Bajaj Allianz Extra Care- Eligibility, Features & Exclusions

Updated: 15-01-2024 07:21:15 AM

Medical costs are rising and chances are high that an individual’s existing health plan may not suffice to bear the additional expenses due to sudden illness or accident. In that case, extra care policy by Bajaj Allianz can take care of all the additional medical expenses. As the expenses of hospitalisation are increasing day by day, an individual may find that their base health plan is no longer enough for their needs. An accident or a serious illness can require complicated treatment and long-term medical attention that can easily exhaust any health cover. Bajaj Allianz Extra Care plan extends the existing health plan and ensures that the policyholder will have adequate financial support to cover the medical expenses. This plan is designed to help people secure their future without worrying about the money.

Eligibility Criteria for Bajaj Allianz Extra Care

The health insurance plan offered by Bajaj Allianz for extra care and protection has the following eligibility criteria:

• Entry age for the proposer is 18 years to 70 years
• Children from 3 months to 5 years of age can also be covered if their parents are covered or insured with the insurer
• Children from 6 years to 18 years of age can be covered if one of the parents either father or month is covered or insured with the insurer
• Children from 18 years to 25 years of age can also be covered if their parents are covered under separate policies
• Dependent parents can be under the plan, but the separate policy would be issued
• The proposer or the primary member of the policy can cover self, their spouse and maximum 3 children
• The plan has lifetime renewal

Features and Benefits of Bajaj Allianz Extra Care Policy 

The health insurance plan by Bajaj Allianz offers an extensive range of special features along with a number of benefits. Some of them are listed below:

Bajaj Allianz Extra Care Policy	Features and Benefits
Coverage to Medical Expenses	The health plan for extra cover or care provided by Bajaj Allianz is designed to provide coverage to medical expense up to the sum insured.
Sum Insured Options	Extra care plan by Bajaj Allianz offers multiple options of sum insured to choose from. The options available are Rs. 10 lakhs, Rs. 12 lakhs and Rs. 15 lakhs.
Pre-Hospitalisation and Post-Hospitalisation	The plan provides the policyholder with pre and post-hospitalisation cover for 60 and 90 days respectively.
Ambulance Charges	Amount paid towards the services of an ambulance during an emergency can be reimbursed. The limit for such expenses is up to Rs. 3,000.
Floater Policy	This plan is a floater policy that can be purchased for self, spouse and up to 3 children on a single sum insured.
No Pre-Acceptance Medical Check-Ups	There is no need to undergo for pre-acceptance medical examination and health check-ups the proposers up to 55 years of age. However, this benefit is a subject to a clean proposal form and medical background.
Waiver for Pre-Existing Conditions	The plan comes with the 4 years of waiting period for the coverage of pre-existing illnesses, diseases and conditions.
Income Tax Benefits	The health plan by Bajaj Allianz provides the policyholder with certain tax benefits on the premiums paid towards the plan. These benefits are provided under Section 80D of the Income Tax Act. Section 80C benefits are no provided under the plan.
Affordable Premiums	The insurance plan has affordable premium rates starting from Rs. 2,500

Deductible under Bajaj Allianz Extra Care Policy

Deductible means the amount mentioned in the policy schedule which will be borne by the policyholder with respect to every hospitalisation claim incurred within or throughout the policy term. The liability of the insurer is to make the payment for every claim under the plan is in excess of the deductibles. Each hospitalisation would be considered by the insurer as a separate claim, however, certain terms and conditions would be applicable.

Look at the following deductible table for more:

Sum Insured Amount	Deductible Amount
Rs. 10 lakhs	Rs. 3 lakhs
Rs. 12 lakhs	Rs. 4 lakhs
Rs. 15 lakhs	Rs. 5 lakhs

Annual Premium under Bajaj Allianz Extra Care Policy

The breakup of premium for this plan has been given here:

PLAN A
Sum Insured and Deductibles	Number of Members	90 Days-40 Years	41-60 Years	61 Years and Above
Rs. 10 lakh and Rs. 3 lakh	1	Rs. 2,500	Rs. 3,750	Rs. 5,900
	2	Rs. 3,500	Rs. 5,250	Rs. 8,100
	3	Rs. 4,025	Rs. 6,038	Rs. 9,255
	4	Rs. 4,430	Rs. 6,645	Rs. 10,145
	5	Rs. 4,870	Rs. 7,305	Rs. 11,114

 

