Bajaj Allianz Tax Gain Plan Insurance

Bajaj Allianz Tax Gain Plan Insurance review

• Tax Gain Plan

  What are the details of coverage the policy offers?
  • Out patient expenses & hospitalization expenses covered forself & spouse on floater basis.
  • Pre & Post hospitalization expenses can be covered under thespecified OPD expenses
  • Ambulance charges in case of emergency hospitalizationup to Rs. 1000/-
  • 130 day care procedures subject to terms & conditions
  • The expenses for crutches will be covered from day 1 underOPD benefit
  • FreeHealth Check up at designated Bajaj Allianz Empanelled Diagnostic center after every 4 claim free policy periods.
  • Income Tax benefit under Sec 80D of the IT Act on thepremiums paid.
  • Separate plan for Senior citizens covering both OPD &hospitalization benefits.
  • 10% co-payment of the admissible claim amountapplicable if treatment is taken in non-network hospital.Waiver of co-payment is available on payment of additionalpremium.
  • In case of Cataract claims would be payable after a waitingperiod of 2 yrs , and restricted to 10 % of SI subject to min of Rs12000/- and maximum of Rs 25000/-
  What is the Entry age?
  • Entry age is 18yrs –75 yrs
  • Entry age is 18yrs –55 yrs for Plan A , Plan B & Plan C (56 yrsonwards provision for shifting to Plan D is available)
  • Entry age is 56 yrs -75 yrs for Senior citizens plan D
  • Renewablefor lifetime
  What is the Renewal age?
  • Under normal circumstances, lifetime renewal benefit isavailable under the policy except on the grounds of fraud,misrepresentation or moral hazard.
  • Insured members covered under Plan A , Plan B & Plan C wouldbe offered to get covered under plan D at the time of renewalafter completion of age 55years.
  • Further lifetime renewal benefit would be available under Plan D.
  What is the Policy period?
  • This is an annual policy
  Which Family members can be covered under the Policy?
  • Once can cover Self and Spouse under this policy
  Sum Insured Tables
  

  Plan A	18-25 years	26-40 years	41-45 years	46-55 years
  Hospitalisation Coverage	₹1 ,00,000
  OPD (Sum Insured ) – Self	3,100	2,900	2,500	1,600
  Plan B	18-25 years	26-40 years	41-45 years	46-55 years
  Hospitalisation Coverage	Floater Sum Insured ₹2,00,000
  OPD (Sum Insured ) – Self	6,500	6,000	5,000	3,000
  OPD (Sum Insured ) – Self + Spouse	5,200	4,800	3,500	1,000
  Plan C	18-25 years	26-40 years	41-45 years	46-55 years
  Hospitalisation Coverage – C1	Floater Sum Insured ₹ 2,00,000
  OPD (Sum Insured ) – Self	9,500	9,000	8,500	7,500
  OPD (Sum Insured ) – Self + Spouse	9,000	8,500	7,000	4,500
  Hospitalisation Coverage – C2	Floater Sum Insured ₹3,00,000
  OPD (Sum Insured ) – Self	9,000	8,500	7,500	6,000
  OPD (Sum Insured ) – Self + Spouse	8,000	7,500	5,500	6,000
  Plan D – For Senior Citizens	56-60 years	61-65 years	66-70 years	>71 years
  Hospitalisation Coverage	Floater Sum Insured ₹1,00,000
  OPD (Sum Insured ) – Self	13,000	12,500	12,000	11,000
  OPD (Sum Insured ) – Self + Spouse	11,000	10,000	9,500	8,000

• Coverages of Tax Gain Plan

  1. Hospitalization Medical Expenses
     If You/Your spouse named in the scheduleare hospitalised on the advice of a Doctor because of Illness or accidental BodilyInjury sustained or contracted during the Policy Period, then We will pay You,Reasonable and Customary Medical Expenses incurred subject to the maximumLimit of Indemnity specified in the schedule.
  2. Out Patient Medical Expenses
     If You/Your spouse named in the schedulerequire treatment to be taken on Out Patient basis on advice of a Doctorbecause of illness or accidental Bodily Injury sustained or contractedduring the Policy Period , then We will pay You, reasonable and CustomaryMedical Expenses incurred subject to the maximum Limit of Indemnityspecified in the schedule.
  3. Ambulance Expenses
     If a claim under Cover 1) is accepted, We will also paythe reasonable cost to a maximum of Rs 1000/- per valid hospitalization claimfor transferring You to or between Hospitals in the Hospital's ambulance or in anambulance provided by any ambulance service provider.

• Bajaj Allianz Tax Gain Plan Insurance exclusions

  • Any medical expenses arising due to 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 nationalisation or requisition of or damage by or under the order of any government or public local authority and claims due to nuclear weapons and/or materials.
  • Circumcision, cosmetic or aesthetic treatments, surgery for change of life/gender.
  • Plastic surgery unless necessary for the treatment of cancer, burns or accidental bodily injury.
  • Convalescence, general debility, rest cure, congenital external diseases or defects or anomalies, genetic disorders, stem cell implantation or surgery, or growth hormone therapy.
  • Human Immunodeficiency Virus or variant/mutant viruses and AIDS, venereal disease or any sexually transmitted disease.
  • Hospitalisation primarily and specifically for diagnostic, X-ray or laboratory examinations and investigations.
  • Vaccination or inoculation unless forming a part of a post-bite treatment.
  • Vitamins, tonics, nutritional supplements unless forming part of the treatment.
  • Surgery to correct deviated nasal septum and hypertrophied turbinate.
  • Treatment for any mental illness or psychiatric illness. Benefits will not be available for any pre-existing condition, ailment or injury, until 48 months of continuous coverage have elapsed, after the date of inception of the first Tax Gain policy.
  • Cost of spectacles in the first year of the policy. This cost is payable in the second year of continuous renewal subject to a maximum limit of 25% of the OPD limit.
  • Cost of dentures in the first two years of the policy. This cost is payable in the third year of continuous renewal subject to a maximum limit of 25% of the OPD limit.
  • Cost of hearing aids in the first two years of the policy. This cost is payable in the third year of continuous renewal subject to a maximum limit of 25% of the OPD limit.
  • Any expenses for treatment taken without the doctor advising the same and which is not duly supported by prescriptions.
  • Any expenses for diagnostic tests without the treating doctor's referral.
  • Cost of annual health check-up.
  • Any expenses in excess of the maximum payable under the outpatient medical expenses limit.
  • Pregnancy and childbirth related expenses.