Features
Group Guard with wellness benefits specially designed to provide financial protection against unseen and unfortunate accidents which can happen anywhere.
Accidental Death - Provides cover against expenses arising out of accidental injury resulting in death of the insurer.
Permanent Total Disability - Provides cover against expenses arising out of accidental bodily injury resulting in permanent total disability (T&C’s as mentioned in policy wordings)
Permanent Partial Disability - Provides cover against expenses arising out of accidental bodily injury resulting in permanent partial disability (T&C’s as mentioned in policy wordings)
Accidental Hospitalization – Protects you against medical expenses incurred in case you are hospitalised for a minimum of 24 hours or have undergone any of the listed day care procedures in policy wordings because of an accidental bodily injury.
Child Care Benefit – Covers expenses towards the cost of education or care of the Insured Beneficiary’s dependent children who are less than 25 years of age in case of Death or Permanent Total Disability of the insured.
Wellness Benefits - Health Services include Tele Consultation Cover, Investigations Cover (Pathology & Radiology Expenses), Doctor Consultation Cover and Annual Preventive Health Check -up cover
Expenses for cosmetic or plastic surgery or any treatment to change appearance unless as a part of medically necessary treatment. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner for reconstruction following an Accident, Burn(s) or Cancer
Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
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. b) Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
Dietary supplements and substances which are available naturally and that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner
Any dental treatment that comprises cosmetic surgery, dentures, dental prosthesis, dental implants, orthodontics, routine dental procedures including but not limited to tooth extractions, root canal treatment, crowns, bridge, dental fillings unless requiring minimum 24 hours hospitalization
Medical expenses where Inpatient care is not warranted and does not require supervision of qualified nursing staff and qualified medical practitioner round the clock. This exclusion is however not applicable for any day care treatment taken for the accidental bodily injury in a day care centre/ hospital
War, invasion, acts of foreign enemies, hostilities (whether war be declared or not) [except for compelling the Government or any other person to do or abstain from doing any act as defined under the definition of Terrorist act], civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition of or damage by or under the order of any government or public local authority. Any Medical expenses incurred due to Acts of Terrorism will be covered under the policy.
Circumcision unless required for the treatment of Illness or Accidental bodily injury
The cost of spectacles, contact lenses, hearing aids, crutches, artificial limbs, dentures, artificial teeth and all other external appliances and/or devices whether for diagnosis or treatment except for intrinsic fixtures used for orthopedic treatments such as plates and K-wires.
External medical equipment of any kind used at home as post hospitalisation care including cost of instrument used in the treatment of Sleep Apnoea Syndrome (C.P.A.P), Continuous Peritoneal Ambulatory Dialysis (C.P.A.D) and Oxygen concentrator for Bronchial Asthmatic condition.
Convalescence, general debility, rest cure, congenital external diseases or defects or anomalies, stem cell implantation or surgery, or growth hormone therapy.
Intentional self-injury (including but not limited to the use or misuse of any intoxicating drugs or alcohol)
Ailments requiring treatment due to use or abuse of any substance, drug and treatment for de-addiction.
Vaccination or inoculation unless forming a part of post bite treatment or if medically necessary and forming a part of treatment recommended by the treating doctor.
Parkinson’s disease.
Any treatment received outside India is not covered under this policy.
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.