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Bajaj Allianz Health Guard Family

Product Description:

Easy Health Exclusive is a Family health insurance (indemnity plan) policy offered by Apollo Munich to indemnify the insured against any medical emergency and the ensuing expenses. Family includes spouse and upto 4 dependent children (between 3 months & 21 yrs). The entry age for the eldest member of the family is 18 yrs – 65 yrs and the Carrier allows assured lifelong renewal to its Insured. People upto the age of 45 yrs can buy this plan online while those above 45 yrs must consult an advisor offline to cover themselves under this plan. Apollo Munich also allows an optional critical illness cover of 50% or 100% of the Sum Assured.

Know more about your Insurance

Key features: Availability, Benefits and Exclusions

Minimum Age at Entry : 90 days
Maximum Age at Entry : 65 years
Maximum Age at Renewal : 80 years
Minimum Sum Assured : Rs 2 lacs
Maximum Sum Assured : Rs 10 lacs
No claim Bonus – Annual : None
No claim Bonus – cumulative : None
Maternity Benefits : N/A
Pre-Existing Disease cover : after 4 years
Waiting Period : 30 Days

Product pricing (Incl. S/Tax)   (Rs)
2 Adults    
Age SA 1 lacs SA 2 lacs SA 3 lacs SA 4 lacs SA 5 lacs SA 7.5 lacs SA 10 lacs
0 - 25 yrs NA   6167 7644 9286 11980 NA
26 – 40 yrs NA   6167 7644 9286 11980 NA
41 – 45 yrs NA   7339 8807 11255 14242 NA
46 – 55 yrs NA   7339 8807 11255 14242 NA
56 – 60 yrs NA   13318 15981 20800 26023 NA
61 – 65 yrs NA            

Claim procedure

  1. Intimation & Assistance - Immediately intimate (with in 24 hrs) Apollo Munich’s TPA ‘Family Health Plan Limited’ about the hospitalization at their helpline no 1800 425 4033 quoting your customer ID. For planned hospitalization, it is advisable to intimate the TPA 7 days in advance of admission.

  2. Reimbursement of medical expenses – Inform the TPA about any claim situation no later than 7 days
    from the time of completion of such treatment. Follow this up with a duly filled claim forms submission
    supported with required documents within 15 days. After cross-verification of documents, the TPA will
    send a cheque in the name of the Proposer within 15 days of receipt of claims form.

  3. Availing the Cashless facility – In case of emergency hospitalization, intimate the TPA no later than 24 hrs of admission to the hospital (network hospitals). For planned hospitalization though, kindly seek cashless authorization from the designated TPA at least 48 hrs before such admission. The TPA will check your coverage and eligibility and send an authorization letter to the provider. In case of non-coverage of an ailment under the policy, a rejection letter will be sent to the provider with in 6 hrs of receipt of your documents.

Some key statistics for Bajaj Allianz

Claims Pending Ratio : To be Announced soon
Complaints Resolved Ratio : To be Announced soon
Provider Network (cashless) : To be Announced soon

General Health Insurance Tips

Understand the cost of healthcare in your city/area before deciding the total cover (Sum Assured)

If your family includes a young bride, it is important to ensure the coverage of maternity benefits

Ask about the coverage of pre-existing diseases

Look at the waiting period

Satisfy yourself about the specific disease’s coverage under the Critical Illness cover

Inquire about the availability of cashless facility at the Network hospitals

Always compare before buying

Disclaimer: This is only an illustrative document to serve as a quick guide for aide in decision making.

Information Source: Bajaj Allianz website www.general.bajajallianz.com as on 28th Dec’2011
IRDAI annual report’2010