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What's Covered in Individual Health Insurance?

From day care procedures to in-patient hospitalization, individual health insurance plans from Bajaj Allianz General Insurance offers coverage against a plethora of medical issues. Choose the best individual health insurance plan and stay protected.

  • Coverage of up to Rs. 50,00,000

    One of the best among insurance providers in India - offering a sum insured of up to Rs. 50,00,000.

  • Reinstatement Benefit

    A standout USP among competition - this plan offers a 100% reinstatement of the sum insured in case you need treatment for the same illness post policy exhaustion.

  • Ayurvedic/Homeopathic Hospitalization

    We offer the highest individual health insurance coverage for ayurvedic/homeopathic hospitalization in India, up to Rs. 20,000.

  • Bariatric Surgery Cover

    Bajaj Allianz General Insurance being the first to introduce this in India, offers coverage up to Rs. 5,00,000.

  • Organ Donor Benefit

    A health insurance exclusive – there is no sub-limit on organ donor treatment expenses.

  • Free Health Check-up

    Get a free health check-up once in 3 policy years, even if you've made claims.

  • Maternity Benefit

    For sum insured between Rs. 3,00,000 to Rs. 7,50,000 get coverage up to Rs. 15,000 for normal delivery and up to Rs. 25,000 for cesarean section.

  • Pre & Post Hospitalization

    Under this plan get coverage for medical expenses incurred 60 days prior to immediate hospitalization and 90 days after hospitalization.

  • Convalescence Benefit

    For more than 10 days of continuous hospitalization, this good health insurance plan provides Rs. 5,000 for sum insured up to Rs. 5,00,000 and Rs 7.500 for sum insured up to Rs. 7,50,000 – the best among competition.

  • Ambulance Charges

    This plan offers coverage of up to Rs. 20,000 for ambulance charges per policy year.

  • Daily Cash Benefit

    In the event of hospitalization, this medical health insurance plan provides daily cash benefit for 10 days per policy year. The amount is capped at Rs 500 per day.

  • Cumulative Bonus

    Get an increment of 10% to 100% on the base sum insured for every claim-free year.

  • Cataract Surgery Cover

    For each year, get 20% of the sum insured, up to Rs 1 lakh per policy year.

  • Newborn Cover

    Apart from providing medical insurance coverage that takes care of the mother, this plan provides coverage for new born babies too.

Exclusions in Individual Health Insurance

  • Diseases contracted within the first 30 days of buying the health insurance.

  • Expenses incurred for treating the insured for use of abusive substances, alcoholism and drugs.

  • Medical expenses incurred when inpatient care is neither warranted nor supervised by a qualified medical practitioner/nurse.

  • Plastic surgery in any form; unless necessitated for treatment of accidental bodily injury, burns or cancer, which must be approved by a medical practitioner.

  • Expenses for use of external medical equipment at home. This includes equipment used for Sleep Apnoea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D) and Oxygen concentrator for Bronchial Asthmatic condition.

  • Cosmetic treatments, including surgery for change of gender.

  • Medical expenses incurred where the purpose of hospitalization is diagnostic - to conduct laboratory examinations, X-ray and other medical investigations.

  • Costs incurred for purchase of contact lenses, spectacles, hearing aids, artificial limbs, crutches, dentures, artificial teeth and other orthopedic treatments like K-wires and plates.

  • Intentional self-injury but not related to alcoholism and drug abuse.

  • Circumcision; unless required for treatment of accidental injury or illness.

  • Expenses incurred for inoculation/vaccination; unless it is part of post-bite treatment or if it is recommended by the treating doctor and deemed medically necessary.

  • Conditions that are directly/indirectly associated with/caused by Human Immunodeficiency Virus or variant/mutant viruses or any syndrome/condition that is referred to as AIDS.

  • For the complete list of exclusions, refer to the PDF in the 'Download' section.

Why choose Finserv Markets For Individual Health Insurance

Trusted Companion

Come join a family of 100+ million customers and allow us to take care of your financial needs.

Swift Claim Settlement

With a success rate of 94%, Bajaj Allianz General Insurance offers quick claim settlement with no third-party involvement.

Reinstatement Benefit

Unlike other health insurance companies in India, we offer reinstatement benefit for the same illness even if your sum insured is exhausted.

Tailor-made insurance plans

From offering medical insurance coverage for families Bajaj Allianz General Insurance is the first to bring Bariatric Surgery in India!

Extensive Coverage

Get the best healthcare at 6000+ emapaneled hospitals across India and plans the offer coverage from 1.5 – 50 lakh.

How To Apply For Individual 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 Individual 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.

Individual Health Insurance: An Overview

Life is uncertain; you never know when a medical emergency may strike and catch you off-guard. Therefore, it is critical that you secure yourself with a Bajaj Allianz Individual Health Insurance plan available on Finserv Markets, to deal with such emergencies or unforeseen risks. Also, it is advised that one should buy a health insurance plan when one is young. The premium payable is comparatively less when one is young, and the benefits to be reaped by the policyholder over the long run are very attractive. Hence, millennials should definitely consider buying individual health insurance. 

 

Features and benefits of individual health insurance

  • Covers medical costs basis your premium payout including pre and post hospitalization expenses
  • Doctor’s fees, laboratory tests, room rent, and surgery costs are also covered under the Individual Health Insurance plan
  • Provides financial stability in case you are diagnosed with a health issue
  • Enables you to enjoy cashless facilities within a wide network medical facilities
  • No-claim bonus (NCB) is added for every claim-free year

Lifetime renewal along with tax benefits under Section 80D of the Income Tax Act, 1961. 

 

Types of health insurance plans

  • You may opt for an individual plan wherein only you are eligible to receive the policy benefits in case of a diagnosis.
  • Alternatively, you may choose family coverage wherein you may cover yourself along with your spouse and dependent children under a single policy.
  • Several companies offer health coverage to their employees as an additional perk through a group insurance plan.

 

Individual vs. family health insurance

Unlike in a family floater wherein your entire family is covered under a single plan, an individual health insurance plan only covers you. Premiums for individual health insurance plans are more expensive than the family health insurance plans. However, the following points highlight why an individual health insurance plan is more beneficial.

  • The premium of a family floater is based on the age of the oldest member
  • When children become adults and migrate to an individual plan, the waiting period and NCB are lost
  • For family floater policy, NCB is lost even if only one member files a claim during the year

 

Why choose individual health insurance from Finserv Markets?

A large number of customers trust us for various reasons. Here is why you must choose Bajaj Allianz Individual Health Insurance plan available on Finserv Markets.

  • A trusted companion for over 100 million customers
  • Extensive coverage with more than 6,000 network medical facilities across the country with sum assured between Rs. 1.5 Lakh and Rs. 50 lakh
  • Approximately 94% claim settlement ratio without third-party participation
  • Customized plans to suit individual needs and requirements
  • Reinstatement benefit for the same medical condition even if you have exhausted the entire sum assured

 

Eligibility Criteria

  • Age between 18 years and 65 years, with lifetime renewal
  • Entry age for children starts at three months and goes up to 30 years

Documents Required

In most cases, you do not require too many documents when you get an individual health insurance plan. You must complete the application form by accurately providing all relevant information, which must be duly signed, to get your Bajaj Allianz Medical Insurance policy. In some cases, we may need you to undergo the medical tests if you are over a certain age limit.

 

How to apply for individual health insurance?

The entire procedure to apply for a Bajaj Allianz Individual Health Insurance plan on Finserv Markets is quite simple, easy and convenient. You just have to fill up & submit the online application form, make the payment and your policy will be issued in no time.

 

Claim process

Cashless claims

  • You need to provide policy details to the network facility. After verification, the hospital will provide a pre-authorization form
  • We will verify the form and provide to the hospital, details about your policy benefits and coverage
  • The hospital will commence the treatment once we approve the claim
  • When you are discharged, the hospital will send the bill along with discharge papers to us and we will settle the claim after reducing the co-payment if any

Claim reimbursement

  • Submit all original documents and bills
  • Our team scrutinizes the data and may ask for any additional information that is needed
  • On receiving all the documents, your claim is approved
  • You will receive the payment based on the policy terms and conditions

Manage all your queries here

  • Do I need an individual health insurance?

    Yes of course, you need an individual health insurance. It is a well-known fact that medical expenses are increasing significantly, and it is hence sensible to invest in a Bajaj Allianz individual health insurance plan, irrespective of your age. The pace at which treatment costs are rising, one hospitalization event can take a huge toll on your savings. Also, there is a noteworthy increase in the number of life-threatening diseases, which makes it essential for every single person to have the best individual health insurance plan available out there.

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

    If you renew your individual health insurance policy 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. Also, 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 premium paid for an individual health insurance plan.

  • When can I enhance the Sum Insured of my individual health insurance plan?

    You can enhance the Sum Insured of your Bajaj Allianz individual 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 individual health insurance policy?

    The following Sum Insured options are available to you under our individual health insurance plans: 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.

  • When am I supposed to renew my health insurance plan?

    It is best to renew your Bajaj Allianz Health Insurance plan before its expiry date. With our plan you have a grace period of 30 days (after the expiry date of the plan), within which you can renew the plan without having to apply afresh. During this grace period, you will not be covered for any ailments or accidents, but the same plan can be continued. However, it is suggested that you pay your renewal premium while your health insurance is still in force so that you can enjoy the uninterrupted coverage.

  • Will I be able to avail medical and premium reimbursements in case my Bajaj Allianz Health Insurance policy gets rejected?

    In the event of your policy getting rejected, you can avail premium reimbursements within the next seven working days. However, your medical check-up expenses will not get reimbursed.

  • What is preventive health check-up benefit?

    If you have held a Bajaj Allianz Health Insurance policy for a continuous period of 3 years, then at the end of it, you are eligible for a free preventive health check-up. Our partner, Bajaj Allianz will reimburse the amount equal to 1% of the sum insured max or up to Rs. 2000/- (whichever is less), for each member, during this block period of 3 years.

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