PLAN B
Sum Insured and Deductibles	Number of Members	90 Days-40 Years	41-60 Years	61 Years and Above
Rs. 12 lakh and Rs. 4 lakh	1	Rs. 4,500	Rs. 5,500	Rs. 7,900
	2	Rs. 5,850	Rs. 7,150	Rs. 10,150
	3	Rs. 6,435	Rs. 7,865	Rs. 11,125
	4	Rs. 7,080	Rs. 8,655	Rs. 12,200
	5	Rs. 7,645	Rs. 9,345	Rs. 13,145
PLAN C
Sum Insured and Deductibles	Number of Members	90 Days-40 Years	41-60 Years	61 Years and Above
Rs. 15 lakh and Rs. 5 lakh	1	Rs. 4,750	Rs. 5,750	Rs. 8,150
	2	Rs. 6,175	Rs. 7,475	Rs. 10,475
	3	Rs. 6,795	Rs. 8,225	Rs. 11,485
	4	Rs. 7,475	Rs. 9,045	Rs. 12,595
	5	Rs. 8,070	Rs. 9,770	Rs. 13,570

Also Read: Bajaj Allianz Extra Care Plus Policy

Exclusions under Bajaj Allianz Extra Care Policy

This plan comes with the following general exclusions:

• Act of terrorism or foreign enemies, invasion, war (whether declared or not), hostilities, civil war, unrest, commotion, revolution, rebellion, usurped power or military, insurrection, nationalisation or confiscation or requisition of or damage by (or under the order of) any public authority or government and claims due to any sort of nuclear material or/ and weapon
• Aesthetic treatments, cosmetic or plastic surgery (unless mandatory for the treatment of accidental bodily injury or illness), laser treatment (for the correction of eye sights), gender change surgery
• Expenses incurred due to the purchase of contact lenses, spectacles, crutches, hearing aids, dentures, artificial teeth, artificial limbs and other types of external equipments/ devices used as post hospitalisation
• Dental surgery or treatment expenses (unless caused by an accidental bodily injury)
• General ability, convalescences, congenital diseases or anomalies or defects and rest cure
• Intentional self-harm, attempted suicide or suicide including but not restricted to the misuse or use of any sort of intoxicating drug or alcohol
• Human Immunodeficiency viruses or mutant/variant viruses and HIV/AIDS, sexually transmitted diseases or venereal diseases
• Hospitalisation specifically and primarily for x-ray, diagnostic or lab investigations and examinations
• Treatment expenses arising out of or from pregnancy, childbirth and related complications excluding ectopic pregnancy
• Inoculation or vaccination (unless forming as a part of post animal bite treatment)
• Tonics, vitamins and nutritional supplements (unless forming as a part of the treatment of an injury, disease or condition by the doctor)
• Any kind of treatment related to sub-fertility, infertility and assisted sterilisation and conception procedures
• Medical expenses incurred due to alternate treatment options such as Ayurvedic, Homeopathy, Unani, etc. and unproven, non-standard and experimental treatments
• Expenses incurred due to donor screening, treatment including organ removal and transplantation
• Surgery or treatment to correct hypertrophied turbinates and deviated septum
• Medical expenses incurred due to the treatment of any psychotic or mental illness
• Weight reduction programmes, weight management treatment including obesity treatment are not covered.

Filing Claims with Bajaj Allianz Extra Care Policy

Making claims for Bajaj Allianz Extra Care policy is quite an easy process. The following are the steps to follow:

For Empanelled Hospitals	For Non-Empanelled Hospitals
· Inform the insurer and get admitted in one of the network hospitals · Show ID proof along with health card issued by Bajaj Allianz to avail cashless facility · The hospital will send all the details received to the insurer for authorisation · Submit the documents required for the claim process	· Immediately inform the insurer and get admitted in any hospital across the country · Pay all the expenses incurred due to the treatment · Collect all the documents including bills, receipts, prescriptions and discharge certificate · Fill out the claim form and send it along with the documents requested for the process

Renewal Process

Under this plan, policyholders are provided with lifetime renewal option until and unless they are not engaged in any kind of frauds, misrepresentation or moral hazard.

Surrender of policy

For surrendering policy, policyholders should give at least 15 days notice in written form to the company. In case where no claims have been made, company will refund the premium amount at short term rates for the unexpired policy period.

Contact Details

The following are the contact details of Bajaj Allianz:

Call (For Sales and Renewal): 1800-209-0144

Call (For Service): 1800-209-5858/1800-102-5858/020-30305858

Email: customercare@bajajallianz.co.in

Website: bajajallianz.com

Address:
Bajaj Allianz General Insurance Company Ltd.

Bajaj Allianz House, Airport Road, Yerawada,

Pune- 411006

FAQs

Q1. What are payment modes for premium amount?

Policyholders can opt for different modes of payment for premium amount such as- Debit/Credit Card, Net Banking

 Q2. What is the entry age under Bajaj Allianz Extra Care Policy?

Under this plan, entry age ranges from 18 years to 70 years.

 Q3. What are the additional features of Bajaj Allianz Extra Care Policy?

There are several additional features under the plan as mentioned below:

1. Single premium payment for the family under Family Floater Policy
2. Affordable premium rates
3. Medical test waived off up to 55 years
4. Ambulance charges cover