Niva Bupa Arogya Sanjeevani
All you need to know
EXCLUSION
- Investigation & Evaluation
- Rest Cure, rehabilitation and respite care
- Obesity/ Weight Control
- Change-of-Gender treatments
- Cosmetic or plastic Surgery
- Hazardous or Adventure sports
- Breach of law
- Excluded Providers
- Refractive Error
- Unproven Treatments
- Sterility and Infertility
- Maternity Expenses
- Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
- 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.
- Any expenses incurred on Domiciliary Hospitalization and OPD treatment
- Treatment taken outside the geographical limits of India.
- War (whether declared or not) and war like occurrence 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.
- In respect of the existing diseases, disclosed by the insured and mentioned in the policy schedule (based on insured's consent), policyholder is not entitled to get the coverage for specified ICD codes.
All You Need To Know
Overview
A basic medical insurance policy covers you for health expenses up to the sum insured while a top-up plan covers costs after a certain threshold is reached. In case of higher expenses due to illness or accidents, the Extra Care Plus policy takes care of the additional expenses. This policy is the perfect fit for a more expansive health insurance cover to take care of the rising health care expenses.
Features
- Floater policy for proposer/spouse/dependent children/dependent parents (dependent parents under same policy)
- Sum Insured Options - 3/5/10/15/20/25/50 lacs
- Wide range of aggregate deductible options*
- Pre-existing disease covered after 12 months from your first Extra Care Plus policy
- Life time renewal option
- Free look period of 15 days
- Free health check-up
- Access to cashless facility at over 6000+ empanelled hospitals across India (subject to exclusions and conditions)
- Income tax benefit under 80 D of the IT Act**
- Health CDC benefit – quick claim settlement through app*
*Extra Care Plus policy pays the hospitalization expenses incurred above the aggregate deductible opted by you
Eligibility
- Entry age from 91 days to 80 years
- No pre-policy medical tests up to 55 years of age (subject to clean proposal form)
Exclusions
- Indian nationals residing in India would be considered for this policy.
- This policy can be opted by Non-Resident Indians also, provided premium is paid in Indian currency & by Indian Account only.
- Claims which have NOT been admitted under Medical expenses section
- Claims not in compliance with THE TRANSPLANTATION OF HUMAN ORGANS (AMENDMENT) BILL, 2011
- The organ donors Pre and Post-Hospitalisation expenses.
Please note: For details, please refer to the product brochure for policy terms and conditions
Claims Process
- To register your claim online, click here.
- Or register your claim on the phone, please dial our Toll Free Number: 1800-209-5858
Frequently Asked Questions
- Customer approaches Bajaj Allianz Network Hospital for cashless treatment
- Hospital verifies customer details & sends the Preauthorization Form duly completed, by fax to Bajaj Allianz – HAT (Health Administration Team
- Bajaj Allianz – HAT, verifies preauthorization request details with benefits & conveys decision to the provider
Approved
- Authorization letter is sent to the provider
- Provider treats the patient without any deposit till discharge
Query
- Query letter is sent to the provider asking for additional information
- Required additional information received from the Provide
- Bajaj Allianz – HAT, verifies preauthorization request details with benefits & conveys decision to the provider
Denial
- Denial letter is sent to the provider
- Provider treats patient as cash paying
Customer may file the claim for reimbursement
You might be under the impression that your existing health insurance cover might be sufficient for all your health related needs but what if the coverage offered is not able to meet all your medical costs? Your present cover may be sufficient to pay for small illnesses, but there is always a chance it would fall short in case of a bigger medical emergency. That’s where top-up health insurance plays a crucial part in covering your expenses and protects your savings