Non-life insurance

8/14/2019 Non-life insurance

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PGDM 2009-2011

Corporate Finance Project 2009:

Non Life Insurance

Course Facilitator Pawan Jain

Term II

Submitted by:

Ben C Kurian 2009067Janit Yadav

2009088Karan Sood

2009090

Chandani Beri2009102

Chandni Caul 2009103Hitansh Vij

2009110Ashish Jose Kavi

2009116


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Aditi Goel2009117

Ayush Bindal 2009120Neha Patet

2009317

Non Life Insurance

Meaning of Insurance

Insurance provides financial protection against a loss arising out of happening of an uncertain

event. A person can avail this protection by paying premium to an insurance company.

A pool is created through contributions made by persons seeking to protect themselves from

common risk. Premium is collected by insurance companies which also act as trustee to the pool.

Any loss to the insured in case of happening of an uncertain event is paid out of this pool.

Insurance works on the basic principle of risk-sharing. A great advantage of insurance is that it

spreads the risk of a few people over a large group of people exposed to risk of similar type.

Definition

Insurance is a contract between two parties whereby one party agrees to undertake the risk of

another in exchange for consideration known as premium and promises to pay a fixed sum of

money to the other party or to indemnify the other party on happening of an uncertain event.

(General Insurance).

The party bearing the risk is known as the 'insurer' or 'assurer' and the party whose risk is

covered is known as the 'insured' or 'assured'.

General insurance only pays out when an insured event occurs. It includes:

home insurance (contents and/or buildings)

car insurance

travel insurance

private medical insurance

accident, sickness or unemployment insurance toprotect your income, mortgage or loan payments (also

called 'Payment protection insurance')


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Now we are analyzing various non life insurance schemes offered by following companies

ICICI Lombard Insurance 24x7

Reliance General Insurance

United India Insurance

Bajaj Allianz Insurance

Iffco-Tokyo General Insurance

Home insurance, also commonly called hazard insurance orhomeowners insurance is the

type of property insurance that covers private homes. It is an insurance policy that combinesvarious personal insurance protections, which can include losses occurring to one's home, its

contents, loss of its use (additional living expenses), or loss of other personal possessions of the

homeowner, as well as liability insurance for accidents that may happen at the home. It requiresthat at least one of the named insured occupies the home. The dwelling policy (DP) is similar,

but used for residences which don't qualify for various reasons, such as non-occupancy or age.


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Point of

comparison

Reliance General

Insurance

ICICI Lombard

Insurance 24x7

Bajaj Allianz United India

Insurance

IFFCO-

TOKIO

Policy Reliance Home

Protect

Home Insurance House-Holders

Insurance Policy

Householders

Policy

Home Suvidh

Key

Benefits

1. Comprehensive

cover: Provides

cover for a large no.

of items including

valuables, glass

items, electronics,

etc.

2.Flexibility inchoosing the cover:

The policy is pretty

flexible in the sense

that you can choose

the amount of cover

and contents of

home that you

would like to be

covered.

3.Attractive

Discounts: Discount

is offered on thepremium depending

on the no. of covers

chosen. There is

also a possibility of

high discounts if

you chose large no.

of covers or if you

have a favorable

claim history.

1. Comprehensive

Cover: Covers

both structure and

contents of your

home.

2.Flexibility in

choosing the

cover: There is a

provision for

optional covers.

eg. Terrorism and

additional

expenses of rent

for alternative

accommodation.

You also have achoice to choose

alternate covers.

3.Attractive

Discounts: The

company provides

15% discount on 3

years home

insurance policy

and a 25%

discount on 5

years policy.

1. Comprehensive

Cover: A single

policy covers all

the risks related to

home.

2. Flexibility in

choosing the

cover: There is

availability of

customized cover

option. Also,

related items get

covered under

respective

sections.

3.Attractive

discounts and

affordable rates:

There are benefits

on sectional

discounts which

will reduce the

premium. Also,

the complete

coverage can be

done at reduced

costs with no

strain on pocketsof insured.

1. Comprehensive

Cover: A wide

variety of

household items

are covered which

includes even the

liability to third

party.

2. Flexibility in

choosing the

cover: Benefits

under four or more

sections can be

chosen in case the

householder is

exposed to any of

the given

contingencies.

1.

