Bajaj Allianz Insurance Plans

Bajaj Allianz Total Health Secure Goal

Bajaj Allianz Total Health Secure Goal - Advantages of the Combi Plan

  • Hassle free comprehensive coverage of life and health insurance needs
  • Single policy covering Health & Life cover
  • Option to choose the right variant from Silver & Gold according to your needs, providing all round coverage during hospitalization.
  • Lifetime renewal
  • Sum insured options of minimum Rs. 10,000 and maximum Rs. 75,000
Request a Call Back
Name is required
Email is required
Contact is required
Thank you for contacting us

Bajaj Allianz Insurance Review

Bajaj Allianz Insurance
Bajaj Allianz Insurance sum insured
3 lacs − 50 lacs options available
Incurred Claims Ratio *
85.00%
Bajaj Allianz Insurance tenure options
For a period of 3 years
Claims Settlement Ratio **
94.55%
List of network hospitals
6,500+ hospitals
Number of policies issued *
531,046
Maximum family floater coverage
Self, Spouse + 4 dependent children
Number of lives covered *
2,46,85,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

Bajaj Allianz Total Health Secure Goal review

  • Key Features
  • Eligibility
  • Advantages
  • Coverages
  • Exclusions

Key Features of Total Health Secure Goal Combi plan

  • Comprehensive plan providing Hospitalization benefit & Life cover
  • Rebate for High Sum Assured & Health Lifestyle insurance
  • Comprehensive health care program to cover the cost of hospitalization arising from an accident or illness.
  • Apart from hospitalization also involves aspects such as the amount of covered recovery, organ donation costs, maternity, etc.

Eligibility Parameters of Total Health Secure Goal(Applicable for the Combo Proposition Only)

Parameter Bajaj Allianz iSecure Bajaj Allianz Health Guard
Min & Max Entry Age 18 to 60 years
Policy Term 10 /15 /20 /25/ 30 years Renewable for Life
Premium Payment Term Equal to Policy Term Annual premium payment with lifetime renewable option for health cover
Benefit Payable Sum Assured opted at inception Hospitalization expenses as per policy terms & conditions
Sum Assured/Sum Insured
  • Minimum –INR 250000
  • Maximum – As per Board Approved Underwriting Process
  • Minimum- INR 150000
  • Maximum- INR 5000000
Premium Payment Frequency Yearly
Grace Period 30 Days
Entry age
  • Proposer /Spouse /Parents/Sister/ Brother/ Father In law/ Mother In law/ Aunt/ Uncle - 18 yrs to 65 years
  • Dependent Children/Grandchildren: 3 months – 30 yrs
Renewal age The policy is renewable for lifetime.
For Dependent Children/ Grand Children- Renewal up to 35 years.
Policy Period? Policy can be taken for 1year/2years OR 3years.
Premium Paying Term Annual premium payment for 1 year policy. For long term policies one time premium will be collected at the time of risk inceptionand for renewal at the end of the policy term.
Floater policy / Individual policy Policy provides Individual as well as Floater sum insured options under both plans.
Relationships that can be covered Self, Spouse, Dependent Children, Grandchildren, Parents, Sister, Brother, Father In law, Mother In law, Aunt, Uncle can be coveredunder individual option

Advantages of Total Health Secure Goal Combi plan

  • Hassle free comprehensive coverage taking care of life & health insurance needs
  • Single policy covering Health & Life cover
  • Single touch point for all communications
  • In-house Claim Administration
  • Global Expertise in managing Health Insurance
  • Quick disbursement of claims
  • Option to choose the right variant as per your needs from Silver & Gold, providing all round cover during hospitalization
  • Simple steps to get a wide range of Health & Life cover
  • An additional discount of 5% is available on the total premium payable under the Combi plan

