Max Bupa Health Companion Plan

Max Bupa Health Companion Plan is your best health companion that secures you and your family from medical expenses arising out of health emergencies, personal accident and critical illness. This plan is the smart choice suited for an individual, couple, nuclear as well as joint families with vast options to select from the sum insured starting from Rs. 3 lakh to Rs. 1 crore. The plan helps you to avail cashless claim facility in just 30 mins in more than 3500+ Max Bupa network hospitals. Overall, this plan is cost-effective and reliable coupled with all the smart features you may want to secure every member of your family against unforeseen medical contingencies.

 

Key Features and Benefits



The key features covered under Max Bupa Health Companion Plan are as follows:

  • Cashless hospitalization

    In times of medical emergencies for you and your family, you need not worry about finances as there would be cashless treatment approval in the hospital within 30 minutes with no third party (TPA) involvement in more than 3500 network hospitals.

  • Day Care Treatments:

    Day-care treatments refer to those medical treatments and procedures that need hospitalization, but not for more than 24-hours, some of the examples of day-care treatments include cataract surgeries, nasal sinus aspiration, cancer chemotherapy, cancer radiotherapy, etc. All the costs incurred such treatments are also covered under the Max Bupa Health Companion Plan.

  • Restore sum insured

    This plan helps you to restore your sum insured if the no claim bonus has been partially or completely exhausted. This benefit helps you to reinstate the entire sum insured in the policy year when it gets exhausted due to incurred claims.

  • Hospital accommodation

    Get coverage for all hospital accommodations except suite & above room category without any room rent capping under this policy.

  • Pre and post hospitalization

    You will also get the Pre-hospitalization and Post-hospitalization cover in this plan. All the expenses are done in 30 days before hospitalizing and 60 days after discharge are covered in the Health Companion Plan.

  • OPD expense cover

    The plan covers OPD treatment charges for vaccinations and immunizations after an animal bite and the cover ranges from Rs. 2500 to Rs. 7500 depending on which variant of the plan selected.

  • Domiciliary cover:

    If in case, you are not hospitalized, and all your treatments are done at home then all those expenses are also covered in this plan. Some individuals prefer their treatment to be done at home rather than in a hospital. On the other hand, some doctors also advise staying at home for the treatment.

  • Organ donor expenses

    Medical Expenses incurred for an organ donor’s treatment for the harvesting of the organ donated will be covered under the policy.

  • Emergency ambulance

    The policy covers ambulance expenses needed to transfer the insured following an emergency to the nearest hospital. These expenses are paid up to Rs. 1,500 per hospitalization only if the insurer has accepted the in-patient claim.

  • AYUSH treatment cover

    You will also get a cover for the in-patient treatment under the AYUSH treatment. AYUSH stands for Ayurveda, Unani, Siddha, and Homeopathy treatments, and maximum cover would be up to the maximum amount of the Sum Assured.

  • Organ donor expenses

    Get the benefit of a free-look period of 15 days and if you still feel this plan isn’t suitable for you then you are free to return the policy within 15 days from the date of inception of the policy.

  • Critical illness cover

    If you are diagnosed with any kind of critical illness like cancer, kidney failure, and many more all are covered under this plan.

  • Tax Benefit:

    Save tax under Section 80D of the Income Tax Act when you buy a Max Bupa Health Companion Insurance policy.

Policy Details

Max Bupa Health Companion Plan
Policy Type Individual/ Family Floater
Entry Age Minimum Entry Age: 91days
Maximum Entry Age: No age limit
Renewal Lifetime Renewable
Tenure One and two years
Sum Insured Rs. 21 lakh
Starting Premium (including all taxes) Rs. 5,066 (Pune), Rs. 5,527 (Delhi)
Policy Variants
  • Individual/ Family Floater (Rs. 2 lakh, Rs. 3 lakh, Rs. 4 lakh
  • Individual/ Family Floater (Rs. 5 lakh, Rs. 7.5 lakh, Rs. 10 lakh, Rs. 12.5 lakhs
  • Family First Plan (Rs. 15 lakhs – Rs. 1 crore)

Plans Available

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. 5066 (Pune) and Rs. 5527(Delhi) including all taxes, with maximum coverage of Rs. 21 lakhs

How to Purchase the Policy

In order to purchase the policy, follow these steps:

  • To apply for the product, click on 'Apply Now' and fill in the necessary details
  • Make the fee payment online using your preferred mode of payment
  • Fill in your name and mobile number
  • Complete the process by clicking 'Buy Now', you can also request a call back

List of Documents Required for purchasing the policy

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

How to Process the Claims

Cashless Claims

  • With the Max Bupa Health Companion Plan, you can avail the benefit of cashless treatment with our 5000+ network hospitals by following the following process:
  • Get admitted to any one of Max Bupa network hospitals.
  • Use your Max Bupa Health Card or share your policy number with the concerned team at a hospital along with your Passport/PAN card/ Voter’s ID as identification proof.
  • Now, the network hospital will verify your identity for validation and submit the pre-authorization request to the insurer
  • After validation, the insurer will review and provide their confirmation to the network hospital by fax and email. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing of the claim request.
  • The only activity left to do now is the final settlement of your claim (as per policy terms & conditions) with the hospital after completion of all the necessary formalities

Reimbursement claim:

  • If you get hospitalized, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay the amount directly to the hospital you are in.
  • After you are discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports and discharge certificate with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
  • Send all the documents to the insurer which should be filled and signed the claim form. Send your valid ID proof and age proof as well.
  • After receiving your documents, the insurer will review your claim request and accordingly will give our approval, raise a query or reject the same (as per policy terms & conditions)
  • Finally, the insurer will settle the claim (as per policy terms & conditions) and reimburse the approved amount.

Documents Required for Reimbursing Claims

Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital

 
  • Original investigation reports
  • Final hospital discharge summary FIR or post-mortem report if happened
  • Pharmacy bills along with the prescription
  • Cancelled cheque or NEFT details for payment
  • Original bills, receipts, and discharge report
  • Indoor case papers and duly filled claim form
  • Original hospital bills and a valid photo ID proof Treating doctor's report
  • Original consultation notes Nature of operation performed and surgeon's bill and receipt
  • Test reports along with attending doctor’s or surgeon’s report.

Major Policy Exclusions

  1. Dental treatments and cosmetic surgeries
  2. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  3. Circumcision unless required for the treatment of Illness or accidental bodily injury.
  4. Breach of law with Criminal Intent, intentional self-injury.
  5. Cosmetic, aesthetic and re-shaping treatments & surgeries.
  6. Psychiatric or psychological disorders, mental disorders.
  7. Ailment wise capping and ambulance charges.
  8. Hearing aids, spectacles or contact lenses including optometric therapy.Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
  9. Miscarriage, Abortion and C-section deliveries Sexually transmitted diseases such as AIDS and HIV.
  10. Waiting Period: The insurer will not cover any treatment during the first 30 days since the commencement of the policy, unless the treatment needed is the result of an accident.
  11. Refer the policy document to know more exclusions in detail

Claim/Assistance Contact Details

BFL Helpline Number:  08698010101

Max Bupa Helpline Number:   1860-500-1000

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).

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, Oriental Insurance Company 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 MaxBupa Health Companion UIN no MAXHLIP21509V042021. 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