Comprehensi

Cover: Provid

comprehensiv

protection for

your househo

assets, interes

liability, fami

members, etc

2.Flexibility

choosing the

cover: You ca

choose the

amount of cov

with no

maximum lim

for sum insur

under any

section of the

policy.

3.Attractive

Discounts:There is a

provision for

premium

discount if six

or more sectio

are covered b

you.


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Point of

compariso

n

Reliance

General

Insurance

ICICI Lombard Bajaj Allianz United India

Insurance

IFFCO-TOKIO

Policy

Coverage

1. Fire and

Allied Perils:

Covers the

structure and

contents of your

home, againstfire and other

natural and

manmade

disasters

including

earthquake.

2.Burglary andHousebreaking:

Cover against the

loss or damage to

the contents of

your home

against burglary

and

housebreaking.

3.All Risk Cover:

All risk cover to

your jewellery

and valuables

anywhere in

India.

4.Domestic

Mechanical and

Electrical

Appliances:

Coverage to

electrical and

mechanical

appliances in

your home

against

mechanical and

electricalbreakdown.

1. Natural &

man-made

calamities: The

calamities

covered are:

- Fire

- Riot, strike &

malicious

damage

- Explosion &

implosion

- Earthquake

- Lightning

- Storm, cyclone,

tempest, tornado,hurricane, flood

& inundation

- Damage due to

impact by

vehicles

- Missile testing

operation

- Subsidence,

landslides and

rockslides

- Leakage from

automatic

Sprinkler

installations

- Aircraft

damage

- Bursting and/or

overflowing of

water tanks,apparatus and

pipes.

2. Burglary and

theft cover: The

contents of your

home are also

covered against

loss due to

burglary or an

1.Fire & allied

perils: Building

& contents -

Covers not only

property, but

also contents.

2.Burglary &

Theft: Covers

loss of house

hold contents

and expenses

Incurred due to

damage causedon incidence of

house-breaking

& theft.

3.Jewellery &

Precious Items:

All risk

coverage for

jewellery and

precious stones.

4.Plate Glass:

Coverage

against

accidental

breakage of

glass.

5.Domestic

Appliances:

Covered against

any electrical or

mechanical

breakdown.

1. Building and

contents: Fire,

lightning, Acts of

God, Riot and

Strike, impact,

explosion of gasin domestic

appliances,

overflow of water

tanks.

2. Burglary,

House breaking

and Theft.

3. Jewellery and

Valuables - Any

accidental

loss/damage Plate

Glass Any

accidental

loss/damage.

4.Baggage -

While on travel,

any accidental

loss/damage.

5. Domestic

Appliances: Any

accidentalloss/damage

entirely due to

electrical/mechani

cal breakdown.

6. TV, VCR,

Audio System.

1.Fire and Allied

Perils: Your residenti

building as well as

various types of

contents is covered

against fire, explosionbursting/overflowing

water tanks, riots,

strikes, malicious

damage, earthquake,

flood, cyclone, landsl

etc.

2.Burglary and otherPerils: Covers the sam

properties as in Fire a

Allied Perils Section

against housebreaking

burglary, robbery or

dacoity.

3.All Risk: Covers

valuable items such a

jewellery, items of go

silver and other precio

metals or stones,

watches, clocks,

photographic

equipments, etc.

4.

Fixed Glass andSanitary Fittings:

Covers accidental

breakage of fixed glas

and sanitary fittings in

your premises.

5.Electronic

Equipment: Covers lo

or damage to electron

e ui ments like


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ACCIDENT INSURANCE PROVIDED BY DIFFERENT COMPANIES

Reliancegeneral

insurance

ICICILombard

Bajaj Allianz United IndiaInsurance

Iffco-Tokyo

olicy Personal

Accident

Policy

Personal

Accident

Policy

Personal Accident

Policy

Personal

Accident Policy

Personal Accident Policy

olicy

overage

Accidental

Death,Permanent

Total

Disability,

PermanentPartial

Disability,TemporaryTotal

Disability

Accidental

Death,Permanent

total

Disablement

and againstTerrorism

and Act ofTerrorism

Covers Death,

PermanentPartiality

Disability,

Permanent Total

Disability, &Temporary Total

disability.

In case of

Temporary TotalDisability 1% of SI

or Rs 5000 / week

(whichever islesser) will be

payable up to max

100 weeks.

