Bajaj Allianz Aarogya Sanjeevani Policy
Medical emergencies can come anytime and can affect anyone irrespective of gender, lifestyle, or age. Such an emergency cannot be predicted, so one can never be prepared for it. But a person can ensure at least the financial stability of the family from the unexpected by buying a health insurance plan. Health insurance plan is a contract between the policyholder and the insurance provider. The policyholder pays an insurance amount, and in return, the insurer pays hospitalisation charges and other related medical expenses.
The Insurance Regulatory and Development Authority of India (IRDAI) has created a general health insurance plan named as the Aarogya Sanjeevani Plan. After creating general guidelines, the Insurance Authority has asked all insurance companies to create such affordable plans for the masses. So, Bajaj Allianz Health Insurance in compliance with IRDAI, has launched Bajaj Allianz Aarogya Sanjeevani Plan.
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What is the Bajaj Allianz Aarogya Sanjeevani Plan
Bajaj Allianz Aarogya Sanjeevani Policy is a health insurance plan that covers pre and post-hospitalisation costs, emergency admission to the hospital, surgeries, and hospitalisation costs. It has a sum insured ranging from Rs 1 lakh to Rs 5 lakh. This policy is a complete health plan that will fulfil the financial needs of the policyholder in times of medical emergency.
This health insurance policy also covers the costs of hospitalisation due to mental illness, new treatments like robotic surgeries, stem cell therapy, and AYUSH treatment, among others. The policy has two options available, i.e. the individual plan and the family floater plan.
- Individual Plan: The beneficiary of Bajaj Allianz Aarogya Sanjeevani policy is a single policyholder.
- Family Floater Plan: Family members of the person insured can choose to become the beneficiaries of Bajaj Allianz Aarogya Sanjeevani plan. The family can include 2 children, spouse, parents, and parents-in-law under this health floater plan.
Features of the Bajaj Allianz Aarogya Sanjeevani Policy
There are various features in the Aarogya Sanjeevani plan that differentiates it from other health insurance policies available in the market Some features of Aarogya Sanjeevani plan are:
- These plans are more economical in comparison to other health insurance plans.
- These are universal coverage plans.
- In this plan, the sum insured is between Rs 1 lakh to Rs 5 lakh.
- As mentioned earlier, these plans are available in two options. They are individual and family floater basis policy.
- This plan covers hospitalisation costs due to COVID-19.
- This insurance policy can be bought online.
Benefits of the Bajaj Allianz Aarogya Sanjeevani Policy
The policy offers ample advantages, which make the policy worth a buy. Benefits of Bajaj Allianz Aarogya Sanjeevani Policy are:
- One of the Lowest Co-payment Options - The plan provides a lower co-payment option as compared to other health insurance policies. There is a co-payment of only 5% on the claim amount to be paid by the insurer. It means that the policyholder needs to pay 5% of the claim amount during the settlement of the claim
- Culminating Bonuses: There are culminating bonuses available with the plan. There are rebates given to the policyholder in the family floater plan option.
- Free-look Period: The policy has a free look period during which a policyholder can return the policy if they are not happy with the policy terms. If he/she returns within 15 days all premiums paid are returned back.
- The premiums paid are eligible for tax benefits under Section 80C of Income Tax Act, 1961.
- There are options available for policy portability.
- The plans have an affordable premium when compared to other policies.
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.
Inclusions of the Bajaj Allianz Aarogya Sanjeevani Plan
The following are the inclusions of the Bajaj Allianz Aarogya Sanjeevani Plan:
- Pre and Post-hospitalisation Expenses - The plan will cover all expenses related to pre-hospitalization and post-hospitalization due to an emergency medical condition or accidental injury.
- COVID-19 Expenses Cover - The plan covers all necessary medical expenses that arise due to hospitalization from COVID-19 or novel coronavirus disease.
- AYUSH Benefit - The plan covers the cost of hospitalization expenditures due to non-allopathic treatments like Ayurveda, Siddha or Homeopathy and others at an approved hospital.
