Bajaj Allianz Health Infinity insurance

Bajaj Allianz Health Infinity insurance review

• Bajaj Allianz Health Infinity Insurance Key Features

  • Indemnity Health Insurance Plan without any limit on Sum Insured
  • Introducing the concept of choosing health insurance as the per day room rent
  • In-patient Hospitalization Treatment without any sublimit
  • Pre- Hospitalization 60 days
  • Post- Hospitalization 90 days
  • Road Ambulance up to Rs. 5000 per hospitalization
  • Coverage for Day Care Procedures
  • Preventive Health Check Up at the end of every 3 policy years, equal to per day room rent opted max. up to ₹5,000 per person whichever is less
  • No pre-policy medical tests up to 45 years of age (subject to clean proposal form)
  • Pre-existing disease covered after 36 months from your first Health Policy
  • Income tax benefit under 80 D of the IT Act on premiums paid for this policy

• Benefits of Health Infinity Plan

  What is the Maximum Sum Insured?	Unlimited Sum Insured
  What is Entry age under this policy?	Minimum Entry age for proposer/ spouse/ dependent parents - 18 years Maximum Entry Age for proposer/ spouse/ dependent parents - 65 years Minimum Entry age for dependent Children - 3 months Maximum Entry Age for dependent Children - 25 years
  What is Renewal Age?	Under normal circumstances, lifetime renewal benefit is available under the policy, except on the grounds of Your moral hazard, misrepresentation, non- cooperation or fraud (Subject to policy is renewed annually with us within the Grace period of 30 days from date of Expiry).
  Eligibility	Indian nationals. This policy can be opted by Non-Resident Indians including PIOs (Persons of Indian Origin) and OCIs (Overseas citizens of India) also, however the Policy will be issued during their stay in India and premium is paid in Indian currency & by Indian Account only We will cover Insured for treatment availed in India. Our liability shall be to make payment within India and in Indian Rupees only.
  What is the Policy period?	Policy can be taken for 1year / 2years or 3years.
  What is Premium paying term?	Annual Premium payment for 1 year policy and for long term policies of 2/ 3 years the total long term premium would be collected at the time of risk inception and renewal as well
  Who can be covered under Health Infinity Policy?	Self, Spouse, Dependent Children, Parents can be covered under individual option

• Bajaj Allianz health infinity insurance coverges

  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 5000/- 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 Infinity 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 ₹5000/-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

• Bajaj Allianz health infinity insurance 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.