Coverages of Total Health Secure Goal Combi plan

  1. In-patient Hospitalisation Treatment
    If the Insured is Hospitalised on the advice of a Medical Practitioner (as defined under Policy) because of Illness or Accidental Bodily Injury sustained or contracted during the Policy Period, then the Company will pay the Insured, Reasonable and Customary Medical Expenses incurred for:
    • Room and Boarding expenses as provided by the Hospital/ Nursing Home, maximum up to the per day room rent plan opted by the Insured
    • If admitted in ICU, the Company will pay up to actual ICU expenses provided by Hospital.
    • Nursing Expenses as provided by the hospital
    • Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees.
    • Anaesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances,
    • Dialysis, Chemotherapy, Radiotherapy, physiotherapy
    • Medicines, Drugs and consumables.
    • Cost of Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopaedic implants, infra cardiac valve replacements, vascular stents.
    • Relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically prescribed by the treating Medical Practitioner
  2. Pre-Hospitalisation
    The Medical Expenses incurred during the 60 days immediately before the Insured was Hospitalised, provided that: Such Medical Expenses were incurred for the same illness/injury for which subsequent Hospitalisation was required, and the Company has accepted an inpatient Hospitalisation claim under “In-patient Hospitalisation Treatment”
  3. Post-Hospitalisation
    The Medical Expenses incurred during the 90 days immediately after the Insured was discharged post Hospitalisation provided that: Such costs are incurred in respect of the same illness/injury for which the earlier Hospitalisation was required, and the Company has accepted an inpatient Hospitalisation claim under “Inpatient Hospitalisation Treatment”
  4. Road Ambulance
    • The Company will pay the reasonable cost upto a maximum of Rs 20,000/- per Hospitalisation incurred on an ambulance offered by a healthcare or ambulance service provider for transferring the Insured to the nearest Hospital with adequate emergency facilities for the provision of health services following an Emergency
    • The Company will also reimburse the expenses incurred on an ambulance offered by a healthcare or ambulance service provider for transferring the Insured from the Hospital where he/ she was admitted initially to another hospital with higher medical facilities.
    • Claim under this section shall be payable by the Company only when:
      • Such life threatening emergency condition is certified by the Medical Practitioner, and
      • The Company has accepted Insured’s Claim under “In-patient Hospitalisation Treatment” or “Day Care Procedures” section of the Policy
      • Subject otherwise to the terms, conditions and exclusions of the Policy.
  5. Day Care Procedures
    The Company will pay the Insured, medical expenses as listed above under “In-patient Hospitalisation Treatment” for Day Care medical treatment, and/or surgical procedure which is
    • Undertaken under General or Local Anaesthesia in a hospital/day care centre in less than 24 hrs because of technological advancement, and
    • Which would have otherwise required Hospitalisation of more than 24 hours.
    • Exclusions specific to Day Care Procedures. Treatment normally taken on an out-patient basis
      • Any dental treatment or procedure
  6. Preventive Health Check Up
    After continuously renewing the Health Guard Policy for 3 years with us, You are eligible for a free Preventive Health check-up. We will reimburse the amount equal to per day room rent as opted by You, maximum up to ₹2000/-for each Insured Member covered under the Policy during the block of 3 years
    You may approach us for the arrangement of the Health Check up. For the avoidance of doubt, We shall not be liable for any other ancillary or peripheral costs or expenses (including but not limited to those for transportation, accommodation or sustenance). Contact Email id - healthcheck@bajajallianz.co.in
  7. Organ Donor Expenses
    We will pay expenses towards organ donor’s treatment for harvesting of the donated organ, provided that,
    • The organ donor is any person whose organ has been made available in accordance and in compliance with THE TRANSPLANTATION OF HUMAN ORGANS (AMENDMENT) BILL, 2011and the organ donated is for the use of the Insured Person, and
    • We have accepted an inpatient Hospitalisation claim for the insured member under In Patient Hospitalisation Treatment
  8. Convalescence Benefit
    In the event of insured hospitalised for a disease/ illness/ injury for a continuous period exceeding 10 days, We will pay benefit amount of Rs. 5,000 per policy year. This benefit will be triggered provided that the hospitalization claim is accepted under In Patient Hospitalisation Treatment. This benefit will be applicable annually for policies with term more than 1 year.
  9. Daily Cash Benefit for Accompanying an Insured Child
    We will pay Daily Cash Benefit of Rs. 500 per day maximum up to 10 days during each policy year for reasonable accommodation expenses in respect of one parent/legal guardian, to stay with any minor Insured Person (under the Age of 12), provided the hospitalization claim is paid under Inpatient Hospitalisation Treatment. This benefit will be applicable annually for policies with term more than 1 year.
  10. Sum Insured Reinstatement Benefit
    If Inpatient Hospitalization Treatment Sum Insured and cumulative bonus (if any) is exhausted due to claims lodged during the Policy year, then it is agreed that 100% of the Sum Insured specified under Inpatient Hospitalization Treatment be reinstated for the particular Policy year provided that:
    • The reinstated Sum Insured will be triggered only after the Inpatient Hospitalization Treatment Sum Insured inclusive of the Cumulative Bonus(If applicable) has been completely exhausted during the policy year;
    • The reinstated Sum Insured can be used for claims made by the Insured Person in respect of the benefits stated in Inpatient Hospitalization Treatment.
    • If the claimed amount is higher than the Balance Sum Insured inclusive of the Cumulative Bonus (If applicable) under the policy, then this benefit will not be triggered for such claims
    • The reinstated Sum Insured would be triggered only for subsequent claims made by the Insured Person. In case of relapse within 45 days, this benefit will not trigger
    • This benefit is applicable only once during each policy year & will not be carried forward to the subsequent policy year/ renewals if the benefit is not utilized.
    • This benefit is applicable only once in life time of Insured Person covered under this policy for claims regarding CANCER OF SPECIFIED SEVERITY and KIDNEY FAILURE REQUIRING REGULAR DIALYSIS as defined under the policy.
    • This benefit will be applicable annually for policies with term more than 1 year.
    • Additional premium would not be charged for reinstatement of the Sum Insured.
    • Incase Family Floater policy, Reinstatement of Sum Insured will be available for all Insured Persons in the Policy

