
• In-patient hospitalisation treatment
• Pre-and post-hospitalisation expenses
• Road ambulance charges
• Day care procedures
• Cost of organ donation
• Benefits of recuperation
• Daily monetary benefits for accompanying a child who is covered
• Sum insured reinstatement benefit
• Health check-ups as a preventative measure

Q. What does the Bajaj Allianz Health Guard Gold Plan cover?

Bajaj Allianz Health Guard Gold Plan offers coverage for the following benefits:
1. In-patient hospitalisation treatment
2. Pre-and post-hospitalisation expenses
3. Road ambulance charges
4. Day care procedures
5. Expenses of organ donors
6. Benefits of recuperation
7. Daily cash benefit
8. Sum insured reinstatement benefit
9. Preventive health check-up
10. Expenses for ayurvedic/homeopathic hospitalisation
11. Maternity expenses
12. New born baby cover
13. Bariatric surgery cover

Q. What is the policy term under this plan?

Bajaj Allianz Health Guard Policy can be purchased for a term of one/two/three years. It is a comprehensive plan that covers medical treatment costs incurred while in the hospital as a result of a major sickness or accident. This policy covers the policyholder, his or her spouse, and up to four dependent children. For parents and in-laws, a separate policy can be purchased.

Disclaimer

Bajaj Finance Limited (BFL) is a registered corporate agent of third-party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, Tata AIG General Insurance Company Limited, ACKO General Insurance Limited, Max Bupa Health Insurance Company Limited, Aditya Birla Health Insurance Company Limited, and Manipal Cigna Health Insurance Company Limited under the IRDAI composite registration number CA0101.

Please note that BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely voluntary after you exercise independent due diligence on the suitability, viability of any insurance product. Any decision to purchase an insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. This product provides insurance coverage under Bajaj Allianz Health Guard Policy, UIN: BAJHLIP21227V042021. Please refer insurer's website for policy wordings. For more details on risk factors, terms and conditions, and exclusions please read the product sales brochure carefully before concluding a sale.

Tax benefits applicable if any will be as per the prevailing tax laws. Tax laws are subject to change. BFL does not provide tax/investment advisory services.  Please consult your advisors before proceeding to purchase an insurance product.