About Raheja QBE Health Insurance

Raheja QBE is a joint venture between Rajan Raheja Group and QBE Insurance that offers insurance solutions to look after the healthcare needs of its customers. The company's adaptable insurance solutions, cater to multiple requirements. At present, the company offers 12 health insurance plans that provide customised health insurance solutions to fulfil consumer demands.

Continue Reading to find more about the company.

Key Features of Raheja QBE Health Insurance Company

Every health insurance company is different and offers different products according to the customers' needs. But choosing the right company with the right insurance plan is quite difficult when you don't know what exactly to look for. We at PolicyX.Com understand your concern and hence assist you to find the best options. After intensive research, we concluded a few parameters that can help an individual to analyze the company's performance and evaluate how the company works. It is crucial to have insights into the company and the parameters which can help you evaluate it are Network hospitals, solvency ratio, claim support, and annual premium.

Take a look at where Raheja QBE stands on these parameters, and make an informed decision.

1. Network Hospitals

   When a medical emergency knocks at your door, having a health insurance plan from a company that offers a cashless facility is a blessing. With a cashless facility, one can avail of the treatment in any of the empanelled hospitals without worrying about the hospital bills.

   With Raheja QBE, you will be able to avail of cashless facilities in more than 5,000 network hospitals across India.

2. Solvency Ratio

   The solvency ratio is another crucial factor to consider while selecting a health insurance company. It helps in assessing the company's financial soundness and the ability to meet its long-term financial obligations. At present IRDAI has made it mandatory for every health insurance company to maintain a solvency ratio of 1.5 which is considered a healthy solvency ratio.

   Let us take a look at the graph below to get an insight into the solvency ratio of Raheja QBE in the last 4 years.

   Solvency Ratio of Raheja QBE from 2016-2020

   

3. Claim Support

   It is highly recommended to choose an insurance company that settles claims quickly and smoothly. It is necessary to ensure that the insurance provider has a good claim settling record before buying a health plan from it. To assist customers in making an informed decision, IRDAI publishes claim support of insurance companies in its annual reports. These reports are a reliable source to determine the claim settling ability of an insurance company.

   Have a look at the table below to get an insight into the Claim Status of Raheja QBE as per the IRDAI Reports of 2019-2020.

   Age Analysis of Number of Claims Paid (%)
   <3 months	3 months to 6 months	6 months < 1 year	1 year to < 3 years	3 years to < 5 years
   30.29	7.21	21.15	37.50	3.13

   **Last Updated on August, 2021

4. Annual Premium

   The annual premium of the company helps the potential buyer to determine how the company is growing. This factor gives an idea of the company's growth as well as builds trust towards it.

   To help you understand better, we've created a graph below that compares the company's annual gross premiums from 2016 to 2020. Let's have a look.

   Annual Premium of Raheja QBE (in crores)

   

Types of Health Plans Offered By Raheja QBE

**Last Updated on August, 2021

Let's explore more about these plans.

1. Raheja QBE Health QuBE

   Health QuBe is a comprehensive health plan that covers all the healthcare needs of an individual and his family. Any person can buy this policy for themselves and their family members.

   Eligibility Criteria:

   • The minimum entry age is 90 days for children and 18 years for an adult.
   • The maximum entry age is 25 years for children and 65 years for an adult.

   The plan offers 4 tailor-made variants that allow the customers to customize their plan as per their needs. The available variants are:

