Bajaj Allianz Health Ensure Plan

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Bajaj Allianz Health Ensure

	Objective		An online health insurance policy which is aimed at including low segment individuals under the umbrella of insurance. The objective of this policy is to indemnify against expenses during hospitalisation caused due to illness or an accident.
Suited for		This is a low cost, low benefits policy suited for a low-income individual who wish to mitigate some part of, if not whole, medical expenses at a time of health urgency.
What does it do?		This policy sticks to providing a very basic cover against inpatient hospitalisation. Like any traditional health policy it covers all general expenses incurred during admission to hospital. Emergency ambulance to transfer patient from home or accidental site to hospital and back from hospital to home is also provided. Apart from inpatient treatment, it covers specific 130 such procedures not requiring a 24-hour hospitalisation due to technological upgradation. A free health check up can be availed at the end of four continuous claim-free years.
Pros		Family discount of 5 per cent is available. Premium paid towards this policy is eligible for tax benefit under section 80D of Income Tax Act.
Cons		The policy offers a maximum cover of Rs 1 lakh only. All benefits have a ceiling limit which means any expense beyond that limit will be denied.
Our View		This policy is specially meant for low income segment. It is low on premium and offers a stingy coverage. Though it may not be sufficient to cover all hospitalisation expenses, it can share a part of the losses. In view of rising medical expenses now a days, everyone must have at least a basic health insurance policy plus a cover for chronic diseases. The cover can be stretched to include out patient treatments and other day to day expenses at time of hospitalisation. There are far more comprehensive policies available in the market which provide a broad and better immunity to medical costs. This policy is thus not recommended for those who can afford a better one as the cover may not suffice. Moreover, each expense is capped to sum insured which is another limitation.

 

	Eligibility
Entry Age (years)
Minimum		18; 3 Months for Children
Maximum		55
Maximum Policy Renewal Age (years)		75
Coverage Type		Individual Cover
Policy Term (years)		1
Sum Insured (Rs)
Maximum		1 lakh
Minimum		50000
Tax Benefit		Premium paid is eligible for tax benefit under section 80D of the Income Tax Act
Discount		Family discount of 5% is applicable
Pre Policy Medical Check Up		Not required upto 55 years
Policy Termination		Policyholder is allowed to terminate the policy at anytime by giving a 15 day written notice. In case no claim has been made under the policy, percentage of premium will be refunded
Customer Service
Address		Bajaj Allianz General Insurance Company Limited. GE Plaza, Airport Road, Yerawad, Pune - 411006
Mail to		customercare@bajajallianz.co.in
Call to		1800 225858(BSNL/ MTNL); 1800 1025858 (Bharti users- mobile/ landline) or 020 30305858

 

	Scope Of Cover
Cashless facility		Available at empanelled hospitals in India
Re-imbursement		In case policyholder opts for non empaneled hosiptal , expenses are re-imbursed withing 14 working days from date of submission of all records.
Pre-post hospitalisation		2% of admissible hospitalization expenses
Hospitalisation Expenses (Inpatient treatment)		Covered
Room, Board & Nursing Expenses		upto 1% Of Sum Insured per day*
ICU Expense		upto 2% Of Sum Insured per day*
*Room, board, nursing and ICU expenses can be taken upto maximum of 30% of Sum insured per illness/ injury
Surgeon, Anesthetist, Medical practitioner, Consultants, Specialist Fees		upto 30% of Sum insured per illness/ injury
Emergency Ambulance charges up to Rs 1000/-, Anesthesia, Blood, Oxygen, operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and any medical expenses incurred which is integral part of the operation		upto 40% of Sum Insured per illness/ injury
Day Care Procedures		130 day care procedures are covered
Emergency Ambulance		Covered; subject to maximum limit of Rs 1,000
Health Check Up		Covered; at the end of 4 continuous claim free years

 

	Exclusions & Waiting Period
Pre-existing disease		2 years waiting period applicable for Pre-existing diseases
No claim period		Any disease contracted during the first 30 days of commencement of the policy
Waiting Period		Certain diseases such as gastric / duodenal ulcers, Surgery of varicose veins/varicose ulcers etc shall be covered after a waiting period of 1 year and some diseases such as cataract, hernia etc. will be covered after a waiting period of 2 years.Certain diseases such as joint replacement surgery will have a waiting period of 4 years.
General exclusions		Non allopathic treatmentAIDS and other related diseases.Cosmetic, beauty, weight reduction and other likely treatments.Use of alcohol or other addictive substances.War, participation in any criminal activity or any other related condition.Treatmenmt of any mental or related disease.

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