What is the coverage limit for ambulance charges?

Ambulance charges are covered for up to Rs. 20,000 in a policy year.

What do organ donor expenses cover?

Organ donor expenses cover the cost incurred in harvesting the organ from the donor.

What is convalescence benefit?

Under convalescence benefit, if the insured is hospitalised for 10 days or more, the plan pays a lump sum benefit for recovery. This benefit depends on the sum insured opted. For Silver plan, the benefit amount is Rs. 5000. In Gold plan, the benefit amount is Rs. 5000 for sum insured of up to Rs. 5 Lakh. For higher sum insured levels the benefit amount is Rs. 7500.

How do preventive health check-ups work?

After every 3 policy years the plan allows free health check-ups. The cost of the health check-up should be up to 1% of the sum insured or Rs. 2000 for Silver plan and Rs. 5000 for Gold Plan, whichever is lower. The check-up is allowed for each covered member under the plan.

Are AYUSH treatments covered under the plan?

Yes, treatments taken under Ayurveda, Unani, Siddha and Homeopathy are covered under the Gold plan variant. Maximum coverage for AYUSH treatments is, however, limited to Rs. 20,000 in one policy year.

What are the coverage conditions for maternity treatments?

Coverage for maternity is available only in the Gold plan after a waiting period of 6 years. Expenses are paid for up to two deliveries, normal or Caesarean in nature. The coverage limit for deliveries would depend on the sum insured opted. For coverage up to Rs. 7.5 Lakh, the limit is Rs. 15,000 for normal delivery and Rs. 25,000 for Caesarean. For higher sum insured levels, the limit is Rs. 25,000 for normal and Rs. 35,000 for Caesarean delivery. New born baby cover would also be available if maternity cover is claimed under the plan.

What is the eligibility for availing coverage for bariatric surgery?

Bariatric surgeries would be covered if the insured is 18 years or above. The obesity should be severe in nature. BMI should be 40 or above and the insured should have a coronary heart ailment or medical refractory hypertension or type 2 diabetes mellitus.

Does bariatric surgery have a waiting period?

Yes, a waiting period of 36 months would be applicable for covering bariatric surgeries.

Are medical tests required before buying the policy?

Medical tests are required only if the insured member is aged 45 years and above.

What is the cumulative bonus under the plan?

A cumulative bonus of 10% of the basic sum insured is allowed for each claim-free year up to a maximum increase of up to 100% of the basic sum insured after 10 claim-free years.

Bajaj Allianz Health Guard Individual Insurance Wordings

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Highlights

Claim Settlement Ratio	92.24%
Network Hospitals	7,000+
Starting Premium for Rs. 5 lakhs SI	Rs. 364/month
Pre-existing Disease Waiting Period	2 years

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Bajaj Allianz Health Guard Individual Brochure

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Jun 08, 2019

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Bajaj Allianz Health Insurance Plan List

Name of Plan	Sum Insured
Health Infinity PolicyMin: 3 months; Max: 65 yearsPopular		Check Premium
Silver Health Min: 46 Years; Max: 70 YearsPopular	50 Thousand	Check Premium
Health Guard Family FloaterMin: 3 Months; Max: 65 Years	1.5 Lakh	Check Premium
Star Package Policy Min: 3 months; Max: 65 years	1.5 Lakh -1 Crore	Check Premium
Corona Kavach PolicyMin: 1 day; Max: 65 years	50,000 - 5 lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years	1 Lakh - 5 Lakh	Check Premium
Tax GainMin: 18 Years; Max: 75 Years	1 Lakh	Check Premium
Hospital Cash Daily AllowanceMin: 3 Months; Max: 65 Years	500/day	Check Premium
Health EnsureMin: 3 Months; Max: No Limit	50 Thousand	Check Premium
Premium Personal GuardMin: 5 Years; Max: 65 Years	10 Lakh	Check Premium
Women Specific Critical Illness InsuranceMin: 21 Years; Max: 65 Years	50 Thousand	Check Premium
Health Guard IndividualMin: 18 years; Max: 65 years	1.5 Lakh	Check Premium
Critical Illness PlanMin: 6 Years; Max: 65 Years	1 Lakh	Check Premium
Global Personal GuardMin: 3 months; Max: 70 years	2 Lakh - 25 Lakh	Check Premium

Bajaj Allianz Health Insurance Top Up List

Name of Plan	Sum Insured

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FAQs on Health Guard Individual Health Insurance Plan

What is the coverage limit for ambulance charges?
Ambulance charges are covered for up to Rs. 20,000 in a policy year.
What do organ donor expenses cover?
Organ donor expenses cover the cost incurred in harvesting the organ from the donor.
What is convalescence benefit?
Under convalescence benefit, if the insured is hospitalised for 10 days or more, the plan pays a lump sum benefit for recovery. This benefit depends on the sum insured opted. For Silver plan, the benefit amount is Rs. 5000. In Gold plan, the benefit amount is Rs. 5000 for sum insured of up to Rs. 5 Lakh. For higher sum insured levels the benefit amount is Rs. 7500.
How do preventive health check-ups work?
After every 3 policy years the plan allows free health check-ups. The cost of the health check-up should be up to 1% of the sum insured or Rs. 2000 for Silver plan and Rs. 5000 for Gold Plan, whichever is lower. The check-up is allowed for each covered member under the plan.
Are AYUSH treatments covered under the plan?
Yes, treatments taken under Ayurveda, Unani, Siddha and Homeopathy are covered under the Gold plan variant. Maximum coverage for AYUSH treatments is, however, limited to Rs. 20,000 in one policy year.

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Claim Process at Bajaj Allianz Health Insurance

Network Hospital
Non-Network Hospital

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
3
Claim Processing
Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
4
Claim Settlement
Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation as soon as it occurs and for planned hospitalisation intimate as soon as it occurs prior to admission.
3
Claim Processing
Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
4
Claim Settlement
Once your request for reimbursement of expenses is approved, the claim will be settled.

Bajaj Allianz Health Insurance Contact Details

Reach us for help anytime

Insurance Dekho
755 1196 989Mon to Sun 10:00 AM to 7:00 PM
support@insurancedekho.com
Bajaj Allianz Health Insurance
1800209585824*7
bagichelp@bajajallianz.co.in