   • Basic
   • Comprehensive
   • Super-Saver
   • A-La-Carte

   Schedule of benefits	Basic		Comprehensive	Super Saver		A-La-Carte
   Sum insured limits (in Rs.)	1 to 2 Lacs	3 to 50 Lacs	3 to 50 Lacs	1 to 2 Lacs	3 to 50 Lacs	1 to 2 Lacs	3 to 50 Lacs
   In-patient hospitalisation	Available		Available	Available		Available
   Room rent (per day)	1% of sum insured		No limit	1% of sum insured		1% per claim* (can be waived with add-on)
   ICU charges (per day)	2% of sum insured		No limit	2% of sum insured		2% per claim* (can be waived with add-on)
   Doctor fees (per day)	25% of sum insured*		No limit	25% of sum insured*		25% per claim* (can be waived with add-on)
   Pre hospitalisation	30 Days	60 Days	60 Days	30 Days	60 Days	30 Days	60 Days
   Post hospitalisation	60 Days	90 Days	90 Days	60 Days	90 Days	60 Days	90 Days
   Ambulance charges	Available		Available	Available		Available
   Daily allowance	Rs. 500 per day	Not Available	Not Available	Rs. 500 per day	Not Available	Rs. 500 per day	Not Available
   Organ donor benefit	Not Available	20% of sum insured	20% of sum insured	Not Available	20% of sum insured	Not Available	20% of sum insured
   Recharge/replenish benefit	Available		Available	Available		Available
   Medical checkup	Available		Available	Available		Available
   Non-Medical expenses	Not Available	Available	Available	Not Available	Available	Not Available	Available
   Sum insured increase	10% on cashless		10% on cashless	10% on cashless		10% on cashless
   Domiciliary hospitalisation	Available		Available	Available		Available
   No claim bonus	Available		Available	Available		Available
   Sub limit waiver*	Not Available		Built-in	Not Available		Not Available	Optional
   Co-pay - 20%	Not Available		Not Available	Built-in	Built-in	Not Available	Optional
   2 Year Policy availability	Available		Available	Available		Optional	Optional

   **Last Updated on August, 2021

   Sample Premium Illustration of Health QuBE

   To get a better idea of how much premium one needs to pay under this plan, take a look at the below example.

   Suppose, a man (30 years old) and his wife (25 years olds) decided to buy the Health QuBE plan for a 1 years policy term with a sum insured of Rs. 5 Lakhs. Have a look at a below graph to understand how the premium payable varies under different variants:

   

2. Arogya Sanjeevani Policy

   Raheja QBE's Arogya Sanjeevani Health plan offers coverage up to Rs. 5 Lakhs and allows the policyholder to secure their healthcare needs with affordable premiums. Under this plan, one can cover themselves as well as their spouse, dependent children, parents, and parents-in-law.

   Eligibility Criteria:

   Entry Age	For Adults: From 18 Years to 65 Years For Child: From 3 Months to 25 Years
   Sum Insured (in Rs.)	Minimum Sum Insured INR 1 Lakh Maximum Sum Insured INR 5 Lakhs, and in the multiple of INR 50,000/-
   Policy Period	1 Year

   **Last Updated on August, 2021

   What Is Covered Under Arogya Sanjeevani Policy?

   Parameters
   Day Care Treatments	Covered
   Pre-Hospitalization	Covered, up to 30 days
   Post-Hospitalization	Covered, up to 60 days
   Cataract Treatment	Up to 25% of Sum insured or Rs.40,000/-, whichever is lower, per eye, under one policy year
   AYUSH Treatment	Covered
   Cumulative bonus	Available. For every claim-free year, there will be an increase in the sum insured by 5% subject to a maximum of 50%.
   Road Ambulance	Covered up to Rs. 2000/- Per Hospitalisation
   Co-Pay	5% co-pay on all claims
   Advance Procedure	Procedures covered are Uterine Artery Embolization and HIFU Balloon Sinuplasty Deep Brain Stimulation Oral Chemotherapy Immunotherapy - Monoclonal Antibody to be given as an injection Intra Vitreal Injections Robotic Surgeries Stereotactic Radio Surgeries Bronchial Thermoplasty The vaporisation of the Prostrate (Green laser treatment or holmium laser treatment) IONM (Intra Operative Neuro Monitoring) Stem Cell Therapy (Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered)

   **Last Updated on August, 2021

3. Health QuBE Super Top-Up

   Have you ever imagined yourself in a situation where the coverage of your health insurance plan expires and you have nowhere to go? Raheja QBE Super Top-Up fulfils all your healthcare needs at the time of a medical emergency when your basic health plan is exhausted. The plan does not require medical check-up required up to the age of 55 years.

   Eligibility Criteria:

   Entry Age	For Adults: From 18 Years to 65 Years For Child: From 91 Days to 25 Years
   Sum Insured (in Rs.)	Up to Rs. 1 Crore
   Policy Period	1/2/3 Year

   **Last Updated on August, 2021

   What is Covered Under Health QuBE Super Top-Up Policy?

   Parameters
   Day Care Treatments	Not Covered
   Pre-Hospitalization	Covered, up to 60 days
   Post-Hospitalization	Covered, up to 90 days
   Donor's Medical Expenses	Covered, up to Rs. 2 Lakhs
   Domiciliary Hospitalization	Covered, up to Rs. 50 Thousand
   AYUSH Treatment	Covered
   Cumulative bonus	Available. For every claim-free year, there will be an increase in the sum insured by 10% subject to a maximum of 50%
   Restoration Benefit	Available
   Renewability	Life-long

   **Last Updated on August, 2021

4. Cancer Insurance

   Rahjeja's QBE Cancer Insurance relieves the policyholder from bearing the high costs of cancer treatment and provides comprehensive coverage for all stages of cancer. Sum insured options starting from Rs.1 Lakh and in multiples thereof subject to a maximum of Rs. 10 Lakhs available under this policy.

   In case an insured is diagnosed with Cancer and requires treatment, then the company will pay:

   • 50% of the Sum Insured or Rs. 250,000.00 whichever is less, as a lump sum amount on the acceptance of a claim under the Policy; and
   • Reasonable charges for medical expenses incurred by the insured during the medical treatment of Cancer, in excess of 75% of the benefit amount paid as a lump sum as stated above.

5. Individual Accident Policy

   Raheja QBE's Individual Personal Accident Insurance offers coverage to you and your family and supports them financially in case of unforeseeable accidents and mishaps. The policy provides coverage against:

   • Accidental Death
   • Permanent Total Disablement
   • Permanent Partial Disablement
   • Temporary Total Disablement

   Features:

   • The plan offers the compensation benefit that solely depends on the nature of the accident.
   • Actual costs incurred on transporting the Insured's mortal remains and for funeral expenses are covered under the plan subject to a maximum limit of the lower of 1% of the Sum Insured or Rs. 2500.
   • The plan offers compensation up to 2% of the sum insured in case of loss of employment due to permanent total disablement following an Accident.

6. Hospital Daily Cash-Group

   Along with hospitalization expenses, many miscellaneous expenses are not covered under a health plan and can cause a financial crunch. To help you in this situation, the company comes up with a Hospital Daily Cash policy to cover inadmissible expenses.

   Who can Take this policy?

   • Employer-Employee Group
   • Non-Employer - Employee Group
   • Minimum Group Size - 7 Lives

   Features:

   • A daily cash benefit will be paid in the case of hospitalisation due to sickness, and the amount will be given twice the daily limit if the insured is admitted to the ICU.
   • In case of accidental death, the daily benefit limit is increased to ten times with a maximum of up to Rs.10,000.
   • The plan comes with several optional covers such as Day Care Procedure Cash, Convalescence benefit, loss of income, International Emergency Benefit, etc.

7. Pravasi Bhartiya Bima Yojna

   Under the Emigration Act, the Pravasi Bhartiya bima yojana is an insurance policy for all Indian citizens who are planning to emigrate to foreign countries. You can now insure your travel plans and stay secured on your travels across 7 continents. The insurance provides travellers with coverage against personal accidents, medical emergencies, and more.

   Eligibility Criteria:

   Entry Age	The minimum age for an adult is 18 years, and the maximum age for a child is up to 21 Years.
   Policy Period	2 years & 3 years

   **Last Updated on August, 2021

   Features:

   • The plan covers the hospitalisation expenses of the insured and his family.
   • Provides repatriation cover for insured for Medical Emergency and 'Employment Emergency'.

8. Corona Kavach Policy

   As per the new guidelines of IRDAI, it is mandatory for every insurer to offer corona-specific health policies. Corona Kavach policy offers coverage against the expenses that arise at the time of COVID-19 treatment. One can file a claim if they are hospitalized for COVID-19 after testing positive at a government-authorized diagnostic centre.

   Eligibility Criteria:

   Minimum Entry Age	18 years
   Sum Insured	Rs, 50,000 to Rs. 5,00,000
   Policy Period	105 days, 195 days, and 285 days

   **Last Updated on August, 2021

   Features:

   • Under this plan, one can get coverage for the treatments under Ayurveda, Unani, Siddha, Yoga, and Homeopathy.
   • One can opt for Individual or Family Floater coverage and can cover self, legally wedded spouse, dependent children, parents, and parents-in-law.

