Bajaj Allianz Health Care Supreme

Product Overview

Bajaj Allianz Health Care Supreme Plan is an inpatient hospitalization policy, which provides an access to best medical care and treatment at an affordable rate.
A Health Insurance products degined to cover hospitalization expenses, day care procedures, Ambualnce cover, etc.

Unique Features - Bajaj Allianz Health Care Supreme Plan

• Annual Health preventive Check up/No Claim Discount
• Sum Insured Reinstatement Benefit/Pre Existing Disease covered after 2 years
• Family discount - 5% discount if 2 or more members are insured under a single policy.
• Out Patient Expenses/Physiotherapy Expenses/No Co-Payment
• Pre Hospitalisation expenses- 60 days/Post-Hospitalisation Expenses - 90 days
• Some Organ Specific are Covered after 1 year like Cataracts, ENT disorder etc

Critical Features - Bajaj Allianz Health Care Supreme Plan

• Room Rent:
  Limits imposed towards room and ICU rent expenses
  No Sub limits on room rent and ICU
• Co-Pay:
  Specific % of the admissible claim amount to be borne by the Insured 
  This plan does not have any co-payment clause.
• No Claim Bonus:
  10 % of Basic Sum Insured per year upto a maximum of 50% for each unclaimed year in case opted for (10 % will be reduced on claim).
• Pre-Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer 

1. This plans has a waiting period of 2 years is case of pre-existing diseases.
2. This plans covers maternity expenses after waiting period of 2 years.
3. This plan has 90 days waiting period related to critical illness.

Eligibility Criteria

• Minimum Age of Entry:- Children - 91 days/ Adults - 18 years
• Maximum age of Entry:- No Limit
• Renewal Age:- Life Long Renewal
• Sum Insured:- 
  Supreme Vital - 5 Lakhs, 8 Lakhs, 10 Lakhs
  Supreme Smart - 15 Lakhs, 20 Lakhs, 25 Lakhs, 30 lakhs
• Policy Tenure:- 1 year
• Family Defination:-
  Individual Plan - Self, Spouse, Dependant Children, Dependant Parents
  Family Plan - Self, spouse, dependent childrens.
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Choosen)

Add-Ons

• Ancillary Expenses Benefit: Benefit paid Under Daily Hospitalization Benefit

1. Daily Allowance as specified under the policy, for each continuous and completed 24hrs of hospitlaization, in Non ICU Section. Subject to max of 30 Days during the policy period for Individual Policy & 60 days during the policy period for Family Floater.
2. Two times the Daily Allowance for each continuous and completed 24hrs of Hospitalization in the ICU. Subject to Max of 15 days during the policy period for Individual Policy and 30 days During the policy period for Floater Policy

• Critical Illness Cover: If the insured is diagnosed with listed 15 Critical Illness shall be paid a Lump Sum Benefit.

1. Cancer of specified severity
2. First Heart Attack - of Specified Severity
3. Coma of Specified Severity
4. Kidney Failure Requiring Regular Dialysis
5. Stroke Resulting in Permanent Neurological Sequelae
6. Major Organ/ Bone Marrow Transplant
7. Multiple Sclerosis with Persisting Symtoms
8. Aplastic Anemia
9. End Stage Lung Disease
10. End Stage Liver Failure
11. Parkinson's Disease
12. Surgery of Aorta
13. Alzheimer's Disease
14. Primary Pulmonary Hypertension
15. Major Burns

Waiting Period: Any Critical Illness Diagnosed within first 90 Days from the date of commencement of the policy. 30 Days Survival Period is not applicable

• Personal Accident Cover: In case the insured or family members with an accident will be covered under the policy

1. Death due to Accident - 100% of Sum Insured
2. Permanent Total Disability - Upto 200% of Sum Insured
3. Permanent Partial Disability - As per the disability table provided in the Policy Wordings
4. Temporary Total Disability - Benefits ranging from Rs. 2,000 to Rs. 15,000 per week, for max 100 weeks.
5. Transport of Mortal Remains - Up to Rs. 5,000
6. Children Education Benefit - Up to Rs. 5000 each for 2 children
7. Dependent Spouse, dependent children, dependant parents - Can be covered upto 5 Lacs
8. Temporary Total Disability will not be applicable for Children.
9. Can be opted for maximum 60 times of the average monthly income.

Additional Discounts

• Family Discount: 5% discount if 2 or more family members are covered under a single individual policy.
• Add on Cover Discount: 5% sectional discount on total premium will be applicable under the policy, if all the add-on covers are opted along with the basic cover.
• Claim Free Renewal Discount: If the policy is Claim Free then 5% Discount on the premium will be applicable at the time of Renewal.

Waiting Period

• Covered from Day 1:
  Accidental Injuries.
• Covered after 30 Days:
  All incidences apart from specified surgeries,Permanent exclusion & Pre existing diseases (if any)
• Covered after 1 Year:
  Any Types Of Gastric Or Duodenal Ulcers, Cataracts, Benign Prostatic Hypertrophy, Hernia Of All Types & Hydrocele, All Types Of Sinuses, Fistulae, Fissure In Ano,Haemorrhoids, Dysfunctional Uterine Bleeding,.Fibromyoma,.Endometriosis, Hysterectomy, Stones In The Urinary And Biliary Systems, Surgery For Any Skin Ailment, Surgery On Ears/Tonsils/Adenoids/Parana-Sal Sinuses, Surgery On All Internal Or External Tumours/ Cysts/ Nodules/Polyps Of Any Kind Including Breast Lumps With Exception Of Malignant Tumor Or Growth.
• Covered after 4 Years:
  - Joint replacement surgery
  - Surgery for prolapsed inter vertebral disc (unless necessitated due to an accident)
  - Surgery to correct deviated nasal septum
  - Hypertrophied turbinate 
  - Congenital internal diseases or anomalies
  - Laser treatment for correction of eye sight due to refractive error

Exclusions

• Circumcision unless required for the treatment of illness or accidental bodily injury, cosmetic or aesthetic treatments of any description, treatment or surgery for change of life/gender.
• War or act of war, nuclear, chemical or biological weapon and radiation of any kind.
• Any form of plastic surgery unless necessary for the treatment of cancer, burns or accidental bodily injury
• Convalescence, general debility, rest cure, congenital external diseases or defects or anomalies, genetic disorders, stem cell implantation or surgery, or growth hormone therapy
• Intentional self-injury
• Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction
• Medical expenses relating to any hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations
• Vitamins, tonics, nutritional supplements unless forming part of the treatment for injury or disease as certified by the attending doctor
• Treatment for any other system other than modern medicine (also known as Allopathy). This exclusion is not applicable for Ayurvedic and Homeopathic medicine expenses
• Fertility, sub-fertility, impotence, assisted conception operation or sterilization procedure
• Weight management services and treatment related to weight reduction programs

 

Note: Any claims arising out of or attributable to any of the following is not covered, Please refer policy T & C for detailed list of exclusions.

Tax Benefits

When you pay the premium for your health insurance policy, you are liable to get a tax rebate under section 80D of the Income Tax Act, 1961.

Claim Process

In case you would like to know about the Claim Process or would like to register a Claim please click the link below

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