Extra Care Plus: Bajaj Allianz
Extra Care Plus: Bajaj Allianz
Extra Care Plus: Bajaj Allianz
A Simple and affordable solution to help ensure that you have an adequate Health Insurance Cover!
◼ COVERAGE
1 Medical Expenses
If You are hospitalized on the advice of a Doctor because of Illness or Accidental Bodily Injury sustained
or contracted during the Policy Period, then We will pay You, Reasonable and Customary Medical Expenses
incurred, subject to aggregate deductible as specified on the policy document
Aggregate deductible is a cost sharing requirement under this policy that provides that the company will not be
liable for a specified rupee amount of the covered expenses, which will apply before any benefits are payable by
the company. A deductible does not reduce the sum insured. The deductible is applicable in aggregate towards
hospitalisation expenses incurred during the policy period
b. Pre-hospitalisation expenses
The medical expenses incurred in the 60 days immediately before you were hospitalised, provided that:
i. Such medical expenses were incurred for the same condition requiring subsequent Hospitalisation, and;
ii. We have accepted the claim underIn-Patient Hospitalisation expenses
2. Maternity Expenses:
We will pay the Medical Expenses related to pregnancy, childbirth or medically recommended and lawful
termination of pregnancy, limited to maximum 2 deliveries or termination(s) or either, during the lifetime of the
insured person as below:-.
i. We will cover the Medical expenses for maternity including complications of maternity over and above the
aggregate deductible limit as specified under the policy schedule
ii. We will also cover expenses towards lawful medical termination of pregnancy during the Policy period.
iii. In patient Hospitalization Expenses of pre-natal and post-natal hospitalization
iv. Waiting Period of 12 months from the date of inception of the first Extra Care Plus Policy with us. However
this 12 months exclusion would not be applicable in case of continuous renewal of Extra Care Plus Policy
without break in cover.
3. Ambulance Expenses
If a claim under Medical Expenses is accepted, We will also pay the ambulance expenses to a maximum of
Rs3000/- per valid hospitalization claim for transferring You/Your family member(s) named in the schedule
to or between Hospitals in the Hospital’s ambulance or in an ambulance provided by any ambulance service
provider.
◼ OPTIONAL COVER:
1. Air Ambulance Cover
In consideration of payment of additional premium by the Insured to the Company and realization thereof
by the Company, it is hereby agreed and declared that Extra Care Plus Policy is extended to pay the expenses
incurred for ambulance transportation in an airplane or helicopter for rapid ambulance transportation from
the site of first occurrence of the illness / accident to the nearest hospital during policy period which directly
and independently of all other causes results in emergency life threatening health conditions provided such
hospitalization claim is admissible under the Extra Care Policy. The claim would be reimbursed up to the actual
expenses subject to a maximum limit as specified under the Air Ambulance Cover in the Policy Schedule, subject
otherwise to all other terms, conditions and Exclusions of the Policy.
◼ What are the exclusions and waiting period under the policy?
I. Waiting Period
A. Pre-Existing Diseases - Code- Excl01
a. Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded
until the expiry of 12 months of continuous coverage after the date of inception of the first Extra Care Plus policy
with us.
b. In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase.
c. If the Insured Person is continuously covered without any break as defined under the portability norms of the
extant IRDAI (Health Insurance) Regulations then waiting period for the same would be reduced to the extent of
prior coverage.
d. Coverage under the policy after the expiry of 12 months for any pre-existing disease is subject to the same being
declared at the time of application and accepted by us.
◼ Eligibility
• Indian nationals residing in India would be considered for this policy.
• This policy can be opted by Non-Resident Indians also, provided premium is paid in Indian currency & by Indian
Account only
◼ Renewal of policy
The policy shall ordinarily be renewable except on grounds of fraud, misrepresentation by the insured person.
a. The Company shall endeavor to give notice for renewal. However, the Company is not under obligation to give
any notice for renewal.
b. Renewal shall not be denied on the ground that the insured person had made a claim or claims in the preceding
policy years.
c. Request for renewal along with requisite premium shall be received by the Company before the end of the
policy period.
d. At the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days
to maintain continuity of benefits without break in policy. Coverage is not available during the grace period.
e. No loading shall apply on renewals based on individual claims experience.
◼ Cancellation
i. The policyholder may cancel this policy by giving 15days’ written notice and in such an event, the Company shall
refund premium for the unexpired policy period as detailed below.