- ICU or ICCU Charges - Bajaj Allianz Aarogya Sanjeevani plan covers the charges of medical treatment in the Intensive Care Unit or ICU and Intensive Coronary Care Unit or ICCU.
- Room Rent - The policy covers the cost of hospital room rent, which can be up to a maximum of Rs 5,000 per day.
- Ambulance Services - This plan pays the cost of the ambulance, which can be up to a maximum of Rs 2000 per hospitalization.
- Daycare Treatment - The plan covers all expenditures which arise due to daycare procedures.
- Plastic Surgery and Dental Treatment due to Illness - This plan also covers the cost of plastic surgery or any dental treatment taken due to a disease or injury of the policyholder.
- Cataract Surgery - For every cataract surgery this plan pays an amount which is a maximum 25% of the sum insured amount or of Rs 40,000 for each eye whichever is lower.
- New Age or Modern Treatment - There is a provision in the policy so that it covers the cost of new age or modern treatment which can be up to a maximum of 50% on the sum insured.
Waiting Period Applied
The policy provider will not pay any claim under the policy if the policyholder is admitted to the hospital for the pre-existing medical conditions until the waiting period is over.
The conditions for pre-existing diseases are:
- Expenses related to the treatment of a pre-existing illness until the waiting period 48-months is over. The waiting period of 48 months is considered to be over if the policy is renewed for 4 continuous years since the date of commencement of the policy.
- If the policyholder chooses to increase the sum insured, then the waiting period will start afresh, and the new waiting period depends on the increase in sum insured.
- If the person insured was previously covered by other health insurance policies and applied for this plan without any break, then the waiting period will be reduced as per IRDAI regulations.
- The expiry of the 4 year waiting period of pre-existing diseases needs to be declared to the policy provider company during the application process of the plan.
Exclusions of the Bajaj Allianz Aarogya Sanjeevani Plan
The following are the exclusions of the Bajaj Allianz Aarogya Sanjeevani Plan:
Hospitalisation due to:
- Breach of the law, i.e. due to drugs
- Cosmetic or plastic surgery
- Change of gender treatments
- Hazardous or adventure sports
- Investigation & evaluation of diseases
- Maternity Expenses
- Obesity or weight control treated.
- Rest cure, rehabilitation and respiratory care
- Refractive error treatment
- Sterility and infertility treatment
- Unproven treatments
Eligibility Criteria to Buy the Bajaj Allianz Aarogya Sanjeevani Policy
The eligibility to apply for Bajaj Allianz Aarogya Sanjeevani Policy are:
- Minimum entry age for adults - 18 years of age
- Maximum entry age for adults - 65 years of age
- Minimum entry age for child - 3 month
- Maximum entry age for child - 25 years
- For joint policy, the policyholder can include his parents, legally-married spouse, children dependent on the policyholder (including legally adopted children) and parents-in-law in this Aarogya Sanjeevani health plan.
Claim Process for Bajaj Allianz Aarogya Sanjeevani Policy
Like any other health insurance policies, Bajaj Allianz Aarogya Sanjeevani Policy can be claimed for cashless or reimbursement hospitalisation facility. The claim process for Bajaj Allianz Aarogya Sanjeevani Policy is as follows:
- Cashless hospitalisation is possible only at network hospitals, where hospitalisation can be planned or emergency. The claim steps are as follows:
- One must inform the insurer about the planned treatment that one will undergo at a particular network hospital at least 7 days before the admission to the hospital. For emergency or accidental hospitalisation, one can inform the insurer within 24 hours of hospitalisation.
- At the hospital helpdesk, one needs to show the ID proof of the policyholder, his/her health card provided by the insurer and other necessary documents for cashless treatment.
- Then fill up the claim form, and the insurer will notify about the claim to the customer within some time.
- When the policyholder is discharged, leave original documents at the hospital. Make 5% co-payment.
