Bajaj Allianz Health Care Supreme Plan

Brief Overview

A joint venture between Bajaj Finserv Limited and Allianz SE, Bajaj Allianz Health Insurance have introduced various health insurance products in the Indian market. In a short time, the company has managed to build its customer’s trust and is becoming one of the leading health insurance providers in the country. 

Bajaj Allianz Health Care Supreme Policy is a comprehensive policy that offers you a cover against all medical issues that life may bring to you. At all stages of life, this plan will help you face medical emergencies confidently without the worry of being in a financial crisis. The multiple benefits offered by this plan would cover your pre and post hospitalisation expenses, alternate treatments out-patient expenses, maternity services etc. 

The Supreme Policy is a yearly policy that offers benefits for Individual and Family Floater sum insured for the medical expenses and also the ancillary expenses. The policy is also available for Group insurance. 

The plan offers reinstatement of the sum insured, cumulative bonus and various other special benefits in the form of value-added features. With over 6,500 network hospitals spread all over the country, the company has also made its name when it comes to settlement of claims in a quick and hassle-free manner.

To make it easy for the customers to understand how the plan works, the company has divided it into two sections:

1. Medical Expenses - Which are Mandatory
2. Add-on Benefits- Which are Optional

If you or someone you know wishes to know more about Bajaj Allianz Health Care Supreme Policy, read on.

Best Features of Bajaj Allianz Health Care Supreme Policy  

Before discussing the plan in detail, let us take a quick look at the most prominent features of Bajaj Allianz Health Care Supreme Policy –

• Wide scope of cover, as sum insured ranges from INR 5 lakhs to INR 50 Lakhs
• You can opt for an Individual or family floater health insurance option
• The plan offers 100% reinstatement of sum insured if the hospitalisation overshoots the expenses
• 60 days prior and 90 days post the hospitalisation, all treatment-related expenses are covered
• Road and Air ambulance service will be covered under this plan
• Be it a c-section or a normal delivery, the expenses will be covered
• Dental Procedures are covered
• You can get free annual health check-ups irrespective of your claim history
• Vaccinations needed by a newborn baby, in the initial 90 days of its birth, are covered
• Special benefits like- Recovery benefit, Physiotherapy and Organ donor expenses are covered
• Ayurveda and Homeopathy are covered
• Add-on options help in increasing the cover of the base plan
• Save on your income tax under Section 80D of the Income Tax Act

Benefits of  Bajaj Allianz Health Care Supreme Policy 

1. Expenses incurred on Hospitalisation 
   When due to an injury or an illness, you have to undergo hospitalisation, the company will cover the in-patient medical expenditure. This would include:
   • Boarding expenses and room rent including ICU and OT charges
   • Nursing care
   • Medicines and Consumables
   • Diagnostic Procedures
   • Consultation fee
   • Cost of prosthetic and other equipment/ implants
2. Pre and Post Hospitalisation
   Many medical expenses go beyond hospitalisation. The company understands this and thus the expenses that you incurred on the treatment 60 days just before and 90 days right after the hospitalisation, with respect to the same illness/ injury, will be covered under the Health Care Supreme plan.
3. Road Ambulance and Air Ambulance
   An ambulance service provided by a service provider or a hospital will be covered under this plan.  
   In case of life-threatening conditions that require quick and immediate evacuation and transportation to a nearby hospital the plan would also cover Air Ambulance expenses.
4. Maternity Cover
   The expenses incurred in delivering a baby, be it a c-section or a normal delivery will be covered. The maternity health insurance cover can be taken only twice, either for delivery or for lawful terminations. Remember that this facility will be available only after continuous coverage of 24 months. 
5. Newborn Baby Cover
   For the newborn baby, the vaccinations needed in the initial 90 days of its birth are covered. The baby will come under the cover for any treatment while you are admitted as an inpatient or any health issues up until a period of 90 days from the date of birth.
6. Out-patient Expenses
   If during the policy tenure, you need to consult a specialist on an out-patient basis, the company will cover expenses for
   • Specialist Consultations
   • Investigations that are linked to the injury or the illness
   • Prescribed medicines by the Specialist
   • Root Canal Treatments and Extractions under Dental Procedures
   • Consultation required for psychiatric disorders
7. Recovery Benefit
   In case an insured member stays hospitalised for an illness/ injury for over 7 days, the company, as per the policy tenure, will pay a lump sum amount once in a policy period. 
8. Day Care Treatment
   The medical expenses that are incurred during a day-care procedure will also be covered in this plan. 
9. Physiotherapy 
   The company will indemnify the cost of physiotherapy taken after an illness or an injury that happened during the tenure of the policy. Note that per illness/injury a total number of 10 sittings would be covered.  
10. Reinstatement of Sum Insured
    If a hospitalisation overshoots the sum insured and the cumulative benefit, then the company will reinstate 100% of the sum insured for the policy period. Remember, that this benefit is possible only once in a policy period. This facility cannot be carried forward.
11. Alternative Treatments
    For many policyholders, non-allopathic treatments such as Ayurvedic and Homeopathic treatment is preferable. For them, this plan covers hospitalisation, which lasts for more than 24 hours. The in-patient expenses will be covered, provided the Doctor/Healthcare centre is Government recognised. 
12. Organ Donor Transplant
    When an organ is transplanted as per The Transplantation of Human Organs Amendment Bill 2011, and amendments thereafter, the company pays a lump sum amount as a one-time payment for Organ Donor expenses.
13. Cumulative Bonus
    For every claim-free year (that is up to 50% of sum insured under hospitalisation) you can avail 10% cumulative bonus to your limit of indemnity.
14. Preventive Health Check-ups
    After every renewal of the Health Care Supreme Policy, you and other insured members under Individual Sum Insured plans, will be entitled to a free yearly health check-up, covering a specific list of tests. In Floater Sum insured, this facility can be availed by the proposer and the spouse.
15. Lifetime Renewability