Cancellation grid for premium received on annual & long term basis and refund is as under
Period in Risk Premium Refund
Policy Period Policy Period Policy Period
1Year 2Year 3Year
Within 15 Days Pro Rata Refund
Exceeding 15 days but less than or equal to 3 months 65.00% 75.00% 80.00%
Exceeding 3 months but less than or equal to 6 months 45.00% 65.00% 75.00%
Exceeding 6 months but less than or equal to 12 months 0.00% 45.00% 60.00%
Exceeding 12 months but less than or equal to 15 months 30.00% 50.00%
Exceeding 15 months but less than or equal to 18 months 20.00% 45.00%
Exceeding 18 months but less than or equal to 24 months 0.00% 30.00%
Exceeding 24 months but less than or equal to 27 months 20.00%
Exceeding 27 months but less than or equal to 30 months 15.00%
Exceeding 30 months but less than or equal to 36 months 0.00%
Cancellation grid for premium received on instalment basis and refund is as under
The premium will be refunded as per the below table:
◼ Grace Period
• The grace period is 30 days
• If hospitalisation of the member occurs during this grace period, the company will not be liable to make any
payments if claims are made due to any treatment of illness/ailment/disease diagnosed or hospitalisation
taking place.
• If the premium is not paid within 30 days of the due date of the first unpaid premium then the policy will be
terminated.
◼ Portability
The insured person will have the option to port the policy to other insurers by applying to such insurer to port the
entire policy along with all the members of the family, if any, at least 45 days before, but not earlier than 60 days
from the policy renewal date as per IRDAI guidelines related to portability. If such person is presently covered and
has been continuously covered without any lapses under any health insurance policy with an Indian General/
Health insurer, the proposed insured person will get the accrued continuity benefits in waiting periods as per
IRDAI guidelines on portability.
For Detailed Guidelines on portability, kindly refer the link https://www.irdai.gov.in/ADMINCMS/cms/Circulars_
List.aspx?mid=3.2.3
◼ Migration
The Insured beneficiary will have the option to migrate the policy to other health insurance products/plans
offered by the company by applying for migration of the policy atleast 30 days before the policy renewal date
as per IRDAI guidelines on Migration. If such person is presently covered and has been continuously covered
without any lapses under any health insurance product/plan offered by the company, the Insured beneficiary
will get the accrued continuity benefits in waiting periods as per IRDAI guidelines on migration.
For Detailed Guidelines on migration, kindly refer the link https://www.irdai.gov.in/ADMINCMS/cms/Circulars_
List.aspx?mid=3.2.3
◼ Withdrawal of Policy
i) ln the likelihood of this product being withdrawn in future, the Company will intimate the insured person about
the same 90 days prior to expiry of the policy.
ii) lnsured Person will have the option to migrate to similar health insurance product available with the Company at
the time of renewal with all the accrued continuity benefits such as cumulative bonus, waiver of waiting period.
as per IRDAI guidelines, provided the policy has been maintained without a break.
◼ Premium Chart
Note: In case of policy issued on Floater Basis, age of the oldest member of the family will be considered for
premium calculation.
Premiums are exclusive of GST
FAMILY SIZE: 1 MEMBER
Sum
Insured 300000 500000 1000000 1500000 2000000 2500000 5000000
(in INR)
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
Upto 20 1,783 1,916 1,184 2,869 2,072 1,418 2,734 2,026 3,278 2,536 1,758 3,745 2,809 2,055 5,466 4,640 3,854
