Health Insurance

- An Overview

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What is Health Insurance• Health insurance, also known as medical

insurance, is a type of insurance coverage that pays the insured for medical and surgical expenses

• It is a contract between the health insurance company (insurer) and the insured. The insured a premium and in return the insurer promises to pay a predetermined sum of money to meet the claims.

• This protects the insured and his dependents against the financial losses caused by expensive medical treatment

Benefits of Health Insurance

Medical insurance saves the insurer from huge financial losses incurred due to medical expenses and post-illness care. Some of the key benefits include of Bajaj Allianz Health insurance include:

• Coverage for hospitalization expenses.

• Provides access to cashless facility at empanelled hospitals across India (subject to exclusions and conditions).

Benefits of Health Insurance

• It covers pre and post hospitalization expenses which include relevant medical expenses incurred 60 days prior to and 90 days after hospitalization.

• 130 daycare procedures are covered subject to terms and conditions.

• Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.

• The benefit of an in-house Health Administration Team which ensures faster claim settlement and more control over claims settlement and customer service.

Types of Health Insurance• Hospitalization Cover Hospitalization cover provides the insured a cover for all

the expenses arising out of hospitalization on account of treatment required for illness or accident. This is an indemnity cover, which ensures, making good for the loss an insured suffers. All the expenses are paid based on the details mentioned on required bills and hospital documents. Each cover comes with its own coverage, exclusion and limitations.

• Hospital Cash Cover Hospital cash cover takes care of those expenses which are

not covered under a pure hospitalization cover. Though hospitalization cover takes care of medical expenses, there are also incidental expenses which are non-medical in nature. For example, expenses arising out of traveling to and from the hospital, or stay, special dietary food expense.

Types of Health Insurance• Critical Illness Cover Critical illness policy is a benefit cover which covers the

insured for any grave or critical illness (such as cancer, paralysis, major organ transplant etc.) for which hospitalization expenses may or may not be covered in a pure hospitalization cover. Some serious illnesses may require prolonged recovery which entails additional costs such as incidental expenses, possible loss of income, or structural changes in the family.

• Personal Accident Cover Personal accident policy covers the insured for expenses

incurred only on account of accident. This is a benefit plan, where the opted cover is paid as a lump sum based on the degree of disability and/or death.

Types of Health Insurance• Top-up Cover A top-up health cover is an extension over your existing

health/hospitalization policy. This policy can be taken as an add-on cover to your existing hospitalization policy. In case of higher expenses due to illness or accidents when the existing policy sum insured gets exhausted, a top-up cover takes care of the additional expenses.

Choosing Health Insurance

There are several important things to consider while you decide on your health insurance cover. These include:

• Age and Family Size Your health portfolio will vary based on your age and marital

status. When you are younger, you are expected to have fewer illnesses or pre-existing health conditions. This is why the health insurance policy for a person who is 25 and single can include a standard standalone hospitalization cover. However, if a person is 30 and married, then the health insurance portfolio can be upgraded to a family floater policy.

Choosing Health Insurance

• Purchasing Power If you have the funds, securing your health adequately

should be your priority. While keeping an eye on the premium, one must also read through the features of the plan, the discounts available, deductibles and co-payments, standard deductions, illness sub-limits and other restrictions.

• Family History If an individual has a family history of lifestyle diseases, the

probability of it being passed on to the next generations is higher. Any individual who is genetically in a high-risk category should buy wider health insurance coverage when he is young and healthy.

Choosing Health Insurance

• Policy Benefits Understanding your health coverage, getting familiar with

the services covered and how much you will have to pay in case of an unfortunate eventuality is important. If you opt for a health insurance cover that is not adequate or is restrictive it might not solve the very purpose it’s bought for.

• Service It is also important to check on the service history of the

company you invest in. The last thing you would want to do while dealing with illness is spend precious time in coordinating with your insurer to settle a legitimate claim.

Health Insurance Claim Process

Why Should You Choose Bajaj Allianz

• Tie-ups with over 3700+ Network Hospitals to provide cashless facility.

• Best claims settlement ratio in the private sector General Insurance companies.

• The company has tie-ups with dental , optical , fitness chains and many other value added services.

• ISO re-certification for health claims processing.• 24X7 call assistance for claims settlement.

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