Features
Flexi Health Protect Plan (Group) provides various benefits as it takes care of the medical treatment expenses incurred during hospitalization, ensuring you are covered for the larger expenses related to Illness/accidental injury.
Inpatient Hospitalization : Covers medical expenses due to illness or injury sustained or contracted during policy period along with room rent and ICU charges as per actuals
Pre and Post Hospitalization Expenses: Covers medical Expenses incurred during 60 days and 90 days before and after hospitalisation respectively.
Day Care Treatment: Covers medical expense under In-patient Hospitalisation/Inpatient Care Treatment for Day care procedures / Surgeries taken as an Inpatient in a Hospital or Day care centre for the procedures as mentioned in policy wordings
Organ Donor Expenses: Covers medical expenses towards organ donor’s treatment for harvesting of the donated organ
Road Ambulance: Covers medical expenses incurred on a Road ambulance offered by a healthcare or ambulance service provider
AYUSH Treatment: Covers medical expenses incurred as an In-patient Hospitalisation for continuous 24 hours for AYUSH Treatments on the advice of a Medical Practitioner because of Illness or Injury sustained or contracted during the Cover Period
Sum Insured Reinstatement : Sum Insured under Base Cover “In-patient Hospitalisation / Inpatient Care Treatment ” would be “reinstated” up to 100% of In-patient Hospitalisation Sum Insured – Unlimited number of times
Air Ambulance - expenses incurred on an ambulance transportation in an airplane or helicopter for emergency life threatening health conditions which require immediate and rapid ambulance transportation upto INR 250,000
Domiciliary Hospitalization: Expenses incurred by You on medical treatment as per In-patient SI for Illness or Injury sustained or contracted during the Cover Period, which in the normal course, would require care and treatment at a Hospital but, on the advice of the attending Medical Practitioner, is taken whilst confined at home
Cumulative Bonus: 50% Of Base Sum insured If No Claim In Preceding Year; Max Upto 100%
Medical Advancement Surgery Covered (As Per List Mentioned In Policy Wording): Up to 25% Of Sum Insured
Cataract limit (24 months waiting period): 20% of the SI for each eye, subject to max. of Rs 1 lac each member
Hospital Daily Allowance (Optional Cover): Daily Allowance for each completed day that you had to be hospitalised for medical reasons because of the Illness or Injury or Both. If opted INR 1000 per day for max 15 days.
Critical Illness Multiplier for CIs listed in Policy Wordings: 2 times of the In-Patient Hospitalization sum insured. This Cover is applicable for self and Spouse only.
Annual Preventive Health Check Up
Wellness Benefit: Health Services include Tele Consultation Cover, Investigations Cover (Pathology & Radiology Expenses), Doctor Consultation Cover and Annual Preventive Health Check -up cover
Investigation & Evaluation
Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded even if the same requires confinement at a Hospital.
Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
Rest Cure, rehabilitation and respite care
Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
i. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
ii. Any services for people who are terminally ill to address medical, physical, social, emotional and spiritual needs.
Cosmetic or plastic Surgery: Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
Please note: For details, please refer to the product brochure for policy terms and conditions.
If an unfortunate event does occur, and you need to make a claim, it can be registered by following two ways :
Cashless Procedure : Insured can avail the cashless service through Bajaj Allianz’s empanelled list of hospitals by presenting BAGIC’s cashless card and registering the claim with Bajaj Allianz 24*7 helpline number 1800-209-5858 within 24 hours of the event.
Reimbursement Procedure : If treatment is taken in a Hospital other than a Bajaj Allianz Network Providers, then Insured needs to directly make the payment to the hospital and send the claim form, all medical bills and all hospitalization documents to Bajaj Allianz for reimbursement.
Please note: For details, please refer to the policy wordings for policy terms and conditions.