21-25 2,170 2,315 1,441 3,370 2,423 1,658 3,157 2,332 3,759 2,895 1,998 4,275 3,197 2,326 6,178 5,222 4,316
26-30 2,397 2,556 1,590 3,720 2,673 1,828 3,483 2,571 4,148 3,193 2,201 4,717 3,526 2,563 6,816 5,759 4,757
31-35 2,533 2,700 1,679 3,929 2,822 1,930 3,678 2,714 4,380 3,371 2,322 4,981 3,722 2,705 7,196 6,079 5,021
36-40 2,885 3,074 1,910 4,472 3,211 2,193 4,185 3,086 4,983 3,834 2,638 5,667 4,232 3,073 8,185 6,912 5,705
41-45 2,982 3,195 1,968 4,779 3,442 2,346 4,547 3,359 5,452 4,206 2,902 6,227 4,657 3,394 9,079 7,694 6,377
46-50 3,952 4,229 2,601 6,325 4,551 3,097 6,013 4,438 7,210 5,558 3,828 8,235 6,153 4,477 12,002 10,165 8,417
51-55 5,129 5,485 3,371 8,200 5,896 4,009 7,792 5,746 9,344 7,198 4,951 10,672 7,968 5,792 15,550 13,163 10,893
56-60 6,305 6,739 4,139 10,075 7,241 4,919 9,571 7,054 11,477 8,838 6,074 13,108 9,782 7,105 19,095 16,159 13,368
61-65 7,902 8,443 5,183 12,619 9,067 6,156 11,985 8,830 14,372 11,064 7,599 16,415 12,245 8,889 23,908 20,227 16,728
66-70 9,088 9,708 5,958 14,509 10,422 7,074 13,778 10,149 16,522 12,716 8,731 18,870 14,073 10,213 27,482 23,248 19,223
More
10,827 11,562 7,095 17,279 12,410 8,420 16,406 12,082 19,674 15,139 10,390 22,470 16,754 12,155 32,721 27,677 22,881
than 70
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
21-25 3,469 3,701 2,303 5,387 3,873 2,651 5,047 3,728 6,009 4,629 3,194 6,834 5,111 3,719 9,877 8,349 6,900
26-30 3,832 4,087 2,542 5,947 4,274 2,923 5,569 4,111 6,631 5,105 3,519 7,542 5,637 4,098 10,897 9,208 7,606
31-35 4,049 4,317 2,684 6,282 4,512 3,085 5,881 4,340 7,002 5,390 3,713 7,964 5,950 4,324 11,505 9,720 8,027
36-40 4,613 4,915 3,053 7,150 5,133 3,506 6,691 4,934 7,967 6,129 4,218 9,061 6,766 4,912 13,087 11,051 9,122
41-45 4,768 5,107 3,146 7,641 5,503 3,751 7,269 5,371 8,716 6,725 4,640 9,956 7,446 5,426 14,516 12,301 10,195
46-50 6,319 6,761 4,159 10,112 7,276 4,952 9,613 7,095 11,527 8,886 6,120 13,166 9,837 7,158 19,189 16,251 13,457
51-55 8,200 8,768 5,389 13,110 9,427 6,409 12,458 9,187 14,939 11,508 7,916 17,062 12,739 9,259 24,860 21,044 17,416
56-60 10,081 10,775 6,618 16,107 11,577 7,865 15,301 11,278 18,348 14,130 9,711 20,956 15,639 11,360 30,528 25,834 21,373
61-65 12,634 13,498 8,287 20,175 14,495 9,842 19,161 14,117 22,978 17,688 12,149 26,243 19,576 14,211 38,223 32,339 26,745
66-70 14,530 15,520 9,526 23,196 16,663 11,310 22,027 16,225 26,415 20,330 13,958 30,169 22,500 16,329 43,937 37,168 30,734
More
17,309 18,485 11,342 27,625 19,840 13,462 26,229 19,315 31,454 24,204 16,611 35,924 26,786 19,432 52,313 44,248 36,581
than 70
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
21-25 4,256 4,550 2,826 6,679 4,808 3,291 6,289 4,650 7,504 5,788 3,999 8,546 6,397 4,663 12,389 10,485 8,679
26-30 4,572 4,885 3,033 7,166 5,156 3,527 6,744 4,983 8,045 6,202 4,282 9,161 6,854 4,992 13,275 11,232 9,293
31-35 4,761 5,085 3,157 7,457 5,364 3,668 7,015 5,182 8,368 6,449 4,451 9,528 7,127 5,189 13,804 11,677 9,659
36-40 5,251 5,605 3,478 8,212 5,904 4,035 7,719 5,699 9,207 7,092 4,889 10,482 7,836 5,700 15,179 12,835 10,611
41-45 5,654 6,050 3,737 8,987 6,469 4,415 8,515 6,291 10,192 7,860 5,423 11,628 8,697 6,336 16,917 14,326 11,865
46-50 7,161 7,656 4,722 11,379 8,185 5,577 10,781 7,957 12,907 9,947 6,852 14,728 11,005 8,006 21,424 18,134 15,009
51-55 8,891 9,502 5,853 14,131 10,159 6,914 13,390 9,876 16,035 12,351 8,498 18,299 13,664 9,932 26,620 22,525 18,635
56-60 10,527 11,246 6,922 16,737 12,029 8,180 15,862 11,694 19,000 14,630 10,059 21,686 16,186 11,758 31,549 26,691 22,075
61-65 12,992 13,874 8,534 20,653 14,837 10,083 19,571 14,421 23,445 18,046 12,398 26,760 19,965 14,494 38,928 32,926 27,222
66-70 14,708 15,717 9,651 23,493 16,882 11,466 22,315 16,444 26,759 20,603 14,155 30,563 22,803 16,558 44,518 37,669 31,158
