Bajaj Allianz Health Ensure Plan
Bajaj Allianz Health Care Supreme Plan
  • Policy Renewal Facility
  • Organ Donor Expense
  • Tax Benefits Under Sec 80D
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Bajaj Allianz Health Ensure Plan

Bajaj Allianz Health Insurance Company is one of the best health insurance providers in the present insurance market. It is serving Health Ensure Plan which has excellent features and benefits. Bajaj Allianz Health Ensure Plan has two plan options under it:

1. Individual Plan

2. Family Floater Plan

The policy buyers are free to choose among the individual plan and the family floater plan as per the requirement of their family. The coverages provided under both are admirable. All you need to do is analyze your budget/needs and finalize the sum insured. The sum insured finalizes the extent of coverage that a policyholder will get.

You can proceed with buying the Health Ensure Policy if you and your family fulfil the below-mentioned eligibility criteria.

Bajaj Allianz Health Ensure Eligibility

CriteriaDetails
MinimumMaximum
Entry Age Adult18 YearsLifetime
Entry age children3 Months30 Years
Sum Assured Options (Individual)Rs.50,000
Rs.75,000
Rs.1 lakh
Rs.1.5 lakhs
Rs.2 lakhs
Rs.3 lakhs
Rs.4 lakhs
Rs.5 lakhs
Rs.10 lakhs
Sum Insured Options (Family Floater) Rs.2 lakhs
Rs.3 lakhs
Rs.4 lakhs
Rs.5 lakhs
Rs.10 lakhs
Policy Term1 Year, 2 Years, 3 Years
Members (Individual Plan)Self, spouse, dependent children, grandchildren, parents, sister, brother, parents-in-law, grandparents
Members (Family floater)
  • Self, spouse, dependent children can be covered under family floater plan.
  • Separate floater plans can be taken for parents and parents-in-law.

Coverage Provided Under Bajaj Allianz Health Ensure Plan

The below-mentioned coverages are provided under the plan which will leave you doubtless while making a buying decision-

  • In-patient hospitalization: You get in-patient hospitalization facility under the Health Ensure Plan. In the case of hospitalization on doctor’s advice due to illness/accidental bodily injury, you get coverage for expenses like doctor’s consultancy fees, operation theatre charges, anaesthesia, blood oxygen, surgical appliances, medicines & drugs, dialysis, chemotherapy, etc.
  • Room Rent Expense Cover: You get coverage for room rent expense. Under the room rent, boarding and nursing expenses are considered. You get the lower of the following:
    • Maximum of 1% of the sum.
    • Up to Rs.5000/- daily.
  • ICU Charges Cover: ICU cover is provided to the policyholder under the Bajaj Health Ensure Plan. ICU charges provided are lower of :
    • Maximum up to 2% of the sum insured.
    • Up to Rs.10,000/-
  • Pre-Hospitalization Cover: You get pre-hospitalization cover under this plan. All the medical expenses incurred during 30 days before the date of hospitalization is considered under pre-hospitalization expense by the health insurance company.
  • Post-Hospitalization Cover: All the medical expenses incurred within 60 days from the date of discharge from the hospital is considered under post-hospitalization expense cover.
  • Ambulance Expense Cover: Ambulance facility expense cover is provided to you in the case of an emergency. Under the ambulance expense cover, you get a maximum up to Rs.1,000 to manage the ambulance conveyance charges.
  • Day Care Procedures: A list of daycare procedures that get coverage is available in the annexure of the policy wordings. Please go through it before buying the policy.
  • Health Checkup: Free health checkup facilities are provided once after completion of every 3 years duration. The health insurance company reimburses an amount equal to the 1% of the sum insured or a maximum of Rs.1,500, whichever is higher.
  • Alternative Treatment Cover: Alternative treatment expense cover is also provided under the Health Ensure Plan. Alternative treatments like Ayurvedic, Yoga & Naturopathy, Homoeopathic, Unani, Siddha (AYUSH) get coverage under the plan. The only condition applied is that the treatment should include hospitalization not less than 24 hours.

Salient Features/Benefits of Bajaj Allianz Health Ensure Plan

Here are few of the noticeable features and benefits of the plan explained for your better understanding and clarity:

  • Pre-Insurance Medical Screening: Generally, it is mandatory to undergo the pre-insurance medical checkup before buying a health plan under any of the health insurance companies. But under the Bajaj Allianz Health Ensure Policy, it is not compulsory for policy buyers less than 50 years of age.
    All the policy buyers more than 50 years of age will have to undergo the following list of tests before buying the plan:
    • Full Medical Report
    • CBC
    • Urine R
    • ECG
    • Lipid Profile
    • Fasting BSL
    • HbA1C
    • SGOT
    • SGPT
    • Sr Creatinine
  • Free Look Period: A 15 days free look period is provided to you. During the free look period, you are free to cancel the policy in case you do not like any of the facilities, coverage, terms and conditions mentioned in the policy.
  • Cumulative Bonus: Cumulative bonus is provided to the policyholder for claim-free years. If you have not claimed in the passing year, the health insurance company rewards you in the form of the cumulative bonus. Under this, the limit of indemnity increases by 5% of the sum assured per annum.
  • Policy Renewal Facility: The Health Ensure Policy comes with a lifetime renewability feature. It is refused only in case of moral hazard, misrepresentation, fraud or non-cooperation.
  • Policy Migration: You can migrate to other similar insurance products available under Bajaj Allianz Health Insurance at the time of policy renewal. The premiums to be paid under the plan is revised as per the insurance product chosen by you.
    Moreover, the waiting period for all the previous policy years would be extended in the new policy subject to the condition that the policy is in force without any break.
  • Organ Donor Expense: All the medical expenses incurred in the transplantation of organ and treatment of the organ donor is covered under the Health Ensure Policy.
  • Tax Benefits: Tax benefits are provided on the premiums paid under the plan as per section 80D of the Income Tax Act, 1961.
  • Pre-Existing Disease Waiting Period: A waiting period of 24 months is to be served by you from your first health insurance policy. This waiting period applies to the treatment expense of the pre-existing disease. After you have served the pre-existing disease waiting period, you get coverage for its treatment expense.

Sample Premium Table For An Individual

For Zone A

Age (Years)/SI (Rs.)Rs.50,000Rs.75,000Rs.1 lakhRs.1.5 lakhsRs.2 lakhsRs.3 lakhsRs.4 lakhsRs.5 lakhsRs.10 lakhs
0.3 Months - 20 YearsRs.1,250Rs.1,552Rs.1,905Rs.2,435Rs.2,700Rs.3,157Rs.3734Rs.4,402Rs.5,511
26 - 30Rs.1416Rs.1825Rs.2238Rs.2861Rs.3170Rs.3708Rs.4388Rs.5173Rs.6476
31-35Rs.1,702Rs.2,194Rs.2,735Rs.3,495Rs.3,872Rs.4,530Rs.5,362Rs.6,323Rs.7,915
41 - 45Rs.1,988Rs.2,592Rs.3,266Rs.4,174Rs.4,623Rs.5,410Rs.6,404Rs.7,553Rs.9,455
51 - 55Rs.3,362Rs.4,337Rs.5,325Rs.6,802Rs.7,531Rs.8,816Rs.10,440Rs.12,317Rs.15,418
61 - 65Rs.6,452Rs.8,325Rs.10,223Rs.13,058Rs.14,452Rs.16,923Rs.20,045Rs.23,654Rs.29,609
71 - 75Rs.9,834Rs.12,691Rs.15,584Rs.19,903Rs.22,025Rs.25,794Rs.30,557Rs.36,060Rs.45,139
Above 75Rs.11,234Rs.14,497Rs.17,803Rs.22,736Rs.25,159Rs.29,464Rs.34,906Rs.41,194Rs.51,565

Exclusions

  • Suicide or self-inflicted injury.
  • Vitamins, tonics, nutritional supplements which have been taken without prescription.
  • Situations arising out of alcoholism or drug abuse.
  • Treatment of medical conditions arising due to nuclear reaction or radiation.
  • Any injury due to participation in war activity.
  • Injury due to involvement in illegal activity.
  • Treatment relating to HIV/AIDs.
  • Treatment relating to venereal and sexually transmitted disease.
  • Cosmetic surgery.
  • Injury due to participation in adventurous activities and life-threatening games.

Bajaj Allianz Health Ensure Plan: FAQs

Yes, you can port your health insurance policy from one health insurance company to another without any loss of accrued bonuses under the plan.

Loading is applied under the plan due to adverse health conditions. The loading is applicable on an individual basis for health conditions mentioned below:

  • Hypertension
  • Diabetes
  • Obesity
  • Cholesterol disorder
  • Cardiovascular diseases, or multiple risk factors

Yes, the premium amount is different for zone A and zone B. Our country is divided into two zones and the premiums are decided based on the same. The states included in both of the zones are mentioned below:

Zone A comprises states like Delhi/ NCR, Mumbai (including Navi Mumbai, Thane and Kalyan), Hyderabad, Secunderabad, Banglore, Kolkata, Ahmedabad, Vadodara and Surat.

Zone B comprises the rest of the Indian states apart from those mentioned in zone A.

The documents required to claim this plan are:

  • Claim form with NEFT details.
  • Cancelled cheque duly signed by the insured.
  • Original copy of discharge summary/ discharge certificate/ death summary with surgical and anaesthetics note.
  • Attested copies of indoor case papers (optional).
  • Original paid receipt against the final hospital bills.
  • Cashless settlement letter.
  • Aadhar number and PAN card copy.
  • Original bills and receipts transportation from the registered ambulance service provider.

You can insure a maximum of 6 members under the plan. It can be inclusive of 2 adults and a maximum of 4 children.

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Last updated on 11-02-2020