Bajaj Allianz's Family Floater Health Guard Policy takes care of the expensive medical treatment incurred during hospitalization resulting from serious accident or illness. The policy covers pre and post hospitalization expenses and also ambulance charges in case of an emergency (subject to a limit of Rs. 1000/-)
the eligible age
-
Entry age for proposer is 18 yrs - 65 yrs. Policy can be renewed upto 80 yrs*.
- Children from 3 months to 25 yrs are eligible if both the parents are insured with Bajaj Allianz.
coverage the policy offers
- With Family Floater Health Guard, the member has access to cashless facility at various empanelled hospitals across India. (subject to exclusions and conditions)
- In case the member opts for hospitals besides the empanelled ones, the expenses incurred by him shall be reimbursed within 14 working days from submission of all document
- Pre and post hospitalization expenses covers relevant medical expenses incurred 60 days prior to and 90 days after hospitalization
- 10% co-payment of the admissible claim to be paid by the member if treatment is taken in a hospital other than a network hospital. Waiver of the co-payment clause is available on payment of additional premium.
- Covers ambulance charges in an emergency subject to limit of Rs.1000/-
- 130 daycare procedures are covered subject to terms & conditions
- 20% Co-payment applicable for any insured person aged 56 yrs. And above, being covered for the first time in the Health Guard policy
benefits offered
- Health Check up in designated Bajaj Allianz Diagnositc Centers or Reimbursement upto Rs. 1000/- at the end of continuous four claims free years.The benefit can be availed by only one member of the family
- Income tax benefit on the premium paid as per section 80-D of the Income Tax Act
exclusions
- 4 years waiting period applicable for Pre-existing diseases
- All diseases/injuries existing at the time of proposing this insurance
- Any disease contracted during the first 30 days of commencement of the policy
- Certain diseases such as hernia, piles, cataract (liability restricted upto 10% of SI, max. upto Rs. 35,000), sinusitis shall be covered after a waiting period of 2 years
- Non Allopathic medicine
- Congenital diseases
- All expenses arising from AIDS and related diseases
- Cosmetic, aesthetic or related treatment
- Use of intoxicating drugs, alcohol
- Joint replacement surgery (other than due to accidents shall have a waiting period of four years)
Pre & Post Hospital Expenses:
- Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill.
- Doctor's Consultation Charges: Mandatory to provide the Doctor's prescription and the doctor's bill and receipt.
- Diagnostic Tests: Mandatory to provide the Doctor's prescription advising tests, the actual test reports and the bill and receipt from the diagnostic centre.
- The claims team would assess the claim for completeness of documentation and Admissibility. A written communication would be sent to the insured regarding Requirement of documents if any or if the claim is deemed to be inadmissible as per Policy terms and conditions.
- In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document.
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