Death ,

Permanent TotalDisablement ,

Loss of two

limbs/ Two eyes

or one limb andone eye,Loss of

one limb or oneeye , PermanentPartial

Disablement ,

Temporary TotalDisablement

Death, loss of both hand

both feet or one hand,Lof one hand/foot and s

of one eye ,Loss of spe

or hearing in b

ears,Permanent tdisability

ligibility This policy can

be issued topersons in the

age group of 5

years to 70years.

It can be

extended tocover persons

beyond the age

of 70 years and

up to 80 yearson payment of

suitable

additionalpremiums.

Age criteria

at entry:Minimum 18

years ,

Maximum 70years.(the

applicant can

buy thepolicy for his

spouse aged

between 18-

70 years)

Age 3 Months 55

years.

Any individual

or group ofindividuals

( through

employer,association, and

institution etc)

aged between 12and 70. Subject

to medical

examination at

70, a person canbe covered up to

80.

If you are not involved in

any activity that ishazardous like aviation,

ballooning etc. and you a

not a member of the armforces and you fall within

the specified age limits (

to70 years), you can applfor this Policy and get

complete protection for

yourself and your

familymembers.
http://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspxhttp://www.icicilombard.com/app/ilom-en/PersonalProducts/Home/Silver_plan.aspx


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xclusions Pregnancy orrelated

consequence

Any mental

disorder

Any pre-existing

conditions /

disabilities

Needlessexposure to

peril, except in

an attempt tosave human

life

Intentional

self-injury,suicide or

attempted

suicide

Influence ofintoxicating

liquor or drugs

Insured

committingany breach of

law with

criminal intent

War and

nuclear perils

Riots, Crimes,

Misdemeanours and Felonies

Intentionalself injury,

suicide,

whilst under

the influenceof

intoxicatingliquor ordrugs,

aviation or

ballooning,whilst

mounting

into or from,

aircraft otherthan as a

passenger,

insanity,criminal

intent, war,

Invasion,civil war,

childbirth or

pregnancy

Pregnancy or relatedconsequence

Any mental disorder

Any pre-existing

conditions /disabilities

Needless exposure to

peril, except in an

attempt to save

human life

Intentional self-

injury, suicide or

attempted suicide

Influence ofintoxicating liquor or

drugs

Insured committing

any breach of lawwith criminal intent

War and nuclear

perils

Compensationunder more

than one

clause for

same periodof disability

not exceedingcapital suminsured

Any payment

after

admission of aclaim for 50

% / 100 % of

Capital SumInsured

Any claim in

the same

period ofinsurance

exceeding the

Capital SumInsured

Suicide,

attempt there

at, VD,criminal

breach of

law,accidentaldeath/injury

under

influence of

liquor/drugs

Pregnancy

related claim

War and

nuclear perils

Some of the importantExclusions under the Pol

are self-injury, suicide,

venereal disease, insanity

influence of intoxicatingliquor or drugs, pregnanc

or childbirth, HIV or AIDwar and nuclear risks etc

ey Benifits It not only Covers Children's On payment of For that extra protection


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providescompensation to

the family in

case of the

accidental deathof the insured

but also takes onthe onus ofproviding the

insured with

compensation incase of injury,

whether

temporary or

permanent.

The sum insured

increases by 5%

for eachcompleted

claim-free year

of insurance,subject to a

maximum of a

50% increase.

This policy canalso be

expanded to

cover actualmedical

expenses

arising out ofthe accident

claimsarising out of

Terrorism or

act of

terrorismChoice of

cover period3,4,5 yearsNo health

checkup

requiredEasy Claim

process with

nominal

documentation

Educational Bonusbenefit.

Daily hospital

confinement

allowance payable incase of

hospitalization dueto accident*

Medical expenses

reimbursement incase of

hospitalization due

to accidents*,

Highest

compensation of

125% of the SI incase of Permanent

Total Disability.

Hassle free in house

claim settlement.

Cumulative bonus

@ 5% per claim free

year to a maximum

of 50%.

Family discount of

10%

Highest

compensation of125% of the SI in

case of Permanent

Total Disability.

extra premium,medical

expenses

incurred up to 25

% of claim or 10% of Sum

Insured can becovered.