9. Group Corona Kavach Policy

   With Raheja's Group Corona Kavach Policy, one can ensure their employees or members and can offer them protection against the hospitalization expenses related to Coronavirus medical treatment. Along with the coverage, an insured can also avail daily cash allowance for hospitalization for up to 15 days.

   Eligibility Criteria:

   Entry Age	For Adults: 18 years-100 years
   Sum Insured	Rs, 50,000 to Rs. 5,00,000
   Policy Period	105 days, 195 days, and 285 days

   **Last Updated on August, 2021

10. Group Health Insurance Policy

    Group Health Insurance policy by Raheja QBE is specially designed to provide comprehensive coverage to a particular group. The plan comes with several add-on covers such as Super Top Up, maternity, AYUSH, air ambulance, assistance services, home healthcare, and critical illness.

    An employer can cover its employees as well as its family members.

11. Group Personal Accident Policy

    Group Personal Accident Insurance policy offers financial compensation to the insured and his family for an injury or death arising out of an accident. The plan offers coverage in 4 scenarios that are: Accidental Death, Permanent Total Disability, Permanent Partial Disability, and Temporary Total Disability.

12. Group Premier Personal Accident Policy

    Raheja QBE Group Premier Personal Accident Policy is a comprehensive personal accident policy, that covers large as well as small-sized groups, and offers complete flexibility to design a cover suited to the requirements of group members. The policy provides comprehensive coverage like Accidental Death, Permanent Total Disability, Permanent Partial Disability, and Temporary Total Disability.

    The add-on cover available under the plan are:

    • In-Patient hospital medical expenses
    • Outpatient medical expenses
    • Burns
    • Broken bones
    • Dependent child education benefit
    • Repatriation of mortal remains

What Is Not Covered Under Raheja QBE Health Insurance Plans?

All the below-mentioned procedures are not covered under the Raheja QBE Health Insurance Plans:

• Pre-Existing Diseases
• Congenital External Diseases, Defects or anomalies
• Suicide or attempted suicide, intentionally self-inflicted Injury or Illness
• Sterility and Infertility
• Maternity Expenses
• Unproven Treatments
• Change-of- Gender treatments
• Cosmetic or Plastic Surgery

To get a complete list of all the exclusions, refer to the policy brochure.

How To Buy Raheja QBE Health Insurance Policy Online?

If you are interested in buying any of the above-mentioned products of the company, just follow the below steps:

Step 1: Visit the official website of Raheja QBE

Step 2: On the home page, find the Health Insurance tab on the top, and then click on the 'Buy Now Option'.

Step 3: Fill in all the details such as your name, age, and contact details.

Step 4: Once done, submit the form, and customize your plan as per your needs.

Step 5: Make the payment online, and once received the company will share all the details on your registered e-mail address.

How Can I File My Claim?

The company offers two ways by which you can file your claim at your convenience. These are Cashless Claims and Reimbursement Claims. Let's take a look at how they work.

For Cashless Claims (Only available in the Network Hospitals)

• In case of planned hospitalization, send the pre-authorisation form in advance (not before 15 days of admission date). In case of emergency hospitalization, send the pre-authorisation form within 24 hours from the time of hospitalization.
• After admission, show your health card at the hospital desk and fill the pre-authorization form. Ensure to fill the form correctly, and then get it signed by the attending doctor.
• Once filled, the company will send that form to the insurance company along with all the other documents.
• After getting approval from the insurance company, the hospital will settle all your bills, and you don't have to pay anything from your pocket.

For Reimbursement Claims

• Inform the company about your hospitalization.
• After availing of the treatment, pay your bills and other expenses.
• Submit all the hospitalization bills and all the other receipts to the hospital's help desk.
• The hospital will then submit the form along with all the documents to your insurance company.
• If approved, the company will reimburse the amount in your account.

Document Required to File A Claim

**Last Updated on August, 2021

Contact Information Of Raheja QBE Health Insurance Company

Address:

Raheja QBE General Insurance Ltd.

Ground Floor, Procter and Gamble Plaza, Cardinal Gracious Road, Chakala, Andheri East, Mumbai, Maharashtra 400099

Call:

Toll-Free: 1800-102- 7723

Timings: Monday - Saturday, 9 AM - 8 PM

Email

customercare[at]rahejaqbe[dot]com