 The Health Care Supreme Policy offered by Bajaj Allianz comes with a lifelong renewability option. Thus, you can easily renew this policy for your entire lifetime.  

1. Tax Benefits
   The health insurance premium that you pay towards your health insurance plan can be claimed for tax benefits under Section 80D of the Income Tax Act.

What Else can be Covered in the Health Care Supreme policy?

There are certain other features offered by the policy that can be very helpful such as:

• Child Education Benefit
  If in case the policyholder dies or gets hurt in an accident, his/ her 2 children become eligible for an Educational benefit of INR 5,000 each.
• Transportation Benefit
  In case of death or injury because of an accident, a transport benefit of INR 5,000 can be availed.

The Health Care Supreme policy offers some add-on benefits which though optional, can further increase the cover of your plan. Let us take a look:

• Critical Illness Benefit
  Under this add-on, there would be-
  • Cover against 15 terminal illnesses
  • The choice among INR 5 to INR 10 lakhs as the sum insured
  • The waiting period of 90 days
  • Lump-sum amount as per your policy will be paid soon after diagnosis
• Personal Accident Cover
  In case an accident that involves you or an insured member getting injured, you will be covered in the following ways:
• Death- 100% of the sum insured to the nominee
• Permanent Disability - 200% of the sum insured
• Permanent Partial Disability- Compensation depends on the kind of disability
• Transportation of mortal remains
• Dependent spouse, children and parents can be covered up to INR 5 lakhs as the sum insured
• Ancillary Cash Benefit
  If because of an illness or an injury, you are admitted to a hospital for over 24 hours, depending upon the kind of plan you select, a daily cash benefit will be provided. The variants are:
  • Vital Plan
  • Smart Plan
  • Ultimo Plan

What is not Covered by the Bajaj Allianz Health Care Supreme Policy?

In every health insurance plan, there are certain services that are not covered, these are called exclusions. When buying a policy, be careful and keep these exclusions in mind as you cannot make a claim in any of the following situations:

• Any pre-existing critical illness
• Any terminal illnesses that is discovered in the initial 90 days of policy purchase
• An injury that happens because of participation in an unlawful act
• Self-inflicted injuries
• Plastic or cosmetic surgery is excluded unless it results from a burn or accidental injury
• Congenital external diseases or anomalies, genetic disorders
• Stem cell implantations
• Illnesses that arise due to abuse of alcohol and/or drugs
• Issues related to fertility, infertility and impotence
• Circumcision
• Surgery for change of gender
• Treatment arising due to war, civil war, invasion, an act of foreign enemies, revolution, military or usurped power, etc.

Renewal of Bajaj Allianz Health Care Supreme Policy

Renewal means that the policy is resumed or restarted once again. A renewal under standard circumstances is not refused provided there has been no non-cooperation, misinterpretation or fraud on behalf of the policyholder. The policy is renewed on an annual basis either before the grace period begins or during the grace period.