Policy also paysfor education

fund for

dependantchildren (2) of

deceased insured

and expenses ofcarriage of dead

body of insuredfrom accidentsite ( as per

details in policy)

Attractive

cumulativebonus at the time

of renewal, by

way of

increasing the

Sum Insured by5 % for each

completed claimfree year of

insurance

( maximum of 50% CSI ) without

collecting extra

premium as perpolicy.

relief in those hard timesITGI's Personal Acciden

Insurance Policy also giv

the following additional

benefits:

Education Benefit:

In the unfortunate event

death or loss of limbs/ey

or permanent totaldisablement of the Insure

the education cost of

dependant children is

covered under the Policyupto specified limits.

Employment Benefit:

This cover provides

financial compensation uspecified limits in the ev

of loss of employment of

the Insured following anaccident resulting in loss

limbs/eyes or permanent

total disablement.

Ambulance Benefit:

If any accident results inuse of an ambulance by t

Insured to reach a hospit

then the Policy will pay tnecessary charges upto

specified limits.

Cumulative Benefit:

Besides these benefits,

Policy also offers benefit

like compensation forclothing damaged in an

accident, expenses for

carriage of dead body etc

On payment of nominalextra premium, our Perso


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Accident Insurance Polic

can also be extended toprovide a whole range of

additional coverages.

Medical Expenses

In addition to the death o

disablement benefits, thePolicy will provide

reimbursement upto

specified limits for mediexpenses incurred for

treatment following an

accident.

Cost of Supporting Item

If the use of supporting

items like crutches,

wheelchair, artificial lim

etc. becomes necessary dto injuries sustained in an

accident, then the costs a

reimbursed upto specifielimits.

Cost of Travel

If the Insured is disabled

a place other than his

normal residence due to accident, then we will pa

upto specified limits for

of travel of the injuredperson for returning hom

and also for the travel co

of any accompanying frior relative to join the

Insured and for returning

home.


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HEALTH INSURANCE

Health Insurance: What are its types?

There are primarily two types of health insurance available to individuals:

1. Fee for Service: Here the insured patient can get treatment from a medical professionalof his choice. The cost of treatment is then claimed by the insured or the medical providerfrom the insurer.

2. Managed Care Health Insurance Plan: This plan is designed in such a way that it helps

minimize unnecessary costs for healthcare. It may provide physicians with reasonable

incentives, may control the admission of inpatients, sign contracts with selective health

care providers and provide incentives to share cost for outpatient surgery. The ManagedCare Health Plan is further divided into 3 types:

Health Maintenance Organization (HMO): In a Group Model HMO plan the insured patient

may visit doctors, who are employees of this HMO, at a centralized medical center. The HMOsare also in contract with the Individual Practice Associations (IPAs) who also have groups of

physicians or individual doctors providing health care.

The HMO may also refer a primary care physician or PCP for an insured patient who seeks a

specialist's service. The patient needs to settle the co-payment as per the agreement and the rest

of the cost will be borne by the insurance company.

a. Preferred Provider Organization (PPO): With this type of healthcare theinsured patients are entitled to receiving medical services from hospitals and other

care providers in contract with the PPO. This can be done at a lesser fee. Patientsseeking medical care from within the PPO network pay lesser than those seekingoutside the network.

The PPO plan reimburses only 70% of the cost incurred. The remaining 30%, i.e.

the difference between the amount that the plan reimburses and what the providercharges has to be met by the insured.


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b. Point of Service (POS): This plan also includes a network of hospitals,

physicians and other care providers. Members of such plans who opt for out-of-network care get little coverage. The advantage of such a plan, however, is that it

offers more choices to the members. Even if members choose a physician outside

the network, they can still be covered to a certain extent.

Reliance

General

Insurance

ICICI

Lombard

Bajaj Allianz Iffco Tokio United India

Insurance

Individual

Mediclaim

Policy

Health

Advantage

Plus

Health Guard Critical illness Uni medicare

insurance

Reliance

Healthwise

Family Floater Silver Health Surgery protector

Personal

Accident

Critical illness Workmens

compensation

Hospital Cash

Star Package

e-opinion

Insta Insure

Health Ensure

Personal Guard

Reliance General Insurance

1) Individual Mediclaim Policy


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Features

A family deserves the best especially when it comes to medical care.

With medical expenses shooting sky high, Reliance Mediclaim Insurance Policy helps meet

hospitalization costs. It frees from financial worries so that one can give full attention to

loved ones.

