Bajaj Allianz M-Care Health Insurance Policy

Brief Overview

Designed in a way to suit the health-insurance portfolio of different customers, Bajaj Allianz has introduced various cost-effective and customer-friendly health insurance plans. One of such plans is  Bajaj Allianz M-Care Health Insurance, which is a customised health plan that covers vector-borne diseases.  In a country like India, where the climate is favourable for mosquitoes, ticks and fleas etc., it is very common for the people getting infected. And the misery that these vectors can cause is immense. Apart from the physical agony, these illnesses can also cause a financial setback. 

In case you are diagnosed with any of the listed 7 diseases, your M-care health insurance plan will cover you from the medical expenses that can otherwise make a big dent in your savings. The cashless treatment offered by the company in the network hospitals, helps you concentrate on the treatment, rather than running around arranging funds for the hospitalisation.

Best Features of Bajaj Allianz M-Care Health Insurance Plan

1. The plan would give you a lump sum payout in case you are diagnosed with any of the 7 listed diseases
2. M-Care Health Insurance comes with a lifetime renewability option
3. You can cover yourself, your spouse, dependent children and parents
4. Various sum insured options are available
5. You can avail a discount when the policy is bought from the company website
6. The plan comes with a 15-day free-look period

Benefits of Bajaj Allianz M-Care Health Insurance Plan

1. Covers Everyone 
   Under the family floater health insurance policy, you can cover yourself, your spouse, dependent children as well as your dependent parents.
2. Wide Coverage
   If you or any other insured member is diagnosed from any of the listed vector-borne diseases, you will receive a lump-sum benefit, as per your policy terms and conditions. The diseases that are covered are:
   1. Malaria
   2. Zika VIrus
   3. Dengue Fever
   4. Kala Azar
   5. Chikungunya
   6. Japanese Encephalitis
   7. Filariasis (This illness is covered only once in a lifetime)
3. Avail Discounts
   If you buy the policy from the company website, you can get a 20% discount.
4. Free Look Period
   If after purchasing the policy, you do not feel fully satisfied with its terms and conditions, you have the option to return it within 15 days from the date of purchase.
5. Sum Insured Options
   As per your needs and budget, you can pick a sum assured you seem to be suitable.
   1. INR 10,000
   2. INR 15,000
   3. INR 25,000
   4. INR 50,000
   5. INR 75,000
6. Lifelong Renewability
   When you pay the premiums on time, you can opt for lifelong renewability.

Plan Details of Bajaj Allianz M-Care Health Insurance Plan

• Waiting Period
  A waiting period is applicable in the following ways (for an exhaustive list of waiting period conditions, please refer to the company website):

1. Any listed disease if diagnosed in the first 15 days of policy inception, will not be covered
2. In case the plan is purchased after the occurrence of any of the enlisted diseases, the waiting period will be increased to 60 days

• Free Look Period
  As mentioned above, when you purchase Bajaj Allianz M-Care Health Insurance Plan, you get a 15-day free look period to go through all the terms and conditions of the policy. In case you do not feel completely convinced with the policy, the company gives you the right to return it, provided no claim has been made so far by you. 
  The health insurance premium that you have paid will be refunded after deducting the stamp duty charges, the proportionate risk amount and medical examination charges will be deducted.
  Free-look period does not apply for policies that are renewed.

What is not Covered in Bajaj Allianz M-Care Health Insurance Plan?

1. Any treatment apart from the listed vector-borne diseases
2. Admission to the hospital that is for less than 24 hours
3. Diagnosis and treatment that is taken outside India, except a few specific countries (please refer to the company website to see the list of countries where this exclusion is not applicable)

Bajaj Allianz M-Care Health Insurance Plan - Renewal Process 

Renewing your health insurance on time is very important. Always keep the renewal a priority as not doing so can leave you at the risk of being without the cover of the policy. The expiry date is clearly mentioned on your policy documents, make sure your renewal request reaches the company before the expiry date. You can renew the policy online as well as offline, as per your convenience. At the time of renewal, bear the following points in mind:

1. Once the expiry date is reached, the policy enters a 30-grace period during which renewal has to be made. Not renewing your policy during this period will lead to policy termination.
2. In case of a claim, you must renew the policy at the earliest. If you renew the policy within 60 days of the date of admission of the claim made, a 60-day cooling-off period would be applicable for the same illness.
3. In case you renew your policy after 60 days of admission of the claim paid, then a 30-day waiting period would apply on all the listed diseases.
4. With Bajaj Allianz M-Care Health Insurance Plan, you have the option of lifetime renewability.

Bajaj Allianz M-Care Health Insurance Plan - Claim Process

When you are diagnosed with any of the 7 listed vector-borne diseases and you seek hospitalisation that would be more than 24 hours, you can make a claim. You must inform the company at the earliest. In case of emergency hospitalisation, you can inform the company within 24 hours of admission. 

• Cashless Claim 
  Before you seek admission in a network hospital, you need to get in touch with the company and request for a pre-authorisation in a written form. In case of emergency hospitalisation, the same can be done within 24 hours of admission. If your cashless health insurance claim is approved then the hospital bill will be cleared by the company. Keep in mind that you would have to pay for the uncovered expenses. The maximum amount that can be paid by the company will depend on the sum insured chosen by you.
  In case the bill amount is less than your payable benefit, the company will pay you the difference between the amount. And if the bill is higher than the benefit, you would have to pay the difference. 
• Reimbursement Claim 
  In case you did not seek the treatment at a network hospital or if you did not receive the pre-authorization from the company, make sure you notify the company about the same within 48 hours of the diagnosis of the disease. After your discharge from the hospital, in order to make a reimbursement claim, you must submit all the required documents within 30 days of diagnosis. The documents are to be sent to:

Bajaj Allianz General Insurance Company ,2nd Floor, Bajaj Finserv Building, Behind Weikfield IT Park, Off Nagar Road, Viman Nagar, Pune 411014

• Required Documents to process a claim
  The following documents are required when making a cashless claim:
  • Pre-Authorization Claim Form
  • Policy papers/ Health ID Card
  • Any other document asked for
  • For making reimbursement claim the following documents are required
  • Claim Form along with NEFT form
  • Discharge Summary
  • Indoor Case Papers
  • Final Hospital Bill
  • Investigative Reports
  • Medical Certificate from Medical Specialist
  • Aadhar Card/ PAN Card

Bajaj Allianz Health Insurance - Network Hospitals

The aim behind buying a health insurance policy is that when you face medical distress in life, you can afford good quality treatment without putting yourself in a financial crisis. With Bajaj Allianz M-Care Health Insurance, you get the advantage of getting hospitalised in a network hospital, where you can get cashless treatment. 

At a network hospital, the bills are directly settled by the hospital. The claim process becomes very easy and smooth. With the cashless facility, you are also not hassled with the worry of arranging funds for the treatment. 

Review of Bajaj Allianz M-Care Health Insurance

Be it summers, winters or monsoons, you are always susceptible to vector-borne diseases all-year-round. Irrespective of the weather, with Bajaj Allianz M-Care Health Insurance, you can ensure that you and your family are always prepared for a medical urgency that may arise due to vector-borne diseases such as Malaria, Chikungunya, Dengue fever etc. The plan comes with different sum insured options and you can select the one that is suitable for you and your family.

So, if you or anyone you know is looking for a one-stop solution for such common infectious illnesses, then  Bajaj Allianz M-Care Health Insurance might be the best option.

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