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Bajaj Allianz Health Guard Insurance

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Coverage type:
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Date of birth
      OR age      years

Unique features

  • Cashless hospitalization across network of quality hospitals
  • Direct claim settlement, no third party involved
  • Get 5% Cumulative Bonus benefit for each claim free year, Maximum up to 50%
  • Income Tax Benefit as per Sec 80 D of the IT Act on the premiums paid for this policy

Bajaj Allianz Health Guard Benefits

  • Key Features
  • Benefits
  • Claims Procedure
  • Exclusions
Below are some of the features and benefits of the Bajaj Allianz Health Guard Individual and Family Floater Plan
  • Cashless claim settlement available across 2300 plus network hospitals
  • Each memeber holding a Bajaj Allianz health guard policy has access to cashless facility at various network hospitals across India.
  • Covers pre & post hospitalization medical expenses incurred 60 days prior to and 90 days after hospitalization
  • No sublimities on room rent & all medical expenses
  • Quick and Hassle-free claim settlement due to In-house claim administration team
  • Wide range of medical coverage options from 1lakh to 10 lakh
  • No medical tests required up to 45 years
  • 10% co- payment if treatment is taken outside the network of hospitals.
  • Waiver on 10% co-payment on payment of additional premium
  • Coverage of pre-existing conditions after 4 years of continuous renewal
  • Covers ambulance charges in case of emergency.
  • 130 daycare procedures are covered subject to terms & conditions
  • Income tax benefit under section 80-D.
  • Health Check up for maximum amount of Rs.1000/- at the end of continuous four claim free years.
  • Renew the Bajaj Allianz health guard insurance policy till the age of 80 years.
  • Persons aged 3 months to 65 years are eligible to buy the Bajaj Allianz Individual health guard
  • Adults from 18 years to 65 years are eligible to buy the Bajaj Allianz Family Floater health guard
  • Dependent children from 3 months to 25 years can be covered if both the parents are covered under the policy.
  • Cover your whole family in one policy by paying single premium
Silver Gold
Sum Insured
Up to 2 Lakhs Up to 50 Lakhs
In-patient Hospitalisation Treatment
  • Covers boarding and nursing expenses, intensive care unit charges, surgeons and doctors fee, operation theatre charges etc.
  • Admitted in ICU:We will pay up to actual expenses provided by Hospital.
  • Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.
  • Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, cost of Artificial Limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically necessary.
Eligibility
Adult 18-65 Years Dependent Children/Grandchildren:3 months – 30 Years
Room, Boarding and Nursing Expenses
Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower. No sublimits
Pre-Post Hospitalization:
Up to 60 days prior and 90 days post hospitalization respectively
Road Ambulance
Up to maximum of Rs.20,000 per policy year
Day Care Procedures
Covered as per the policy terms and conditions.
Pre-existing diseases
Covered after 3 years of continuous renewal
Organ Donor Expenses
  • The company pays 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, 2011 and the organ donated is for the use of the Insured Person, and
  • Company has accepted an inpatient Hospitalisation claim for the insured member under In Patient Hospitalisation Treatment
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 applicable annually for policies with term more than 1 year.
Sum Insured Reinstatement Benefit
  • 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;
  • This benefit will be applicable annually for policies with term more than 1 year.
  • 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 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
  • Additional premium would not be charged for reinstatement of the Sum Insured.
Daily Cash Benefit for Accompanying an Insured Child
Rs. 500 per day maximum up to 10 days
Preventive Health Check Up
Plan will reimburse the amount equal to 1% of the sum insured max up to Rs. 2000/- for each member in Individual policy during the block of 3 years. This benefit can be availed by proposer & spouse only under Floater Sum Insured Policies
Ayurvedic / Homeopathic Hospitalisation Expenses
Not Covered Hospitalised for not less than 24 hrs then it is covered
Maternity Expenses
Not Covered Covered
Other benefits
Any Medical Expenses incurred during the first 36 months during which You have the benefit of a Health Guard policy with Us in connection with:
  • Joint replacement surgery
  • Surgery for prolapsed inter vertebral disc (unless necessitated due to an accident)
  • Surgery to correct deviated nasal septum
  • Hypertrophied turbinate
  • Congenital internal diseases or anomalies
  • Treatment for correction of eye sight due to refractive error recommended by Ophthalmologist for medical reasons.
  • Bariatric Surgery
Sub-limits
  • Room rent restricted to max 1% per day of Sum Insured opted.
  • Cataract Limit per eye 20% of Sum Insured .
  • Cataract Limit per eye 20% of Sum Insured max up to Rs. 1lac.
  • Bariatric Surgery restricted to 50% of the Sum insured, subject to maximum of Rs 5 lac.
  • Maternity Expenses- From Sum insured Rs. 3lacs to Rs. 7.5lacs it is restricted to Rs. 15000 for normal delivery and Rs. 25000 for caesarean section and from Sum insured Rs. 10lacs to Rs. 50lacs it is restricted to Rs. 25000 for normal delivery and Rs.35000 for caesarean section.
  • Any illness / claim should be reported immediately to the Bajaj Allianz General Insurance company either by telephone or in writing (email/letter)
  • The health administration team will send the claims form to the insured along with the checklist of document to be submitted
  • The insured hands over the relevant medical documents (in original) mentioned in the check list along with the filled claims form.
  • Scrutiny of the medical bills and settlement of claim.
  • All diseases/injuries existing at the time of proposing this insurance.
  • Any disease contracted during the first 30 days of commencement of the policy.
  • Certain diseases such as hernia, piles, cataract,sinusitis shall be covered after a waiting period of 2 years.
  • Non-allopathic medicine.
  • Congenital diseases.
  • All expenses arising from AIDS and related diseases.
  • Cosmetic, aesthetic or related treatment.
  • Use of intoxicating drugs and alcohol.
  • Joint replacement surgery (other than due to accident shall have a waiting period of four years).
  • Medical expenses where Inpatient care is not warranted and does not require supervision of qualified nursing staff and qualified medical practitioner round the clock
  • Treatment for any mental illness or psychiatric illness, Parkinson's Disease
  • Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus or Variant/mutant viruses and or any syndrome or condition of a similar kind commonly referred to as AIDS.
  • Any treatment arising from or traceable to pregnancy, child birth including cesarean section and/or any treatment related to pre and postnatal care and complications arising out of Pregnancy and Childbirth.However this exclusion will not apply to Ectopic Pregnancy proved by diagnostic means and certified to be life threatening by the attending medical practitioner

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  • InstantCover Insurance Web Aggregator Private limited
    710, 6th B Cross, 16th Main Road, Koramangala 3rd Block,
    Bangalore - 560 034.
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022