Key Advantages

a) Hospitalization Care for the Family

Reliance Mediclaim Insurance Policy covers you and your family for hospitalization

and related expenses.

Family members between the ages of 5 and 80 years can be covered.

The policy also provides health insurance for children between the ages of 3 months

and 5 years if one of the parents is covered concurrently.

b) Claim-Free Bonus

We reward you with a no-claim bonus of 5% on every claim-free renewal. This can

be accumulated up to a maximum of 50%.

c)Tax Advantage

With health insurance you not only protect your family but also can avail of tax benefits

under Section 80D of the Income Tax Act.

d) Policy Coverage

Value Added Benefits


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Reliance Healthwise

Key Highlights

Rs. 2 lakh cover for a family of two at Rs. 2245 per annum

24 x 7 cashless facility and TPA support

No medical check-up up to age of 45 years

Income Tax benefit under Section 80 D

Features

Access to quality healthcare is a necessity today. The Reliance Healthwise Policy ensures you

provide the best medical care to your family. We offer a health insurance policy that gives you

the optimum value for money without compromising on the quality of medical attention.

Key Advantages

a)Affordable Premiums

We offer premiums as low as Rs. 2245 p.a. for a sum insured of Rs. 2 lakhs, for a

couple

The Family Floater benefit covers the entire family, ensuring that the cover is used

Reliance Mediclaim Insurance Policy offers you value-added benefits to give you extra

cushioning and added cover.

The policy will cover pre-hospitalization expenses for 30 days and post-hospitalization

expenses for 60 days.

It also provides you with health cover for technologically advanced treatment that does

not require 24-hour hospital stay.

No medical check-up up to the age of 45.

Free medical check-up after 4 claim-free renewals.


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optimally

Policies are available for people up to the age of 65 years.

b)Convenience all the way

No health checkups for people under the age of 45 years. With our instant health-kit issuance, your health cover gets an instant start.

A 24-hour cashless facility is provided at more than 4,300 hospitals across India.

c) The Reliance Advantage

Pre-existing illnesses will commence after two years or four years (depending on the plan

you choose) of continuous cover We also provide you and your family with extended coverage for pre- and post-

hospitalization expenses.

What's more, we reward you with a no-claim bonus of 5% on every claim-free renewal.

This can be accumulated up to a maximum of 50%.

d) Tax-wise

With the Reliance HealthWise Policy, you can avail of tax benefits under Section 80D ofthe Income Tax Act.

Value Added Benefits

Reliance General Insurance strives to provide more than what is expected. Our value-added

benefits include:

Nursing allowance for a maximum of five days.

Reimbursement of charges towards ambulance services

Allowance for expenses of a person accompanying the insured, for a maximum of five

days

Reimbursement of cost of health check-up after four claim-free renewals.


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Outpatient Department (OPD)

Basic Hospitalization Cover

It covers inpatient Hospitalization expenses up to sum insured of Rs. 2 or Rs. 3 Lakhs

(depending on the plan chosen). You can avail the cashless claim facility in any of the 4500+

network hospitals across India.

Basic Hospitalization cover includes:

Medical expenses incurred as an inpatient during Hospitalization for more than 24 hours,

including room charges, doctors / surgeons fee, medicines, diagnostic tests, etc.

30 days prior to Hospitalization

60 days post Hospitalization

Pre-existing diseases shall be covered after 24 months of continuous coverage since inception

of first individual health policy with the company.

Technologically advanced treatment that do not need 24-hour Hospitalization but are covered

under this policy are:-

- Cataract

- Lithotripsy (Kidney Stone Removal)

- Tonsillectomy

- Eye Surgery

- Dialysis

- Dilatation & Curettage

- Chemotherapy

- Radiotherapy


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- Coronary Angiography

- Cardiac Catheterization

Coverage limit for specific ailments / conditions:

Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under

this policy.

All others ailment(s) / surgery(s)/ procedure(s) are covered up to the sum insured under the

policy.

*- Pre-Hospitalization period, the period of Hospitalization and the Post-Hospitalization period,

should fall within the Period of Insurance


This covers outpatient treatment expenses in the form of reimbursement of medical bills, dental

expenses, etc. In case of an OPD treatment (Outpatient Department), the claims will be settled

later after furnishing the medical prescription documents/bills.

