Bajaj Allianz Women Specific Critical Health Insurance

Benefits of Women Specific Critical Health Insurance

• Critical Illness Cover
• Congenital Disability Benefit
• Inbuilt add on benefits
  • Children Education Bonus
  • Loss of Job

Coverages of Women Specific Critical Health Insurance

1. Critical Illness Cover
   100% of sum insured would be paid ifthe insured member is diagnosed with the listed CriticalIllness, subject to policy terms and conditions.List of Specific Critical Illnesses as below:
   • Breast Cancer
   • Fallopian Tube Cancer
   • Uterine/Cervical Cancer
   • Ovarian Cancer
   • Vaginal Cancer
   • Permanent Paralysis of Limbs
   • Multi trauma
   • Burnsy
2. Congenital Disability Benefit
   50% of the sum insured wouldbe payable if the insured member gives birth to a baby havingcongenital disease/ disorder; congenital diseases covered arelisted under the policy. This benefit will be available for firsttwo children only.List of congenital diseases covered under Congenital DisabilityBenefit:
   • Down's syndrome
   • Congenital cyanotic heart disease:
     • Tetrology of Fallot
     • Transposition of great vessels
     • Total Anomalous pulmonary venous drainage
     • Truncus Arteriosus
     • Tricuspid Atresia,
     • Hypoplastic Left Heart Syndrome
   • Tracheo-esophageal fistula
   • Cleft Palate with or without cleft lip
   • Spina bifida
3. Children Education Bonus
   If the claim for Critical illnessbenefit is paid under this policy we will also pay Rs. 25000/-towards future education of the dependent children (If any).The amount payable under this section would be restricted toRs 25000/- for one or more child put together.
4. Loss of Job
   In the event of the insured person losing her jobwithin a period of 3 months of the date of diagnosis of any ofthe Critical Illness as covered in the policy, the policy will payan amount of Rs 25000/- towards loss of employment, providewe have paid a claim under Critical Illness Section for theInsured Member.

• The benefit amount under Critical Illness Section of this policyis payable once the disease is diagnosed meeting specificcriteria and the insured survives 30 days after the diagnosisand in case of the congenital disability section the childsurvives 30 days after the diagnosis.
• The insured needs to submit the claim form along withcertificate from the specialist confirming occurrence of thecritical illness /congenital disability (in case of child) ascovered under the policy.
• For a claim to be admissible under Congenital DisabilityBenefit section the member should also have conceivedduring the policy period.

• The insured receives the amount as lump sum so that he canplan the treatment accordingly.
• Additional benefits like coverage for new born baby'scongenital ailments, Children education bonus, Loss of job areavailable under same policy.
• Hassel free in-house claim process.
• Premium paid is exempt under section80-D of Income Tax Act.

• Pre policy medical examination mandatory for age 41years and above
• Pre policy medical examination can be conducted at a good diagnostic centre.
• List of Pre –policy medical tests:
  • Full Medical Report,
  • Ultrasonography of Abdomen and Pelvis
  • PAP Smear Test.

Exclusions of Women Specific Critical Health Insurance

• For breast cancer
  • Tumours that are histologically described as pre and ductal/lobular carcinoma in situ (location) of the breast.
    
  • Breast lumps, for example, fibroadenoma, fibrocystic diseases of breast, etc.
  • All hyperkeratosis or basal cells carcinomas, melanomas, squamous cell carcinoma, Kaposi's sarcoma and other tumours associated with HIV infections or AIDS of the skin.
• For fallopian tube cancer
  • Carcinoma in situ
  • Dysplasia
  • Inflammatory masses
  • Hydatid form mole
  • Trophoblastic tumours
• For cervical cancer
  • Tumours showing the malignant changes of carcinoma in situ - an early form of cancer that is defined by the absence of invasion of tumour cells into the surrounding tissue, usually before penetration through the basement membrane.
  • Squamous intraepithelial lesion.
  • Fibroid, endometriosis, cystic lesions, hyperplasia of any type presenting as tumours.
  • Hydatid form mole, trophoblastic tumours.
• For ovarian cancer
  • Non-cancerous (benign) ovarian masses including abscesses or infections, fibroids, cysts, polycystic ovaries, endometriosis.
  • Hydatid form mole is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease pregnancy-related tumours.
  • Trophoblastic tumours appear when cells in the womb start to grow out of control. Cells grow in the tissues that are formed following conception. Gestational trophoblastic tumours start inside the uterus. This type of cancer occurs in women during the years when they are able to have children.
• Vaginal cancer
  • Vulval cancers/tumours.
  • Vaginal/vulval granulomatous diseases.
• Congenital diseases
  • This benefit will not be available if the birth of the child occurs after you reach the age of 40 years.
• Congenital diseases
  • This benefit will not be available if the birth of the child occurs after you reach the age of 40 years.
• Multi-trauma
  • A single fracture.
  • Injuries involving fractures of small bones of hand, feet, ribs; even if multiple.
  • Any type of fracture such as open or closed, displaced or not displaced, simple or compound types.
• Other exclusions
  • Any critical illness for which care, treatment, or advice was recommended by or received from a physician, or which first manifested itself or was contracted before the start of the policy period, or for which a claim has or could have been made under an earlier policy.
  • Any critical illness diagnosed within the first 90 days of the date of commencement of the policy.
  • Death within 30 days following the diagnosis of the critical illness.
  • Treatment arising from or traceable to pregnancy or childbirth, including caesarean section and birth defects.
  • Treatment arising due to war, invasion, an act of foreign enemy, terrorism, hostilities (whether war be declared or not), civil war, rebellion, revolution.
  • Treatment arising due to radioactive contamination.
  • Intentional self-injury and/or injury due to the use or misuse of intoxicating drugs and/or alcohol.
  • Intentional losses of any kind such as loss of profit, loss of opportunity, loss of gain, business interruption, etc.