The grace period is a period 30 days from the date of expiry. This time is given for the renewal of the policy, after this, the policy will terminate automatically. You must keep a note that a claim made during the grace period will not be accepted. 

In order to avoid any break in the policy, ensure that you get in touch with the company to raise a request and pay the renewal amount before the policy expires.

For children who are dependent, the policy is renewable to an age of 35 years. Once this age limit is reached, the policy can be renewed for life. A separate proposal form has to be submitted at renewal. 

Eligibility of  Bajaj Allianz Health Care Supreme Policy

Bajaj Allianz Health Care Supreme Policy Claim Process

In order to make the health insurance claim settlement an easy and quick process, the company follows the different types of Claim Processes. Depending on the kind of policy that you have, and the kind of hospitalisation that you undergo (planned/emergency) you can select the one that suits you the most:

1. The claim by Direct Click
   Bajaj Allianz has introduced a procedure through which the claim submission can be application-based. This is called “Claim by Direct Click” - CDC and with this app, you can submit the paperwork and make a claim for INR 20,000.
   For this you need to:
   • Register your policy and health card number on the app
   • Register the claim by filling in the claim form
   • Upload the treatment-related documents (list given below)
   • Submit the claim
   • In a few hours check for confirmation
2. Cashless Claim 
   Cashless facility is available to the policyholders, all year round and is available at all network hospitals. It is advised that you keep a regular check on the updated list of network hospitals, especially the ones that are close to your residence, as it keeps changing. 
   Before you are admitted to a network hospital, you need to show your Policy Health Card and a Valid Identity proof at the Hospital Help Desk. Remember to follow the steps given below when you go to a network hospital for hospitalisation:
   • If going for a planned hospitalisation you must register your admission at least 3-4 days before, in case of an emergency admission make sure you inform the company within the first 24 hours
   • You then need to fill in and submit the pre-authorisation form and get it signed by the hospital/doctor
   • This form and other required documents will be sent to the health administration team
   • The HTA will verify the form along with other documents
   • Once approved, you will be able to avail all benefits of the cashless claim
3. Reimbursement 
   Applicable medical expenditure that was incurred either before or after the admission and discharge will be compensated as per the policy rules. It is advised that you take Certified True Copies for all treatment-related bills from the hospital and submit them along with the Claim Form to the company at the earliest.
4. Documents Required
   Given below is the list of documents that you would have to produce when making a claim:

• Valid Photo Identity Card
• Original Policy papers
• Duly filled and signed claim form
• Consultation letters from the Doctor
• Hospital bill giving the detailed break-up of all treatment-related expenses
• All Diagnostic Reports
• Copy of death certificate(for death claim)
• Copy of post-mortem report, if conducted
• Police FIR or Medico-Legal Certificate in case of accidental injuries
• Any other document that may be needed by the insurance company

Bajaj Allianz Health Care Supreme Policy Cashless Hospital Network

When you buy a health insurance policy, the main reason behind is to ensure a good quality treatment that doesn't make a big dent in your savings. One of the best ways to save yourself from the worry of arranging lots of money before treatment is to opt for a cashless claim in a network hospital. 

A network or an empanelled hospital is one that has a collaboration with the insurance company and the bills produced by the hospital are directly settled by the hospital. You must keep a regular check on the online list of network hospitals, especially the ones that are close to your residence so that in case of an emergency you can reach the hospital on time.

Sometimes it may happen that you are out of town, and face a medical emergency. In such a case, you would not have anyone to fall back on. Going to a network hospital can surely make things very easy.

Bajaj Allianz Health Insurance Customer Care Details

Health Insurance offers different modes of contacting the company for your queries or complaints. These modes are as follows –

Review of  Bajaj Allianz Health Care Supreme Policy

Over the past few years, medical inflation in India has seen a steep rise. The rise of the pandemic COVID-19 has also brought about many changes in the way people think about health insurance. When you think of fulfilling your and your family’s health insurance needs, you would want to select a plan that offers wide coverage and comes with a variety of benefits.  

Health Care Supreme Policy is such a health insurance product launched by Bajaj Allianz Health. With a sum insured that can range from INR 5 to INR 50 lakhs, it is a full-fledged health insurance plan that renders a lot of benefits and striking features.

From in-patient to daycare expenses, from maternity benefits to reinstatement of sum insured, this plan would save you from a financial crisis in all stages of your life.