Outpatient Department Covers:

Room, Boarding Expenses as charged by the Hospital

Nursing Expenses

Expenses related to Dental Treatment

Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees

Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and


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Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of

Pacemaker, Cost of Artificial Limbs External Medical Aids, Dental treatment charges,

Ambulance charges

Claims under OPD Benefit can be made only on a re-imbursement basis. You can lodge a

claim only once during the Period of Insurance, i.e. 90 days after commencement of policy

and 30 days after expiry of the Period of Insurance.

Sum Insured for Plans covering 2 individuals comes under the Floater benefit.

Key Benefits

Floater benefit The floater benefit would mean that one policy covers 2 family members with

one sum insured and one premium. This takes care of Hospitalization expenses as well as

Outpatient Treatment expenses in case of a sudden illness, accident or planned surgery of either

of the family members.

Optimum income tax benefit under section 80 D*. Save up to Rs. 5099/- on your Policy

premium.

Fixed premium of Rs 15,000 for all plans excluding Senior Citizens aged 65 & above.

Reimbursement of OPD expenses upto Rs. 10,000/- This includes diagnostics tests, dental

treatment, etc. (OPD Benefit depends on age of senior most insured member and the plan

chosen)

Declared pre-existing illness covered after 2 years, i.e. from the 3rd year.

Cashless claim facility available at over4,500 network hospitals across India.
http://www.icicilombard.com/app/ilom-en/personalproducts/Health/Health-Advantage.aspxhttp://www.icicilombard.com/app/Personalproducts/Health/Network-Hospitals.asphttp://www.icicilombard.com/app/ilom-en/personalproducts/Health/Health-Advantage.aspxhttp://www.icicilombard.com/app/Personalproducts/Health/Network-Hospitals.asp


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No health check up required upto the age of 55 years (as on last birthday).

Free health check-up coupon for any one insured family member.

Medical check-up mandatory for insured of age 56 years and above.

Eligibility

The enrolment age (of the senior most family member) should be between 5 years to 65 years.

The policy cover is renewable till the age of 70 years.

The customer can buy the policy only for his two family members - defined as self, spouse or

dependent children or dependent parents for the purpose of income tax exemption u/s Sec. 80D.

Family Floater

Policy Coverage

This is a comprehensive Tax-Saving health plan and provides 2 covers:



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This covers inpatient Hospitalization expenses up to sum insured of Rs. 2 or Rs. 3 Lakhs

(depending on the plan chosen). You can avail the cashless claim facility in any of the 4500+

network hospitals across India.

Basic Hospitalization cover includes:

Medical expenses incurred as an inpatient during Hospitalization for more than 24 hours,

including room charges, doctors / surgeons fee, medicines, diagnostic tests, etc.

30 days prior to Hospitalization

60 days post Hospitalization

Pre-existing diseases shall be covered after 24 months of continuous coverage since inception

of first individual health policy with the company.

Technologically advanced treatment that do not need 24-hour Hospitalization but are covered

under this policy are:-

- Cataract

- Lithotripsy (Kidney Stone Removal)

- Tonsillectomy

- Eye Surgery

- Dialysis

- Dilatation & Curettage

- Chemotherapy

- Radiotherapy


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- Coronary Angiography

- Cardiac Catheterization

Coverage limit for specific ailments / conditions:

Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under

this policy.

All others ailment(s) / surgery(s)/ procedure(s) are covered up to the sum insured under the

policy.

*- Pre-Hospitalization period, the period of Hospitalization and the Post-Hospitalization period,

should fall within the Period of Insurance


This covers outpatient treatment expenses in the form of reimbursement of medical bills, dental

expenses, etc. In case of an OPD treatment (Outpatient Department), the claims will be settled

later after furnishing the medical prescription documents/bills.

Outpatient Department Covers:

Room, Boarding Expenses as charged by the Hospital

Nursing Expenses

Expenses related to Dental Treatment

Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees

Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and


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Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of

Pacemaker, Cost of Artificial Limbs External Medical Aids, Dental treatment charges,

Ambulance charges

Claims under OPD Benefit can be made only on a re-imbursement basis. You can lodge a

claim only once during the Period of Insurance, i.e. 90 days after commencement of policy

and 30 days after expiry of the Period of Insurance.

Sum Insured for Plans covering 2 individuals comes under the Floater benefit.

