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If your Health Plan falls short while covering additional medical expenses exceeding existing coverage, Health Insurance Top-up will get you covered!

Overview

Customer care is an important part of running a business and Bajaj Allianz, with its customer-first approach, understands the importance of bringing the best to the table when it comes to customer satisfaction. The claim settlement process of Bajaj Allianz health insurance plans is painless and hassle-free. With a huge network of hospitals in its list of partnered healthcare centres, Bajaj Allianz General Insurance takes care of health insurance claims with easy reimbursement and cashless treatment at any network hospital in India. Moreover, with an impressive claim settlement ratio of 98%, the company highlights its commitment to serving its customers better.

 

How to Claim Your Bajaj Health Insurance Policy Online

No rocket science here! Follow 5 simple steps and you’re done

  • Visit Finserv MARKETS

  • Click on the ‘Register a claim’ button

  • Upload the necessary documents

  • Your insurer will assess the claim

The insurer will transfer the claim amount to your bank account once the claim is processed. You can visit the Bajaj MARKETS website to check your claim status online.

What are Cashless Claims?

A pioneer in cashless claim settlement, the Bajaj Allianz General Insurance works toward making this process better. With cashless treatments across the empanelled hospitals, you get treated for a particular illness without paying a single penny of the medical bills. With over 6,500 network hospitals of Bajaj Allianz Health Insurance in the country, this process becomes even easier.

Here’s how you can file a cashless claim:

  1. Find the nearest Bajaj Allianz network hospital in your city where you want to get treated.

  2. Inform the insurer regarding your hospitalisation.

  3. Carry your identity proof and your Bajaj Allianz cashless card while visiting the hospital.

  4. Fill the pre-authorisation request form available at the hospital desk and submit it to the hospital.

  5. The hospital will then send the pre-authorisation request form to Bajaj Allianz-HAT (Pune) for verification.

  6. The insurer will review your application and convey the claim decision to the hospital.

  7. On approval, the hospital will begin the cashless treatment.

Document Required for Filing a Cashless Claim
  • Duly signed hospitalisation claim form
  • Original discharge summary document
  • All lab and test reports
  • First consultation letter from doctor
  • Original hospital bills with detailed cost breakup
  • Copy of invoice/stickers/barcode in case of implants
  • KYC form

What are Reimbursement Claims?

While cashless claims come with the ease of getting your treatments done without paying for the hospital bills out of pocket, you can also choose to get your treatment done at your cost and get the amount reimbursed later against your health insurance policy

These are the steps you will need to follow for the Bajaj Allianz health insurance claim process:

  1. Submit all original hospitalisation-related documents to the insurer.

  2. Bajaj Allianz General Insurance will then complete the verification, for which other documents may be required.

  3. The insurer then takes the process forward.

  4. Once your claim is approved, the customary verification is initiated, post which the team releases the payment.

Document Required for Filing a Reimbursement Claim
  • Duly filled hospitalisation claim form
  • Completely filled and signed NEFT form by the policyholder/proposer
  • Original payment receipts and discharge summary document
  • Copy of the invoice in case of implants
  • Original hospital bills with detailed cost breakup
  • All lab and test reports
  • Doctor’s first consultation letter
  • KYC documents

Cashless Claims

  • You need to approach the network hospital along with your policy details.

  • The network hospital verifies the details provided by you and sends a pre-authorization form to the network hospital.

  • The insurance provider verifies the pre-authorization request and informs the network hospital about your policy's coverage. If needed, the insurance provider may send a query letter to the network hospital requesting more details. The network hospital needs to respond to this query with the information requested for.

  • Once the network hospital receives approval from the insurance provider, treatment begins. Upon discharge from the network hospital, the final bill, along with the discharge papers, are sent to the insurance provider. The insurance provider will settle the final amount with the network hospital after deducting co-payment (if applicable) and other consumable expenses.

  • Should the pre-authorization request get rejected; you will have to bear all treatment expenses which can be reimbursed later.

Claim Intimation

  • Claim Intimation

    • Claims should intimated within 48 hours in case of emergency hospitalization*
    • Claims should be intimated within 24 hours in case of planned hospitalization*

  • Claims can be intimated on the following platforms:

    • Contact the executes at the Call Center- 1800 209 5858 (Main Toll Free) and dedicated health toll free (1800 103 2529)
    • Email on health.admin@bajajallianz.co.in 
    • Branch walk-in at the customer care desk
    • Visit the website- https://general.bajajallianz.com/BagicHCM/cstprtl/getCustDtls.do
    • Download the Caringly Yours App on App store/Play store

  • Following details are required for claim intimation:

    • Policy Number
    • Name of the Patient
    • Hospital Name
    • Hospital Address
    • Date of Admission
    • Diagnosis
    • Mobile Number
    • Email Id

*Note: Relaxations in the timelines mentioned above may be considered in the extreme cases of hardship where it is proved to our satisfaction that under the circumstances in which you were placed, it was not possible for you or any other person to give notice or file claim within the prescribed time limit. 

Claim Reimbursement

  • Once discharged from hospital, you need to collect all original documents and bills and submit them to the insurance provider.

  • The insurance provider initiates scrutiny of all claim-related documents. If additional documents are needed, you will be intimated about the additional documents required.

  • Once all necessary documents are received, the insurance provider approves the claim.

  • Payment will be released to you based on what is admissible under the insurance policy.

Cancellation Process

  • Company Cancellation

    The insurance provider may cancel your insurance policy providing a written notice 15 days prior to cancellation date. If no claim has been made, a refund of the premium for the unexpired policy period shall be provided on a pro-rata basis. 

    Your insurance policy will be cancelled for reasons such as non-disclosure of material facts, misrepresentation, fraud and non-cooperation.

  • Customer Cancellation

    As a customer, you may cancel your insurance policy by providing a written notice 15 days prior to cancellation date. If you've made no claims, the insurer will refund short-term rates for the unexpired policy period as per the rates detailed below.

    Period of Risk Premium Refund - 1 Year Policy Period
    Exceeding 15 days but less than 3 months 65.00%
    Exceeding 3 months but less than 6 months 45.00%
    Exceeding 6 months but less than 12 months 00.00%

    Period of Risk Premium Refund - 2 Year Policy Period
    Exceeding 15 days but less than 3 months 75.00%
    Exceeding 3 months but less than 6 months 65.00%
    Exceeding 6 months but less than 12 months 45.00%
    Exceeding 12 months but less than 15 months 30.00%
    Exceeding 15 months but less than 18 months 20.00%
    Exceeding 18 months but less than 24 months 00.00%

How to Check Bajaj Allianz Health Insurance Claim Status

Here are the steps you can follow to check your Bajaj Allianz health insurance claim status:

  1. Visit the official Bajaj Allianz General Insurance website.

  2. On the website, visit the ‘Support’ section.

  3. Click on ‘Policy Tracker’.

  4. Submit all the details and documents required.

  5. Your online Bajaj Allianz health insurance claim status will be displayed on the screen.

In case you want to check the status of your claim offline, you can contact the Bajaj Allianz customer care team or visit their office in person.

With a health insurance claim settlement ratio of 98% and the option for lifelong insurance renewals, Bajaj Allianz can be an excellent choice when buying health insurance.

Why Your Bajaj Allianz Health Insurance Claims May Get Rejected

Apart from understanding the process, it is also very important to note why your claims on your health insurance policy may get rejected. This way, you can prevent the rejection of your claim and make full use of your insurance coverage. Here are a few reasons why your claims may get rejected:

  • Cost Exceeds Sum Insured

In case the treatment cost exceeds the sum insured amount you are entitled to, your claims may get rejected.

  • Ignoring Exclusions

In case the claim is made for a treatment that is not covered under the plan, your claim request is rejected.

  • Invalid Claim

If any incorrect or false information is provided during claim intimation, the claim is held invalid and is rejected.

  • Inactive Policy

If you file a claim after your policy has lapsed, the claims stand null. This further reinstates the importance of renewing your health insurance on time.

  • Waiting Period

In case you file a claim for the expenses incurred for the treatment of a disease within the waiting period, your claim could be denied.

We are Here to Help You

  • Health Insurance

At Finserv MARKETS

You can also get in touch with the Finserv MARKETS team, should you need any help with Bajaj Allianz Health Insurance

At Bajaj Allianz General Insurance

Here’s how you can connect with the Bajaj Allianz health insurance team, in case you need any assistance regarding the product. 

  • Contact the executes at the Call Centre- 1800 209 5858 (Main Toll Free) and dedicated health toll free (1800 103 2529)
  • Email on health.admin@bajajallianz.co.in
  • Branch walk-in at the customer care desk
  • Visit the website- https://general.bajajallianz.com/BagicHCM/cstprtl/getCustDtls.do
  • Download the Caringly Yours App on App store/Play store

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Manage all Your Queries Here

✔️What is a claim settlement ratio?

A claim settlement ratio (CSR) helps understand the percentage of claims an insurer has settled during a financial year. It is the percentage of insurance claims settled by an insurer with regards to the total number of claims received.

✔️How can I check my Bajaj Allianz health insurance claim status?

You can check your health insurance claim status on the ‘Support’ section of the Bajaj Allianz website.

 

✔️What is the contact number for Bajaj Allianz health claim intimation-related queries?

You can call on the dedicated health toll-free number 1800 103 2529 for any claim-related queries.

 

✔️How can I contact Bajaj MARKETS support by email?

You can contact Bajaj MARKETS at insuranceconnect@bajajfinservmarkets.in.

 

✔️How can I contact Bajaj Allianz support by email?

You can contact Bajaj Allianz support by email at health.admin@bajajallianz.co.in.

 

✔️Can I buy Bajaj Allianz Health Insurance online?

Yes, you can buy Bajaj Allianz Health Insurance on Bajaj MARKETS.

 

✔️What is the Bajaj Allianz health insurance claim settlement ratio?

The claim settlement ratio of Bajaj Allianz health insurance is 98%.