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Fracture Care

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A fracture occurs when the bone's continuity is disrupted. A bad fall or a car crash is the leading cause of fractures. Healthy bones are tough and durable, and they can withstand a lot of force. Fractures become more common as people age due to two factors: weakened bones and a higher risk of falling. It affects more children than adults, who lead more physically active lives. People with underlying illnesses or disorders that weaken their bones are more prone to fractures. Examples include osteoporosis, infection, or a tumour. Fracture care plan by EBH, provides benefits by reducing the money spent on Lab Test Packages, Doctor consultation benefit and Network discounts.

Plan Details

Fracture Care Essential Classic
Lab and Radiology benefit
(Open Market - Reimbursement)
Benefits up to Membership fee Benefits up to Membership fee
Benefit amount Rs. 2000
Rs. 999
Rs. 3000
Rs. 1,999
OPD/DOCTOR Consultation Benefit
(Open Market)
Rs.500
Rs.1000
General Physician/Orthopaedic/ Dietician
Network Discounts (Prime Network) - 10% Discount on Pharmacy, Doctor Consultation, lab & radiology, Discount on health plans & packages, Dental Procedures - 5% Discount on IPD room rent, & Spectacles - Free Ambulance for IPD admissions

What's covered

  • Money-in-bank

    Lab and Radiology Benefit

    Lab and radiology benefit refers and involves the utilization of any pathology or radiology tests upto the benefit amount. Here are the benefits you can avail:
    - Take any pathology or radiology test of choice from any lab/radiology center and get reimbursed up to the benefit amount. Lab or Radiology invoice with the amount, consumption date, and stamp should be clearly visible on the uploaded invoice for approval.
    - This benefit can be availed by all members listed under the policy.
    - The benefit amount can be claimed in a single visit or spread over multiple pathology or radiology tests to the extent of the value of benefits.

  • Money-in-bank

    OPD/Doctor Consultation Benefit

    Doctor consultation benefit refers and involves consultation with a doctor with a minimum degree of MBBS, BDS, BAMS, or BHMS up to the benefit amount mentioned under plan details. In case any specific doctor/medical speciality is offered under the plan,you can consult with doctor/specialist of that specific speciality. In case no speciality is mentioned, you can consult any doctor of your choice. Here are some of the benefits that you can avail.
    - Consult with a doctor of your choice subject to a minimum degree of MBBS, BDS, BAMS, and BHMS (allopathic, dental, homeopathic, and ayurvedic dental) as per the doctor speciality offered in the plan. Submit the invoice for reimbursement. The invoice should clearly state doctor consultation fees, doctor name and speciality, doctor registration number, date of consultation, doctor stamp, and customer details for reimbursement.  
    - This benefit can be availed by all members listed under the policy.
    - The benefit amount can be claimed in a single visit or spread over multiple visits for doctor consultations to the extent of the value of benefits.

  • Money-in-bank

    Network discounts

    Discounts are offered on healthcare expenses within the Bajaj Finserv Health Prime network. Here is the list of discounts.

    1. OPD Consultation Discount: 10%
    2. Lab & Radiology Discount: 10%
    3. Health Plans & Packages Discount: 10%
    4. Pharmacy Discount: 10%
    5. Spectacle Discounts: 10%
    6. Dental Procedure Discounts: 10%
    7. Room Rent Discount: 5%
    8. Free Ambulance for IPD Admissions

    Note:
    - Network Discounts are applicable only at the Bajaj Finserv Health Prime network. Please note that all network discounts may not be applicable at all Bajaj Finserv Health Prime networks.
    - Network discounts can be utilized multiple times (unlimited) with no capping on the maximum discount that can be availed by the customer.

What is Not Covered / Exclusions

Exclusions under Lab And Radiology Benefit

  • Reimbursements will not be made for any diagnostic procedures undertaken by the doctor
  • Benefit is not transferrable to anyone else, even to family members if not covered under the policy
  • No carry forward of any un-availed benefit is allowed, even on re-purchase of benefit after the expiry of 1 year
  • Benefit is not redeemable against cash
  • Lab and Radiology benefit cannot be clubbed with any other benefit

Exclusions Under OPD/Doctor Consultation Benefit

  • Reimbursements will not be made for any medical procedures undertaken
  • Benefit is not transferrable to anyone else, even to family members if not covered under the policy
  • No carry forward of any un-availed benefit is allowed, even on re-purchase of benefit after the expiry of 1 year
  • Benefit is not redeemable against cash
  • Doctor consultation benefit cannot be clubbed with any other benefit

Exclusions To Availing Network Discounts

  • Network Discounts cannot be clubbed with any other benefits
  • Network discounts cannot be utilized outside the Bajaj Finserv Health Prime network

How to Apply

Click on ‘Apply Now’ button and share your basic details in the online application form

Check and confirm your application by entering the OTP received on your mobile number

Pay the premium via credit/debit card, UPI, mobile wallet, or any other available online payment mode