Key Benefits

Floater benefit The floater benefit would mean that one policy covers 2 family members with

one sum insured and one premium. This takes care of Hospitalization expenses as well as

Outpatient Treatment expenses in case of a sudden illness, accident or planned surgery of either

of the family members.

Optimum income tax benefit under section 80 D*. Save up to Rs. 5099/- on your Policypremium.

Fixed premium of Rs 15,000 for all plans excluding Senior Citizens aged 65 & above.

Reimbursement of OPD expenses upto Rs. 10,000/- This includes diagnostics tests, dental

treatment, etc. (OPD Benefit depends on age of senior most insured member and the plan

chosen)

Declared pre-existing illness covered after 2 years, i.e. from the 3rd year.
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Cashless claim facility available at over4,500 network hospitals across India.

No health check up required upto the age of 55 years (as on last birthday).

Free health check-up coupon for any one insured family member.

Medical check-up mandatory for insured of age 56 years and above.

Eligibility

The enrolment age (of the senior most family member) should be between 5 years to 65 years.

The policy cover is renewable till the age of 70 years.

The customer can buy the policy only for his two family members - defined as self, spouse or

dependent children or dependent parents for the purpose of income tax exemption u/s Sec. 80D.

Personal Accident

Policy Coverage

Personal Accident policy covers you for

Terrorism and Acts of Terrorism: In case of the death of the insured arising out of terrorism

or acts of terrorism within the policy period, the nominee (mentioned in the policy) is

compensated with the sum Insured. The Company shall also pay compensation against

permanent and total loss of limbs, sight etc. (of the insured) arising out of terrorism or acts of

terrorism.

Accidental Death: In case of death of the insured due to an accident within the policy period,
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the nominee (mentioned in the policy) is compensated with the Sum Insured.

Permanent Total Disablement (PTD) : Personal Accident pays compensation against the

permanent and total loss of limbs, sight etc. due to an accident.

Note: If any such injury as mentioned above shall result in the inability to remain gainfully

employed, then the Capital Sum Insured payable will be 100%.

Key Benefits

Covers claims arising out of Terrorism or acts of Terrorism

Covers against Accidental Death or Permanent Total Disablement (PTD)

Choose among Sum insured options of Rs. 3, 5, 10 and 20 Lakhs

Choice of cover period: 3, 4 or 5 years

No health check-up required

Easy Claim Process with minimal documentation

Eligibility

Age criteria at entry: Minimum 18 years, Maximum 70 years.

The applicant can buy the policy for his spouse aged between 18-70 years.


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Health Guard

HEALTH GUARD -COVERS ALL MEDICAL EXPENSES ON HOSPITALIZATION

It is rightly said Health is Wealth. We are all aware that health care costs are high and getting

higher. At times, unfortunately we fall prey to unanticipated accidents & illness. Bajaj Allianz

promises to stand by you during those difficult times of physical and mental stress. Our Health

Guard policy takes care of your hospitalization expenses & also offers a wide coverage of pre

& post hospitalization expenses. We are the first company to provide the higher coverage of SI

10 lacs.

Features

The member has cashless facility at over 2400 hospitals across India The member can opt for hospitals besides the empanelled ones, in which the expenses

incurred by him shall be reimbursed within 14 working days from submission of all

documents.

Pre and post - hospitalization expenses covers relevant medical expenses incurred 60

days prior to and 90 days after hospitalization.

Cumulative bonus of 5 % is added to your sum assured for every claim free year.

Family discount of 10 % is applicable.

Covers ambulance charges in an emergency subject to limit of Rs. 1000 /-

No tests required up to 45 years up to SI 10 lacs*

10% co- payment applicable if treatment taken in non-network hospitals. Waiver of co-

payment is available on payment of additional premium


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Pre-existing diseases covered after 4 years continuous renewal with Bajaj Allianz

Benefits

In house Health Administration Team for Hospitalization claims to lower turn around

time

Access to over 2400 hospitals all over India for cashless facility.

No Sub-limits applicable on room rent and other expenses.

Hassle-free claim settlement due to In-house claim administration.

Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per

existing IT law.

Health Check up for maximum amount of Rs. 1000 /- at the end of continuous four

claim free years

Family discount of 10% is applicable

Coverage

10 lacs coverage available from 3 months up to 55 years*

Policy can be renewed up to 70 years*

In built E-opinion cover for SI 5 lacs & above.

Silver Health

SILVER HEALTH POLICY - EXCLUSIVE HEALTH INSURANCE FOR PEOPLE AGED

46YRS AND ABOVE

As the age of an individual increases the health care costs increase & become a burden on the

individual. The senior citizens have to pay out the hard earned savings to meet the expenses.

Bajaj Allianzs Silver Health plan is exclusively designed for the senior citizens, which covers

medical expenses incurred during hospitalization period.


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HOSPITAL CASH - COVERS NON-MEDICAL EXPENSES DURING HOSPITALIZATION

With a Hospital Cash policy from Bajaj Allianz you and your family can now breathe a sigh of

relief! As this is a benefit policy which covers the incidental expenses incurred during the

Hospitalization period. In the event of hospitalization this policy provides a cash allowance of

Rs 500-2500 for each day of hospitalization.

Benefits

Covers miscellaneous expenses incurred during hospitalization.

Comprehensive coverage with nominal premium.

Premium amount upto Rs.15000/- p.a. is eligible for tax exemption under section 80-D

of Income Tax Act as per existing IT law.

Dependent spouse and children can be also covered under this policy.

5% family discount is applicable if cover taken for family

Coverage

SI available from 500-2500.

Cover available for 30days & 60 days.

Star Package

STAR PACKAGE - COVERS HEALTH & HOME IN A SINGLE PLAN

Star Package policy is a unique family floater policy which protects your family against

various risks and contingencies. It provides a gamut of covers for various health risks,

household contents, education grant, travel baggage and public liability all under a single

policy. It has 8 sections and you would have to opt for a minimum 3 sections to avail for this

policy.


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Features

Covers Hospital Cash, Health Guard, Critical Illness, Personal accident, Education

Grant, Householders contents, Traveling Baggage & Public liability.

Family floater can be opted by paying 50% & 25% of self premium for spouse &

children respectively.

Add on covers can be opted under Health Guard.

12 Dreaded diseases are covered under Critical illness.

The policy can be taken for maximum 3 years to avoid yearly renewal.

10-15% section discount can be availed if 4 or more sections are opted.

10-15% Long term discount can be availed if the policy is taken for 2 or more years.

Benefits

Wide coverage from Health to Home.

Access to over 2400 hospitals all over India for cashless facility.

No Sub-limits applicable on room rent and other expenses.

Hassle-free claim settlement due to In-house claim administration

Income tax benefit on the premium paid as per section 80-D of Income Tax Act* as per

existing IT lawCoverage

Age 3 Months 55 years.

Wide range of Sum Insured is available under different cover

TRAVEL POLICIES

BAJAJ ALLAINZ

1) Swades Yatra


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Travelling has become very frequent be it for business or leisure. The risk of accidents increase

due to frequency of travel. Any accident would affect your finances either due to medical

expenses incurred or loss of income to the family due to unfortunate circumstances like death or

disability. Swades Yatra is a comprehensive package policy for domestic travelers which

provides complete personal accident benefit cover including hospitalization expenses as a resultof accident.

2) Travel Assist

Bajaj Allianz General Insurance along with ASSIST CARD a Swiss company has launched a

co-branded travel insurance product called TRAVEL ASSIST. The product has all the benefits

of the existing travel insurance products plus several value-added services to quality-sensitive

customers.

1) Travel Companion

Whether you travel for business or pleasure, international travel involves risk. Medical

treatment abroad can be expensive & one never knows, when one would require it. Having to

spend for medical bills in foreign currency can be an expensive proposition. There are other

difficult situations also, that one might face like loss of passport or baggage. Bajaj Allianz's

Travel companion is specially designed to help you deal with situations while overseas travel

1) Travel Elite

Bajaj Allianz General Insurance has recently launched an exclusive policy for high end

travellers called Travel Elite- a cluster of benefits policy made for the specific customer group.

Travel Elite is a plan for high end travellers who have various plans and packages to choose

from : Travel Elite,Travel Age Elite,Travel Corporate Elite,Student Elite,Travel Asia

Elite,Travel Elite Family.

ICICI POLICY

1) Platinum-Plan

Overseas Travel Insurance covers unexpected and unplanned medical and non-medical


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Documents

Non-life insurance