Reimbursement Claim Process:
- Reimbursement claim is registered if a cashless claim is rejected and health-care treatment is availed from a non-network hospital. The claim steps are as follows:
- For the reimbursement process, admit to the hospital for the treatment and notify the policy provider in advance.
- After the treatment is over, collect all the original prescriptions, bills, discharge sheets, receipts, and other bills and pay all hospital bills.
- Fill out the claim form and send it to the insurer. Ensure to include the documents required for the claim process.
- Bajaj Allianz will verify the documents received to either approve or reject the claim.
- After some days Bajaj Allianz will notify the policyholder about the approval by email or SMS.
If all the documents are submitted, Bajaj Allianz will approve the claim and the claim will be settled by transferring the payment.
Documents required for Claim Process
The documents required for the claim are mentioned below:
- Filled up the claim form
- Medical record to show that the policyholder has no pre-existing illness
- Medical documents of the treatments undergone
- Prescription copy
- Any type of indoor case paper
- Extra documents as asked by the policy provider company
After submission of the required documents, Bajaj Allianz will notify about the claim approval.
How to Buy the Bajaj Allianz Aarogya Sanjeevani Policy?
For Bajaj Allianz Aarogya Sanjeevani Policy, one can buy the policy through an online process by visiting Paisawiki.com. The steps are:
- Step I: Visit paisawiki.com
- Step II: Select Bajaj Allianz Aarogya Sanjeevani Policy to buy. Go to 'Buy Now'.
- Step III: One must enter all personal details and create a new account. Click on next.
- Step IV: Fill up the details asked, then one can choose to compare online with other health plans or click next.
- Step V: Enter some details like number of policyholders, etc. Choose the sum insured, policy duration, and other such details.
- Step VII: Select riders if needed.
- Step VIII: Add the necessary health information.
- Step IX: Upload documents asked by Bajaj Allianz.
- Step X: One must agree to the terms & conditions of the plan.
- Step XI: Enter bank details & continue with the payment process.
After payment, the policyholder will send the policyholder.
Documents Required to Buy the Bajaj Allianz Aarogya Sanjeevani Policy
The documents required to apply for Bajaj Allianz Aarogya Sanjeevani Policy are:
- Age Proof: School or College Certificate, Birth Certificate, Voter Card, PAN card, Adhaar Card, Driving License, Passport
- Address Proof: Electricity Bill, Ration Card, Passport, Bank A/C statement, Utility Bill, Telephone Bill, Postpaid Bill
- Photo Identity Proof: Aadhar Card, PAN Card, Driving License, Voter ID, Passport
- Recent passport size photograph
Renewal Process of the Bajaj Allianz Aarogya Sanjeevani Policy
The renewal process is as follows:
- For renewing the policy, visit the official website of Paisawiki
- Step I: Log in to the website.
- Step II: Choose 'renew policy option.' Enter the policy number asked.
- Step III: After entering the policy number, fill up various details like name, age of family members, email, and mobile number.
- Step IV: Click on 'renew.'
- Step V: If one wishes, they can add riders. After choosing, click 'proceed option.
- Step VI: In this step, one can add or remove family members. For new adding members, choose the 'add members' option.
- Step VII: Input their necessary personal & medical details.
- Step VIII: Choose to proceed option.
- Step IX: Agree to the changed details in the policy terms & conditions.
- Step X: Get the premiums to be paid, compare if want.
- Step XI: Pay the premiums through credit/debit card or net banking.
After payment, new policy documents will be mailed.
Ans: No, there is no charge for an annual payment of premiums.
Ans: A GST of 18% is charged on the policy.
Ans: Yes, NRIs can buy this plan but the treatments done within India will be covered.
Ans: No these expenses are not covered in this plan.
Ans: The following premiums are paid back:
- Up to 30 days - 75%
- 31 to 90 days - 50%
- 3 to 6 months - 25%
- 6 to 12 months - 0%
Written By: Paisawiki - Updated: 03 March 2021