You will receive the details of your membership via email/WhatsApp

Claim Process

Doctor Consultation Benefit/Lab and Radiology Benefit

Reimbursement claims for Doctor Consultation Benefit or Lab and Radiology benefit can be raised in following three ways:

  • Bajaj Finserv Health App
  1. Download the Bajaj Finserv Health app
  2. Sign-up using the registered mobile number
  3. Under my “Health Plans”, select the purchased plan
  4. Select ‘Doctor Consultation’/‘lab & radiology benefit’
  5. Enter necessary details and upload the invoice
  6. Share bank account details and upload a canceled cheque
  7. Submit the claim
  8. The claim will be reimbursed within 48 working hours directly in the bank account

 

  • Bajaj Finserv Health Website
  1. Sign-up on the Bajaj Finserv Health website
  2. Under my “Health Plans”, select the Purchased plan
  3. Select ‘Doctor Consultation’/‘lab & radiology benefit’
  4. Enter necessary details and upload the invoice
  5. Share bank account details and upload a canceled cheque
  6. Submit the claim
  7. The claim will be reimbursed within 48 working hours directly into the bank account

 

  • Emailing to Customer Service
  1. Email to customercare@bajajfinservhealth.in
  2. Attach a scanned copy of the invoice with all details clearly visible
  3. Mention details like hospital/lab name, patient name, and bill amount
  4. Share bank details (account number, bank name, IFSC, primary account holder name) and upload a canceled a cancelled cheque
  5. The claim will be reimbursed within 48 hours directly into the bank account

 

Teleconsultation benefit

Cashless claims for Teleconsultation benefit can be raised nd availed in below two ways:

  • Bajaj Finserv Health App
  1. Download the Bajaj Finserv Health app
  2. Sign-up using the registered mobile number
  3. Under my “Health Plans”, select the Purchased plan
  4. Select teleconsult benefit option
  5. Select the doctor of choice from the doctor list
  6. Select the date and time of choice
  7. Submit
  8. The customer will receive the link to join the call 15 mins before the consultation
  9. The doctor will join the call on scheduled day and time

 

  • Bajaj Finserv Health Website
  1. Start by visiting bajajfinservhealth.in website
  2. Sign-up using the registered mobile number
  3. Under my “Health Plans”, select the Purchased plan
  4. Select teleconsult benefit option
  5. Select the doctor of choice from the doctor list
  6. Select the date and time of choice
  7. Submit
  8. The customer will receive the link to join the call 15 mins before the consultation
  9. The doctor will join the call on scheduled day and time

 

Lab Test Package (Prime Network Only)

Cashless claims for Lab test package can be availed in below three ways.

  • Bajaj Finserv Health App
  1. Download the Bajaj Finserv Health app
  2. Sign-up using the registered mobile number
  3. Under my “Health Plans”, select the Purchased plan
  4. Select Lab test package benefit option
  5. Select the hospital/lab of choice
  6. Enter the date of redemption and confirm
  7. SMS with voucher link shared on the registered mobile number
  8. Share the voucher code to avail cashless Lab test package benefit

 

  • Bajaj Finserv Health Website
  1. Start by visiting bajajfinservhealth.in website
  2. Sign-up using the registered mobile number
  3. Under my “Health Plans”, select the Purchased plan
  4. Select Lab test package benefit option
  5. Select the hospital/lab of choice
  6. Enter the date of redemption and confirm
  7. SMS with voucher link shared on the registered mobile number
  8. Share the voucher code to avail cashless lab test package benefit

 

  • Emailing to Customer Service
  1. Email to customercare@bajajfinservhealth.in
  2. Mention details like hospital/lab name, customer name, and date
  3. The customer care executive will call to confirm the customer’s identity using OTP
  4. SMS with voucher link shared on the registered mobile number
  5. Share the voucher code to avail cashless Lab test packages

 

Network Discounts

Network discounts can be availed in Bajaj Finserv Health Prime network in the following ways:

  • Visit and avail health services in any of the Prime network hospital or lab
  • Mention the health prime Network benefit and registered mobile number with the billing executive
  • Share the OTP with the executive to avail upto 10% discounts basis services utilized at the network hospital/lab

Contact Us

In case you have any queries about coverage, exclusions, or claims, please write to us at wecareinsurance@bizsupportc.com.

Disclaimer - Conditions apply. This product is offered under the Group Insurance scheme wherein Bajaj Finance Limited is the Master policyholder. The insurance coverage is provided by our partner Insurance Company. Bajaj Finance Limited does not underwrite the risk. IRDAI Corporate Agency Registration Number CA0101. The above-mentioned benefits and premium amount are subject to various factors such as age of insured, lifestyle habits, health, etc (if applicable). BFL does NOT hold any responsibility for the issuance, quality, serviceability, maintenance and any claims post sale. This product provides insurance coverage under ManipalCignaFlexiCare Group Insurance Policy, UIN: MCIHLGP20120V011920. Purchase of this product is purely voluntary in nature. BFL does not compel any of its customers to mandatorily purchase any third-party products.

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