General Exclusions

  1. Any dental treatment that comprises of cosmetic surgery, dentures, dental prosthesis, dental implants, orthodontics, surgery of any kind unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization.
  2. Medical expenses where Inpatient care is not warranted and does not require supervision of qualified nursing staff and qualified medical practitioner round the clock
  3. War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition of or damage by or under the order of any government or public local authority.
  4. Circumcision unless required for the treatment of Illness or Accidental bodily injury, Investigation & Evaluation
  5. Rest Cure, rehabilitation and respite care
    • Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
      • Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
      • Any services for people who are terminally ill to address medical, physical, social, emotional and spiritual needs.
  6. Obesity/Weight Control : Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions:
    • Surgery to be conducted is upon the advice of the Doctor
    • The surgery/Procedure conducted should be supported by clinical protocols
    • The member has to be 18 years of age or older and
    • Body Mass Index (BMI);
      • greater than or equal to 40 or
      • greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss:
    • Obesity-related cardiomyopathy
    • Coronary heart disease
    • Severe Sleep Apnea
    • Uncontrolled Type2 Diabetes
  7. Change-of-gender treatments : Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  8. Cosmetic or plastic Surgery : Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
  9. Hazardous or Adventure Sports : Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
  10. The cost of spectacles, contact lenses, hearing aids, crutches, dentures, artificial teeth and all other external appliances and/or devices whether for diagnosis or treatment except for Cost of Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopaedic implants, infra cardiac valve replacements, vascular stents etc.
  11. External medical equipment of any kind used at home as post Hospitalization care including cost of instrument used in the treatment of Sleep Apnoea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D) and Oxygen concentrator for Bronchial Asthmatic condition.
  12. Congenital external diseases or defects or anomalies, growth hormone therapy, stem cell implantation or surgery except for Hematopoietic stem cells for bone marrow transplant for haematological conditions.
  13. Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol)
  14. Breach of law : Expenses for treatment directly arising from or consequent upon any Insured committing or attempting to commit a breach of law with criminal intent.
  15. Birth control, Sterility and Infertility :Expenses related to Birth Control, sterility and infertility. This includes:
    • Any type of contraception, sterilization
    • Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
    • Gestational Surrogacy
    • Reversal of sterilization
  16. Maternity :Medical Treatment Expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.

Brochure

Review Bajaj Allianz Total Health Secure Goal brochure to understand coverage details.


Know more »

Proposal form

Fill the online Bajaj Allianz Bajaj Allianz Total Health Secure Goal proposal form.


Know more »

Policy wordings

Review Bajaj Allianz Bajaj Allianz Total Health Secure Goal policy wordings which explains the terms and conditions.

Know more »

Get quotes for Bajaj Allianz health insurance!

Review and compare the best health insurance.
Compare health insurance quotes
Find the best Bajaj Allianz health insurance

India health insurance blogs and articles

health insurance India
Tips for buying best mediclaim insurance

India health insurance tips and tricks to choose the best medical insurance in India Click here to read more

Top reasons for health insurance claims rejection

Find out the different reasons why a medical insurance claim is rejected, Cashless hospitalization, Reimbursement. Click here to read more

India health insurance coverage, factors and premium calculator

Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more

Bajaj Allianz health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

Know more »

Network hospitals

Bajaj Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 6,500+ Hospitals

Know more »

Compare health plans

Compare Indian health insurance policies, Health insurance India comparison


Know more »

Health insurance benefits

Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.

Know more »

Portability

Portability Information for Mediclaim Insurance in India


Know more »

Health insurance FAQ

FAQ related to Indian health insurance. Get answers for any health insurance questions


Know more »

Search for Bajaj Allianz health insurance

CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
-

ONLINE CHAT