More
17,799 19,014 11,671 28,418 20,416 13,859 26,988 19,881 32,363 24,911 17,106 36,963 27,569 20,010 53,834 45,543 37,661
than 70
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
21-25 5,010 5,361 3,326 7,906 5,695 3,899 7,466 5,523 8,918 6,882 4,759 10,163 7,610 5,553 14,756 12,498 10,354
26-30 5,298 5,667 3,515 8,350 6,013 4,114 7,880 5,827 9,411 7,260 5,017 10,724 8,027 5,853 15,565 13,178 10,914
31-35 5,470 5,849 3,628 8,615 6,202 4,242 8,127 6,008 9,705 7,485 5,171 11,058 8,276 6,032 16,047 13,584 11,247
36-40 5,917 6,324 3,921 9,303 6,694 4,576 8,769 6,479 10,470 8,071 5,571 11,928 8,922 6,498 17,300 14,640 12,115
41-45 6,284 6,729 4,157 10,010 7,210 4,923 9,495 7,018 11,368 8,772 6,057 12,973 9,707 7,078 18,884 15,999 13,258
46-50 7,902 8,446 5,217 12,508 8,996 6,134 11,828 8,731 14,147 10,902 7,512 16,134 12,057 8,772 23,444 19,839 16,416
51-55 9,710 10,372 6,399 15,371 11,049 7,525 14,537 10,722 17,392 13,395 9,218 19,837 14,814 10,768 28,825 24,385 20,168
56-60 11,200 11,962 7,373 17,746 12,753 8,680 16,790 12,380 20,095 15,472 10,641 22,924 17,113 12,432 33,318 28,182 23,304
61-65 13,671 14,595 8,989 21,660 15,559 10,581 20,492 15,101 24,529 18,879 12,973 27,984 20,880 15,159 40,671 34,393 28,430
66-70 15,236 16,275 10,008 24,249 17,424 11,841 22,993 16,945 27,550 21,210 14,575 31,451 23,468 17,041 45,767 38,717 32,017
More
18,115 19,356 11,886 28,933 20,791 14,120 27,482 20,251 32,956 25,373 17,432 37,640 28,082 20,391 54,825 46,390 38,370
than 70
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
21-25 5,768 6,177 3,830 9,136 6,584 4,507 8,642 6,395 10,330 7,975 5,517 11,777 8,822 6,440 17,118 14,504 12,022
26-30 6,039 6,465 4,007 9,553 6,882 4,709 9,031 6,680 10,793 8,330 5,760 12,304 9,214 6,723 17,877 15,143 12,548
31-35 6,200 6,636 4,113 9,802 7,060 4,830 9,263 6,851 11,069 8,542 5,904 12,618 9,447 6,891 18,330 15,525 12,861
36-40 6,620 7,081 4,388 10,449 7,523 5,144 9,866 7,293 11,788 9,093 6,280 13,435 10,054 7,329 19,508 16,516 13,677
41-45 6,966 7,462 4,610 11,112 8,007 5,469 10,548 7,800 12,632 9,751 6,737 14,417 10,792 7,873 20,996 17,793 14,751
46-50 8,486 9,075 5,606 13,459 9,685 6,607 12,740 9,409 15,243 11,752 8,103 17,387 13,000 9,465 25,280 21,401 17,718
51-55 10,549 11,266 6,958 16,656 11,972 8,158 15,731 11,604 18,809 14,485 9,971 21,445 16,017 11,642 31,139 26,338 21,780
56-60 11,950 12,760 7,874 18,887 13,573 9,243 17,848 13,162 21,348 16,437 11,308 24,345 18,177 13,206 35,360 29,906 24,726
61-65 14,352 15,319 9,444 22,688 16,298 11,089 21,442 15,804 25,652 19,744 13,571 29,256 21,833 15,852 42,495 35,932 29,699
66-70 15,822 16,897 10,402 25,121 18,050 12,274 23,792 17,536 28,491 21,933 15,076 32,513 24,263 17,620 47,282 39,994 33,069
More
18,736 20,015 12,304 29,845 21,445 14,571 28,310 20,863 33,928 26,120 17,948 38,736 28,902 20,987 56,381 47,698 39,446
than 70
Age/
deduc- 200000 200000 300000 200000 300000 500000 300000 500000 300000 500000 1000000 300000 500000 1000000 300000 500000 1000000
tible
21-25 6,544 7,011 4,345 10,389 7,490 5,127 9,839 7,283 11,767 9,087 6,289 13,419 10,054 7,343 19,518 16,543 13,717
26-30 6,803 7,286 4,515 10,789 7,775 5,321 10,212 7,556 12,211 9,427 6,521 13,924 10,429 7,613 20,246 17,155 14,221
31-35 6,958 7,451 4,616 11,027 7,946 5,436 10,434 7,719 12,475 9,630 6,659 14,225 10,653 7,774 20,680 17,521 14,521
36-40 7,360 7,877 4,880 11,647 8,389 5,737 11,013 8,143 13,164 10,158 7,020 15,008 11,235 8,194 21,808 18,471 15,302
41-45 7,691 8,242 5,092 12,283 8,853 6,049 11,666 8,629 13,972 10,788 7,458 15,949 11,942 8,715 23,234 19,694 16,331
46-50 9,147 9,788 6,047 14,531 10,461 7,139 13,766 10,170 16,474 12,705 8,766 18,794 14,057 10,241 27,338 23,151 19,174
