Raheja QBE health Insurance Plans

Raheja QBE India health insurance

Buy Raheja QBE India health insurance

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Why health insurance from Raheja QBE ?

Costly medical care from sudden medical emergencies will trigger family financial stress. Medical insurance helps you cover your wealth and take care of yourself and everyone you love.

Our health insurance policies provide broad and exclusive coverage. We offer cashless facilities, simple claim registration and a huge network of hospitals to ease your stress like a friend.

Raheja QBE Health Insurance Review

Raheja QBE Health Insurance
Raheja QBE Insurance sum insured
1 lac − 50 lacs options available
Incurred Claims Ratio *
33.00%
Raheja QBE Insurance tenure options
1 or 2 years options available
Claims Settlement Ratio **
100.00%
List of network hospitals
5,000+ hospitals
Number of policies issued *
135
Maximum family floater coverage
Self, Spouse + 2 dependent children + parents
Number of lives covered *
135
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website
Raheja QBE is a joint venture between Rajan Raheja Group and QBE Insurance, Australia’s second largest global insurer. Raheja QBE has been established to help create the most conducive environment for consumers and partners in the insurance sector. While Rajan Raheja Group brings in its extensive knowledge across various business sectors in India, QBE insurance offers global expertise in insurance that together results in innovative insurance solutions for diverse consumers.

When it comes to insurance, every entity and individual has diverse needs. Raheja QBE collaborates internally and externally for assuring the delivery of highly adaptable insurance solutions that can cater to these multiplicities in requirement while ensuring to follow Hassle-Free Processes, Complete Transparency in their operations and being as Customer Centric as possible to ensure complete consumer satisfaction.

Raheja QBE offers their health insurance customers the option of availing quality treatment at more than 5,000+ leading hospitals across the country. With an incurred claims ratio of 35.00%, they also covered 135 lives during the same year 2018-19, as per the data provided by IRDAI.

Why Should One insure themselves through Raheja QBE Health Insurance plans?

Expensive medical treatment from unforeseen medical emergencies can cause financial burden for families. Health insurance helps you to safeguard your finances and to take care of yourself and your loved ones. Raheja QBE’s health insurance plans provide extensive and exclusive coverages and they offer cashless facility, easy claim registration and a large hospital network to ease your stress like a friend.
  • Raheja QBE is one of newer Private sector General Insurance companies overall and now aggressively ventured into the Health Insurance.
  • Cashless Hospitalization Across the Large Network With More Than 5,000+ Hospitals in India for their insured customers offering Transparent and Trusted claims service.
  • Wide Range Of Health Insurance Products From Individual Plans to Family Floater Schemes with Sum Insureds ranging from ₹1 lacs to ₹50 lacs.
  • World class Customer Centric Support through its 24X7 service centre known for transparency and ease.
Raheja QBE Insurance is today one of the fastest growing insurance players in India with a lot of focus on both retail and group insurance products. Today the Raheja QBE health insurance premium is one of the most competitive in the market across all their plans apart from being competitive in their benefit structure. They are also one of the players who have built a strong hospital network across India with a current strength of 5,000+. Most of the customer’s Raheja QBE health insurance reviews have been positively influencing the growth of their business year on year. One can also follow the Raheja QBE health insurance renewal link on eindiainsurance for renewal of their existing policies and if one needs to file a claim, all they need to do is to fill in the Raheja QBE health insurance claim form available on the same website.

  • Benefits
  • How to buy
  • Claims Procedure
  • Exclusions

Benefits under Raheja QBE Health Insurance plans include:

Some of the benefits under the Raheja QBE Health plans are below…
  • Cashless facility – Raheja QBE processes all cashless claims across 5,000 + quality hospitals in their network across India.
  • Inpatient Benefit / Hospitalization Benefit : Hospitalisation expenses for a period of more than 24 Hours.
  • Pre /Post Hospitalization Benefit : Medical expenses incurred upto fixed days specified as per SI Band/Plans .
  • Ambulance Charges: Upto a maximum of 2500/- based upon the SI & Plan opted .
  • Daily Cash Allowance : Hospital daily cash benefit of upto maximum of 6 days .
  • Organ Donor Benefit : Medical Expenses on harvesting the organ from the donor for organ transplantation..
  • Recharge/Replenish Benefit: Replenishment of the basic sum insured if the basic sum insured has been exhausted during the policy year.
  • Health Checkup: Free Health Checkup based upon the SI Selected irrespective of the claims .
  • Non Medical Expenses: Reimbursement of Non-Medical Expenses upto the limit specified. .
  • Sum Insured Increase: In case of Cashless claim we would reduce your limit only by 90% .
  • Domicillary Hospitalisation : Medical expenses incurred for availing medical treatment at home which would otherwise have required hospitalisation
  • Optional Addons:
    • Sublimit Wavier : On payment of additional premium as specified we would waive the sub- limits pertaining to room rent, ICU charges, Medical Practitioners’ fees and disease related sub-limits.
    • Special NCB : On payment of additional premium we would given you a special premium discount of 5% on renewal of policy for a claim free policy. (Upto maximum of 20% cumulatively).
    • Co Pay : If you opt for co-pay of 20% we would give you a premium discount.
  • Income Tax Exemption under section 80D if the Income Tax Act.

How can one Buy a Raheja QBE Health Insurance policy?

There are many distribution channels that distribute Raheja QBE Health insurance products that include Agents, Banks and Brokers. One of the key distributors is the Web Aggregators which are online distributors of insurance and the advantage is that they offer a comparison of all insurance products to the customer, to allow them to compare the plans before opting for a health insurance plan that most suits his/her needs.
  • Step 1- Visit a product comparison website eindiainsurance to review and compare policy benefits, coverage and premium details online.
  • Step 2 - Seek information and clarity on the charges, inclusions, exclusions, other terms and conditions under the policy.
  • Step 3 - Fill the Raheja QBE online Health Insurance proposal form stating your personal details and health profile while ensuring the information given is complete and accurate.
  • Step 4 – If this is a Straight through proposal, the premium remitted online will be transferred directly to the insurance company, and the policy will be issued, dispatched and will reach you in 7 working days.
  • Step 5 – For Non Straight through cases, Raheja QBE will process the application forwarded to them. Based on the information provided, one may be required to undergo pre-policy tests at designated diagnostic centers or they may just levy a loading based on the health report.
  • Step 6 - If the proposal is accepted, the same will be issued accordingly.
  • Step 7 - The Policy Schedule, Policy Wordings, Cashless Cards and Health Guide will be sent to the insured’s mailing address mentioned on the proposal form in the prescribed Turn around time.

Claim Process

TPA Details

Kindly get in touch on the below mentioned toll free number or email for any claim related queries or assistances.

Toll Free Number : 1800-4259-449
Email Address : info@mediassistindia.com
Write To : Medi Assist Insurance TPA Pvt. Ltd, 4th Floor, Aarpee Chambers,
Shagbaug, Off Andheri-Kurla Road, Next To Times Square, Marol,
Andheri East, Mumbai, Maharashtra 400059
(or)
Medi Assist Insurance TPA Pvt. Ltd. IBC Knowledge Park,
Tower D, 4th Floor, Bannerghatta Main Rd, 4/1, Bengaluru,
Karnataka 560029

You can also contact Raheja QBE Insurance through:
Toll Free Number : 1800-102-7723
Email Address : customercare@rahejaqbe.com

List of documents needed for Registering a Health Claim

Please take care to submit all the below documents while submitting your claim:
  • Duly filled claim form duly signed by the insured and the treating doctor.
  • Discharge summary with the details of complaints and the treatment availed.
  • Final Hospital Bill with detailed break-up along with interim bills payment receipts.
  • Doctor’s consultation papers.
  • All investigation reports (e.g. original blood report, X-ray, sonography, CT scan, MRI, etc.)
  • All pharmacy bills supported by doctor prescriptions.
  • Implant sticker or invoice, if used (e.g. lens details in cataract case, stent details in angioplasty).
  • Medico legal certificate (MLC) and / or FIR for all accident cases.
  • For all miscellaneous charges, detailed bills supporting prescription of the treating doctor.
  • Photocopy of the health card.
  • Any other related documents,
  • Please note all documents that are sent to the TPA should be in original.
  • Medical Practitioner’s referral letter advising Hospitalization
  • Indoor case paper
  • First Information Report, final police report, if applicable;
  • Post-mortem report, if conducted;
  • Death Certificate from the municipal authorities;
  • Death Summary from the Hospital authorities, if death is confirmed by the Hospital;
  • Inquest/Panchnama Report;
  • Coroner’s Report
  • Submit documents at nearest Raheja QBE branch.
Points to Remember
For Cashless Claims For Reimbursement Claims
Avail the benefits of cashless service at Raheja QBE network hospitals. Mention correct and complete communication address with the pin code on the claim form.
Kindly ensure that the pre-authorisation form is completely filled and signed by the Insured and the attending doctor. Always keep a photocopy of the claim documents submitted to RQBE.
Kindly ensure to mention the mobile number on the pre-authorisation form. Kindly ensure that the claim form is completely filled and signed by the insured and the attending doctor.
In case of planned hospitalization, please send the pre-authorisation form in advance (not before 15 days of admission date). Kindly ensure to mention the mobile number on the claim form.
In case of emergency hospitalization, please send the pre-authorisation form within 24 hours from the time of hospitalization. All claim documents are to be submitted in original within 30 days from the date of discharge.
In case of cashless denial, insured to pay hospitalization expenses. Quote your cashless (pre-authorisation) number as reference in all the future correspondence with RQBE. Quote your claim number as reference in all future correspondence with RQBE.
Do not refer to the network list of any other service provider. Insured to bear any inadmissible expenses, co-payments and or deductions.
Do not wait until the discharge time to raise the enhancement request.  
Insured to bear any inadmissible expenses, co-payments and or deductions.  


Exclusions Under the Policy

Some of the General Exclusions under the Raheja QBE Health plans include:
  • Expenses related to any admission primarily for diagnostics and evaluation purposes.
  • Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment
  • Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.
  • Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  • 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.
  • Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, parajumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
  • Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
  • Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.
  • Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons.
  • Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure
  • Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters.
  • Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
  • Expenses related to 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
  • Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy
  • War (whether declared or not) or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
  • Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense.

List of Raheja QBE health insurance policies

Key Features:
  • Entry Age: Minimum entry age is 90 days for children and 18 years for an adult. Maximum entry age is 25 years for children and 65 years for an adult.
Key Features:
  • Room Rent: Up to 2% of sum insured, maximum `5,000 per day. For ICU, up to 5% of sum insured,maximum ` 10,000 per day
  • Co-pay :% co pay on all claims.
Key Features:
  • Entry Age: 1 day to 70 years can opt for this insurance cover.

Key Features:
  • Policy can be availed by persons between the age of 18 years up to 65 years, as Proposer. Proposer with higher age can obtain policy for family, without covering self.

Raheja QBE Health Insurance FAQ’s

Your insurance company rewards you for staying hale and hearty! Every year you get cumulative bonus in the form of increased sum insured for not making any claims in consecutive of 2 years. We at Raheja QBE offer cumulative bonus of upto 100%

The fixed amount or percentage paid by the insured ( the one who is covered) for the medical treatment. If your co-payment percentage is 20% then in case of hospitalization you are suppose to bear 20% of the expense and remaining shall be paid by your insurer.

If you are suffering from any ailment at the time of buying a policy is termed as pre existing illness or disease. It’s important to declare pre existing disease at the time of policy issuance or else at the time of claim; if the insurer knows about your existing illness your claim may get denied.

Insurance Company gives you a chance to cancel your policy post payment if you have found a better plan and wish to take a different plan. This period is called free-look period.

Get additional sum insured equal to your actual sum insured in case your sum insured gets exhausted.

You must notify Us either at the call center Toll free 1800 425 9449 or in writing at info@mediassist.com, in the event of planned or emergency hospitalization.

The earlier the better, typically, everyone should consider buying a health insurance policy in their early 20's and one has just started earning. Health insurance also helps in planning within a family to ensure there is financial coverage in case of an unexpected health emergency. It also offers wider coverage at a lower premium.

Your ideal sum insured or total coverage would highly depend on factors such as your current age, lifestyle, medical history, income and place of residence. Looking at the medical inflation, most of our customers prefer a health insurance policy with a sum insured of 5 lacs and above.

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

Raheja QBE has an extensive network of 5,000+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through the Raheja QBE network hospital list available on Health QBE plans.

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

It refers to payment of the Medical Expenses incurred by the insured while undergoing Specified Day Care Procedures/ Treatment (as mentioned in the Day Care Surgeries list), which require less than 24 hours Hospitalization.

The premium paid on a health insurance policy is eligible for deduction under Section 80D of the Income Tax Act. So save with your policy now!

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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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