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What's Covered in Family Health Insurance?

Caring for those who matter is the #1 reason why individuals opt for best family insurance coverage. Here you get a complete family health insurance plan from Bajaj Allianz Health Insurance, that provides coverage for 2 or more individuals and offer benefits such as maternity and newborn baby coverage.

  • Organ Donor Benefit

    The best family health insurance from Bajaj Allianz General Insurance exclusively covers expenses incurred during organ donor treatment.

  • Reinstatement Benefit

    Applicable on the same illness with 100% coverage of the sum insured – this is a standout feature offered by Bajaj Allianz General Insurance.

  • Bariatric Surgery Cover

    Bajaj Allianz General Insurance is the first insurance company in India to introduce Bariatric surgery cover up to Rs. 5,00,000

  • Ayurvedic/Homeopathic Hopitalization

    Bajaj Allianz General Insurance offers the highest family health insurance coverage for Ayurvedic/Homeopathic hospitalization in India, up to Rs. 20,000.

  • Convalescence Benefit

    Bajaj Allianz General Insurance provides convalescence benefit up to Rs. 7,500 (depending on sum insured) for more than 10 days of continuous hospitalization.

  • Free Health Check-up

    With no pre-conditions attached, health insurance from Bajaj Allianz General Insurance comes with a free check-up once every 3 policy years, even if you’ve made any claims earlier.

  • In-Patient Hospitalization Expenses

    Comprehensive Family insurance covers expenses incurred on medical processes and diagnosis, ICU charges and fees charges by specialist doctors, consultants and medical practitioners.

  • Pre & Post Hospitalization

    Offering the best family insurance policies, expenses incurred pre & post hospitalization are covered by Bajaj Allianz.

  • Maternity & New Born Baby Coverage

    As part of maternity benefits, get coverage up to Rs. 25,000 for normal delivery and up to Rs 35,000 for cesarean section, depending on your sum insured.

Exclusions in Family Health Insurance

  • Any medical condition or complication which existed before the commencement of the policy period or for which care, treatment or advice was sought, recommended by or received from a physician.

  • Routine physical or other examinations where there is no objective indication of impairment of normal health.

  • Medical expenses beyond the expiry of the policy period.

  • Routine physical or other examination where there is no objective indication of impairment of normal health.

Why choose Finserv Markets For Family Health Insurance

Trusted Companion

We are the entrusted financial partner for 100 million+ customers all over India. It’s time you join the family too.

Swift Claim Settlement

No third party involved, no delays and a claim settlement rate of 94% - why wouldn’t you choose us?

Reinstatement Benefit

Get reinstatement benefit for the same illness, even when your sum insured is exhausted – an exclusive from Bajaj Allianz General Insurance.

Tailor-made Insurance Plans

Enjoy medical insurance coverage for your complete family (children and parents included). Also, Bajaj Allianz Health Insurance is the flagbearer for Bariatric surgery in India!

Extensive Coverage

With medical coverage from 1.5 lakh to 50 lakh and tie-up’s with 6000+ hospitals across India, Bajaj Allianz is ‘the’ insurance company in India to buy from.

How To Apply For Family Health Insurance?

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

  • Choose your coverage

  • Fill form

  • Assessment by Insurer

  • Complete payment

  • Policy Issued

Claim Process for Family Health Insurance

Filing claims was never so simple. Just follow these steps and you’re done!

  • 1

    Register your claim online

  • 2

    Upload documents online

  • 3

    Claim Assessment

  • 4

    Claim Decision

For information on your health insurance policy, refer to the 'Process' section below.

  • Process
  • Download
  • Emergency Contact
  • Cashless Claims
  • Claim Reimbursement
  • Cancellation Process
  • 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.

  • 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.

  • 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%

Period of Risk Premium Refund - 3 Year Policy Period
Exceeding 15 days but less than 3 months 80.00%
Exceeding 3 months but less than 6 months 75.00%
Exceeding 6 months but less than 12 months 60.00%
Exceeding 12 months but less than 15 months 50.00%
Exceeding 15 months but less than 18 months 45.00%
Exceeding 18 months but less than 24 months 30.00%
Exceeding 24 months but less than 27 months 20.00%
Exceeding 27 months but less than 30 months 15.00%
Exceeding 30 months but less than 36 months 00.00%
  • Cashless Claims
  • Claim Reimbursement
  • Other Health Insurance Related Claims
  • Links for Claim Settlement Forms
  • List of Network Hospitals

Link to redirect customers to links category.

  • Cashless Claims Request Form
  • Reimbursement Form
  • Self Declaration of KYC Document Submission - For Individual Partner
  • Non-Medical Expenses List of Exclusions
  • Personal Accident Claim Form
  • Cashless Claims Request Form
  • Reimbursement Form
  • Self Declaration of KYC Document Submission - For Individual Partner
  • Personal Accident Claim Form
  • Non-Medical Expenses List of Exclusions
  • List of Network Hospitals

Need further assistance? Reach out on the Toll-Free Number: 1800-209-5858 to connect with an insurance expert.

Family Health Insurance: An Overview

A family health insurance is an insurance cover, which covers your family in case of unforeseen medical emergencies and the resulting financial expenses. The Bajaj Allianz Health Insurance comprehensive package is designed to provide cover for the entire family and will eliminate the need of buying separate covers for each individual in your family. 

 

Features and benefits of family health insurance

  • Comprehensive coverage

With a Bajaj Allianz family health insurance plan, you get cover for all the family members including yourself, your spouse, parents, and children.

  •  Increase in the sum assured

A health insurance plan comes with a no-claim bonus (NCB), which helps you to increase the sum insured each year if no claims have been filed during that period.

  • Policy term

You can choose a policy term ranging from one year to three years for your Bajaj Allianz Health Insurance plan.

  • Cashless claim settlement

You may avail of cashless services at the time of a claim if the healthcare facility is in the insurer’s list of network hospitals.

  • Tax benefit

One of the biggest advantages of a Bajaj Allianz Health Insurance policy is the tax benefit on the premium paid for the policy under section 80D of the Income Tax Act, 1961.

  • Affordable

With a single plan, you can cover the entire family and save money, if buying separate individual plans for every member is out of your budget.

  • Conveniently add a member

It is possible for you to add any other member of the family easily in the same plan.

 

Types of family health insurance

A family health insurance plan can be customized as per your needs. The Bajaj Allianz Medical Insurance plan can be classified into the following two categories. 

Medical insurance

In this insurance, you are reimbursed for the cost of hospitalization subject to the treatment. Either you will get a cashless treatment or the amount will be reimbursed to you by the insurance company.

 

Family health insurance vs. Individual health insurance

It is important to understand the difference between an individual health insurance and family health insurance plan. In case of an individual cover, the policy is for one person only and you will have to buy different policies for all the members of the family. In the case of a family health insurance plan, all members of the family will be covered under a single policy and there is a dedicated sum insured. The premium in the case of family health insurance will be determined in relation to the senior most member covered in the plan and the renewals will be applicable up to a certain age only. 

 

Eligibility criteria

The basic criterion for a family health insurance plan is that the primary policyholder should be aged between 18 and 65 years. The medical tests are only required for the family members over the age of 45 years. The age of dependent children should be between 90 days and 30 years in order for you to get a Bajaj Allianz Medical Insurance.

 

Documents required for buying health insurance

Here is a list of documents that are required for buying family health insurance.

  • The premium depends on the policyholder’s age, which is why it is important to provide a valid proof of your age. You can provide a birth certificate, Permanent Account Number (PAN) card, voter’s ID card, Aadhar card, passport, or driving license.
  • You may submit your ration card, utility bills, passport, rent agreement, Aadhar card or driving license as your address proof.
  • A copy of the PAN card and Aadhar card
  • Passport-sized photograph
  • Proposal form filled and duly signed
  • Medical examination report, if required by the insurance company to get your Bajaj Allianz Medical Insurance plan 

Manage all your queries here

  • What is meant by family health insurance plans?

    A health insurance plan for family is one single policy that takes care of the medical expenses of your entire family. The Sum Insured can be used by any member of the family or by everyone covered in the policy, multiple number of times, till the time the limit is exhausted. It is far better than a family Mediclaim policy and is always a good choice.

  • Who all can be covered under a Bajaj Allianz family health insurance plan?

    A health insurance for family covers self, spouse and up to 4 dependent children.

  • If I have a kid who is 3 years old, can I take a Bajaj Allianz family health insurance policy for her?

    Children can be covered with either of the parent in a policy but are not covered individually in our health insurance plans. Dependent children from the age of 3 months up to the age of 30 years are covered under our family health insurance plans.

  • Is it important for me to take a family health insurance policy for my child?

    As compared to adults, children are way more sensitive and therefore prone to falling ill a lot more. Since kids tend to fall ill more frequently, it is important for children to be covered under one of the best family health insurance plans. It helps you deal with the medical and hospitalization expenses better.

  • My wife and children are residing in Pune while I am residing in Mumbai. Can all of us be covered under one policy?

    Yes, you can cover your family residing anywhere in India under one policy. You can use your Bajaj Allianz family health insurance plan in India across all cities and states.

  • When can I enhance the Sum Insured of my Bajaj Allianz family health insurance policy?

    You can enhance the Sum Insured of your family health insurance policy only at the time of renewals. The enhancement would be subject to underwriting approval, based on the declaration on the application.

  • What are the Sum Insured options available to me under Bajaj Allianz family health insurance policy?

    The following Sum Insured options are available to you under this family health insurance plan: 1) Health Guard Silver Plan: Rs.1.5/2 lakh. 2) Health Guard Gold Plan: 3/4/5/7.5/10/15/20/25/30/35/40/45/50 lakh.

  • What additional benefits do I get if I renew my Bajaj Allianz family health insurance policy with you?

    If you renew your family health insurance plan with us without any break and there has been no claim in the preceding year, Bajaj Allianz will increase the ‘Sum Insured Amount’ by 10% of the base sum insured per annum. However, the maximum cumulative increase in the ‘Sum Insured Amount’ will be limited to 10 years and 100% of your first health insurance policy with us. There are tax benefits under the Income Tax Act, 1961 (in India); every taxpayer can avail an annual deduction up to Rs. 50,000 from his/her taxable income for Bajaj Allianz Medical Insurance premium paid for self and dependents in the family.

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