51-55 11,345 12,114 7,488 17,880 12,852 8,762 16,872 12,448 20,165 15,530 10,692 22,985 17,169 12,481 33,358 28,213 23,329
56-60 12,687 13,546 8,365 20,018 14,386 9,801 18,901 13,940 22,597 17,400 11,973 25,763 19,238 13,980 37,402 31,631 26,152
61-65 14,988 15,998 9,870 23,660 16,997 11,570 22,344 16,471 26,721 20,568 14,141 30,469 22,741 16,514 44,238 37,405 30,916
66-70 16,526 17,647 10,873 26,190 18,818 12,802 24,782 18,268 29,663 22,836 15,699 33,841 25,258 18,344 49,189 41,603 34,397
More
19,396 20,717 12,746 30,836 22,156 15,061 29,222 21,537 35,020 26,948 18,520 39,996 29,822 21,650 58,244 49,264 40,728
than 70
*Note: Waiver of conditions (i), (v) and (vi) may be considered where it is proved to the satisfaction of the
Company that under the circumstances in which the insured was placed it was not possible from him or any
other person to give notice or file claimwithin the prescribed time limit.
c. Paying a Claim
i. You agree that We need only make payment when You or someone claiming on Your behalf has provided Us
with necessary documentation and information.
ii. If the insurer, for any reasons decides to reject the claim under the policy the reasons regarding the rejection
shall be communicated to the insured in writing within 30 days of the receipt of documents. The insured may
take recourse to the Grievance Redressal procedure.
Contact:
Health Administration Team,
Bajaj Allianz General Insurance Co. Ltd.
2nd floor, Bajaj Finserv Building, Behind Weikfield IT Park, Off Nagar Road,Viman Nagar-Pune - 411 014.
For sales and Renewal-1800- 209- 0144
For service-1800- 209- 5858 / 1800- 102- 5858 / 020-30305858
Cashless facility offered through network hospitals of Bajaj Allianz only.Cashless facility at 5500+ Network
hospitals PAN India.
Please visit our website for list of network hospitals and network Diagnostic Centers , Website: www.
bajajallianz.com or get in touch with 24*7 helpline number: 1800-103-2529 (toll free) / 020-30305858
◼ Section 41 of Insurance Act 1938 as amended by Insurance Laws Amendment Act, 2015
(Prohibition of Rebates)
No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out
or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate
of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any
person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in
accordance with the published prospectuses or tables of the insurers. Any person making default in complying
with the provision of this section shall be liable for a penalty which may extend to 10 lakh rupees.
Age of Coverage opted on Coverage opted on individual basis covering Coverage opted on floater basis with overall Sum Insured
the Individual Basis covering multiple members of the family under as single (Only one sum insured is available for the entire family)
members each member of the policy (Sum Insured is available for each
to be family separately (at a member of the family)
insured single point in time)
Premium Sum Premium Discount Premium Sum Premium or Floater Premium Sum Insured/
Insured/ after Insured/ consolidated discount after Deductible
Deductible discount Deductible premium for if any discount
all members
of family
55 NA NA NA NA NA NA
50 NA NA NA NA NA NA 7,525 NA 1,000,000/500,000
20 NA NA NA NA NA NA
18 NA NA NA NA NA NA
Note: Premium rates specified in the above illustration shall be standard premium rates without considering any loading. Also, the premium rates
shall be exclusive of taxes applicable.
www.bajajallianz.com
For more details on risk factors, Terms and Conditions, please read the sales brochure before concluding a sale.
CIN: U66010PN2000PLC015329 | UIN: BAJHLIP20147V021920
BJAZ-B-0305/1-Oct-2020
Policy holders can download Caringly Yours app for one -touch access Available on: