A top-up health policy is an additional coverage only for people who have an existing health insuance or a mediclaim from the employer.
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What is Extra Care Plus?
Ever been in a situation where you’ve been hospitalized and your basic health insurance plan falls short of covering expenses? With medical costs on the rise, why wait for the exhaustion of your sum insured amount that prevents you from getting the required medical help? Here’s presenting Extra Care Plus, a health insurance top-up plan that is designed to take care of medical expenses, should you deplete your basic health insurance policy amount. A plan that acts as an extension of your base health insurance plan by offering a high sum insured with a low deductible at a nominal premium. Moreover, individual Extra Care Plus top-up plans for individual health insurance come for as little as Rs. 2500 per annum.
Benefits of Health Insurance Top-Up
What is a deductible?
You've always heard the term Deductible under health insurance, but have never been able to understand it well, right? Here's making things a little easier for you. A deductible is an amount of money which you, as an insured, have to pay from your own pocket or your base health insurance/group health insurance (up to the limit specified in the policy). Once you have paid the deductible, your insurance provider will pay for your claims thereafter. Let's say for instance that the deductible limit mentioned in your health top-up plan is Rs. 3 Lakh. You got hospitalized for an illness and the bill came to a whopping Rs.20 Lakh. In this case, you'll have to pay Rs. 3 Lakh on your own or from your base health insurance policy & the remaining amount of Rs. 17 Lakh will be covered by your top-up plan.
Reasons To Buy Extra Care Plus
What is a health insurance top up?
Why choose Finserv MARKETS For Extra Care Plus
Extra Care Plus Eligibility Criteria
- Entry Age
- Policy availability
- Policy Period
- Medical Test Requirement
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Minimum Entry Age for Proposer/ Spouse/ Dependent Parents – 18 Years
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Maximum Entry Age for Proposer/ Spouse/ Dependent Parents – 80 Years
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Minimum Entry Age for Dependent Children – 91 Days/3 Months
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Maximum Entry Age for Dependent Children – 25 Years
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Residential Indians
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NRI’s (premiums to be paid in INR)
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Annual
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Age up to 55 Years – No Medical Test
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Age more than 55 Years – Medical Test Required
Claim Process for Extra Care Plus
Filing claims was never so simple. Just follow these steps and you’re done!
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1
Register your claim online
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2
Upload documents online
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3
Claim Assessment
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4
Claim Decision
For information on your health insurance policy, refer to the 'Process' section below.
- Process
- Download
- Emergency Contact
- Cashless Claims
- Claim Intimation
- Claim Reimbursement
- Cancellation Process
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You need to approach the network hospital along with your policy details.
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The network hospital verifies the details provided by you and sends a pre-authorization form to the network hospital.
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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.
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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.
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Should the pre-authorization request get rejected; you will have to bear all treatment expenses which can be reimbursed later.
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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*
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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
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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.
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Once discharged from hospital, you need to collect all original documents and bills and submit them to the insurance provider.
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The insurance provider initiates scrutiny of all claim-related documents. If additional documents are needed, you will be intimated about the additional documents required.
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Once all necessary documents are received, the insurance provider approves the claim.
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Payment will be released to you based on what is admissible under the insurance policy.
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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.
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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%
- Cashless Claims
- Claim Reimbursement
- Other Health Insurance Related Claims
- Links for Claim Settlement Forms
- List of Network Hospitals
- Brochure
- Policy Wordings
Link to redirect customers to links category.
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Cashless Claims Request Form
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Non-Medical Expenses List of Exclusions
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Personal Accident Claim Form
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Cashless Claims Request Form
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Reimbursement Form
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Self Declaration of KYC Document Submission - For Individual Partner
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Personal Accident Claim Form
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Non-Medical Expenses List of Exclusions
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List of Network Hospitals
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Extra Care Plus Brochure
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Policy Wordings - Extra Care Plus
Need further assistance? Reach out on the Toll-Free Number: 1800-209-5858 to connect with an insurance expert.
Manage all your queries here
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✔️I have health insurance in place. Why would I need a Bajaj Allianz Health Insurance Top-up plan?
A basic health insurance plan offers protection for you and your family against financial contingencies that may arise due to medical emergencies. However, what does one do if the sum insured provided gets exhausted? Here’s where an individual Health Top-up plan helps. It acts as a supplement over and above your existing health insurance plan. If you are bound to change your job, a health insurance top-up is a must as it will supplement your savings especially when the costs incurred due to medical treatment are more than your savings. -
✔️What is a 'Deductible'?
The term ‘deductible’ refers to the cost/specific amount that a health insurance policy holder must bear as per the policy in question. For example, certain medical equipment used during hospitalization (syringes, gloves for doctors, bed charges) may be categorized as ‘deductibles’ and are not covered by the health insurance policy. These costs are then borne by the policyholder. However, do keep in mind that deductibles do not reduce the sum insured amount of the policy. To help understand this better, here is an example - Rahul opts for a basic plan with a sum insured of Rs. 10 Lakhs. In the same policy year, he makes a claim for Rs. 6 Lakhs. The amount is reimbursed by the insurer while Rahul still has Rs. 4 Lakhs of his sum insured remaining. On the other hand, Raveena opts for a base plan of Rs. 10 Lakh and a top-up plan of Rs. 15 Lakh and a deductible amount that is of Rs. 3 Lakh. She then makes a claim of Rs. 6 Lakh and has Rs. 4 Lakh of the sum insured amount left. This is reimbursed to Raveena. Going forward, she makes another claim of Rs. 7 Lakhs for which Rs. 4 Lakh is reimbursed from the base plan and Rs. 3 Lakh from the health insurance top-up plan. Raveena can still make a claim for Rs. 12 Lakh. -
✔️Please list the benefits offered by Bajaj Allianz Extra Care Plus top-up plan available on Bajaj Finserv MARKETS.
Extra Care Plus Top-up plan provides the following benefits: 1. Coverage of costs in the event of in-patient hospitalization, 2. Pre-& post hospitalization costs (60 days prior and 90 days post-hospitalization), 3. Certain costs related to organ donor procedures, 4. Day care treatment costs, and 5. Coverage of ambulance expenses in the event of road accidents. For a complete list of inclusions and benefits, please refer to the ‘What’s Covered’ section of this page. -
✔️Could you please tell me the eligibility criteria to avail this Bajaj Allianz Extra Care Plus top-up plan with Bajaj Finserv MARKETS?
The basic eligibility criteria would be your entry age. This should be between 91 days to 80 years. For more information on this, refer to the Eligibility Criteria section of this page. -
✔️Is it possible for me to save on taxes on the policy premium?
Yes, you can. Premiums paid for this top-up plan are tax-exempted under section 80D of the Income Tax Act.
